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Section E - Indemnity & Hold Harmless Aitreement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />Date: 40 81 Z2126Z.- Event Date: % / Z.71 ZC'ZS <br />Event <br />Organization:Wt1h6S Ofx Cot�-0. <br />'LyC <br />Applicant (Contact) Name: 4 f O n ak r%CPp <br />Applicant(Contact)Phone: 7-0 220-23Z57 Alt. Phone: <br />Email: '\�n�a� („`�I 3 Q qw,m . Cow, <br />"-T <br />Address: «Z7 E Cc" k,)/ A*jl City/State/ZIP: 5&.K <br />Event Location (Please describe): <br />Qty�\c r block 6v�- "66d C�4rca M� n 7�n�i yvrds at <br />Length of Event (Dates/Times): 3 ko�c Lf —7.4+v` <br />• APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Bend, Indiana, from any <br />liability, loss, costs, damages or expenses, including attorney fees, which the Civil City of South Bend, may suffer <br />or incur as a result of any claims or actions which may be made against the City, its agents, employees, or <br />subdivisions by any person, including a participant in the activity, arising out of the approval of this request by <br />the Civil City of South Bend, Indiana, through the Board of Public Works, to close a portion of the public right-of- <br />way for the event described above, or for any harm or damage alleged to have occurred because of the holding <br />of the special event. The undersigned certifies that he/she is authorized to bind the APPLICANT to these terms. <br />Signed on this Date: 81Z2/7 O Z 57 <br />Authorized Organizer Signature <br />Printed Name and Title <br />0 <br />