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4. REQUESTED EVENT COMPONENTS: <br /> Date requested: _July 29, 30, 31 2011_ Alternate date: NA_ <br /> Requested hours of operation: _8am (a.m./p.m.) To: ' 12am (a.m./p.m.) <br /> Set up beginning date and time: July 28 2011 <br /> Complete dismantle date and time: August 1 2011 <br /> Describe the number and type of animals (if any) to be used in this event: None <br /> Attach a draft of the entry form for participants andJor spectators. <br /> Anticipated number of participants: _100 Spectators: _2,000+ <br /> 5. INSURANCE: Received and forwarded from Hilb, Rogel & Hobbs. <br /> Attach to this application either an insurance policy or a certificate of insurance including the policy number, <br /> amount, and the provisions that the City of Centerville is included as an additional insured. (Please note that <br /> insurance requirements depend upon the risk level of the event. Also, if your event can be classified as first � <br /> amendment expressive activity, insurance requirements can be waived under certain circumstances.) <br /> 6. SANITATION: Please see note after a deposit of $500. <br /> Attach your "Plan for clean-up/Material Preservation". Include number, type and location of trash containers to be <br /> provided for the event. Indicate who and how man will be responsible for emptying and cleaning up around <br /> containers during the event. Indicate who and how many will be responsible for cleaning up after animals if they are <br /> present daring the event. Indicate who and how many witl be responsible for cleaning up after the event. Describe <br /> the number, type and location of portable toilets to be provided for the event (or permanent toilets to be used in the <br /> event.) Tnciude any other plan you have for ensuring post-event cleaniiness and material preservation of city <br /> facilities, equipment, premises and streets A denosit of $500 will be reauired for clean-u� and restoration. If <br /> premises are left in satisfactorv condition, this deposit will be refunded in full followin� inspection Waste <br /> Management is donating trash containers to be used by participants. The Lions Club will clean up any left garbage. <br /> Please waive deposit, a good standing letter can be provided from Mainstreet Bank in needed. <br /> 7. LOCATION: Laurie LaMotte Park in Centerville. I <br /> Please attach a map of your event land design. Check off below items that apply to your event <br /> and indicate them on the attached map. Use, where necessary, a"to scale" drawing. <br /> A. If a route is involved, the beginning and finish area with arrows. <br /> B. If a route is involved, the places where buses, autos or other motorized vehicles need to <br /> be considered. <br /> C. If a route is involved, attach separate maps giving two or more alternate routes. <br /> D. X Entertainment or stage locations (grandstand operators should provide you with a <br /> "to scale" drawing.) <br /> E. X Alcoholic beverage concession area. <br /> F. X Non-alcoholic concession area. <br /> G. X Food concession area. <br /> H. X General Merchandise concession azeas. <br /> Page 2 of 10 <br />