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8 <br /> 4 <br /> Attachment 1 <br /> Port of Event ID: <br /> EVERETT Facility Rental Application Staff Initials: <br /> Port of Everett,PO Box 538,Everett,WA 98206 PORT OFFICE USE ONLY <br /> Phone:425.388.0226,Fax:425.252.7366 <br /> FACILITY USE/ACTIVITY INFORMATION <br /> ROOMS) REQUESTED: ® Blue Heron Room A D Blue Heron Room B <br /> Blue Heron Rooms A&B D Sandpiper Room <br /> DATE REQUESTED: 11/6/2013 Blue Heron Room A / 11/7/2013 Blue Heron Rooms A&B <br /> TIME REQUESTED: FROM: 7:30 AM TO: 6:00 PM <br /> (include set-up&breakdown) <br /> EVENT START& END TIME: FROM: 8:30 AM TO: 5:30 PM <br /> IS EVENT OPEN TO THE PUBLIC? D YES Dx NO ESTIMATED NUMBER OF GUESTS: 65-75 <br /> DESCRIPTION OF EVENT/ACTIVITY: <br /> Rain Garden Design for Landscape Professionals <br /> WILL FOOD BE SERVED? ®YES D NO NAME OF CATERER: tBD <br /> WILL ALCOHOL BE SERVED? D YES ® NO See Public Meeting Spaces Use Policies and Procedures regarding alcohol service <br /> APPLICANT INFORMATION <br /> APPLICANT/ORGANIZATION NAME: City of Everett <br /> CONTACT PERSON: Apryl Hynes <br /> ADDRESS: 3200 Cedar Street <br /> PHONE(CELL): (Home): (Work): 425-257-8992 <br /> E-MAIL: ahynes@everettwa.gov FAX: 425-257-8882 <br /> I am a duly authorized agent of the applicant.As part consideration for the permission to use the above described Port of Everett facility; <br /> the applicant and I agree to comply with all Public Meeting Space Policies and Procedures as set by the Port of Everett. Further, to the <br /> extent permitted by law,the applicant and I do hereby agree to release, indemnify and forever hold harmless the PORT OF EVERETT, its <br /> commissioners, directors, officers, employees, and representatives from all liability, claims, losses, damages, or expenses (including <br /> expense of litigation)resulting from any actual or alleged injury to or death of any person or from any actual or alleged loss or damage to <br /> any property caused by or in any respect resulting from the applicants admittance or activities at the facilities described above. The <br /> applicant and I do hereby agree to limit said activities to the specified facilities and will return the premises in a neat,clean and undamaged <br /> condition and further agree to reimburse the Port of Everett for any damage arising from the applicant's use of said facilities.The applicant <br /> and I agree to abide by all lawful rules, codes, laws and regulations in connection with its use of the said premises.The applicant and I <br /> agree that during the use of the Ports facilities described above,we will not exclude anyone in the participation in,deny anyone the benefit <br /> of or otherwise subject anyone to discrimination because of the person's race,color,national origin,sex,religion,age or handicap. I have <br /> read and understand the foregoing. <br /> APP LICANT/AGENT SIGNATURE: DATE: <br /> PORT OFFICE USE ONLY <br /> USE TYPE: D PRIVATE D COMMUNITY D POE MEMBERSHIP ACTIVITY: D LOW IMPACT D HIGH IMPACT <br /> RENTAL FEE(S): SECURITY DEPOSIT: <br /> MAINTENANCE: A/V EQUIP.: LINENS: GARBAGE: <br /> 7 <br /> 28 <br />