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PERMIT/AGREEMENT <br />MR A PROCESSION <br />l Sponsor shall reimburse the Board fox the actual cost to the City for the event, if deemed <br />necessary. <br />2. Sponsor shall provide to the Board a Certificate of Insurance showing a liability policy in <br />#lull force and effect with limits 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. If this event results in closure of a residential street, all residents within the affected area <br />inust be notified of this event. The APPLICANT mast make a reasonable attempt to <br />notify all residents that reside on the block. A copy of a brochure or letter rleserlbing <br />the event purpose, date, and time'must be distributed to all affected neighbors and <br />Included with the application. <br />5. K this event results in closure of a residential street, the applicant is responsible, prior to <br />the event, for determining if there -ate any residents affected that could potentially need <br />assistance in accessing their residence. The applicant is responsible for providing said <br />resident access or transportation to their property. <br />6. Sponsor agrees to -abide by all terms and conditions of the Board's policy governing <br />walks, runs, parades or other similar event adopted by the Board on lviarah 3, 1965. <br />7. In order to ensure public safety during the event, the Board agrees to f4mish traffic <br />planning, materlals, equipment and personnel as deemed necessary by the Police <br />Department Traffic Bureau, the Bureau of Traffic and Lighting, and, where applicable, <br />tho Board of Fa* Commissioiners.- - <br />S. Sponsor acln owledgea that the Tolice Departmer#t reserves the right to change this route <br />for safety purposes. <br />9. In consideration for approval by the 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 attorney fees, which the Civil City of South fiend may suffer or <br />incur,. as a result of any claims or actions whivla may be made by any person, includirrg.0 <br />puiicipatnt in said activity, arising out of the approval of the request to use the sidewalks <br />indicated in the City of South Bend. The undersigned certifies that he/she is authorized to <br />bind the above mentioned sponsor to the terms hereof <br />10. Notification of approval/denial of this request will be issued by return of this form, upon <br />signed authorization by the Board of Public Works <br />I understand the above rules and regulations and that this application may be denied based on <br />any false or incomplete information. <br />Sponsor Signature <br />t <br />RETURN FORM TO: <br />Board of Public Works <br />1316 CountyaOty Building <br />227 West 7offerson Boulevard <br />Soutb.Bend, IN46601 <br />Phone: (574) 235-9251 • Fax; (574y 235-9171 <br />