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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: 05/15/23 Event Date: 06/17/23 <br />Event Name: Hermitage Estates South Block Party <br />Organization: Hermitage Estates South HOA <br />Applicant (Contact) Name: Drew Lister <br />Applicant (Contact) Phone: 574-360-6197 <br />Email: drew.lister@gmail.com <br />Address: 713 Finch Dr <br />Alt. Phone: <br />City/State/ZIP: South Bend, IN 46614 <br />Event Location (Please describe): <br />Larkspur Drive within our subdivision. This is a very short connecting street between Finch Dr <br />and Wheatly Drive. <br />Length of Event (Dates/Times): 06/17/23 5 - 8pm ET <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 />Signed on this Date: 05/15/23 <br />Authorized Organizer Signature <br />Drew Lister, VP Hermitage Estates South HOA <br />Printed Name and Title <br />