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4. INSURANCE: <br /> Attach to this application either an insurance policy or a certificate of insurance including the <br /> policy number, amount, and the provisions that the City of Centerville is included as an <br /> additional insured. (Please note that insurance requirements depend upon the risk level of the <br /> event. <br /> 5. AVAILABILITY OF FOOD,BEVERAGES AND/OR ENTERTAINMENT: <br /> If there will be music, sound amplification or any other noise impact, please describe, including <br /> the intended hours of the music, sound or noise: none <br /> Will alcoholic beverages be served? Yes. [I—(] No <br /> If yes, describe what system will be used to ensure that alcoholic beverages will be consumed by <br /> persons 21 years and older: <br /> If a casino party, a dance, or live entertainment is part of your event,please describe: none <br /> Please note that certain licensing may be required by City, County and State agencies,such <br /> as a Large Assembly License for gatherings over 1,000 people, some types of food handling <br /> licensing, Gambling License, Cabaret License, etc. It is your responsibility to check with <br /> the City Clerk or local authorities to determine what licensing is required prior to <br /> submitting this application. Attach all required licenses to this application. <br /> Will food and/or non-alcoholic beverages be served? Yes No <br /> If yes, describe the nature of the food (such as pre-packaged foods, hot dogs, pre-mixed soda, <br /> unpeeled fruit,raw meats,vegetables, fish or peeled and cut fruit.) <br /> on-site running water in parish community center, grill/griddle for cokking hot dogs/hamburgers <br /> If yes, you may need a permit from the Anoka County Department of Environmental <br /> Health. Please attach a copy of the permit to this application. <br /> Page 2 of 5 <br /> P22 <br />