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3) If alcohol Is being served, copy of current on-sale liquor ficeinse must be prWded. <br /> n s urance Re u1ire !!!! <br /> The City of Centerville reqiii ms cerfain I 9to obtain Insurance 1pirlor to approval The fbilkyMing <br /> events lindude parades sand/ it other irnobile events uUIIIc 7jing City of CenWirville strefts, events open W the public <br /> with a large uiiumber or attendees, City staff, or any other,events deemed inecmssery. by the City of Centerville. <br /> As a condiffion of the permit the applicant shWI: <br /> PI .d oaddiftlProcure,avid malintain insuranoe,which Includes the City of Centerville as named Insure r lowal <br /> lnsured. Note: I isting the City as the Cerfificate. I ioldeir d(.:ies not mean-the City is an addFdonal Insured, It <br /> must Aate in the desrAption lbox the City(or if listed as CeirtifirAte I Iolder) is an additional insigired. <br /> bility <br /> do oa <br /> If aicohol is be!ing served, the enUty serVoing the allicoliol rnl,ii�,O, provide a Cefifica f Ilquor L.1lr <br /> Insurance and fisfing the My of Centerville as an additional inst,pred.. <br /> rhe Certiflocate c..A$nsurance.iUag�� td rt ., <br /> .......... ... <br /> detenminesto The <br /> rhis insurance Wil ne(..-W to provide the If.wel of coverage that the City of Centerville <br /> necessary and adequate undeir the lir curn stainces. <br /> .......... <br /> I- itcm.rtain events the Cfty may imDquive slimple proof ofins ur <br /> Is insurance required (as determined by City staff):....................... Yes ..................................... No <br /> Date: 2,z <br /> Sigirlature'. ........................................­............................................................... <br /> le I/. ...................I'll............... ........................................................................ ............................................................... <br /> IRetuirin this fornrk-to: City of Centerville <br /> 2.880 Main Street <br /> Centerville,MN 550:38 <br /> th q he W ar* (De wit, se W, <br /> O'Nease note that there are fees awadated with ease ft 0 sp s P U rr Ft <br /> *Ijf you iwould like your sivent pubfisPied on the OWs tsite iiinor A,le ruder fterd? Please indicate: 121re"S_Z 111(a <br /> Please nate,it viroust oveetthen City's irdterla as bek-rilff.' <br /> 1. Irdbrmation priatemP ipa 'fit y business ar other yoverno iffim"ciff <br /> 2. Requests frain CeparrEpn�rdol Sdvol DisblciR'1.2 terwile <br /> 3. Rejuests from all registered non-pmfit g3rqanj�zjff,tjorls located wMin the ir'Ry afiCen <br /> 4. May not be rooteird iiers a non pralft uArganization(i.e. School evvenft,/. de des Lacs int c.) <br /> 21 IIP a g P, <br /> 7 <br />