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Section K - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: 1 /17/23 Event Date: 6/3/23 <br />------------------------ ------------------------------ <br />Sunburst Races <br />Event Name: ---------------------_-- <br />Beacon Health System <br />Organization: __ _ _ <br />Applicant (Contact) Name: Courtney Kipker_ Travis Bladecki -- <br />Applicant (Contact) Phone: 574_514.4176 (Courtney) Alt. phone: 219.393.9511 (Travis) <br />Email: ckipker@beaconhealthsystem.org, tbladecki@beaconhealthsystem.org <br />Address:------------------------------------------City/State/ZIP: -------------------------------------------- <br />111 W. Jefferson Blvd., Suite 300 South Bend, IN 46601 <br />------------------------------- ------- <br />— --------------------------------------- <br />Event Location (Please describe): <br />Races start and finish at the Century Center - course maps show specifics for all routes. <br />Length of Event(Dates/Times):613123 7:00am (start of half marathon & 5K run) - 11:00am (finish line closes) <br />------_--------------------------------------------------___----__ <br />Insurance Amount: This event is insured for no less than $700.000 per occurrence and $1.000,000 in aggregate, <br />and the certificate of insurance includes a rider naming City of South Bend, Special Events Committee, and Board <br />of Public Works as additionally insured for the event. <br />Beacon ----- agrees to indemnify, <br />Organization Name: _—___---Health-System 'fy, defend <br />and hold harmless the Civil City of South Bend, Indiana. from any liability. loss. costs, damages or expenses, <br />including attorney fees, which the Civil City of South Bend, Indiana, may suffer or incur as a result of any claims <br />or actions which may be made against the City, its agents, employees, or subdivisions by any person, including a <br />participant in the activity, arising out of the approval of this request by the Civil City of South Bend, Indiana, <br />through the Board of Public Works, to close a portion of the public right-of-way for the event described above. <br />or for any harm or damage alleged to have occurred because of the holding of the special event. The <br />undersigned certifies that he/she is authorized to bind the APPLICANT to these terms. <br />Signed on this Date: _-1 Z'3__ <br />., <br />--------------------------------------------------------------------------------- <br />Authorized Organizer Signature <br />JeFF-z.; P cojkh" , fir' <br />Printed Name and Title <br />