Driver s License (Required) Day Phone Night Phone Cellular/Pager Number Fax Number

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1 Indoor Event Information Responsible Party Applicant Information Application to Reserve City of Sacramento Indoor Facilities Oak Park Community Center 3425 Martin Luther King Jr. Blvd., Sacramento, CA (916) Event # FAX: (916) Name Address Driver s License (Required) E Mail Address City State Zip Code Day Phone Night Phone Cellular/Pager Number Fax Number Company/Organization Name (if applicable) Is this a company event? Yes No Web Address Company Address / City / Zip Company Phone Number Answer All Questions Completely Will you be in attendance at this event? Yes No Are you the responsible party for this event? Yes No IF YOU ARE NOT THE RESPONSIBLE PARTY YOU MUST ANSWER THE FOLLOWING ITEMS: Responsible Party s Name Driver s License Number Address City State Zip Day Phone Night Phone Cellular/Pager Number Fax Number Name of Alternate Contact Person Phone Number Answer All Questions Completely Event Date Day of Week Event Start Time (include set-up) Event End Time (include clean-up) / / *Multiple Dates? (List dates, day of the week and times; attach additional page if necessary) What time will guests arrive? What time will guests leave? Building Oak Park Community Center What type of event are you having? Room (s) Will alcohol be consumed at your event? Yes No If yes, will it be sold? Yes No If your group is having alcohol, it is not allowed outside the rooms you have reserved and not outside the facility. I understand that my event will be shut down if I don t take care of alcohol related issues. (initial). Are you a visual or performing arts agency? If yes, which art? Are you a non-profit agency? Non-profit Number: * Note: You must provide the current non-profit status document with this application. Is this event open to the public? Yes No If open to the public, how will it be advertised? Is this event a benefit to the community? Yes No If yes, how? Is this event an educational workshop or seminar? Yes No Is this event a planning meeting for an upcoming community service event? Yes No Is this a private social function either by membership or private invitation? Yes No What is the maximum number of people you expect to attend? Adults Teens Children Total Will there be amplified sound at your event? Yes No If yes, explain: Does this activity include dancing? Yes No *Note: City noise ordinance hours are 6am 10pm

2 Indoor Event Information continued ***PLEASE BE AWARE, YOU ARE RESPONSIBLE FOR YOUR OWN SET-UP AND BREAKDOWN. (Please initial) Will food be at the event? Yes No Will it be catered? Yes No Will it be for sale? Yes No If not catered, how will the food be prepared or provided? What is the caterer s arrival time? Will you need the use of the kitchen? Yes No *Note: A cleaning/damage deposit will be required if food and/or beverages are served; if decorations are used; or if the stage and backstage area is used. Will you have any need to access electricity? Yes No If yes, explain: Will you be bringing any equipment like coffee pots, TV/VCR, screen, overhead projector, extension cords, and service carts? Yes No If yes, what items? Do you need any City equipment? (Including tables and chairs) Yes No * Note: Our facilities have limited availability of these items. There may be an additional fee for City supplied items. Will money be charged or exchanged? Registration? Tickets? Raffle? Donations? Yes No Explain: Will you need a stage or special lighting? Yes No If yes, explain: Do you need special access for the physically challenged? Yes No Will your guests need to park adjacent to the building (in the parking lot)? Yes No Have you been given a guideline on building procedures and have all your questions been answered? Yes No Have you been given a diagram for room set-up? Yes No If yes, list type of set-up: Initial In case of emergency or for reasons beyond the City s control, the City reserves the right to cancel the scheduled event prior to scheduled use without liability. Refunds will be made if cancellation by the City is necessary. Initial I have read, signed, and received a copy of the cancellation and refund policy. I accept the terms as outlined. In addition, I understand that only after all fees and required documents are turned in, will my reservation be considered approved and finalized. Initial Cleaning and damage deposits are refunded according to the condition of the room after use. Tables must be wiped clean, floors swept, any spills cleaned off the floor decorations taken down and all trash picked up, bagged and taken to the dumpster located outside. Any equipment needed to complete the cleaning of the room may be obtained from the event host that will be on site for the duration of your event. Should your event go past the time on your permit, the overtime will be deducted from your deposit. Any fees paid by check less than 60 days prior to event may delay the refund up to 8 weeks. Note: Cleaning/damage deposit and refunds will be processed within 21 business days after the event cancellation or event provided that the building is cleaned, repaired and restored to its condition immediately prior to the activity. Note: Please state if the refund should be sent to anyone other than the applicant Initial I hereby attest that the forgoing information is true and correct, and that should any of the information be found to be false or should any conduct by myself, participants or guests not be as described in the application; or should any applicable City, State or Federal rules, regulations, codes or laws be violated, said reservation will be deemed null and void and any activity associated with this reservation will immediately cease.. Initial I also agree that I will be financially responsible for any costs incurred by the City for damages to city property; costs associated to any public safety action or enforcement as a direct or indirect result of the event; the recovery of any and all reasonable attorney fees to enforce the provisions of any permit that is issued for the event described in the application; forfeit all fees and deposits as liquidated damages of any costs associated with the enforcement of the provisions of the application or permit or providing false information on the application; pay any costs that exceed deposits or fees already collected by the City for enforcement or provisions related to this application or reservation. Initial The users agrees to fully indemnify, defend, and save harmless, the City of Sacramento, its officers, agents, employees, and volunteers from all actions, liabilities, claims, damages, to personals or property, losses, costs, penalties, obligations, errors, or omissions that may be asserted or claimed by any person, firm, or entity arising out of or in connection with the activities conducted by the applicant, whether or not there is concurrent passive or active negligence on the part of City or City Personnel. This shall be a continuing release and shall remain in effect until revoked in writing. Initial If I, the Applicant, am not the Responsible Party, I represent and warrant that I am authorized to execute this Application on behalf of the Responsible Party. Signature of Applicant Date Authorized Signature: Received/Processed By: Date:

3 BUILDING USE CHECKLIST Oak Park Community Center/MPR 3425 Martin Luther King Jr. Boulevard Individual/Group Permit Date Event Number Total fees due: $ Deposit paid: $ Total line 10 (Payment Summary Sheet) plus Deposit Amounts. Room and Kitchen Balance Due: $ Due Date for fees: Line 10 (Payment Summary Sheet) **ALL FEES ARE DUE BY THE ABOVE DATE.** Paperwork: Facitlity user to initial below (PLEASE INITIAL) Monitor List We will provide a staff monitor. Check in with monitor. Insurance Certificate Proof of Insurance must be on file with your permit. A general liability insurance certificate, for one million dollars, naming the City of Sacramento as additionally insured. For events with alcohol, liquor liability coverage must be stated on the certificate as well. Security One(1) guard per 75 people. Fee is $22.00 per hour. Over 8 hours is considered overtime and the fee is $33.00 per hour. The guard is scheduled 30 minutes before the actual time your guest arrives and 30 minutes after your event ends. Non-Profit Status State of California Non-Profit number required for file. A.B.C. License Must be on file with permit for sale of alcohol. Sale of alcoholic beverages contingent on Police Department's approval and A.B.C. license. Must make initial Contact with: SACRAMENTO POLICE DEPARTMENT South Area 5303 Franklin Blvd. (916) Signature of applicant: Date: Staff representative's initials:

4 (Staff to complete this sheet). Payment Summary Sheet Date Amt Receipt # Check/ Money Order # Cash Fee description *Room Deposit (refundable) *Kitchen Deposit (refundable) * Refund based on rental guideline checklist Line 1 Rental Fee per hour Rooms: A B C D E F MPR 2 X hours 3 Total for Room Fees 4 Kitchen flat fee $50 non refundable 5 Alcohol flat fee $50 non refundable 6 Fundraising fee $50 non refundable 7= Total Lines 3-6 Security Guards $22.00 per hour (regular) / $33.00 per hour (overtime) 8a X (regular) hours 8b X (overtime) hours 9 = Total 10 Total Total lines 7&9 Due Date: (60 days prior to event) Comments

5 Insurance Liability Coverage Requirements For Indoor Events The City of Sacramento requires anyone holding an event at a City facility to provide verification of general liability insurance in the amount of $1 million. A certificate of Insurance must be presented to the reservation office at Oak Park Community Center, 3425 Martin Luther King Jr., Blvd., Sacramento, 60 days prior to your event date. This certificate may be obtained through your personal insurance company*. If you do not have a personal insurance you can purchase insurance thru the City of Sacramento Risk Management Division at 915 I Street, 4 th Floor, Sacramento, CA , Phone: (916) , Fax: (916) *If you are obtaining insurance your personal insurance company, it is imperative that they contact our Risk Management Division to ensure that all requirements have been met. The standard proof of insurance is the Acord certificate form. A sample is attached. Coverage verification provided on an insurance company s Certificate form is also acceptable. Following are the requirements for proof of insurance: The name of the insured, the insurance carrier, the policy number and coverage limits must be stated on the certificate of insurance as well as the effective and expiration dates for the coverage. An endorsement specifically naming The City of Sacramento, its officials, agents, If alcohol will be served, a liquor liability endorsement is also required. The certificate holder will be: City of Sacramento Risk Management Division, 915 I Street, Fourth Floor, Sacramento, CA A second page, known as the Additional Named Endorsement must accompany the Certificate of Insurance. (The endorsement page is often referred to as page CG ) Name and address of the facility you are using (Oak Park CC, 3425 Martin Luther King Jr., Blvd., Sacramento, CA 95817) Date(s) and times of your event Permit/Reservation Number Note if alcohol is being served (Certificate of Insurance must state that alcohol is covered under the policy). Proof of insurance must be filed with the Risk Management office at least one week prior to the event, unless other arrangements have been made. INITIAL

6 CANCELLATION AND REFUND POLICIES ALL CANCELLATION NOTIFICATIONS MUST BE IN WRITING. Cancellation notifications can be faxed, ed, brought in person or sent USPS mail. It is the responsibility of the customer to make sure the cancellation notification has been received by the community center at which the reservation was made. Once a Facility Booking has occurred, the following fees and charges will be assessed for cancellation: SMALL & MEDIUM ROOMS NOTE: Final payment for small & medium rooms due no later than 10 days prior to the event date. A $25 cancellation fee will be retained for all small & medium rooms cancelled, in writing, 10 or more days in advance of the event/use date. If a small or medium room rental, is cancelled LESS than 10 calendar days, prior to the date of use, an additional penalty fee of $25 will be retained. (Total Fee $50.00) LARGE & X-LARGE ROOMS A $175 cancellation fee will be retained for all large & x-large room cancellations, if written notification Is received more than 50 days in advance of the reservation date. A $350 cancellation fee will be retained for all large & x-large room cancellations, if written notification Is received more than 30 days and up to 50 days, in advance of the reservation date. If written notification is not received at least 30 calendar days in advance, the customer will be liable (charged) for the total cost of the rental. NOTE: Large & X-Large Room reservations, made less than 30 days in advance, are expected to be paid in full at the time of booking. Should the event be canceled, fees are non-refundable. I have read, received a copy of and agree to the term of cancellation and refunds outlined in this policy. SIGNATURE: DATE:

7 FACILITY RENTAL INFORMATION All Building Use Applications must be completed in advance (at least 10 working days). No requests or holds will be made over the phone. Completion of the Building Use paperwork is required for all usages. Rooms are reserved on a first come, first served basis. For fee-based rentals, a $ or security/cleaning deposit must be submitted with your completed application, or you may pay in full at that time. All applications are pending and represent only a temporary hold. Your application will be reviewed and any questions will be directed to the contact person. Full payment must be submitted no later that 60 days before your event. Due dates for all your supporting documents will be listed on your Building Use Checklist. It is the customer s responsibility to follow up on their application status. In requesting use of our facility, you must ask for ALL the time you need, including set-up, decorating and cleaning time at the end. You will not be allowed into the room before your permit time. Make sure to allow ample time for decorating and set-up, as well as take down and clean-up; because, you are financially responsible for all the time used. We will do a basic table and chair set-up for you, if a diagram is provided at least thirty (30) days prior to your event. Specialty set-ups will required additional fees and Center Supervisor approval. This facility does not allow rented tables and chairs, customers must use the center equipment. All events and music must end at midnight. Individuals renting the center until 12:00 a.m. MUST be checked out no later than 1:00 a.m. All rentals require a 4-hour minimum rental time. The Oak Park Community Center is NOT AVAILABLE for open to the public, pay at the door dances, concerts or parties. RENTAL FEES: Multi-Purpose room ( guests) $ per hour Cleaning Deposit (no alcohol rate) $ Cleaning Deposit (event with alcohol) $ No Kitchen available for MPR Rentals.Must use caterer Room A/B ( guests) $ per hour Room A (50-75 guests) $ per hour Room B (50-75 guests) $ per hour Cleaning Deposit (no alcohol rate) $ Cleaning Deposit (event with alcohol) $ Room C/D (50-75 guests) $ per hour Room C (30-40 guests) $ per hour Room D (30-40 guests) $ per hour Cleaning Deposit (no alcohol rate) $ Cleaning Deposit (event with alcohol) $ Kitchen Use (in conjunction with an activity rental only) $ flat fee Cleaning Deposit Kitchen $ Alcohol Beverage Surcharge $ flat fee Fundraising Surcharge $ flat fee

8 GENERAL GUIDELINES The Oak Park Community Center requires that all persons using our facility read and understand the following items as they relate to center rental/usage, and you need to be aware of them as you plan your event. Review this list to make sure you are familiar with the guidelines that govern the operations at our center. Please feel free to make additional copies for your designated adult monitors, and catering crew. In order for your deposit to be returned, you must adhere to the following guidelines. Failure to complete any item will result in the loss of your facility deposit. Please initial the following guidelines in order to indicate your acceptance and understanding: Alcohol consumption by any person under the age of 21 years NOTE: In order to serve alcohol at your event, we require certain paperwork to be in place. If you do not have the necessary paperwork on file, you will not be able to have alcohol on the premises. If for some reason, we are made aware that there is alcohol being consumed, you will be asked to remove it from the premises or have it removed by one of your representatives. The City of Sacramento, Oak Park Community Center reserved the right to entirely close down an event of alcohol violations. Loitering in the parking lot and outside of the Community Center Anyone consuming alcoholic beverages outside the designated room in the Community Center, in vehicles, in parking lot or in area around the Community Center. Alcoholic beverage containers found in Community Center parking lot area or area around the Community Center Garbage not taken out and dumped correctly Alcoholic beverage containers found in Community Center parking lot Lack of cleaning rooms, floors, spills, tables, lobby and patio areas Disregarding City of Sacramento building regulations Fighting or any other physical violence Vandalism or damage to building or building contents Police or Fire responding to non-medical emergencies Threatening City or security personnel Falsifying application or any required documents Theft of City of Sacramento property Over maximum capacity of reserved room or attendance listed on application Uncontrolled exits and entrances Smoking on City property Fire alarm being activated Event exceeds time reserved on contract Any form of criminal activity, (i.e. illegal drugs) Garbage left in building, parking lots and bathrooms As a reminder, you are responsible for the behavior, actions, etc., of all the people attending your event. You are responsible for your own event set-up and breakdown. Please do not drag the tables and chairs on the floor when moving them. NO TAPE, PINS OR DECORATIONS ARE ALLOWED ON THE WALLS. The motion detectors in the ceiling are sensitive. A $50.00 charge will be deducted from your deposit if any balloons are left floating on the ceiling after your event.

9 Pursuant to City of Sacramento code no banners, signs, or sandwich boards will be allowed to be posted on City property to advertise your event. GENERAL GUIDELINES (continued) Rooms must be left free of debris, mess, spills and stains. Please check out the Building Monitor will at the end of your event. No animals are allowed inside the center, except those assisting persons with disabilities. No bicycles are allowed in the building. Please lock bicycles outside. No smoking in ANY public facility. (City Ordinance #67-022). KITCHEN INFORMATION (PLEASE INTITAL) The stove and ovens are for re-heating and warming only. Absolutely no grilling or frying of any kind is allowed. Bring all your utensils and kitchen equipment. We do not furnish these. Always use the ice machine scoop (provided) and never place anything directly In the ice machine. Sanitation rules apply at ALL times! As the permit holder/contact person, you will be the individual our Building Monitor looks for, if any sort of a situation or problem occurs. We hope nothing will happen to bring a negative light to your special event and it is better to have a plan of action in place, just in case. If an individual gets out of hand, and cannot be controlled by members of your group, the Building Monitor has been instructed to call the Center Supervisor and the Park Safety Police. I, have read and received a copy of these guidelines. By signing this agreement, I take full responsibility for enforcing these rules during the course of my event. I realize that violation of the above rules will result in forfeiture of my deposit and may also incur additional fees and/or my event/activity being closed down early. I am aware that I will receive my deposit (if applicable) at the address listed on my application 3 to 4 weeks AFTER my rental. Requestor s signature: Date: Processed by: (Staff Signature) Date:

10 Oak Park Community Center Cleaning Agreement It is the permit holder s job to do a thorough clean up of the areas used during the activity. This includes the lobby and restroom areas. We suggest cleaning as you go, not waiting until the end of the event to start cleaning everything. You are required to do the following: Rental Room(s) (All equipment has been left in the same condition as it was received). ALL TABLES AND CHAIRS have been wiped clean of food, drink and debris. REMOVE ALL tape from tables, chairs and walls. SWEEP AND SPOT MOP the floor to eliminate debris, food, spill, and stains. REMOVE ALL decorations, including the balloons you can safely reach. If there are more than 10 balloons on the ceiling at the end of your event, a fee of $1.00 per balloon will be deducted from your cleaning deposit. REMOVE ALL garbage. Take all garbage to dumpster area. RESTROOMS and LOBBY areas have been checked and they are clean and tidy. Kitchen (if applicable) Remove all your items from the refrigerator. Wipe out any spills. Remove all utensils, serving dishes, beverages and food items. Wipe down and clean all stainless steel areas( sinks, counter tops and cabinet fronts.) Wipe the Microwave clean both inside and outside. Spot mop the floor to eliminate spills and food stains. As the permit holder/contact person you will need to do a walk-through of the center with our City Building Monitor. If you have an event coordinator or a clean-up committee, please share these guidelines with them. They will be responsible in your absence. **You should receive a full refund of your security deposit, if you have stayed within you time frame, there is no damage or excess mess, and all of the above condition have been met. The Center Supervisor will review the center and make a final decision regarding your refund.** I,, the PERMIT HOLDER/CONTACT PERSON have read and understand these (print your name) requirements for use of the Oak Park Community Center. SIGNATURE: DATE:

11 REQUIREMENTS FOR SERVING OR SELLING ALCOHOL The City of Sacramento considers an event to include alcohol if beer wine, champagne and/or hard liquor is being used in any of the following ways: for a toast, furnished on the tables, served to guests or sold to attendees. To have any form of alcohol in the Oak Park Community Center or on City property requires advance notification (disclosed on the permit) and several additional items. The additional paperwork items we require MUST be given to us 4 weeks before your event. Failure to submit the necessary documents on time will change your event to NON-ALCOHOL. On-site violations will result in event closure by the Center staff and the Sacramento Police Department. All events including alcohol require the following: Alcoholic Beverage Surcharge $ flat fee Security Deposit $ At an additional cost to the permit holder, we also require: A Certificate of Liability Insurance with Liquor Liability coverage, in the amount of $1,000, (one million dollars). The Certificate must name the City of Sacramento, Oak Park Community Center additionally insured. The certificate must clearly state the type of event and that liquor liability is included in the coverage. Park Safety will evaluate the event and notify us of the Security Cost. It is a customer s choice to have alcohol. In order to serve alcohol at your event, we require the above paperwork. If you do not have the necessary paperwork on file, you will not be able to have alcohol on the premises. If for some reason, we are made aware that there is alcohol being consumed, you will be asked to remove it from the property or have it removed by one of your representatives. As the permit holder you need to make this clear to your guests. The City of Sacramento, Oak Park Community Center reserves the right to close an event down early for alcohol violations. It is a misdemeanor to sell, furnish or give alcohol to any person under the age of 21. It is misdemeanor to sell, furnish or give alcohol to an obviously intoxicated person. An alcoholic Beverage Control (A.B.C.) Permit is required if you plan on selling alcohol. Selling alcohol is considered fund raising and your group must have made prior arrangements and received written approval from the Center Supervisor. Your group must also be recognized by the State of California as a non-profit organization. A copy of your organization s non-profit status, showing the actual number, is required as well. I,, the PERMIT HOLDER/CONTACT PERSON have read and understand these (print your name) requirements for serving or selling alcohol at the Oak Park Community Center. SIGNATURE: DATE: