Fillable SE SpecialEventsApplication 2012 Special Events Application.xls

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SE SpecialEventsApplication 2012 Special Events Application.xls

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The SE SpecialEventsApplication 2012 Special Events Application.xls form is 7 pages long and contains:

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File type: PDF

U.S.A. forms for City of Chandler

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Fax Number Cell Phone Number
Other
Participants Spectators
Audience Demographics
Name of property owner where event is to be held
Address
Phone Number
Nonprofit Benefacto
r
Event Co-Producers
Will you have event co-producers? Yes No
If Yes, complete below.
Co-Producing Organization
Contact Name and Phone Number
Event Responsibilities
Nonprofit** Business/Promoter
Physical Address City
Mailing Address City State Zip Code
State Zip Code
Name Office Phone Number
Event Chairperson
Email Address Home Phone Number
Event Date(s)
Type(s) of Event
Parade/March/Procession Race/Walk/Cycle/Skate
Concert/Performance/Live Music Festival
Public Property
Farmers' Market Athletic/Recreation Activities
Extension of Premise Bike Park Showcase/Activity
Skate Park Showcase/Activity
Proposed Location of Event
New Re-Occurring
*Events taking place on Private Property must provide written permission from the property owner. This letter must accompany the
application.
Anticipated Attendance
Event History
Location Is Private Property
*Please attach letter of permission from Property Owner
*Please attach a letter from the non-profit organization verifying their partnership
**A Certificate of 501(c ) (3) status from the IRS must accompany the application form.
SPECIAL EVENT APPLICATION
Please complete all information; do not leave any spaces blank. Write N/A in spaces that do not pertain to your
event. Incomplete applications will not be processed.
APPLICANT INFORMATION
Name of Company/Organization Please Check One:
Event Start Time Event End Time
GENERAL EVENT INFORMATION
Name of Event
Is this considered to be an annual event? Yes No
Extension of Premise
Page 1
Event Details
Fees
Admission Yes No Cost
Food Vendors Yes No Cost
Merchandise Vendors Yes No Cost
Set Up Tear Down
Date/Times Date/Times
Open to the public Yes No
If no, please describe why?
Contact person for media/citizen information, questions or concerns
Name
Phone Number Email Address
Event Web Site
Event Description
Illustrative Site Map
Do you want fire services? On Call On Site
Will you have a first aid station on site? Yes No
Canopies
Will you have canopies or tents? Yes No
If Yes, complete Appendix C
10' x 10' 20' x 20' Other Size
Scaffolding
Will you have scaffolding? Yes No
Where will it be placed?
What are the dimensions?
Fencing
Will fencing be used? Yes No
Type of fencing
Height of fencing
Dimensions of fenced area
Will you have open flames? Yes No
If Yes, complete Appendix E
What will your open flame usage be? (check all that applies)
Grilling/BBQ Deep Fryer Activity/Entertainment
Other
Will you be having fireworks? Yes No
If Yes, complete Appendix D
Company providing service
Length of display
Location of anticipated launching site
Anticipated start time
Describe types of materials being used for show
Pyrotechnics
*Attach Certificate of Insurance of Company
A
site map of the event area including location(s) of equipment and activities must be submitted with this
application. Please include the information listed in the handbook on page 27.
GENERAL EVENT INFORMATION CONTINUE
D
FIRE SERVICES
Medical
Structures
Open Flames
Page 2
What closures are being proposed for the event?
Streets Yes No
If Yes, complete Appendix G
Alleys Yes No
Sidewalks Yes No
Parking Lots Yes No
Provide a detailed description of all traffic closures for this event (include location, times and closure devices)
Name of contracted professional barricade company
Contact Name Phone #
Please describe your parking plans
Food or Beverages? Yes No
Sold Free Caterer Served
Will food be prepared on site? Yes No
Please describe
Number of anticipated vendors
Do vendors have all permits/licenses with Maricopa County Environmental Health Department?
Yes No
Is your completed vendor list attached to this application? Yes No
Will you have sponsors? Yes No
Will these sponsors have booths? Yes No
Will these sponsors be selling items? Yes No
Will you have these types of vendors? Yes No
Number of anticipated vendors
Alcohol?
No Alcohol Allowing Guests to Bring Their Own
Sold (City & State Permit Required) (City Beer Permit Required)
If Selling Alcohol - Answer This Section
Have you submitted the special events alcohol application? Yes No
Date Submitted
When will the special events alcohol application be reviewed by the City Council?
Date of City Council Meeting
Please describe in detail how the alcohol sales will be sold and monitored
TRAFFIC CLOSURES
*A Traffic Control Plan and Road Restrictions and Closure Permit MUST be completed
VENDOR INFORMATION
Food
Sponsors
Informational / Crafts / Merchandise
Alcohol
If Yes, complete
Appendix H
If Yes, complete
Appendix H
If Yes, complete
Appendix H
Page 3
Allowing Guests to Bring Their Own Alcohol - Answer This Section
Are you aware that this option only applies to city parks? Yes No
Have you purchased the City's beer permit? Yes No
Permit Number
How do you plan on regulating the drinking of alcohol during your event? Please Explain.
Responsible person on site Cell Phone Number
Please describe your plans for on site security.**
Private security company name
Security guard certification
# of security personnel How identified?
Will you be requesting off duty Chandler Police Officers? Yes No
# of officers requested
Start Time End Time
Will you be using the city facilities? Yes No
Start Time End Time
Will you bring in portable facilities? Yes No
Name of company providing services
Delivery Date Delivery Time
# of standard units # of disabled units
# of handwashing stations
Pick-Up Date Pick-Up Time
Do you want to rent trash containers from the City? Yes No
90 Gallon Containers
Quantity Delivery Date/Time
How will you dispose of the trash? On-Site Roll Off Bins Hauling Trash Off-Site
If roll off bins are brought in…
What company will be used?
Location of roll off bin
Delivery Date Delivery Time
Removal Date Removal Time
Are you hiring a professional clean up crew? Yes No
Name of company Cell Phone Number
Person responsible for final clean up
Alcohol Continued
PUBLIC SAFETY
Police
**After reviewing the application, the City reserves the right to require the use of off duty police officers at the expense of your
organization.
RESTROOM FACILITIES
EVENT MAINTENANCE / CLEAN-UP
*It is the responsibility of the event organizer to ensure trash is picked up during and at the conclusion of the event. Event organizer is responsible for all
trash on the event site and any trash associated with the event or event patrons or spectators that impact the surrounding area, adjacent streets, right-of-way,
neighborhood homeowners property, schools, businesses or places of worship.
Page 4
Will you be needing the city supplied electrical outlets? Yes No
Date Needed Start Time End Time
Please list the following
Equipment Needing Electricity Voltage/Amperage # of Outlets
Generators on-site? Yes No
Name of company providing services
Size of Generator Quantity
Will you be needing the city supplied water outlets? Yes No
Date Needed Start Time End Time
Please list the following
Item Needing Water Potable/Non-Potable
List all signs/banners being used Locations Size
How will these banners be hung/secured?
Will you have bleachers? Yes No
Quantity Bleacher Dimensions
Name of company providing services
Placement location
Do you want to rent the City's bleachers? Yes No
Delivery Date Pick-Up Date
Delivery Time Pick-Up Time
Will there be a stage or multiple stages? Yes No
Quantity
Stage Dimension
Who are you getting the stage from?
Do you want to rent the City's showmobile or portable stage? Yes No
Showmobile Portable Stage
Delivery Date Pick-Up Date
Delivery Time Pick-Up Time
What will take place on the stage? Please Explain
Will there be amplified sound? Yes No
Will there be a sound check? Yes No
What time will the sound check take place?
AUXILLARY EVENT INFORMATIO
N
Electrical
Water Requirements
Signs - Banners
Bleachers
ENTERTAINMENT / AMPLIFIED SOUND
Page 5
Will Inflatables be on site? Yes No
Name of company providing services
List types of Inflatables Quantity Sizes
Will Mechanical Rides be on site? Yes No
Name of company providing services
List types of Rides Quantity Sizes
Will Animals be on site? Yes No
Name of company providing services
List types of Animals Quantity
Are there any downtown businesses involved in planning this event? List Business Names
How and where will you be promoting this event?
Describe how this event will benefit Downtown Chandler and the local merchants.
Financial Sponsor* (a separate grant request needs to be completed - will be sent to you)
Amount Requested *Include your event budget
Signature Date
ENTERTAINMENT / AMPLIFIED SOUND CONTINUE
D
*Attach Certificate of Insurance for Mechanical Ride Company
*Attach Certificate of Insurance for Inflatable Company
*Attach Certificate of Insurance for Animal Company
DOWNTOWN CHANDLER EVENTS ONLY
**Complete this section if your event takes place in the Downtown Chandler Enhanced Municipal Services
District (south of Chandler Blvd, north of Frye Rd.)
**Only Complete if Requesting Funding from the Downtown Chandler Community Partnership**
By requesting funding, I understand that the Downtown Chandler Community Partnership has the right to
audit all receipts and expenses to this event. I will make these records available within one week of event
completion.
Page 6
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signature
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(INITIALS) Name of Insurance Certificate Holder
Will public official(s) be invited to the event? Yes No
Explain
Name Venue Phone #
Name Venue Phone #
Name Venue Phone #
(INITIALS)
(INITIALS)
Authorized Agent/Event Chairperson Name (PRINT) Signature
Title Date
ACCESSIBILITY
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.
NEIGHBORHOOD NOTIFICATION
INSURANCE REQUIREMENTS
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.
MISCELLANEOUS ITEMS
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
o
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
Page 7
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Completed 11 July 2020

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