Agenda Item Number: _7__
CITY OF SEBASTOPOL
CITY COUNCIL
AGENDA ITEM
Meeting Date: February 7, 2023
To: Honorable Mayor and City Councilmembers
From: Ana Kwong – Administrative Services Director
Subject: Review, Discuss and Consider of Sebastopol Rotary Club Sponsorship Request Recommendation: That the City Council Review, Discuss and Consider the Request for Sponsorship Program from the Sebastopol Rotary Club Application Music Event Concert at Ives Park June 3, 2023
Funding: Currently Budgeted: ___X____ Yes _______ No _____ N/A Account Code/Costs authorized in City Approved Budget (if applicable) ___AK_____ (verified by Administrative Services Department) INTRODUCTION/PURPOSE:
This item is to request City Council Review, Discuss and Consider the Request for Sponsorship Program from the Sebastopol Rotary Club Application Music Event Concert at Ives Park June 3, 2023.
BACKGROUND:
The City Council adopted a Community Sponsorship Policy No.84 in early September 2021. The policy established the parameters to promote significant and special community events primarily benefitting the Sebastopol community. City supports of such program may consist of monetary funding and/or in-kind support. Community sponsorships can be an effective means to identify the event with the City and building community partnerships while raising revenue.
The purpose of this sponsorship policy is to set forth guidelines and criteria governing the granting of City of Sebastopol funds or in-kind services for the purpose ofsupporting local festivals, special events, community projects or programs. Although the City makes a concerted attempt to limit the amount of General Fund monies expended toward such sponsorship activity, the City recognizes that sponsorships play an vital role in supporting our community, as well as to promote cultural experience and economic development efforts of the City.
As stated in Council Policy 84 Community Sponsorship.
“The City of Sebastopol recognizes that sponsorships play an important role in supporting our community and providing support for community events that are held for the following purposes:
• Support of nonprofit organizations, service clubs, groups or organizations serving the Sebastopol community; • Cultural, recreational and educational activities;
• Promotion of the City of Sebastopol
In order to expand access to a wide range of cultural experiences and diversified community connections for all its residents, the City of Sebastopol provides limited assistance to local organizations in support of community events that are consistent with the goals and priorities of the city and that serve a public purpose.” Agenda Item Number 7
City Council Meeting Packet February 7, 2023
Agenda Item Number: __7__
“Sponsorship – A sponsorship is any monetary or in-kind support from the City (City logo, City staff time, public safety services, and the use of City facilities or property, event permit fees, etc.) to the organizing agency that helps offset the costs of the event operations.”
DISCUSSION:
City staff has received an application from the Sebastopol Rotary Club requested for monetary support for their upcoming June 3, 2023 music concert featuring Tommy Castro and the Painkillers at Ives Park. A short excerpt from the application as follows. Please see full application for more information. “The music event will feature Tommy Castro and the Painkillers Band, the 2022 BB King Entertainment of the Year, 2022 Blues Album of the Year, and 2022 Band of the Year. The event also feature local beer and wine. The band will draw from all over Sonoma County and the Bay Area where they are well known.” GOALS:
4.2.2, Foster a Sense of Community by Providing and Encouraging Participation in Community Events, Volunteering, and working with Non-Profits to Support Local Events
Goal 5 - Provide Open and Responsive Municipal Government Leadership
5.3.3. Encourage and increase public awareness of City Policies, decisions, programs and all public processes and meetings, by investigating effective methods of communication and obtaining feedback from the community.
Action CHW 5c: Practice an open-door policy in City programs, and actively engage and encourage participation from all individuals regardless of ethnicity, race, religion, class, disability, sexual orientation, and gender.
PUBLIC COMMENT:
As of the writing of this staff report, the city has not received any public comment. However, if staff receives public comment from interested parties following the publication and distribution of this staff report, such comments will be provided to the City Council as supplemental materials before or at the meeting. In addition, public comments may be offered during the public comment portion of the agenda item.
PUBLIC NOTICE:
This item was noticed in accordance with the Ralph M. Brown Act and was available for public viewing and review at least 72 hours prior to schedule meeting date.
FISCAL IMPACT:
The financial impact of $6,000 is requested for this event and listed below provided by the Sebastopol Rotary Club of such event budget cost.
The current sponsorship program has a remaining budget of $10,500 identified in the 2022-23 budget.
RECOMMENDATION:
That the City Council Review, Discuss and Consider the Request for Sponsorship Program from the Sebastopol Rotary Club Application Music Event Concert at Ives Park June 3, 2023.
ATTACHMENT(S):
Application
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
FILING INSTRUCTIONS
ffiuctionScarefullyinordertocompletelyandaccuratelyfileyour application:
1. PREPARE YOUR APPLICATION PACKET containing the following:
ne (1) application packet, single sided, 8%x 11, white Paper, unbound, unstapled, unpunched. Color documents may be includ
and detail. Application packet will contain the following:
. Application with signature
ed if desired for clarity
. Attachrnents as necessary for further explanation of application content, all 8 Yzx 11" or smaller in size
2. RETURN COMPLETE APPLICATION PACKET in a sealed envelope via mail or hand delivery to:
City of Sebastopol
Administrative Services Department
7120 Bodega Ave
Sebastopol, CA 95472
ATTN: SPONSORSHIP REQUEST
3. SUBMIT. lncomplete packets will not be considered until all required information is received.
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
Application
1. GENERAL INFORMATION
Date of Request:
Amount Requested:
Name of Organization
Organization Contact:
Mailing Address:
Physical Address:
Phone Number:
E-mail address:
Federal Taxpayer l.D. No:
Sebastopol Business
License No. (Required for
any work or service
performed in city limits)
Non-Profit Tax Status
(verification must be
attached):
A/0,,"*,r1.* I ,
Taz-/
,Szb"s/o,rz/ /a r, OlJ
$
v
/ JT .%/a-/ri
3tq { 7/n E.L) u
,
,**rn e-
/u/4
501(c):
Other class (specify):
ES No
Heceived
|\r0v 8 7022
City of SobastoPol
Admin Services' Finance
FOR CITY USE ONLY
Date Received
trtr
Original Sponsorship Application
Sponsorship Request Letter
l-l Complete -
-aRI lncomplete-aprm to Applicant
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
\
2. STATEMENT OF PURPOSE
1. Description of services or event being provided to the city. (Describe the evenUactivity and explain the impact you believe that it will have on the Sebastopol community.
Will it generate sales tax and/ or bed tax through retail sales or hotel stays? Will it educate and/or provide quality of life to Sebastopol residents/visitors?):
l' frw^'."1 Grlro *t! t{^.Qaur.Karr.aa Cg}uor.} L ltr.s R+g a',n dt.'^*7, tD?S.
A. At*t wftL Z agb.1,c bar4lrb,fu ete'"* t,ritl rq,e\ lror^ lrbau *oI:oyn V";,11iar-.1pa.{en .4,"i,1 4 rrlr*= tprl t be terueD. fttn Bb4*"o lce4t're s.Ttv il\1s1- aa-,+t utrtl Mt*r.--Tovrtrtf &S*ro *r) 16v- ft';OfttU-e,<S BA'o4 ?* 2ozz Bgb;:,s E^)k;/ate)€ES o( i-{ut4ror, zozz-,Bh.s 4tbum of {"Lt* Llear, er{ bzu fiAnO aF *h1 y*.'.. 'f'ht avt*tt at,tl 4t* $g+{Unu /OCll fuer a4qd a2)^/€- , 7^z.9anto' atrl/ drn^' €*^all ou7 *xanta (o*,r{7 & f* e?nrr* ailerc ftot au. uxl( Tdtauszt, ( CdD {. How will the city's funds be used? (Provide specific details regarding your reason for request and how those funds will be spent. Funds are considered per line item, and appropriate information should be provided fo assist the City Couniit's review and decision. lf necessary, attach a separate sheet):
3' Total number of persons that benefit from or will attend this progra ^ o, ,r"*o@?(ar
4. Of the total number benefitting, give an estimate of the percentag e (%) of Sebastopol residents that participate in said benefit:
-4Resident 6{Non-Resident
2,
*E 00
r
2.,/AO
a
i
5aa
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
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Agenda Item Number 7
City Council Meeting Packet February 7, 2023
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3. AGENCY BUDGET
1. Sources of Funding:
A. Sebasfopo/ Supporf List any and all funding requested from the City of Sebastpol, including type of request (grant, sponsorship, donation, fundraiser, etc.), the amount your agency requested and the actual amount received, and a description of thefunding request:
B. Community Suoport: List any and all funding requested from other community partners, including type of request (grant, sponsorship, donation, fundraiser, etc.), the amount your agency requested and the actual amount received, and a description of the funding requested (lf necessary, attach a separate sheet.):
f
E*amplet'' :;.:: i::
Sponsorsfilp
$1,500
.fitlortt so rs,h, B fua ;lpr frl4tvr 2 ABa/€',,Pn- n"* !
t
;919'9Q9-, -$10,000 Education grant
tilP-r1Y)t.; lLi4rl -(,-dL.ta *'^ I doo &Jio, frroJ***,rl o &-, q uz
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
2. Budget: Please provide event budget. (lf necessary, attach a separate sheet.) CIr.rb.o qruA fl,a- E*LrUee3 I o,ooo
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GRAND TOTAL OF EXPENDITURES: $
.al
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Agenda Item Number 7
City Council Meeting Packet February 7, 2023
4. SIGNATURE AUTHORIZATION
1. ldentify the principal (owner, president, or equivalent) who is ultimately responsible for the applicant's event:
a
NAME:
TITLE:
ADDRESS:
PHONE:
E.MAIL:
7,ry/a./,
e-)
707*47q- A24 D
e
2. Signature of authorized official:
The undersigned does hereby confirm that the information herein is true and correct, that the applicant agency meets the criteria set forth herein, and that the applicant agency agrees to comply with all requirements.
Signatu
#
e\.^- rA)0., b Date: ,ZOLL
- END OF DOCUMENT -
PageT of7
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
C.tIPY
*i
I
CITY OF SEBASTOPOL
Special Event Permit APPlication
To Special Event Permit Applicants:
The City of Sebastopol is host to many variecl special events throughout the year. These events are an important part of our.comrnunity and can add significantly to the qualrty of life for out residents and visitors. Depending onthe nature of the events, they can enhance our neighborhoods, highlight products and services, provide malketing opportunities, and add to our cultural enrichment.
This packet is intended to help you rurderstand the special event permitting process and provide helpful inlbnnation as yotl plan your event.
The City of Sebastopol is committed to supporting quality events that are safe and enioyable. If you haw questions iegarding the permifiing process, please contact the Public Works b.prtt*ntt et70:l-B?F,-5331 or email [email protected] for further inforrnation.
On behalf of the City of Sebastopol, we thank you for contributing to the spirit and vitality of our community through the staging of your event. Best wishes for a successful event.
Application Process
l. Contact public Works Deprartment to ascertain the availability of the location where the event is requested to be held.
Z. Complete tire application packet (and provide any additional materials regarding this event).
3. Ensure ati blank; are filled out and iniiial the bottom of every page. Please uss black ink to complete the application'
4, nnsrlre the application has a wet signature. Electronic signatures will not be accepted'
5. Submit the packet and filing fees to Public V/orks Department.
6. Complete and subrnit the City event requirements.
7. pay event fees when the application is submitted for routing. The application will not be routed without payment of fees in full.
L Ensure appropriate have been contacted a minirnum of 10 days prior to the event.
9. Request the City conduct a walk-through the first working day after the event' your application is the
special event request.
of first step and should not be Note: Please keep in mind that Depending on the size and construed as approval or ofyour type of event and its Potential on City services, other departmental approvals may be required. Event aPplications less tlran 30 days prior to the event may not be approved. a Banner Installation
mcre information, please
.g., power poles) is not
Murt
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
"}
Noter Generally, temporary off-site signs, such as banners, A-frameso or other si.gnage within the public right of way, are not permitted. (Contact the City Planning Department at 707-823- 6167 for specific:information on signage.)
PartyJumps, Climbing Rock Walls, etc.
Groups renting party jumps, or other similar activities, must note this activity on their application. Companies providing the jump, etc., must have liability insurance as listed below as weII a$ a current business license. No structure that requires staking inlo tire grass or grouqd is permitted in the parks. Requests must be made in advance for electrical service by indication on the application.
Park Hours
City of Sebastopol parks are open seven days a weelq year-round fiom dai"'n to dusk. All unreserved areas remain open to the public at all tirnes during park hours.
Can*ellation Fee
If cancellation is necessary, the City must be notified immediately. If a rsservation is cancelled more than 30 days prior to the event, the entire deposit will be refunded. If a reservation is cancelled less t}*n 30 days prior to the event, a $25.00 non-refundable canoellation fee will be withheld from the deposit.
The applicant is responsible for reading the City's noise ordinance, pal'k nse ordinance, no ,smoking ordinance, and alcohoi in the park ordinance.
Insurnnce Requirements
As a condition of use of City of Sebastopol facilities or programs, your organization must provide, at your sole expense, each of the following items as indicated:
Proof of insurance cornprised of a certificate of insurance and original policy endorsement of comprehensive general liability insurance written by one or more responsible insurance companies licensed to do business in California. This coverage requires the following:
L. The Cit'y,of Sebcstopolo its oflicerso officials, employees and volunteers are to be named as additional irsured by errtlorsement against liability for iqjury to psrsons, damages to properly and for the death of,a person or persons arising or resulting from any act or omissio.n on the part of your organization, its agents or employees.
2. Liability coverage i.s required for claims made by participants in your event/program. You are advised that any and all exclusions pertaining to athletic or recreational eventiprograms must be disclosed in the endorsement, and f,ailwe to do so will not necessarily insulate yow organization from individual liability for claims made as a result of the use of the facilities and your event/program
3. The insurance provided must be PRIMARY with respect to the additional insured named above. Any other insurance available to the City of Sebastopoln its officers, officials, emplo;ees and volunteors must be excess and noncontributing. A Primary NonContributory Endorsement is required. 4, The comprehensive general liability insurance policy limits of such insurance shall not be less than $21000,000 per occurrence for bodily iniuryo personal injury and property damage.
Please note the City may require an increase in policy limits due to the nature of the event.
ffi
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
a. Any deductible or self-insured retention must be identified and approved by the City. In the event the deductible is deemed to be too greato the City nay require you to have your insurer eliminate the deductible or reduce it.
5, You must satisS tirese requirements by furnishing the City with certificates of insurance and errdorsements affecting the required coverage. The certificates and endorsements are to bs on l$O-approved tbrms.
Note: Please inform ycur insurance agent that a "Certificate of Insurance" on Form Accord 25 by itself is not sufficient. A certificate of endorsement naming the City of Sebastopoln its oflicers, of{ieials, employees and volunteers as additional insured is required.
The City willnot accepl a certificate of insurance alone as proof of insurance coverage. The City will not ecceptthe wording listed below in the Dessription of Operations box on the certifi cate of insurance.
The original endorsement must specifically list the following:
"The City of Sebastopoln its officers, officials, employees and volunteers are additional insured against liability fbr injury to per$ons, damages to properly and for the death of a person or persons arising or resulting frorn any act or omission on the part of your organization, its agents or employees.
This insurance is primary with respect to the additional insured named above. Any other insurance available to the Cify of Sebnstopol, its offieers, officials, employees and volunteers shall be excess and nonconlributing."
6. If alcohol is to be sold, the proof of insurance must contain liquor liability and must be satisfactory to the City.
You are strongly wged to show this Notice of Conditions (including the precise wording of these insurance requirernents) to your insurance agent or broker. Doing so will [elp you, your agent, and the City process tbe proper documents in a timely manner.
You must provide the City with the required endorsements 10 days prior to the start of your evont/program. Each endorsement shall be subject to approvai by the City of Sebastopol as to form and as to insuranoe somp{rny.
Please sign and return this original Notice of Conditions to indicate your receipt and understanding of each of the listed above,
Authorized Signature: Ilate: 20zuNams of Organization:
Thank you for choosing to plan a special event within. the City of Sebastopol. We are proud to be the venue for a wide range of special events each year.
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
1 CITY OF SEBASTOPOL
Special Event Permit Application
PARMITTING PROCESS
Special. events often involve a number of permits and other requireinents to ensure the safety of the event and to minimize impacts on the surrounding community.
A Special Event Permit is required for any event utitizing City parks, City buildings, or other City facilities, such as City conference rooms, parking lots, etc. $uch activities include, but are not limited to, craft fairs, fbstivals, ceremonies, and other events.
Events that are ts be conducted on City public sffeets or sidewalks require an Encroachrnent Permit from the City of Sebastopol Engineering Division. Please contact them at ?14 Johnson Street ar 707 -823-21 5 l.
Closure of-streets for block parfies are handled through the Sebastopol Police Department.
Please contactthem at 6850 Laguna Park Way or 707-8294400.
I, on behalf of the organization I represent, certi$i that all forgoing pages in this Special Event Permit Application have been completed. I attest that the infonnation contained herein is accurate, to the best of my knowledge and belief. I attest that I have read all the rules, regulations and guidelines specified herein and that which is included in this Special Event Permit Application.
I, acting on behalf of the organization I represent, am authorized to commit that organization to agree to abide by the nrles, regulations and guidelines specified herein, and that I will accept all responsibilities for any damage to City property and/or faciiities, and any payments for municipal services and/or resourees as they have been outline.d and as they may be utilized by me and the organization whom I am representing and the patrons who will be served by this event.
Authorized Signature:
Printed Name of $igner: J T {il^ae
Date:
I 1: ,u1lt
5, i"
ffi)
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
Please use black ink to complete this applicalion.
CITY OF SEBASTOPOL
Special Event Permit Application
Return To: Public Works Department
714 Johnson St.
Sebastopol, CL95472
Phone: 7A7-823-5331
Email: [email protected]
Applicant Name:
Street Address:
Crty:
Main Phone:
Emnih
,*h.s6o/ (* zip: 0//
\-F ""*,*; GD rfvtcrvui.\or , dU e**'
St*te:
Cell:
\ l)lll l{',\,.r'l l\ l;{ }l{\.'i'\ l'l{ )N
0' ,
On-site Contaet Name (if different):
Street Address:
City:
Main Phone:
EmaiI:
CA zipt €
Zipt q€*r73
Sponroring,
Street Address:
City:
Phone;
Website:
b
Namo (if any):
stD
State
Cell:
State:
q
I r \" i:\'f I
^v
i"{ }l{;\,i.'\ f It)\
ls the organizationa nonprotit', N, es _ No (lf yes, please provide a tax-exempt lett€r to the Cify.) Event Namer
Short Deseription: (This should be pronrotional 'l nature and should excee{20 words.) deEvont Description: (Please provide a naffative and timsline of your event. You may '
pages if needed. A complete Site Plan/Route Map is required with your application. rt,
ru
L^,o I o
-i^\ Agenda Item Number 7
City Council Meeting Packet February 7, 2023
1 l:\jlr\ I' I\l:()Rhl..\1 l{ }N i('urrlirruetl)
Event Location: (e.g., "Ivgs a
to include stage and BBQ area" or "City Hall Conference Room") Wiltyou need access to electricity? {Yes _ No
Event Location Des*ription: (Please describe the location of your event and provide a detailed map of activities of your event in the location being requested. A map showing the location of event acti
5te>
vities must be submiued with the
n e.p
for processing.)
Does the event involve fhe use of a City pnrk? K Yes
?*,r_No
If yeso list name(s) of park(s): flrcq lc_
Event Type: _ Athletic/Recreation Exhibits/Misc. *_ Parade/Procession/March Farmers/Outdoor Market $Concert/Performance CircuslCarnival _ Festival/Celebration ' Free Speech _ Block Pa*y
Other (please explain):
Attendance: AnticipalerJ Total Attendance:
Is event open to the public?
W;p*icipated Daity Attendance ,/aua" $ac)
XYes No
Is this an.annual event? _ Yes tsNo
Ifyes, how rnany years has the event beeri held? QPrior location(s) of eveff: .@* .. -.-... .,,, , ,, Setupl Start Date: b-z- Zazo. Start Time: nc) av rrP(a
Event: Start Date
End Date:
6- Stan Time:
End Time:
g- 9
&-7 -za zg
/z:oa aw4w
7l0c-t AMqM
AM 'fPM Cleanup: Bnd Date: 6 "'{-zo+s; End'fime: /z|4)
fffi
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
Ampli{ied Sound:
Type of Sound Equipment:
Location of Amplified Sound:
Date of Amplified Sound:
es No If yes, complele the following.
b-z-nz-B
Start Time: 12:OA AM LfM End Time: oO AM a-p.M
Purpose: frlhs
Description:
-
Stereo nStatft "
DJ ,Z{,n", ophone/PA Systern
Owner of Amplified Sound Equipment:
First Name Last Name
Business/0rganization Name : /'&di,A.b,"#-
Max Power:
-
wan$ Max Volu*u, !|QQ. Decibels Dist. of Audible Sound:
-
Feet
Far Sound Vehtcle OnIy: Vehicle License Number: Vehicle Make:
Vehicle VIN' ehicle Year:
Security Plan;
-
Yes ufro If yes, compiete the f.ollowing.
Security Plar Description:
If using licensed professionnlso list company name:
Number of licensed professional staff:
trf using volunteerso how many?
How will volunteers be idenfified?
If event is open tc the public, Americans with Disabilities Act (ADA) accessibility requirements are required (e.g,, accessible parking, passenger loadinglunloading &reas, restrooms, seating, path of travel, e.tc.).
!V"r
-
Food: No if yes, complete the following.
Deseri-u-e how food will be serv.ed and/or prepnred:
On-Site Food Preparation Method:
w
_ Electric _ Other
Caterer(s) and/or food vendor(s) must have a Sonoma County Food Industry Health Permit and a City of Sebastopol Business License for this special Tlttt.
Will your event include food vendors?
-
Yes
"zf
No If yes, how many?
-
l;\.'FNl' Di; t ,,\lt.S
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
l :\i l:\"[' ])l : l'.{l I-S i {.'ottlittLrcri
Alcoholic Beverages t :fies
-
No If yes, complete the following.
,*&Clicense may be required
Alcohol Distribution Method:
-
Free-trost gdor Sale (Type: 1#., & -"ard Alcohol)
Please contactthe Department of ABC and Sonoma County Health Department to determine if permits are required for your event. Please notify the City of Sebastopol in writing the determinations from these departrnents.
Parking Plan:
Pqking Plan Description:
-*\otr har,J"o*r,
Yes _ No If yes, complete the following.
fJ,tl ?eu Cer^+r.* {n- +J^r At^lq
ha*r',^.l
Portable Toilets:
-5r \
lfYes _ No If yes, complete the following
Number of Standard Toilets: Nrrmber of ADA Aseessible Toilets: 7 Description of Piacement: (Please indicate location of toilets on your site diagram.) /
Garbage8ecyeling: y(V*t
-
No If yes, complete tlie following.
Number of garbage cans provided: /o Number of recycling cans provided: /-? Cleannp Plan Description: (Please indicate location of receptacles on your site diagram.) Mitigation of Impact:
Have you notifred or met \Mith the residents, businesses or other entities thet may be impacted by your event?
Do you have a sample of the written notice that you propos€ to distribute prior to your event? If yes, please attach the wriuen notice.
Yes
Yes
4 ,K
l:\11.\ l- t'( )t\.,1llt)N-l:N l'l
Pleasc indicatq which components will be present at the event; / { Ap"nFlame
-
Inflatables/Jump Houses
Sisns/Banners
lstig.t
,/ruarc,
fientslCanopies
Vendors
m,
Agenda Item Number 7
City Council Meeting Packet February 7, 2023
,\ (l ll l, l: I'l l"r N' I r\ \. I ) S I ( i r r-,,\ f I ; lt l.r t) l.{i{' l -. \ I L,l I : l{ I understand that this is only an application and not a guarantee that a permit will be issued, I agree to assume the defense of and indemnify and save harmless tlre City of Sebastopol, its officers, officials, employees and volunteers from all suits, actions, damages or clainrs to which the City may be subjected of any kind or nature whatsoever resulting from, caused by, arising out of or as a consequence of such activities permitted in connection therewith. The City requires, as a condition of issuance of a permit, that the applicant obtains insurance to serve this end, in such an amount and with such terms as the City determines to be appropriate under the eircumstances.
This shall be a continuing reiease and shall remain in effect until revoked in wr{ting.
I certify that this application is true and correct and hereby accept full responsibility for any breakage or damage to property and/or building, and for conduct of those attending the frmction for which the facilify is requested. The undersigned, who is to be in charge of the event, is twenty-one years of age or older, The applicant agrees that he/she will be responsible for the use and care of City property. Applicant firther agree$ that the character of entertainment at the above-named place will conform to that stated in the application. Applicant agrees to indemni$, defend, and hold/save harmless the City of Sebastopol, its oflicers, officials, employees and volunteers and against any and all claims, demands and causes of aetion that may be brought against fhe City of Sebastopol, its offieers, officials, employees and volunteers, caused by, arising out of or itt any way connected with the use by the undersigned of the City of Sebastopol facilily or the exercise of the privilege herein granted, except that arising out of the sole negligence of the City. If permission is granted, I, or my representative, agree to be present d,uring the entire use of the facility,
My signafine below signifies that I agree to abide by the conditions of this application, the Special Event Use Folicy and of any contract issued based on this application.
I agree to pay to the City of Sebastopol all costs the City may incur as a result of any ilwe to compiy with all of these conditions, including damages due to faihue to leave the premises in rentable condition.
I understand that all conditions of approval for this permit must be complied with no later than 10 days prior to the event. Failure to meet all conditions may result in permit being deemed null and void.
I HAVE READ AND AGREE TO THIS CON RACT AND WILL CONFORM WITH THE RULES ATIACHED TO THIS AGREEMENT.
I agree that I ano to be responsible fbr reimbursing the City of Sebastopol for any costs incurred to repair or replace
Signature:
as a result of the activity.
Date: ,{-27- WzSL
Please submit this fomr along with a non-refundable Special Event Permit Application Fee to:
Public Works Deparknent Phonel 70'l-823-533I
714 Johnson St. Email: [email protected]
Sebastopol, CA95472
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Agenda Item Number 7
City Council Meeting Packet February 7, 2023