Fillable Predicted Number of Attendees: Alcohol at Event: Yes (City of Paducah)

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Predicted Number of Attendees: Alcohol at Event: Yes (City of Paducah)

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BROWSE CITY OF PADUCAH (KY) FORMS

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Revised 11/28/18
Application for Contractual Off Duty Police Officer Employment
Paducah Police Department
1400 Broadway
Paducah, KY 42001
Business/Organization/Individual
Billing Address
Business Telephone
Number/Email Address
Authorized Representative
Home Telephone #/Cellular #
Predicted Number of Attendees: Alcohol at Event: Yes No Permitted Event: Yes No
Requested # of
Officers/Cruisers
Number of Officers
Number of Cruisers
Service Date(s)
Service Times
Name or Type of
Event/Event
Location
Assignment
Responsibilities
I,
,
as the authorized representative of
(Name of Representative)
hereby acknowledge the attached “Conditions of Contract” and agree that
will
(Name of Business)
abide by and be subject to these conditions in all respects of an off-duty officer’s employment.
I acknowledge that payment for services must be received by the police department ten (10) calendar days
prior to the services date, unless other arrangements are made with the Assistant Chief of Operations or
his/her designee. If payment is not made, the contract may be cancelled at the sole option of the Chief of
Police or his/her designee. This contract will expire one (1) year from the approval date unless indicated
otherwise.
Authorized Representative Date
Contract Approval
The above application for contract is hereby granted, and the above application, together with the attached
“Conditions of Contract,” is hereby adopted, by reference, and is made a part of and constitutes the terms and
conditions of this contract.
Assistant Chief of Operations or Designee
Date Approved
Chief of Police or Designee
Date Approved
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Predicted Number of Attendees: Alcohol at Event: Yes (City of Paducah)

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Completed 23 February 2021

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