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4. REQUESTED EVENT COMPONENTS: <br />Date requested: _4 -3 -2010 Alternate date: 4 -4 -2010 <br />Requested hours of operation: _l lam (a.m. /p.m.) To: _l2pm (a.m. /p.m.) <br />Set up beginning date and time: 4- 3- 2010.8am <br />Complete dismantle date and time: 4- 4- 2010.3Dm <br />Describe the number and type of animals (if any) to be used in this event: N/A <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 />5. INSURANCE: *City of Centerville add -on through HRH has been completed and is provided for <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 under certain circumstances.) <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 />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 deposit of $500 will be required for clean -un and restoration. If <br />premises are left in satisfactory condition. this deposit will be refunded in full followin¢ inspection. *Please <br />waive, a letter of good standing from Central Bank will be provided if needed. The Lions Club will pickup all left <br />behind trash in LaMotte Park. <br />LOCATION: <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 />see U. <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 />Page 2 of 10 <br />