(INITIALS) Name of Insurance Certificate Holder
Will public official(s) be invited to the event? Yes No
Name Venue Phone #
Name Venue Phone #
Name Venue Phone #
Authorized Agent/Event Chairperson Name (PRINT) Signature
It is the responsibility of the event organizer to ensure the event site is accessible to the disabled. Such examples are public sidewalks may not be blocked with tents,
portable toilets or other structures; cables or electrical cords must not create an obstacle; ADA accessible parking and portable toilets must be available. Vendors should
be prepared to meet any accessibility accommodations.
For consideration to hold the event and use of City property, the applicant agrees to provide general liability insurance and indemnify, defend and
hold the City of Chandler harmless as set forth in the Insurance Specifications and Indemnification guidelines (attached). If your event includes
alcohol, liquor liability or host liquor liability coverage must be included on your certificate of insurance. Certificates of insurance are due NO
LATER than two weeks before the event date. Failure to comply with insurance requirements will result in the forfeiture of the use of city
property for the event or future events.
If this is a NEW event to the City of Chandler, please provide three references of past coordinators that have worked
with you and your organization on events:
The applicant is required to notify residents, businesses, places of worship and schools that are affected by street closures and/or noise related to your event. This
notice must be submitted to the Special Event Coordinator for review prior to notification delivery. Once approved, the notice must then be mailed or hand
delivered to designated impacted areas at least two weeks prior to your event (or sooner per the level of impact of the event on the community). Information on the notice
should include, but not be limited to; the name of the event, date(s), time(s), location, the assigned Police Traffic Sergeants name and phone number (if applicable), type
of activity and telephone number where the public can contact your organization for concerns or issues. Failure to comply with notification requirement can result in
the cancellation, postponement or other significant restrictions to your event or future events. Verification of neighborhood notification is required.
PLEASE READ CAREFULLY BEFORE SIGNING
The Contractor agrees to indemnify, defend, and save harmless the City of Chandler, its Mayor and Council, appointed boards and commissions, officials, officers,
employees, individually and collectively; from all losses, claims, suits, actions, payments and judgments, demands, expenses, attorneys' fees, defense cost, or actions of
any kind and nature resulting from personal injury to any person, including employees of the Contractor or of any subcontractor employed by the Contractor (including
bodily injury and death) or damages to any property arising or alleged to have arisen out of the negligent performance of the Contractor for the work to be performed
hereunder, except any such injury or damages arising out of the sole negligence of the City, its officers, agents or employees.
IT IS THE INTENTION OF THE PARTIES to this contract that the City of Chandler, its Mayor and Council, appointed boards and commissions, officials, officers,
employees, individually and collectively, are to be indemnified against their own negligence unless and except their negligence is found to be the sole cause of the injury t
persons or damages to property. The amount and type of insurance coverage requirements set forth in the contract will in no way be construed as limiting the scope of
indemnity in this paragraph.
I certify that the information set forth within this application is complete, true and correct to the best of my knowledge and belief, and that I have received and will comply
with the information set forth on the attached Information Sheet and Fact Sheet. Information from your application is considered public information and may be used in
developing a calendar of community events. Acceptance of your application should in no way be construed as final approval or confirmation of your request. The City of
Chandler reserves the right to refuse the application and it is revocable if deemed in the best interest of the City of Chandler.
Mail Completed Application To
Special Event Coordinator
City of Chandler Recreation Division
Mail Stop 500, P.O. Box 4008, Chandler, AZ 85244
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