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<br />4. REQUESTED EVENT COMPONENTS: <br /> <br />Date requested: _August 1st. 7th, 8th and 9th 2009_ Alternate date: August 2nd 2009_ <br />Requested hours of operation: _8am (am.lp.m.) To: _12am (am.lp.m.) <br />Set up beginning date and time: Julv 31st 2009 <br />Complete dismantle date and time: AU2USt II th 2009 <br />Describe the number and type of animals (if any) to be used in this event: None <br /> <br />Attach a draft of the entry form for participants and/or spectators. <br />Anticipated number of participants: 100 Spectators: 2,000+ <br /> <br />5. INSURANCE: Received and forwarded from Hilb, Rogel & Hobbs. <br /> <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 under certain circumstances.) <br /> <br />6. SANITATION: Please see note after a deposit of $500. <br /> <br />Attach your "Plan for c1ean-upIMateria! 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 deoosit of $SOO wlU be reauired for clean-un and restoration. If <br />nremises are left in satisfactory condition. this deoosit will be refunded in full folium!! insneclion. Waste <br />Management is donating trash containers to be used by participants. The Lions Club will clean up any left garbage. <br />Please waive deposit, a good standing letter can be provided from Mainstreet Bank in needed. <br /> <br />7. LOCATION: Laurie LaMotte Park and Peltier Lake Boat Landing in CentervilIe. <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. <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. _X_Entertainment or stage locations (grandstand operators should provide you with a <br />"to scale" drawing.) <br />E. _X_Alcoholic beverage concession area. <br />F. _X_ Non-alcoholic concession area <br />G. _X_Food concession area. <br />H. _X_ General Merchandise concession areas. <br /> <br />Page 2 of IO <br /> <br />24 <br />