Department of Parks, Recreation & Cultural Arts P.O. Box 229045 Hollywood, Florida 33022-9045 SPECIAL EVENTS APPLICATION CITY OF HOLLYWOOD CODE OF ORDINANCES, CHAPTER 102 Any person or organization desiring to hold a special event shall make application for a Special Events Permit to the Director. Such application shall be accompanied by a non-refundable application fee (see page 5). The fee shall be in the form of cashier s check or money order made payable to the City of Hollywood. RATE SCHEDULE The rate schedule for Special Events fees shall be established by resolution of the City Commission. Today s Date: Name of Proposed Event SECTION 1: Promoter Information Sponsoring Organization /Enter ALL information as it appears on www.sunbiz.org Status of Organization: For Profit Not for Profit Individual Other Name President /CEO Address City State Zip_ Phone ( ) Fax ( ) Applicant Name /Position within Organization Name Position Phone ( ) Fax ( ) Cell ( ) E-Mail Please describe your special event experience and the experience of the sponsoring organization in producing events. List events affiliated with in the past. Please list two (2) professional event related references: Name: Address: City: State: Zip Code: Phone: 1
Name: Address: City: State Zip Code: Phone: SECTION 2: Event Details & Requirements REFER TO PAGE 4 FOR RECOMMENDED TIMELINES TO ACCOMMODATE EVENT APPROVAL. Requested Location (Requests for use of City Property are subject to daily site fees in accordance with schedule of fees and charges) Requested Date(s) Alternate Date(s) Hours of Operation: Day 1_ Day 2_ Day 3 Load In Date/Time_ Load Out Date/Time_ Admission/Entry Fee $_ Free By Invitation Only Estimated attendance per day Based on Have you ever held this event before? Yes No If yes, list: Date(s) Location(s) List event sponsors Please list all bands, genres, emcees, speakers that are scheduled to appear: (Mark all applicable) Acoustic Amplified Classical Latin R&B Rock Pop Jazz DJ Other Is the proposed event a New Event Re-Occurring Event Describe the event and its goals Characteristics of proposed event (Mark all applicable) Festival Parade Carnival Private Party Sports Event Concert 5K Walk/Run Fireworks Commercial Vendors Handcrafted Art /Merchandise Sponsors Inflatable Activities / Amusements Other / specify: Note: additional costs /requirements may apply Amphitheatre Rental Mobile Stage Rental Sound/PA Rental Please describe 2
Will the event include? *The following items may require additional permitting. TEMPORARY STRUCTURES Canopies (without sidewalls) Tents (with sidewalls) Canopies (Without Sidewalls) PROFESSIONAL (FRAME) CONSUMER (POP-UP) Size(s) Size(s) Quantity Quantity Tents (With Sidewalls) PROFESSIONAL (FRAME) Size(s) Quantity CONSUMER (POP-UP) Size(s) Quantity PORTABLE TOILETS / CROWD PLEASER TRAILER Portable Toilet /Contractor STAGE Yes No Provide detailed information BLEACHERS Yes No Provide detailed information ELECTRICITY / GENERATORS Yes No Size(s) Quantity Provide detailed information FOOD / BEVERAGE VENDORS *City of Hollywood Code of Ordinances, CH 122 includes permitting requirements for Mobile Food Dispensing (i.e. food trucks, food trailers, and food carts) and may be subject to additional permits. *Food /Beverage vendors may be required to attend a pre-event meeting with Hollywood s Fire Marshal and Florida Department of Business & Professional Regulation representatives prior to inclusion in a proposed event. Provide Vendor list with food/beverage items proposed to be sold. (Use separate page if necessary) Alcohol /Sampling, Service, Sales Food Beverages /Non alcoholic (Beer, Wine, Liquor) On site food service requires environmentally proper disposal of grease and gray water. Attach a detailed plan including copy of contract with outside vendor. A viable, comprehensive recycling plan must be submitted on a separate page. 3
The City of Hollywood is committed to recycling and requires the event organizer to provide and implement a program that includes containers for garbage, recycling, and their removal with your event. You must present a copy of the recycling plan (contract) with your application. Include the following: Name of the Company The equipment being used The number of garbage containers and sizes being used The number of staff during the event The disposal destination The following items are recyclable material only: Glass - Brown, Green, Blue, Clear Plastics - Number 1, 2, and 3 ONLY Cans - Aluminum and Steel Reserved Public Parking or use of Public Right of Way request? Yes No *Additional charges may apply Specify Street Closures requested. List all, specifying dates and times (attached detailed information). Will animals be present at this event? Yes No *City of Hollywood Code of Ordinances, CH 92.60 Animals Displays or Exhibits, (A) (D). Due to the above referenced City Ordinance, displays of animals on public or private property are restricted to educational purposes only and must adhere to additional permitting requirements. List methods by which you intend to promote this event: Local radio National Radio Local TV National TV Cable TV Local Newspaper National Newspaper Direct Mail/Flyers Internet E-mail Outdoor (billboards) Social Media Other (specify) SECTION 3: Timelines REQUESTS FOR VARIANCES require submittal at least 60 days prior to proposed event date. Examples include: Street Closure, Alcohol Sales on Public Right of Way, Food and/or beverage on the sand. CITY OF HOLLYWOOD and DEPARTMENT OF ENVIRONMENTAL PROTECTION permits require submittal at least 30 days prior to proposed event date. Examples include: Building Permits, Mobile Food Vending, Events on the beach. 4
SECTION 4: To be included in the application packet submittal Completed, Signed Application Special Event Application fee: (90+ days prior to event date) $318.00 ($300 + $18 tax) $210.00 Non-Profit $222.60 Non-profit + tax ($210 + $12.60 tax) (45-90 days prior to event date) $450.00 ($425 + $25.50 Tax) $297.50 Non-Profit $315.35 Non-Profit + tax ($297.50 + $17.85 tax) (30-44 days prior to event date) $583.00 ($550 + $33 Tax) $385.00 Non-Profit $408.10 Non-Profit + tax ($385 + $23.10 tax) **NON-PROFIT ORGANIZATIONS must submit a copy of the 501(c) (3) and a State of Florida Tax Exempt Certificate with the application to receive the 30% discount. If you are a non-profit organization but not tax exempt, you will need to provide proof of non-profit status in order to receive the non-profit discounted rate; taxes will apply. Executed Indemnification Agreement Site plan showing the layout of the event. The site plan must include the location of booths, rides, stages, canopies, parking lots, gates, fencing, portable rest rooms, and ADA seating areas. Preliminary event budget. Commercial General Liability General Aggregate $1,000,000 Each Occurrence $1,000,000 Fire Damage $ 50,000 City of Hollywood, PO Box 229045, Hollywood, Florida 33022 named Certificate Holder and Additional Insured. The insurance coverage shall be for any and all associated activities related to the event. Said certificates of insurance will be reviewed and approved by the City s Risk Management Division. $1,000 Refundable damage deposit / clean up bond When the proposed event is to be held within 500 feet of a residential property, the sponsors or operators of the event must submit written waivers of objection for the event from at least 80% of the property owners. *It is the applicant s responsibility to determine affected properties and self-survey or hire a third party to facilitate the waivers of objection. The information I have provided in this application is true and complete to the best of my knowledge. I have read and understand the accompanying materials. I understand that I (the applicant) am financially responsible for all aspects of this event. Signature Date Title 5
INDEMNIFICATION AGREEMENT THIS INDEMNIFICATION AGREEMENT made and entered into this day of, 20, among the City of Hollywood, Florida, a municipal corporation of the State of Florida ( City ), and the City of Hollywood, Florida, Community Redevelopment Agency ( CRA ) and ( Vendor ). I,, Vendor or Company Name individually and/or as the agent of the Vendor performing Service performed or Product being sold ( Services ) do hereby agree to indemnify and hold harmless the City, and CRA, their officers, agents, employees and contractors from and against any and all loss, damage, claim, demand, liability or expense by reason of any damage or injury to property or person which may be claimed to have arisen as a result of or in connection with the occupancy or use of said premises by Vendor performing Services. During the conduct of a at Name of Event on the date(s). Location of Event Such obligation to indemnify and hold harmless shall continue notwithstanding any negligence or comparative negligence on the part of the City and/or CRA relating to such loss or damage and shall include all costs, expenses and liabilities incurred by the City and/or CRA in connection with any such claim, suit action or cause of action, including the investigation thereof and the defense of any action or proceeding brought thereon and any order, judgment or decree which may be entered in any such action or proceeding or as a result thereof. These provisions shall survive the expiration or earlier termination of the use of premises. Nothing in this Agreement shall be construed to affect in any way the City nor the CRA s rights, privileges, and immunities as set forth in Florida Statutes section 768.28. Signature Title Print Name Daytime phone number Email Address (Please Print) Address City State Zip code APPROVED AS TO FORM & LEGAL SUFFICIENCY For the use and reliance of the City of Hollywood, Florida, and The City of Hollywood, Florida, Community Redevelopment Agency only. DOUGLAS R. GONZALES, CITY ATTORNEY 6