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PERMIT/AGREEMENT <br />FOR. A PROCESSION <br />1. Sponsor shall reimburse the Board for the actual cost to the City for the event, if deemed <br />necessary. <br />2. Sponsor shall provide to the Boarrd a Certificate of Insurance showing a liability policy in <br />full force and effect with limiis of $300,000.00 per occurrence and $5,000,000.00 <br />aggregate and the City of South Bend listed as an additional named insured for this event. <br />3. Sponsor shall provide to the Board all additional licenses, permits and documentation <br />required for the event. <br />4. Sponsor agrees to abide by ah tcnns aad conditior_s of the Board's policy governing <br />walks, runs, parades or other similar event adopted by the Board on March 3, 1985. <br />5. In order to ensure public safety during the event, the Board agrees to furnish traffic <br />planning, materials, equipment .and personnel as deemed necessary by the Police <br />Department Traffic Bureau, the 3ureau of Traffic and Lighting, and, where applicable, <br />the Board of Park Commissioners. <br />6. Sponsor acknowledges that the Police Department reserves the right to change this route <br />for safety purposes. <br />In consideration for approval) y th- Board and the use of the sidewalks for the purposes <br />set out above, the undersigned agrees and undertakes to hold the Civil City of South <br />Bend, Indiana, free and harmless from any liability loss, costs, costs, damages or <br />expenses, including atto.tney fees, whi= h the Civil City of South Bend may suffer or <br />incur, as a result of any ch;irrs uz scti.ons "41ich may be made by any person, including a <br />participant in said activit.1 11TiS n(, o ;t of the apfroval of the request to use the sidewalks <br />indicated in the City of South Bei,d. The undersigned certifies that he/she is authorized to <br />bind the above mentioned sponsor to the terms hereof. <br />8. Notification of approval/denial of tb:i regaest wa! be issued by return of this form, upon <br />signed authorization by the .board of Pvfflic Works <br />I understand the above rules LIMI regulations and flat 'his application may be denied based on <br />any false or incomplete <br />Sponsor Signature <br />Printed Name <br />Title <br />Member <br />RD OT' P RLIC WORK` APPROVAL <br />AAgz Dber <br />Member <br />9 f a3/,;GI& <br />Date <br />RI TU RA Fii'RIi T0: 2 <br />E'• of sd uF P❑E`_o �x'urks <br />luild;ng <br />2.27 J, clff., .. i. bou;e"aid <br />St u.a; Pcnd, N 4601 <br />Phone: (574) 235-9251 o F: 1,57,1; 235-91"'i a -Mail: publicwks@southbendin.gov <br />