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•om: Thomas Story Fax: (8(36) 610.8379 To: Fax: (574) 235-9171 Page 3 of 4 05116f2018 9:24 AM <br />2 <br />3_ <br />M <br />PERMITIAGREEMEPNT <br />FOR A PROCESSION <br />Sponsor shall reimburse the Board for the actual cost to the City for the event, if deemed <br />necessary. <br />Sponsor shall provide to the Board a Certificate of Insurance showing a liability policy in <br />full 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 />Sponsor shall provide to the Board all additional Licenses, permits and documentation <br />required for the event. <br />If this event results in closure of a residential street, all residents within the affected area <br />must be notified of .this event. The APPLICANT must make a reasonable attempt to <br />notify all residents that reside on the block. A copy of a brochure or letter describing <br />the event purpose, date, and time must be distributed to all affected neighbors and <br />included with the application. <br />5. If this event results in closure of a residential street, the applicant is responsible, prior to <br />the Event, for determining if there are 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 />C. Sponsor agrees to abide by all terms and conditions of the Board's policy governing <br />walks, runts, parades or other similar event adopted by the Board on March 3. 1985, <br />7. 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 Bureau of Traffic and Lighting, and, where applicable, <br />the Board of Park Commissioners. <br />8. Sponsor acknowledges that the Police Department 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 Bend may suffer or <br />incur, as a result of any claims or actions which may be made by any person, including a <br />participant 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 />121s'TUWN FORM TO: 3 <br />Board cifPublis works <br />1316 County -City Building <br />227 west Jefferson Boulevard <br />South Bend, CN 466Q.1 <br />Phone: (574) 235-9251 a i<axi (574) 235-9171 <br />