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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: .3 Event Date: '1 dL <br />Event Name: rJ bx,,%- 1 at 1 OVj; jnr-• 1 <br />Organization: 1 <br />Applicant (Contact) Name: S�rn�a I MAI Lf_ <br />Applicant (Contact) Phone: S1� J. LQ Alt. Phone: <br />Email: WOf 1d6J Zak Cnr,!ti&' (4-A cc -- <br />Address: �� �Qi✓10Lr� City/State/ZIP: Sou+K Cd t Ia( C(li(o—A <br />Event Location (Please describe): <br />Length of Event (Dates/Times): 1 P _ <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: 31�1oy3 <br />Organizer Signature <br />I,tiL (('Ifef <br />Printed Name and Title <br />