2006/04/12 Council Agenda Packet

1, ' � O�- oe re 4-4- (hereafter referred to as"User"), agree that the information on this 2 C request is true and complete to the best of my knowledge. I further agree to abide by these conditions: 1. The request to Use a School Facility Form, Certification Form, rental/monthly fees,and insurance are due two weeks prior to the first date of the event. 2. Written notice of cancellation must be given at least two weeks prior to the scheduled rental date. 3. Overtime will be billed;charges must be paid within two weeks after the invoice date. 4. If you plan to utilize the kitchen facilities you will need to contact the Food Services Department two weeks prior to your event at (425) 385-4250. 5. The user will be held responsible for costs of repair for damages, as determined by the Everett Public Schools. 6. The user will provide proof of required assets and proposed insurance as follows: A. Limits of General Liability: $1,000,000 Combined Single Limit per occurrence. B. A Certificate of insurance naming the Everett Public Schools as additional named insured must be received by the Everett Public Schools at least two weeks before facility use begins. C. If self-insured, the party must provide proof of insurance coverage acceptable to Everett Public Schools for the purpose of the rental. 7. The following person/organization will be responsible for payment of all charges; NAME TITLE ORGANIZATION ue:e PU bl' L; b r‘-k-e ADDRESS 2Z y 1- R-ue CITYJxnI- STATE L A- ZIP 9 ,z_0/ PHONE (day) .12 7 2'7 e 3 c-7 (eve) FEE$ fNVOICE DUE DATE 8. All usage shall conform to requirements set forth in the Uniform Fire Code. The user shall restrict attendance to the facility's assigned occupant load. Section 4.108 of the U.F.C. states that any candle or open flame used in assembly requires a permit from the Everett Fire Department at (425) 257-8120. A copy of any permit issued must be on file with Everett Public Schools two weeks prior to event. All facility use outside of the City of Everett boundaries shall strictly adhere to section 4.108 of the Uniform Fire Code. Violations shall be deemed a misdemeanor and shall be punishable by a fine of not more than $1,000 or not more than ninety days in jail. 9. The user will be held responsible for supervision and control of all individuals present during the time of the facility use. Animals are not allowed inside Everett Public School facilities. Alcohol, tobacco and firearms/weapons are prohibited on all Everett Public School property. 10. Compliance must be made with all federal, state and local laws prohibiting discrimination with regard to creed, race, color, sex, age, national origin or disability. 11. User agrees to notify the district technician or custodian of any accidents immediately and file a District Accident Report. 12. User is responsible for all copyright or royalty fees associated with this activity. SIGNATURES The user agrees to protect, indemnify,and hold harmless the district, it's elected and appointed officials,employees,agents,staff and volunteers, from any and all claims, liabilities, damages, expenses,or rights of action, directly or indirectly attributed to the users activities and/or use of premises, in connection with this agreement, except for the sole negligence of the district. User Date Confirmation Date (Everett Public Schools) Please return this form,both sides complete to: (for Everett Memorial Stadium and Lincoln Field rentals): (for Everett Civic Auditorium and all other rentals): Everett Public Schools,Athletics Everett Public Schools,Community Services 3721 Oakes Avenue PO Box 2098 Everett WA 98201 Everett WA 98213-0098 Ph:(425)385-4260 Fx:(425)385-4262 Ph:(425)385-40451(425)385-4046 Fx:(425)385-4012 When your agreement has been confirmed, a copy will be mailed to you. Revised 0254/05