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4. LICENSING AND INSURANCE <br /> Approved by: <br /> Signature Title <br /> Date: <br /> 1. Dance and/or live entertainment. <br /> List types or permits or licenses required: <br /> 2. Alcoholic beverages. <br /> 3. Peddlers. <br /> 4. Noise abatement. <br /> 5. Other provisions as may be required: <br /> INSURANCE: Your insurance coverage must be reviewed and approved by <br /> the City's insurance carrier. <br /> 1. Public liability insurance naming City of Centerville and other public <br /> agencies <br /> additionally insured is required. <br /> 2. Hold harmless forms executed and failed. <br /> 3. List and approve/disapprove other insurance coverage as may be <br /> required. <br /> 5. FIRE DEPARTMENT <br /> Approved by: <br /> Signature Title <br /> Date: <br /> 1. Emergency vehicle access. <br /> 2. Use of fireworks,pyrotechnics,vehicle fuel, open flame. <br /> 3. Cooking facilities. <br /> Page 11 of 14 <br />