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Section E - Indemnity & Hold Harmless Agreement <br />City of South Bend Special Events Committee <br />• Indemnity & Hold Harmless Agreement <br />Date: MA%4 2� j _3 Event Date: <br />f n 1_� <br />Event Name: �F) I <br />Organization: <br />Applicant (Contact) Name:�L/ 1 <br />Applicant (Contact) Phone: Alt. Phone:-® 57Y-f.00 -395 8 <br />Email: <br />Address: liv.P _ City/State/ZIP: 4�nPJE�un <br />Event Location (Please describe): <br />Length of Event (Dates/Times): <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 />sr a 3 <br />Signed on this Date: e y�� I O <br />� <br />Authorized Organizer Signature <br />I e.loris M. 0-�L-4rr- <br />Printed Name and Title <br />