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3) If alcohol is being served, dopy of current on -sale liquor license must be provided. <br />Insurance Regulred: <br />The City of Centerville requires certain events to obtain Insurance prior to approval., The following <br />events include parades and/or other mobile events utilizing City of Centerville streets, events open to the public <br />with a large number of attendees, City staff, or any other events deemed necessary by the City of Centerville. <br />As a condition of the permit the applicant shall: <br />( ji iP =re and maintain insurance, which Includes the City of Centerville as named Insured or additional <br />Insured. Note: Listing the City as the Certificate Holder does not mean the City is an additional insured. it <br />must state in the description box the City (or tf listed as Certificate Holder) is an additional insured. <br />k, D tf alcohol is being served, the entity serving the alcohol must provide a Certificate of Liquor Liability <br />1" 1 rence and listing the City of Centerville as an additional insured. <br />Certificate of Insurance must bg submitted with this anolication. <br />This insurance will need to provide the level of coverage that the City of Centerville determines to be <br />necessary and adequate under the circumstances. <br />D For certain events the City may require simple proof of Ensu <br />Is insurance required (as determined by City staff:✓o _ Yes ❑ No <br />Slgnature•::] X,� Date: APrii 19, 2017 <br />Return this form to: City of Centerville <br />1880 Main Street <br />Centerville, MN 55038 <br />"Please note drat there are fees associated witlr the use of the city's parks (Depork User Fee, Etc.) <br />r7 you would J/ke you event publisher/ on the C Ws website or Reader Board? Pkase Indicate: R yesn No <br />Pkase note, It must meet the City's criteria as below: <br />L Information related to City business or other government opendes <br />2. Requests from Centennial School Distrkt 12 <br />3. Requests from ail retter+ed nonprofit organkaftu located witW the Qty of CodervNe <br />4. May not be registered as a non profit organkation (ie. SdwW everts, Fete des Lacs, etc.) <br />21Page <br />