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<br />4. REQUESTED EVENT COMPONENTS: <br /> <br />Date requested: _04-11-2009 Alternate date: 04-12-2009 <br />Requested hours of operation: _llam (a.m./p.m.) To: _12pm (a.m./p.m.) <br />Set up beginning date and time: 04-11-2009.8am <br />Complete dismantle date and time: 04-12-2009. 30m <br />Describe the number and type of animals (if any) to be used in this event: N/ A <br /> <br />Attach a draft of the entry form for participants and/or spectators. <br />Anticipated number of participants: _500 to 1,000 Spectators: 500 <br /> <br />5. INSURANCE: -City of Centerville add-on through HRH has been completed and is provided for <br /> <br />review. <br />Attach to this application either an insurance policy or a certificate of insurance including the policy number, <br />amount, and the provisions that the City of Centerville is included as an additional insured. (Please note that <br />insurance requirements depend upon the risk level of the event. Also, if your event can be classified as first <br />amendment expressive activity, insurance requirements can be waived WIder certain circumstances.) <br /> <br />6. SANITATION: -Current trash bins in Park should be adequate for this short event. Lions will <br />provide a few more as insurance. <br /> <br />Attach your "Plan for clean-up/Material Preservation". Include number, type and location of trash containers to be <br />provided for the event. Indicate who and how man will be responsible for emptying and cleaning up around <br />containers during the event. Indicate who and how many will be responsible for cleaning up after animals if they are <br />present during the event. Indicate who and how many will be responsible for cleaning up after the event. Describe <br />the number, type and location of portable toilets to be provided for the event (or permanent toilets to be used in the <br />event.) Include any other plan you have for ensuring post-event cleanliness and material preservation of city <br />facilities, equipment, premises and streets. A deDoslt of $500 will be reouired for c1ean-UD and restoration. If <br />nremises are left in satisfactory condition. this deDoslt will be refunded in full followiDl! insDection. 'Please <br />waive, please refer to the previous good standing letter from Mainstreet Bank from the Ice Fishing Contest just <br />completed in February. Lion members will pick-up alllef! behind articles and trash. <br /> <br />LOCATION: <br /> <br />Please attach a map of your event land design. Check off below items that apply to your event <br />and indicate them on the attached map. Use where necessary, a "to scale" drawing. NA, please <br />seeU. <br /> <br />A. _ If a route is involved, the beginning and finish area with arrows. <br />B. _ If a route is involved, the places where buses, autos or other motorized vehicles need to <br />be considered. <br />C. _ If a route is involved, attach separate maps giving two or more alternate routes. <br />D. _ Entertainment or stage locations (grandstand operators should provide you with a <br />"to scale" drawing.) <br />E. _ Alcoholic beverage concession area. <br />F. Non-alcoholic concession area. <br /> <br />Page 2 ofl0 <br />