City of Bisbee Park, Facility and Right-of-Way Use Permit
Special Event License Application
This application must be returned to the Public Works Department no less than 45 days before the
scheduled event. Application will NOT be considered without required paperwork.
APPLICANT INFORMATION:
Date:
Name and Title (If Applicable):
Organization Name (If Applicable):
Applicant or Organization Mailing Address
Phone: Contact Name and Phone # during event:
Email Address:
Insurance: Events held on City Property are required to include a certificate of insurance of one million dollars ($1,000,000)
minimum for high risk functions and appropriate endorsements naming the City of Bisbee as additional insured. Applicant’s
policy is primary.
EVENT INFORMATION:
Event Name: Expected Attendance:
Event Date(s): Start Time: End Time:
Event Location and Address:
Will you be serving food? Yes / No If yes, a copy of the Cochise County Health Department Certificate MUST
accompany this
application otherwise this permit will not be accepted
Description of Event and Activities (If more space is needed attach a separate sheet):
SERVICES REQUESTED FROM THE CITY OF BISBEE:
General Electricity Access (City, Lower Vista & Grassy Parks Only) Actual Cost will be calculated by Public Works
Band Shell (City Park) Actual Cost will be calculated by Public Works
Generators are PERMITTED… All Jumping Castles must have insurance and generators
Beer Permit (Non-Commercial permits only) $25.00
Police: Escorts, Security, Road Closures, Redirecting of Traffic: $40.00 per day per vehicle+ Employee OT Rate and ERE’s
Public Works / Park & Recreations Department
76 Erie Street P.O. Box 4601 Bisbee, AZ 85603-4601
(520)
43
2-6002 LValdez@BisbeeAZ.gov
PERMIT NO:
Parks/ Public Works Personnel $25.00/ hr. per person
Water Access- Parks $25.00
No Parking Signs, access to facility/ band shell/ restrooms etc. $1.50 per sign Note: Road Closed Signs/ Barriers must be
supplied by Applicant.
Operations Plans $100 minimim (personnel hours including ERE’s)
CONDITIONS APPLICANT MUST MEET THAT ARE REQUIRED BY THE CITY OF BISBEE :
$35.00 non-commercial or $65.00 commercial permit fee paid before permit is processed.
$50.00 refundable deposit paid before permit is processed (if a check is issued, must be “Written separately from other
charges) This deposit will be refunded at the completion of the event, provided that the facility has been left in the same, or
better, condition as it was at the start of the event. The City will deduct from this deposit any expenses that may be incurred for
cleaning or repairing the facility following the event prior to refunding any remaining balance.
Business License/ Special Event License fee of $39.56 must be paid before permit is processed- where there is a promotor
sub-letting booth space to vendors, the promotor will pay a fee of $39.56 and $6.00 per vendor per day (must
be submitted prior
to the event). The promotor is required to supply a list of vendors which describes the items or service the vendor will be selling
and pay all applicable fees prior to the event. Sales tax on all items sold at the City rate will be collected by the City for all sales
made by the promotor and all vendors via their State tax forms.
County Health Department Food Permit must be attached If serving food or having food vendors. Health Department can be
contacted at 520-432-9400 for more information (This is not a food handler’s certificate).
Special Event Liquor License Application submitted to the City Clerk’s office required in order to serve or sell liquor from
the State of Arizona (Department of Liquor Licenses & Control, Phoenix Office). The Sale of or consumption of alcohol beverages
must be approved by the City Council.
Copy of flyers or promotional material associated with this event.
NOTES:
1.) THERE IS NO WATER USAGE AT ANY PARK AT ANY TIME.
2.) NO PARTY OF MORE THAN 50 PEOPLE, MAY NOT TAKE PLACE WITHOUT THE APPROPRIATE PERMITS.
TOTAL FEES: TOTAL ADDED FEES: TOTAL SUBMITTED:
SPECIAL EVENT PERMIT AGREEMENT AND ACKNOWLEDGEMNENT
Applicant shall indemnify, defend, save and hold harmless the City of Bisbee and its officers, officials, agents and
employees (hereinafter referred to as “Indemnitee”) from and against any and all claims, actions, liab
ilities, damages,
losses, or expenses (including court costs, attorney’s fees, and costs of claim processing, investigation and litigation) for
bodily injury or personal injury (including death), or loss or damage to tangible or intangible property caused,
or alleged
to be caused in whole or in part, by the negligent or willful acts or omissions of Applicant or any of its owners, officers,
directors, agents, employees, subcontractors or invitees. This indemnity includes any claim or amount arising out of or
recovered under the Workers' Compensation Law or arising out of the failure of Applicant to conform to any federal,
state or local law, statute, ordinance, rule, regulation or court decree. It is the specific intention of the parties that th
e
Indemnitee s
hall, in all instances, except for claims arising solely from the negligent or willful acts or omissions of the
Indemnitee, be indemnified by Applicant from and against any and all claims. It is agreed that Applicant will be
responsible for primary loss in
vestigation, defense and judgement costs where this indemnification is applicable. In
consideration of permission to hold the event, Applicant agrees to waive all rights of subrogation against the City, its
officers, officials, agents and employees for los
ses arising out of or resulting from the event. The City reserves the right
to refuse installation of amusements or facilities that violate safety regulations. If Applicant is acting on behalf of an
organization, Applicant certifies that he/she is an authorized officer of the Applicant or the agent of the organization, is
FOR CITY USE ONLY
Police Department Approval
Yes No
Initials Date
Remarks
Public Works Approval
Yes No
Initials Date
Remarks
Fire Department Approval
Yes No
Initials Date
Remarks
COUNCIL ACTION:
Approve Deny
Mayor’s Signature __________________Date_________________
With conditions as noted:
___________________________________________________________________________________________
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__________________________________________________________________
________________________________
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____________________________
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acting on the organization's behalf, and is duly authorized to execute this Agreement and Acknowledgement on the
organization’s behalf. Applicant further certifies that he/she has read and
understands all the terms of this Agreement
and Acknowledgement, agrees that the Applicant shall be bound by its terms and conditions, and is of lawful age and
legally competent to sign this Agreement and Acknowledgement. The City's issuance of a special
event permit shall
constitute a written agreement or contract between the City and Applicant for purposes of insurance requirements.
Applicant agrees to the payment of all non
-refundable and refundable fees specified in this document unless otherwise
autho
rized by the Public Works Department. Applicant further acknowledges that depending upon the nature and
location of the Applicant's special event, additional permits may be required. The City reserves the right to withhold
clean/damage deposits depending o
n the condition of the facility when the permit expires.
PERMIT HOLDER INITIALS ___________________ DATE: _________________________
_______________________________________________________________________________________________
NOTE:
SHOW DIMENSIONS, SERVING AREAS, AND LABEL TYPE OF ENCLOSURE AND
SECURITY POSITIONS.
SHOW NEAREST CROSS STREETS, HIGHWAY, OR ROAD IF LOCATION
DOESNT HAVE AN ADDRESS.
PARK, FACILITY AND SPECIAL EVENT FEES
(ORDINANCE: O-20-04, APRIL 7, 2020)
SPECIAL EVENT PROMOTER
(PER-DAY)
SPECIAL EVENT VENDOR
(PER-DAY)
POLICE OFFICER/
PERSONNEL/ POLICE UNIT
PERMIT FEE NON-
COMMERCIAL
PERMIT FEE
COMMERCIAL
REFUNDABLE DEPOSIT
BEER PERMIT
NON-COMMERCIAL ONLY
WATER ACCESS PARKS
ELECTRICITY ACCESS
PARKS
ELECTRICITY ACCESS
BANDSHELL (CITY PARK)
PARKS PUBLIC WORKS
PERSONNEL
DUMPSTER 1 DAY
DUMPSTER PICK UP
AFTER HOURS
DUMPSTER PICK UP-
HOLIDAY & WEEKENDS
TRASH CART RENTAL
“NO PARKING” SIGNS
VENDOR FEES
OPERATIONS PLAN