Special Event, Race, Public Assemblage Checklist

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Special Event, Race, Public Assemblage Checklist *Completed and signed application January 2017 version *Description of event *Map of event and/or address - If streets are to be closed, provide list of streets names List of Food Vendors, with Chester County Health Dept. licenses (if applicable) List of Subcontractors with Insurance Certificates (if applicable) - All subcontractors need to have a certificate of insurance naming the Borough of West Chester as additionally insured Borough Services requested - Will be reviewed by the Borough s Departments *Applicant Certificate of Insurance - Applicant s Certificate of Insurance needs to name the Borough of West Chester as additionally insured *Application fee (cash, check, or money order) - Application fee is NON REFUNDABLE *West Chest Police Dept. fees (due when application is submitted for all Runs/Races) Public Transportation approval verification (SEPTA, TMACC, and/or Krapf s Buses) - Required if public streets/roads are being closed PLCB Permit (if applicable) *All items marked with * must be included with your application. If any of these items are not included, your application will be considered incomplete and will be returned to you

Special Event, Race, Public Assemblage Permit 2017 January 2017 version *SUBMITTING AN APPLICATION DOES NOT GRANT THE APPLICANT A PERMIT OR PERMISSION TO HOLD AN EVENT. *All applications and application fees MUST be submitted 45 days prior to your event date. NO EXCEPTIONS *West Chester Police Dept. fees are due when application is submitted for ALL RUNS/RACES *An application fee of $250.00 is required with all event applications *An application fee of $50.00 is required with all block party applications Application fees are NON REFUNDABLE Applicant Information Name of applicant/group/org. Date applications was submitted to the Borough Main Contact Name: Home/Cell phone: Email: Billing address: Day of Event Contact & Cell Phone (if different from above) Non-Profit Organization YES NO (if yes, please attach current verification of 501 (c) (3) status) Event Information Name of event Date/s of event and times Set up and breakdown times for event Description of event (use separate sheet of paper if needed)

Event info cont d Type of Event: Walk/Run Parade Block Party Festival Film March/Rally Other (if other, explain below) Event Location Use the attached map to provide event location/address Address - List all street closures, on a separate sheet of paper, in addition to the attached map. Will your event cause delays or alternate routes for Public Transportation? YES NO If yes, you are required to submit proof of notification from SEPTA and/or TMACC SEPTA 215-580-7800 http://www.septa.org/cs/ask/ TMACC (Transportation Management Authority of Chester County) 610-993-0911 http://www.tmacc.org/public-transportation/ Total number of expected participants and/or attendance? Total number of workers/volunteers/marshals for event? Will your event have food vendors, food trucks, or caterers? YES NO If yes, you will need to provide a list of all food vendors with a copy of that vendor s Chester County Health Dept. yearly license or Temporary Event License specific to your event. 610-344-6000 http://www.chesco.org/2652/temporary-events - All food vendors are required to provide a certificate of insurance naming the Borough of West Chester as additionally insured Will you event have crafters, non-crafters, or information booths? YES NO If yes, how many vendors do you plan on attending? List (on a separate sheet of paper) any/all subcontractors or 3 rd party companies hired to help run the event (Examples - port-o-potties, trash removal, fencing, sound, inflatables, etc.) - ALL subcontractors need to provide proof of insurance with a certificate of insurance naming the Borough of West Chester as additionally insured and must be properly endorsed.

Event info cont d Signature of applicant: x Date: Applicant, for itself and its successors and assigns, hereby agrees to reimburse the Borough for reasonable attorney fees/costs of suit that it incurs, indemnify, and hold harmless, the Borough, and its officers, supervisors, employees, attorneys, successors and assigns from and against losses, liabilities, claims, demands, causes of action, damages, costs, including reasonable attorneys fees, and expenses of every kind and nature, whether or not covered by insurance, arising out of, resulting from or caused by, in whole or part, any negligent act, error, omission or willful misconduct on part of Applicant, its agents, employees or subcontractors in connection Applicant pursuant to this Agreement, including but not limited to, those in connection with loss of life, bodily injury, personal injury, damage to property, contamination or adverse effects on the environment, any liability for fines, fees or penalties for violations of any statutes, ordinances, codes, rules, regulations or standards applicable to the services performed by Applicant, its agents, employees or subcontractors (hereinafter Acts and/or Omissions ). These obligations contained within this Section shall survive the termination of this Agreement. Notwithstanding anything to the contrary as may be contained above, the Applicant shall reimburse the Borough for reasonable attorney s fees/costs of suit that it incurs in defending any suits or claims attributable (as determined by a Court of competent jurisdiction) to any Acts and/or Omissions.

Check ALL that apply: Borough of West Chester Services Requested Police Security Police Traffic Control Police Traffic Diversion Public Works Road Closures Public Works Waste Removal Parking Dept. No Parking Notifications Public Works Street Sweeping *There is a fee associated with ALL Borough of West Chester services. The Borough of West Chester, in its sole discretion, shall determine the type and level of services and equipment needed to support the event. The Borough will deny the application or require the applicant to use and pay for the Borough s services. BELOW FOR OFFICE USE ONLY Date Received: Initial Checklist complete: YES NO Reviewed by Parks, Recreation, & Special Events Dept. Date: Notes: Reviewed by Public Work YES NO N/A Approved: Reviewed by Parking Department YES NO N/A Approved: Reviewed by West Chester Police Department: YES NO N/A Date: Notes: Police approval signature: Date: Application Denied/Reason: YES NO

Borough Council Approval: Date: Important Information and FAQs - Applicant is responsible for payment, in full, for all Borough of West Chester services provided. o Approved permits will not be issued without receipt of payment in full. o The Borough of West Chester will accept cash, cashier s check, or money order o Checks and money orders should be made payable to Borough of West Chester 401 E. Gay St. West Chester, PA 19380 - All applications will be reviewed by the necessary Borough of West Chester departments. Recommendations will be made for approval or denial based upon several qualifying factors including, but not limited to: o Whether event will substantially interrupt the safe and orderly movement of traffic o Whether the event will require the West Chester Police Dept. to provide safety for the event and the number of officers deemed necessary to adequately service the event and whether the event will prevent the Borough from providing adequate police services to the remainder of the Borough and to East Bradford Twp. o Whether the event will otherwise interfere with or be a detriment to the general health, safety, and welfare of the Borough o Only one Special Event application will be approved on any one given day in the Borough of West Chester - How long does the review/approval process take? o Review is dependent upon the size, time, date, and scope of your event. It may take several weeks for all Borough departments to review each application. - What is an Event or Public Assemblage? o A preplanned single event or series of events that, because of its nature, interest, location, promotion or combination of similar influences, is expected to draw a large number of people, proposed to be held on public property, or on private property but impacting public property or roadways, and/or requiring the use of public support services, for the purpose(s) of entertainment, celebration, amusement, cultural recognition, arts and craft displays and/or

sales, special sport competition(s), block parties or similar activities generally considered entertainment or recreational in nature. - All runs/races are required to use the services of two (2) West Chester Police Department Officers for their race/run for a minimum of three (3) hours. o Each officer is to be compensated at a rate of one hundred and fifty dollars ($150.00) per hour o Payment for police services needs to be separate from the application fees and is due when the application is submitted o If the West Chester Police Dept. cannot provide one or both officers a refund will be provided to the event organizer listed on this application - All running events are required to use a race sweeper. The task of the sweeper is to trail the slowest participants of the race from start to finish. No marshal/volunteer is to leave their post/intersection until the race sweeper has passed their intersection and informed them that all race participants are clear of the course at their location. - No special event, race, or public assemblage shall start earlier than 8am and must conclude by 10pm. - All run/race marshals are required to have a current PA Driver s license - All event signage and equipment needs to be removed from the event grounds by the end of the event day - Every applicant shall provide as part of the application, a certificate of insurance naming The Borough of West Chester 401 E. Gay St., West Chester, PA 19380 as additionally insured o Minimum amount of coverage required is as follows: o General Liability: $1,000,000 per occurrence/$2,000,000 Aggregate o Auto Liability: $1,000,000 Combined Single Limit o Workers Compensation and Employers Liability: Statutory/$1,000,000 o Professional Liability: $1,000,000 Per Occurrence - Applications for events that involve alcohol served, purchased, or sampled will be considered on an individual basis. If applying for an event that involves alcohol the applicant is required to have an approved Special Occasion Permit (PLCB-1229). o www.lcb.state.pa.us o Alcohol is not permitted in any Borough of West Chester park o Additional costs and police coverage will be required for events involving alcohol - All events are required to abide by all Borough of West Chester codes and ordinances unless special exemption has been approved by Borough Council - ALL approved event applications are subject to change by the Borough of West Chester at any point in time leading up to and during the event

Emergency Services Contact Info Borough of West Chester Police Department Ph: 610-696-2700 website: http://www.west-chester.com/183/police-department Chester County Department of Emergency Services Ph: 610-344-5000 Fx: 610-344-5050 website: eoc-pio@chesco.org Good Fellowship Ambulance and EMS Ph: (610) 431-3132 website: http://www.goodfellowship.com/ Fire Departments West Chester Fire Chief Mike McDonald Email: wcfirechief@west-chester.com First West Chester Fire Co. #1 Ph: 610-431-1580 website: http://firstwestchester.org/ Good Will Fire Co. #2 Ph: 610-431-4366 website: http://goodwillfireco.org/ Fame Fire Co. #3 Ph: 610-431-7565 website: http://famefireco.org/

2017 Special Event, Race, Public Assemblage Fee Schedule January 2017 version When the Borough of West Chester deems that public services are required for your event, race, or public assembly the following fee schedule will be enacted. Personnel West Chester Police Officer with vehicle - $150.00 per hour per officer (minimum 3 hours) -All runs/races in the Borough of West Chester, on public streets/grounds will require at least two West Chester Police officers, with vehicles, for a minimum of three hours West Chester Police Officer w/ bicycle - $125.00 per hour per officer (minimum 3 hours) West Chester Police Officer- $100.00 per hour per officer (minimum 3 hours) West Chester Public Works Department - $50 per hour per man (minimum 3 hours) West Chester Fire Police - $30.00 per hour per officer (minimum 3 hours) West Chester Parking Department (Postings) - $30.00 per hour per officer (Number of personnel to be determined by the individual departments of the Borough of West Chester) Equipment Orange cones - $1.00 per cone Two orange cones and horizontal bar (blockade) - $5.00 per Road Closed free standing sign - $10.00 per sign

Trash and/or recycling receptacles - $2.00 per Parking meters - $21.00 per day per meter (5 hours or more) - $11.00 per meter, less than 5 hours per day *Any lost and/or damaged equipment will be replaced by the permit holder at the Borough of West Chester s costs. * Payment for all Borough of West Chester personnel, services, and equipment (otherwise already not specified) is due no later than five days prior to your event. If payment is not received by the Borough your event can be canceled.

West Chester Police Department 401 EAST GAY STREET WEST CHESTER, PENNSYLVANIA 19380 TELEPHONE: 610-696-2700 SCOTT L. BOHN Chief of Police SAMUEL J. IACONO Lieutenant FBINA 186 Special Duty Police Coverage Agreement to Pay Fees In order to process your request for Police Coverage at your event, please complete the information below and return to the West Chester Police Department, Attn: Staci King, 401 East Gay Street, West Chester, PA 19380 or via email to sking@west-chester.com. Please call 610-436-1323 with any questions. Payment of fees is due no later than 5 days prior to event. (All Races must pay fee at time of application) Name of Organization: Event Date: Name of Event: Name of person responsible for payment of fees: Address: Start Time: Contact Person: End Time: Contact Phone: Number of Police Officers Requested: (Please note: Special Duty Police Coverage is invoiced at a minimum of 3 hours per officer) I,, certify that I am requesting Police Coverage for the event listed above and that I am authorized to do so on behalf of the organization. I am aware that Police Coverage for this event is invoiced at $150.00 per officer, per hour, with a 3 hour minimum for all events. (*Events that take place on a Holiday are billed at Double Time rate) Print Name Date Signature *Holidays: New Year s Day, President s Day, Good Friday, Easter Sunday, Memorial Day, July 4 th, Labor Day, Columbus Day, Thanksgiving Day, Christmas Day