Laserfiche WebLink
• Section E - Indemnity & Hold Harmless Aereement <br />City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date: 0 \' I I Z Event Date: O i )" I Z LI <br />Event Name: I t n-1f I c' �Z N' A y <br />Organization: <br />Applicant(Contact)Name: ) -V—C\( 1VN' S t—kC)V—V—\ S. <br />Applicant (Contact) Phone: L qO Pik 7 (D (D 4 � Alt. Phone: <br />Email —Al \ Y%'1n % % /-) n e, r. �t \ - t: l\Wl <br />Address: L�Z C�(�� R I1 City/State/ZIP: SDt7tla <br />Event Location (Please describe): <br />Length of Event (Dates/Times): 7)%— 0' Z `1 iI(. � V\ 16 '� ' ` <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 Date4LA-: Pt7 <br />Authorized Organizer Signature <br />Printed Name and Title <br />is <br />