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Section K - Indemnity & Hold Harmless Agreement <br />• City of South Bend Special Events Committee <br />Indemnity & Hold Harmless Agreement <br />Date:_ �z0 u <br />Event Date: f0' �J L <br />Event Name: _AAA-1'LA-< S7LL ri4N kstst- 9Peas/`cGuclop r' CT� <br />Organization: ff IAktA I'('C-)A9C-I't <br />Applicant (Contact) Name: G 6{A'�/� ldl e r 1 2 p <br />Applicant (Contact) Phone: " 1395 Alt. Phone: <br />Email: JG <br />Address: /SY1 7� EJr V s e(S Z)r Cit <br />Event Location (Please describe): <br />14wra"'rJ 7a k� S+r(It L' �cQ <br />JOy �cu� ti/eG37 <br />R-513(/M�r u — y�JQ��IkC2-tt✓Anoat� <br />P4,s1— <br />Length of Event (Dates/Times): -5l k 4u . ®LI �� 1� z �� z S� (p t�l�il ' Z^ N <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: 6 I`C4 V4(ACo- ,r PCP f Y V agrees to indemnify, defend <br />and hold harmless the Civil City of South Bend, Indiana, from any liabili , 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. (/ / 9 q <br />Signed on this Date: A- C5 k1 o / 401 1 " r e T <br />AJ A P Pr6 f4' CJ <br />Authorized Organizer Signature <br />Printed Name and Title <br />