RentaIAgreement # 9-b Zn 'Z)C'f
Sports Field Rental Application '#"SC,.35
ONLY SAN PABLO INCORPORATED RESIDENTS ARE ELIGIBLE FOR RESIDENT RATES
CITY, SAN PABLO
FacilitvReqyested (Hours of Operation):
[IELPortaIField(8:00AM-Time of Sunset)[JRumrilIField #1(8:00AM-12:00AM Depending on Day of Renta]) DI)gpis Park Baseball Field (8:00AM-10:00PM) [IRumrill Field #2 (8:00AM-12:00AM Depending on Day of Renta]) Dt5avis Park Field . . (8:00AM-10:00PM) [JRumrilIField #3 (8:00AM-11:00PM Depending on Day of Renta]) &';d'b.. //.& dl.:d'Date Requested:.
b' J 't OP 'a
.Day of Week:..1:4g. 1:.!:£2.Type of Activity:
5 nm -o€eke,' ,6 am/pmStarting Field Time: anVpm .11Q Ending Field Time:
Name of Applicant: J4+dr{ Zy/7Z4}eS Phone Number: Zlg/PJ q?J ' - / e'7ZI Assoc;e /.b State Non-ProHlt m# ig'dP' .g.S g7 V/Z>Name of Organization: Sein GALlo CDuLo-ls Yik+lt Designated Person in Charge on the Day of Event:..d=fl11e Z- fyi'//llpl7d5' Phone: Cglo9 q79- 6976 Address: z'7b S io fh '. C)t '. .city: Arch"''ic?nA ZiP: qq1"06 Email: g'L''t PX & /b coo/z,7.Sd.9n'":tl-/ L d:',HCellphone: ga p '"' Below please wi'ite in attendaitcefor each age group. Attendance numbers need to be as accurate as possible Children(ages 1-12) 5D Teens(ages 13-20)..!.g dults(ages 21-35) Adults(ages 35+)..Z11?.
RENTAL AGREEMENT
My signature certifies that Ihave read and understood the rules and regulations as set forth by the City of San Pablo Recreation Division goveming the use of the Public Field Rentals, that lwilltake fullresponsibility for ensuring that the use of this facility and pleas by the organization/paily I represent is in fulladherence and compliance with these rules and regulations, and that lwillhold the City of San Pablo harmless from any damage, claim for damage For personal injury or death, damage or loss of property, claim for damage to or loss of property incurred in the use of the field(s) reserved. I will accept full responsibility for them tluoughout the period specified in the Sports Field Rental Application. I further understand that as the applicant lassume fullresponsibility far any penalty fees assessed by the City of San Pablo $or any violations of these rules and regulations goveming the use of the above requested field. I am fuMare that the Deposit is non-refundable ifl cancel within 2-weeks of my reservation for any reason. I am also aware that by signing this coi!)rdEt, I takSI fullresponsibility for the behavior exhibited by lny guests during my rental.
SIGNATURE OF APPLICANTS/(--;/..at,.;,£.e ,,"y" "'t.4'' -.,Z.'l------.-..--.. DATE: e/ Pz7'/'Z 3 leakcon
APPLICANT
Recreation Staff Signature: Date Received
CM Staff Signature: Date Received
KPP''"d au\y ;q - 0«.2dhao,'
OFFICEUSEONLY
Application Fee(Non-Refundable)
Deposit
Hourly Fee
insurance Fee(Willorganization/applicant provide their own ]nsurance? AlcohoIFee
StafrFees ($20/person/hour)
Security Guards
Equipment
Amount Total
S
$
CITY OF SAN PABLO RECREATION DIVISION
2450 ROAD 20, SAN PABLO, CA 94806
PHONE: (510) 215-3080
FAX: (510) 215-3015
CITY.SANPABLO
Cite' avnet\ Dire(lions
PARK KIOSK AND CONCESSION STAND RENTAL APPLICATION
Rumrill Food Kiosk Da\:jp#ark Concession Stand
( )#i )#2 (H.#i
: ll;m./S P C ' n--l Applicant's Name: .Day Phone: &5;iO) Z279'-"6 p'7 (1) EvePhone
Day Phone:Designated/ Contact Person Name:
2. Address: l2.'7 6'$ \)t) (.)I
(Please Print Clearly) EvePhone:
R., h hm..nd ... ....: 'l''j g'06('. City:
3. EmaiIAddress: €q t'\oPaL\olO co Li) L) Osf5 19 (\ vvllh.i C,'Ci
4. 5.
Lease Duration: ( ) I month trial( ) 3months ( 6 months ( ) I year Request access to San Pablo Community Center (SPCC) commercial kitchen? a.Requested Days of the week: /7?0#2ild\v -- 'S 41.h igZa ( )Yes (iyiq;
b. Rental Times: a.m. /p.m. to
1.,.,'....es' . C6..''''s
a.m. /p.m
e,a. +, fade;S6 Description of good to be sold: a.....I W. I.rJ RENTALAGREEhIENT
My signature cei'tifies that shave read and understood the rules and regulations as set forth by the City of San Pablo Recreation Division goveming the use of the Public Facility and Field Rentals, that lwill take full responsibility far ensuring that the use of this facility and areas by the organization/party Irepresent is in fulladherence and compliance with these jules and regulations, and that lwillhold the City of San Pablo harmless Rom any damage, claim for damage for personalinjuiy or death, damage or loss of property, claim 6or damage to or loss of property incurred in the use of this facility. I will accept full responsibility for them throughout the period specified in the Park Kiosk and Concession Stand Rental Application. I fiirther understand hat as the applicant I assume full responsibility 6or any penalty fees assessed by the City of San Pablo for any violations of these niles and regulations goveming the use of the above requested facility or field. I am fully aware that the Deposit is non-refundable fl cancel within 2-weeks of
Applicant's Signature
Contract Approved By Recreation Staff Nal
For OfHce Use Only
Amount Paid
Amount Due
Amount Paid
Amount Due
Amount Paid
Application Fee(non-refundable)
Rental Fee
Insurance Fee
Other
TOTAL
RECPT/NO
RECPT/NO
RECPT/NO
RECPT/NO
RECPT/NO
Amount Refunded
Request sent to Finance Date.
Payment Request Date
Check NO.
SanPablo
2014
City of San Pablo
Recreation Division
2450 Road20
San Pablo. CA 94806
C[']'V-r SA]q PABLr]
Field RentaIFee Waiver Application
Copies of the following items are required at the time of application submittal 1 )
2)
3)
4)
5)
501(c) Status / IRS documentation - Articles of Incorporation Current Organization Roster of Membership
a) Roster must include player's names, guardians, and addresses List of Organization Officers and Contact Information
Certificate of Insurance
a) Must be valid for the season requested
b) List the "City of San Pablo ' as the additionally insured party for the season Copy of Organizations bylaws or articles of incorporation
OF SAN PABLO STAFF USE ONLY
Date
Date
Received By:
CounciIReview Date: CounciIDecision
SpecialConditions
ORGANIZATION DETAILS
Name of Organization: Sa-n 't)4bl.e, e,oooboyi -yoK:+h R.s9z'cfn'Ffo© Contact Name: A-mare L. HCCLil.,+ ,u-. Phone: (s lo.) ql g '- 6 7'7 f.
Organization EmaiIAddress: 'z'7Z) 5 1.J p d4n,a ZJf #f'c&+,..7a,,.J d-a.
Oraanization Mailina Address:
FEE WAIVER REQUEST DETAILS
Season: % o%3 -- 2 '7 , /
Seasam a s'. ~lt'15\a.o...'3 J 12..I'2-ll"'z02.'3
*LocationReauested: .Oar/b /ohr/'( ' '
*lf requesting the Davis Park location, your group must schedule a mandatory parent meeting to be had with Community Services and the Police Department to discuss Darkina restrictions to address public safetv concerns.