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• <br />Date: <br />Event Name: <br />Organization: <br />• <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Event Date: Sunday, June 2, 2024 <br />Christi Procession <br />St. Adalbert Parish/St. Casimir Parish <br />Applicant (Contact) Name: Fr. Ryan Pietrocarlo, CSC <br />Applicant (Contact) Phone: 574-288-5708 <br />Email: parishsecretary@stadalbertschool.org <br />Address: 2505 West Grace St. <br />Alt. Phone: 574-334-0049 <br />City/State/ZIP: South Bend, IN, 46619 <br />Event Location (Please describe): Starting outside St. Adalbert Church in the 2500 block of Huron St., <br />east on Huron to Philippa St., South on Philippa to Ford St., East on <br />Ford to Webster St., South on Webster to St. Casimir Church at Webster <br />and Dunham Streets. <br />Length of Event (Dates/Times): June 2, 2024, 2:15 pm to 4:30 <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 />Organization Name: St, Adalbert Parish/St. Casimir Parish 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: <br />5 /0 L/ <br />Authorized Organize gnature <br />• Fr Ryan Pietrocarin, CSG Pactnr <br />Printed Name and Title <br />