Fillable APPLICATION FOR ORGANIZATIONAL USE OF BOONE COUNTY COURTHOUSE (Boone County, Missouri)

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APPLICATION FOR ORGANIZATIONAL USE OF BOONE COUNTY COURTHOUSE (Boone County, Missouri)

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Updated 1/30/14
APPLICATION FOR ORGANIZATIONAL USE OF
BOONE COUNTY COURTHOUSE PLAZA
The undersigned organization hereby applies for a use permit to use the Boone County Courthouse Plaza as follows:
Organization:
Address:
City: State: ZIP Code
Phone: Website:
Individual Requesting Use:
Position in Organization:
Address:
City: State: ZIP Code
Phone: Email:
Event:
Description of Use (ex. Concert, speaker, 5K):
Date(s) of Use:
Start Time of Setup: AM/PM
Start Time of Event: AM/PM (If start times vary for multiple day events, please specify)
End Time of Event: AM/PM (If end times vary for multiple day events, please specify)
End Time of Cleanup: AM/PM
Emergency Contact During Event: Phone:
Will this event be open to the public? Yes No
If yes, please explain the publicity that will be used to promote the event, including names and contact
information of any promoters:
Boone County Commission
Daniel K. Atwill, Presiding Commissioner
Fred J. Parry, District I Commissioner
Janet M. Thompson, District II Commissioner
Roger B. Wilson
Boone County Government Center
801 East Walnut, Room 333
Columbia, MO 65201-7732
573-886-4305 FAX 573-886-4311
Updated 1/30/14
How many attendees (including volunteers) do you anticipate being at your event?
If you anticipate more than 50 attendees (including volunteers) at your event, please detail your safety plan in the event
of an emergency. If you have a separate Fire Safety, Public Safety and Evacuation Plan, please submit with application.
If you anticipate more than 1000 attendees (including volunteers), please provide the names and contact
information of your crowd managers (1 per every 250 attendees):
Will the majority of attendees be under the age of 18? Yes No
If yes, please note the number of adult supervisors in attendance: # adults per #minors
Will you need access to electricity? Yes No
Will you be using amplifiers? Yes No
Will you be serving food and/or non-alcoholic drinks? Yes No
If yes, will you be selling food and/or non-alcoholic drinks? Yes No
If yes, please provide the following with copies of licenses attached to application:
Missouri Department of Revenue Sales Tax Number:
County Merchant’s License Number:
City Temporary Business License Number:
Will you be serving alcoholic beverages? Yes No
If yes, will you be selling alcoholic beverages? Yes No
If yes, please provide the following with copies of licenses attached to application:
State Liquor License Number:
County Liquor License Number:
City Liquor License Number:
Updated 1/30/14
Will you be selling non-food items? Yes No
If yes, please provide the following with copies of licenses attached to application:
Missouri Department of Revenue Sales Tax Number:
County Merchant’s License Number:
City Temporary Business License Number:
Will outside vendors be selling food, beverages or non-food items at this event? Yes No
If yes, please provide the following information (use separate sheet if necessary):
Vendor Type of Sales Contact Information License Number(s)
Will you be requesting a road and/or sidewalk closure? Yes No
If yes, what road(s) and/or sidewalk(s)?
Please attach to application a copy of the order showing City of Columbia City Council approval.
Does your event include cooking or use of open flames? Yes No
If yes, please provide the Columbia Fire Department Special Events Permit Number:
Please attach to application a copy of the approved Columbia Fire Department Special Events Permit
Events that may pose increased responsibilities to the local law enforcement may be required to enlist the services of a
professional security company. This will be determined by the Boone County Sheriff’s Department and Boone County
Commission. If necessary, have you hired a security company to handle security arrangements for this event?
Yes No
If yes, please provide the following:
Security Company:
Contact Person Name and Position:
Phone: Email:
Will you be using portable toilets for your event? Yes No
**Please note: portable toilets are not permitted on the Boone County Courthouse Plaza grounds. Please contact the
City of Columbia for options.
If your event is such that requires insurance per the Boone County Courthouse Plaza Rules and Regulations, please provide a
copy of acquired insurance plan.
Updated 1/30/14
A deposit is required for use of the Boone County Courthouse Plaza. Please refer to the Boone County Courthouse Plaza Rules
and Regulations for the deposit fee schedule. Boone County Facilities Maintenance Staff will inspect the Courthouse Plaza
before and after each event. If staff finds the Courthouse Plaza is left the condition in which it was found, the deposit will be
refunded to the organization. Please indicate below to whom the refund check should be issued:
Name/Organization:
Address:
City: State: ZIP Code
The undersigned organization agrees to abide by the following terms and conditions in the event this application is approved:
1. To notify the Columbia Police Department and Boone County Sheriff’s Department of time and date of use and
abide by all applicable laws, ordinances and county policies in using Courthouse Plaza grounds.
2. To abide by all rules and regulations as set forth in the Boone County Courthouse Plaza Rules and Regulations
document updated July 11, 2013 and attached to this document.
3. To remove all trash or other debris that may be deposited (by participants) on the courthouse grounds and/or in
rooms by the organizational use.
4. To repair, replace, or pay for the repair or replacement of damaged property including shrubs, flowers or other
landscape caused by participants in the organizational use of courthouse grounds and/or carpet and furnishings in
rooms.
5. To conduct its use of Courthouse Plaza grounds in such a manner as to not unreasonably interfere with normal
courthouse and/or Boone County Government building functions.
6. To indemnify and hold the County of Boone, its officers, agents and employees, harmless from any and all claims,
demands, damages, actions, causes of action or suits of any kind or nature including costs, litigation expenses,
attorney fees, judgments, settlements on account of bodily injury or property damage incurred by anyone
participating in or attending the organizational use on the courthouse grounds and/or use of rooms as specified in
this application.
Organization Representative/Title:
Address:
Phone Number: Date of Application:
Email Address:
Signature:
Applications may be submitted in person or by mail to the Boone County Commission, 801 E. Walnut, Room 333,
Columbia, MO 65201 or by email to commission@boonecountymo.org.
PERMIT FOR ORGANIZATIONAL USE OF BOONE COUNTY COURTHOUSE PLAZA
The County of Boone hereby grants the above application for permit in accordance with the terms and conditions above
written. The above permit is subject to termination for any reason by duly entered order of the Boone County Commission.
ATTEST: BOONE COUNTY, MISSOURI
County Clerk County Commissioner
DATE:
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APPLICATION FOR ORGANIZATIONAL USE OF BOONE COUNTY COURTHOUSE (Boone County, Missouri)

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Completed 20 August 2020

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