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Section K - Indemnity & Hold Harmless Agreement <br />• <br />Date: C✓ /Fl r o�3 <br />Event Name: <br />Organization <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Event Date: 913 /CP -3 <br />Applicant (Contact) Name: 27 S CGm pu S <br />Applicant (Contact) Phone: Sly- c,2n - 5 7J r Alt. Phone: <br />Email: <br />Address: 6'SU S <br />Event Location (Please describe): <br />) 3 0'K .04 /N i V" 56-• <br />SoLq 4�1 j9e'4- � �166/a1 <br />Length of Event (Dates/Times): 9 <br />City/State/ZIP: S,� 4` ae�,12e 7y <br />A7s ,s a-V se . <br />Pu/7s,� . Fes 7`/✓a O <br />A42'I JI u� <br />v� 04 %A4r, <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 />Ki., _- C7L • CC{S//hI'r PC, /I� agrees to indemnify, 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: i�;-/093 <br />Authorized Organizer Signature <br />Printed Name and Title <br />