Fillable Fillable Facility Use Aug2017

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Fillable Facility Use Aug2017

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BROWSE COLUMBIA COLLEGE (CA) FORMS

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1
Yosemite Community College
District
(Modesto Junior College and Columbia
College)
Application and Agreement for Use of District
Facility
Room:
1.
Contact
Person:
2.
Today's
Date:
3.
Organization:
4.
Address:
5.
City:
6.
State:
7.
Zip:
8.
Phone
Number:
9.
Fax
Number:
10:
Email:
11.
Dates
Requested:
12.
Hours:
13.
Nature
of
Activity:
14.
Est.
Attendees:
15:
Equipment
Requirements
(media
equipment,
table,
chairs,
etc.:
16. General Type of Use:
For Profit
Non-Profit
If
for-profit,
explain:
17. An admission charge or collection will be made:
Yes
No
Yes,
proceeds
for:
A. This application and agreement is hereby entered into between the Yosemite Community College District (District) and Applicant
wherein District agrees to allow the Applicant to use its facility, and Applicant agrees to be legally bound by the terms and
conditions as set forth herein.
B. District assumes no liability or responsibility for any personal property of Applicant or of its employees, agents, representatives,
guests or invitees brought into the facility, during the term of this application and agreement.
C. Applicant agrees that in the event this permit is canceled by District, or due to Applicant's failure to meet agreement
requirements, refunds of any fees paid will be at the sole discretion of the Executive Vice Chancellor.
D. Any modifications to this application and agreement such as changes in the date or extension of time shall be made only with the
written consent of the YCCD Chancellor's Office.
E. Applicant agrees that it will make good and reimburse District for any expenditures which may be incurred as a result of
Applicant's use of the facility.
F. Applicant hereby agrees to hold harmless, indemnify, and defend District and its board, officers, agents, and employees from any
loss, damage, liability, cost, or expense that may arise as a result of the Applicant's use of the facility or arising directly
or indirectly out of this application and agreement, unless such loss, damage liability, cost or expense is due to the sole negligence
of District, its board, officers, agents, or employees.
G. Applicant shall, at applicant's sole cost and expense, provide for and maintain in full force and effect for the period of
time Applicant is requesting to use said facility, a policy or policies of insurance covering Applicant's use of facility and furnish a
certificate of insurance evidencing all coverage and endorsements required hereunder prior to the commencement of the use of
thefacility. Applicant agrees to secure and maintain comprehensive general liability policy or policies in the amount of ONE
MILLION DOLLARS ($1,000,000) NAMING Yosemite Community College District, its board, officers, agents, and
employees as additional insureds. Further, the certificate of insurance shall provide thirty (30) days notice of any
reduction or cancellation of coverage. Applicant shall deliver the certificate of insurance along with a copy of the required
endorsements at least fifteen (15) days in advance of the event, or applicant's request will be cancelled. Applicant agrees to
secure and maintain workers' compensation insurance coverage for all of Applicant's employees using the facility
during the term of this agreement.
2
The undersigned as an authorized representative for Applicant, states that, to the best of his or her knowledge, the facility for use of
which application is hereby made will not be used for the commission of any crime or any act, which is prohibited by law. Applicant
certifies that he/she has read the rules, regulations, conditions, and terms of this application and agreement and agrees to abide by all
applicable laws of the State of California and all other directives of District, which may be communicated to the Applicant. Any use
contrary to or in violation of any law, rule, regulation, condition, or term of this application and agreement shall be grounds for immediate
cancellation of the permit and removal of the applicant from the facility and shall bar such Applicant from further use of the facility.
Authorized Organization Signature/Date
Printed Name and Title
For office use:
Rec'd Certificate of Ins.
Rec'd Add'l Ins. Endorsement
Rec'd Fee
Authorized District Signature/Date
This form must be signed and returned to Columbia College, IMC Department, 11600
Columbia College
Drive, Sonora, CA, 95370 along with necessary
certificates of insurance and endorsements, before using the facilities or risk cancellation.
TERMS AND CONDITIONS (Per Board Policy 6700 Procedures)
A. Applications under the Civic Center Act shall originate with established and responsible
organizations
in the District.
B. All meetings under the Civic Center Act shall be open to the public.
C. No use will be inconsistent with the purpose for which the facility was designed nor inconsistent with use of facilities
for school purposes nor interfere with regular school work.
D. No use shall be granted in such a manner as to constitute a monopoly for benefit of any person or organization.
E. No usage or entertainment shall be permitted which reflects in any adverse way on any persons because of race, color, age,
medical condition, ancestry, sexual orientation, marital status, physical or mental disability, religion, sex, gender, or national
origin.
F.
District/college
premises shall not be used as political campaign headquarters.
G. Facility use permits shall not be issued for a period exceeding one semester or quarter. Long-term facility use permits are not
valid on holidays unless specified when the request is made.
H. Applications for use shall be filed at least two weeks in advance of the proposed usage.
I. Any facility or equipment usage is limited to that listed on the application and contract. Special requirements must be requested
in writing at least two weeks prior.
J. A District employee shall be fully in charge of any facility being used.
K. No promotional or advertising materials shall be sold without prior approval.
L. No goods or services may be sold on the college campus without prior approval.
M. Concession operation approval must be obtained from the college.
N. Organizations shall not use the name of the District or any of its Colleges, facilities, or equipment to sell a commercial product
or to promote personal service to gain financial or material advantage.
O. No group may use a College swimming pool unless an approved lifeguard(s) (holder of a Red Cross Life Saving Certificate) is
on duty. Red Cross water safety regulations shall be observed.
P. The user at all times during the use and occupancy of the premises shall thoroughly comply with all ordinances, laws, and
regulations affecting the use and occupancy thereof, including all state and local fire, health, and safety laws, ordinances, and
regulations.
Q. Smoking is prohibited in all District facilities.
R. Lighted candles and any devices having any form of open flame are prohibited; any material or device which constitutes a fire
hazard is expressly prohibited.
S. The possession and carrying of firearms and weapons of any kind on District/College premises shall be subject to Procedure
3530 – Weapons on Campus.
T. No person while in or on District/College buildings or grounds shall possess, consume, give or deliver to any other person any
alcoholic beverage, other intoxicants or narcotics. A person convicted of a violation of this section, in addition to the penalty
imposed for the misdemeanor, shall be barred from further use of the facilities. (Business and Professional Code,
Section 25608)
3
U. No structures may be erected or assembled on District/college premises nor may any electrical, mechanical, or other
equipment be brought thereon unless authorized.
V. No activity shall be conducted which constitutes a violation of any federal, state, or
local law.
W. The
District/College
is not responsible for articles left on school property.
X. Use of facilities for dances shall be restricted to events sponsored or approved by the
colleges.
Y. The
District/College
reserves the right to cancel facility use permits at any time
without notice.
Z. The District/College reserves the right to reject at any time an application for use of District/College facilities
from any organization which proposes an activity which could cause potential damage or which the District/College
determines would not be in the best interests of the District or the community.
AA. No food or drink will be allowed in classrooms.
BB. No person applying for (or authorize to use) District property shall be issued a key to District facilities.
4
Equipment
Requested
Tables (6ft) Tables (8ft) Chairs Trash
Can BBQ (Carkeet Park) Bleachers
Flags Podium Platform/Riser
Stage
Technology/Media
Services
Other Other
Data Projector Computer/Laptop Internet Access
Portable Sound Microphone
Note: Identify number needed
Other
Hospitality
Will food be made available to attendees?
YES NO
If yes, please describe type (i.e. breakfast hospitality,
prepackaged
food for sport event, water/coffee only, etc.)
Are catering services being requested from either the Columbia College Snack Bar or Columbia College Culinary Dept?
YES NO
If yes, please contact Raquel Tiscareno, Auxiliary Services Manager at 588-5319.
Requesting Use of Oak Pavilion Snack Bar?
YES NO
Oak Pavilion Snack Bar: The Columbia College Athletic teams maintain the first right of refusal to operate the Oak Pavilion
Snack Bar for food sales as a fundraiser. All food and staffing will be provided by the Teams; Coaches (or designee) will
supervise.
In the event the Athletic Teams are unable to operate the Oak Pavilion Snack Bar, applicant will have the opti on to do so and
retain any profits made from food sales. A current ServSafe Certification is required from permittee to sell prepared foods.
Otherwise, food sales are limited to pre-packaged snacks only such as chips and bottled/canned beverages. Permittee will
provide their own cooking equipment. College cooking equipment may be available for use at a charge of $50.00 plus a
refundable $100 deposit. Refund is based on a final inspection that equipment was cleaned properly and is in good working
order.
Parking
Please note that campus parking regulations are enforced at all times while on campus. Please ensure your attendees
have a valid parking permit and park only in designated parking spaces. Please contact Greg Elam, Campus Security
Supervisor, at 588-5213 for assistance.
Signature
Signature:
Date:
5
Office Use
Only
Cost Estimate
Security
$
Custodial
$
Grounds
$
IT Technician
$
Facility Fee
$
HVAC
$
Deposit
$
Other
$
Total
Estimated
Fees
$
Prepared By:
Date
Approval:
Vice President, College &
Administrative
Services
Date
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Completed 22 March 2020

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