Fillable Gift Donation Proposal Application Form

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Gift Donation Proposal Application Form

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The Gift Donation Proposal Application Form form is 4 pages long and contains:

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Country of origin: US
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BROWSE CITY OF HOMER (AK) FORMS

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CITY OF HOMER
GIFT/DONATION PROPOSAL
APPLICATION
PLEASE TYPE OR PRINT CLEARLY AND MAKE YOUR RESPONSES COMPLETE AND THROUGH.
DATE
CONTACT PERSON TITLE
ORGANIZATION IF APPLICABLE
ADDRESS CITY STATE ZIP
PHONE FAX CELL
EMAIL
TELL US WHY YOU WISH TO DONATE THIS TO THE CITY OF HOMER?
DIMENSIONS
PLEASE COMPLETE THE APPROPRIATE SECTIONS RELATED TO YOUR DONATION.
TITLE OF ARTWORK
ARTIST(S) NAME
YEAR COMPLETED
MATERIALS USED TO CREATE ARTWORK
PHYSICAL DESCRIPTION OF THE PROPOSED DONATION–
NARRATIVE DESCRIPTION OF THE PROPOSED DONATION- TELL US THE STORY BEHIND THE PIECE OR SIGNIFICANCE -
IS THE PROPOSED PIECE ONE OF A KIND? IS THE PIECE PART OF A SERIES, LIMITED OR OTHERWISE?
IF SO, AN EDITION OF HOW MANY? IS THE PIECE COMPLETED? IF NOT WHEN IS THE
EXPECTED COMPLETION DATE?
WHAT IS THE CURRENT CONDITION OF THE PIECE?
PROPOSED SITE OR LOCATION
DO YOU HAVE A SITE(S) IN MIND FOR THE PLACEMENT OF THE PIECE? IF SO WHERE?
IS THIS A CITY OWNED PROPERTY IF NOT WHO OWNS THE PROPERTY?
WHAT IS THE RATIONALE FOR SELECTING THIS/THESE LOCATION(S)?
ARE YOU AWARE OF ANY PERMITS OR PERMISSIONS THAT MAY BE REQUIRED?
TECHNICAL SPECIFICATIONS
DESCRIBE HOW THE PIECE IS CONSTRUCTED OR MADE. PLEASE INCLUDE ANY DOCUMENTATION AT
THE END OF
THIS
APPLICATION.
HOW IS THE PIECE TO BE PROPERLY INSTALLED?
DOES THE PIECE REQUIRE ELECTRICITY, PLUMBING OR OTHER UTILITY HOOKUPS?
WHO WILL BE INSTALLING THE PIECE?
WHAT IS THE EXPECTED LIFETIME AND STAYING POWER OF THE MATERIALS USED IN CREATING THE PIECE?
WHAT MAINTENANCE IS REQUIRED AND HOW OFTEN?
PLEASE IDENTIFY ANY SPECIFIC MAINTENANCE PROCEDURES AND OR EQUIPMENT AND THE ASSOCIATED COSTS:
WHAT PRECAUTIONS HAVE BEEN TAKEN TO GUARD AGAINST VANDALISM IF ANY?
WHAT STEPS HAVE BEEN TAKEN TO ASSURE THIS PIECE WILL NOT PRESENT A SAFETY HAZARD?
BUDGET
PROJECT MANAGEMENT FEES $
$
$
$
$
$
INSURANCE $
UTILITY HOOKUP $
DELIVERY $
INSTALLATION $
SIGNAGE $
RECOGNITION $
ARTIST’S FEES
PURCHASE PRICE PERMITS
STRUCTURAL
ENGINEERING SITE
PREPARATION OTHER
COSTS NOT LISTED
$ DESCRIPTION
DATE PIECE WAS LAST APPRAISED?
WHAT IS THE VALUE OF THE PIECE OR ESTIMATED MARKET VALUE IF NO APPRAISAL WAS DONE?
TIMELINE
WHAT IS THE TIMELINE FOR THE COMPLETION OR INSTALLATION OF THE PIECE? IDENTIFY THE DIFFERENT STAGES AND
DATE GOALS TO PREPARE THE PIECE FOR DONATION
RESTRICTIONS
ARE THERE ANY KNOWN COVENANTS, REQUIREMENTS OR RESTRICTIONS THAT COME WITH THE PIECE?
WHAT EXPAECTATIONS DO YOU HAVE FOR THE CITY OF HOMER IN ACCEPTING THIS ARTWORK?
COMMUNITY INVOLVEMENT
WAS THERE ANY COMMUNITY OR USER INVOLVEMENT IN SELECTING THE RECOMMENDED LOCATION?
PLEASE INCLUDE ANY LETTER(S) OF SUPPORT FOR THE PROJECT OR PROPOSED DONATION.
APPLICANT MUST SUBMIT THE FOLLOWING SUPPORTING DOCUMENTATION WITH THIS APPLICATION.
AN RESUME OR BIO FROM THE ARTIST WHO CREATED OR WILL CREATE THE ARTWORK.
FIVE TO TEN IMAGES OF PAST WORK FROM THE ARTIST. THESE CAN BE PHOTOGRAPHS.
THREE TO FIVE CLEAR IMAGES OF THE PROPOSED ARTWORK
SCALE DRAWING/MODEL OF THE PROPOSED ARTWORK
IF YOU HAVE A SITE(S) IN MIND PLEASE INCLUDE PHOTO AND DESCRIPTION OF THE SITE(S) AND A SCALED
DRAWING OF THE PROPOSED ARTWORK IN THE RECOMMENDED LOCATION.
A COPY OF A FORMAL APPRAISAL IF AVAILABLE
TECHNICAL SPECIFICATIONS, MAINTENANCE MANUAL OR DRAWINGS/RECOMMENDATION FROM STRUCTURAL
ENGINEER.
APPLICATIONS ARE TO BE SUBMITTED TO:
THE CITY OF HOMER
CITY CLERKS OFFICE
491 E. PIONEER AVENUE
HOMER, AK 99603
OR YOU MAY SUBMIT VIA FAX AT 907-235-3143 TO SUBMIT VIA EMAIL PLEASE SEND TO clerk@ci.homer.ak.us
IF YOU HAVE ANY QUESTIONS PLEASE FEEL FREE TO CONTACT THE CLERK’S OFFICE AT 235-3130.
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Gift Donation Proposal Application Form

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Completed 11 July 2020

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