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3) If alcohol is being served, copy of current on -sale liquor license must be provided. <br />Insurance Required: <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 />❑Procure 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 if listed as Certificate Holder) is an additional insured. <br />❑ If alcohol is being served, the entity serving the alcohol must provide a Certificate of Liquor Liability <br />Insurance and listing the City of Centerville as an additional insured. <br />❑The Certificate of Insurance must be submitted with this application. <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 />-------------------------------------------------------------------------- <br />❑ For certain events the City may require simple proof of insurance. <br />Is insurance required (as determined by City staff): _� Yes No <br />Signature: <br />Return this form to <br />City of Centerville <br />1880 Main Street <br />Centerville, MN 55038 <br />Date: <br />7/22/2022 <br />REVISED, <br />KSIMONS2 , 7/22/2022, 12:38:32 PM <br />*Please note that there are fees associated with the use of the City's parks (Deposit, User Fee, Etc.) <br />*If you would like your event published on the City's website or Reader Board? Please indicate: 0 Yes_2 No <br />Please note, it must meet the City's criteria as below: <br />1. Information related to City business or other government agencies <br />2. Requests from Centennial School District 12 <br />3. Requests from all registered non-profit organizations located within the City of Centerville <br />4. May not be registered as a non-profit organization (i.e. School events, Fete des Lacs, etc.) <br />2 1 P a g e <br />