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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: tiQ +a3 <br />Event <br />Organ <br />Applic <br />Applic <br />Email: <br />Addre <br />Event Date: s q icc la <br />Name: C i <br />ization: <br />ant (Contact) Name: ` / tv <br />ant (Contact) Phone: -7 i I a-<:�,a I aSfklt. Phone: LI <br />ss: N City/State/ZIP: 1 6 (S� <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 />Signed on this Date: <br />Authorized Organizer Signature <br />Printed Name and Title <br />��Y-C <br />