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Special Event Application

2. City of Eloy

4. 595 N. C Street, Suite 104 Eloy, Arizona 85131

   595 N. C Street, Suite 104 Eloy, Arizona 85131

5. P: 520-466-9201 / F: 520-466-3161

   P: 520-466-9201 / F: 520-466-3161

7. Special Event Application

   Special Event Application

9. Fees
   Application Fee: $10.00 Permit Fee: $20.00 Non-Profit: $0.00 *A deposit is not required unless the applicant does not clean-up after their event and/or damages City property.

   Application Fee: $10.00 Permit Fee: $20.00 Non-Profit: $0.00 *A deposit is not required unless the applicant does not clean-up after their event and/or damages City property.

11. Please Note:
    THIS DOCUMENT MUST BE FULLY COMPLETED OR IT WILL BE RETURNED. APPROVAL OF THE APPLICATION SHALL BE WITHIN THE DISCRETION OF THE CITY OF ELOY, BASED UPON SUCH CONSIDERATIONS DEEMED APPROPRIATE, INCLUDING BUT NOT LIMITED TO HEALTH AND SAFETY CONSIDERATIONS OF THE ATTENDEES, THE SURROUNDING COMMUNITY, AND ZONING.

    THIS DOCUMENT MUST BE FULLY COMPLETED OR IT WILL BE RETURNED. APPROVAL OF THE APPLICATION SHALL BE WITHIN THE DISCRETION OF THE CITY OF ELOY, BASED UPON SUCH CONSIDERATIONS DEEMED APPROPRIATE, INCLUDING BUT NOT LIMITED TO HEALTH AND SAFETY CONSIDERATIONS OF THE ATTENDEES, THE SURROUNDING COMMUNITY, AND ZONING.

13. Name of Business/Organization/Individual Sponsoring Event:*

14. Non-Profit I.R.S. Tax Exempt Number/Tax I.D. Number*

16. Sponsor's Address

17. City

18. State

19. Zip

21. Sponsor's Phone Number

22. Driver's License Number

    If Sponsor is individual

23. State

25. Name of the event:*

27. Provide detailed description of event:*

29. Location of the event*
    -- Select One --Central (Main Street) ParkEloy Memorial ParkJones (Little League) ParkNorth Toltec ParkShumway (North) ParkTrekell ParkOther (specify under other location)

30. Other Location

32. Property Owner:

34. (Attach written permission of the property owner if the location includes any private property. Include phone number, address and any other contact information.

    (Attach written permission of the property owner if the location includes any private property. Include phone number, address and any other contact information.

36. IF YOU ARE PLANNING TO REQUEST THE USE OF A CITY FACILITY (PARKS, POOL, RECREATION FACILITIES) AND USE OF ELECTRICITY, OR RENTAL OF CITY EQUIPMENT FOR THIS EVENT, PLEASE FILL OUT THE CITY FACILITY USE SECTION OF THIS APPLICATION.

    IF YOU ARE PLANNING TO REQUEST THE USE OF A CITY FACILITY (PARKS, POOL, RECREATION FACILITIES) AND USE OF ELECTRICITY, OR RENTAL OF CITY EQUIPMENT FOR THIS EVENT, PLEASE FILL OUT THE CITY FACILITY USE SECTION OF THIS APPLICATION.

38. Information of the person filling out the application:

40. First

41. Middle

42. Last

44. Applicant's Mailing Address

45. City

46. State

47. Zip

49. Applicant's Home #

50. Applicant's Business #

51. Applicant's Fax #

53. Date(s) and Hours of Event:

55. Day of the Week
    -- Select One --MondayTuesdayWednesdayThursdayFridaySaturdaySunday

56. Day 1
    Day 1

57. FROM
    FROM

58. TO
    TO

60. Day of the Week
    -- Select One --MondayTuesdayWednesdayThursdayFridaySaturdaySunday

61. Day 2
    Day 2

62. FROM
    FROM

63. TO
    TO

65. Day of the Week
    -- Select One --MondayTuesdayWednesdayThursdayFridaySaturdaySunday

66. Day 3
    Day 3

67. FROM
    FROM

68. TO
    TO

70. Day of the Week
    -- Select One --MondayTuesdayWednesdayThursdayFridaySaturdaySunday

71. Day 4
    Day 4

72. FROM
    FROM

73. TO
    TO

75. Is the organization using the services of a promoter or other person to manage the event? If yes, attach a copy of the agreement

    1. Yes

    1. No

76. Agreement (PDF Format)

78. Specify the anticipated number of attendees at the event:

79. # of Persons

80. # of Vehicles

82. Specify the anticipated gross revenues from the event:

83. Gross Revenue

85. Will alcoholic beverages be sold and/or allowed at the event?*

    1. Yes

    1. No

87. If "No", what measures will be implemented to ensure that alcoholic beverages will not be brought into the event?*

89. If Yes, will you have the appropriate liquor license required on or before the date(s) of the event?*

    1. Yes
    2. No

    (Failure to provide proof that this or any required permit has been obtained shall result in automatic revocation of a Special Events Permit).

91. What security and control measures will you have in place before, during and after the event? (List type and number of security/police personnel, parking/traffic control measures, and type of fencing and control barriers, if applicable).

    What security and control measures will you have in place before, during and after the event? (List type and number of security/police personnel, parking/traffic control measures, and type of fencing and control barriers, if applicable).

93. # of security/police personnel

95. Parking/Traffic control measures

97. Name of barricade company

98. Traffic Control Plan (PDF Format)

100. Fencing/Control barriers for alcohol sales:

102. Other

104. Approximate number of equipment, commercial vendors and temporary facilities such as stands, stages, seating or game booths, if any, which will be involved in the event; the type of animals, and description of vehicles, equipment and facilities, if any.

     Approximate number of equipment, commercial vendors and temporary facilities such as stands, stages, seating or game booths, if any, which will be involved in the event; the type of animals, and description of vehicles, equipment and facilities, if any.

106. Number of temporary food booths

107. Are booths privately owned?
     -- Select One --Yes No

109. Number of bleachers

110. Are bleachers privately owned or rented from the City?
     -- Select One --Privately OwnedRented from the City

112. Other Equipment:

     Tents, canopies, stage, DJ equipment, generators, etc.

114. Canopy Size

116. State the scope of use of any open flame devices, flammable or combustible liquids or gases. If any fireworks or pyrotechnics special effects materials are planned to be used, state the name(s) of the individual/company directly responsible for their use or operation, listing qualifications and training for such operation or use.

118. A description of the proposed signs to advertise the event, including size, shape, color and location.

120. Flyer Upload (PDF Format)

     Upload your flyer in PDF format here.

122. What provisions have been made for first aid or medical services?

124. What provisions have been made for sanitary facilities?

125. # of port-o-johns

126. # of ADA accesible port-o-johns

128. Location of port-o-johns

     *Port-o-johns cannot be placed on the sidewalk due to ADA accessibility.

130. What arrangements have you made for clean-up during and after the event?

132. Will you require the rental of additional trash dumpsters from the City? If so, select the size in the drop down menu.
     -- Select One --20 yard roll off30 yard roll off40 yard roll off 2 yard front load 4 yard front load 6 yard front load 8 yard front load 95 gallon residential

133. How many containers?

135. Will this event require the closure of streets? If so, please list the intersections and the closure times. (Example: Main Street, from 6th Street - 7th Street, 6:00 a.m. - 5:00 p.m.)

137. Digital signature*

     By clicking "I agree" you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your electronic signature is valid and binding upon you to the same force and effect as a handwritten signature. 3)By agreeing to this special events permit application, the listed applicant agrees to abide by all requirements set forth by Ordinance #02-521, related to special events and shall be held responsible for all aspects of the listed special usage, including any and all special conditions placed on the approval of this special events application by the City. 4)The Event Sponsor agrees to indemnify, defend, and hold harmless the City and its officials, officers and employees from and against any and all claims, losses, liability, costs, or expenses (including reasonable attorneys' fees and costs) arising out of the use of City property in connection with event, including (without limitation) claims involving bodily injury of any person (including death) or property damage. 5)In the event that the City will need to clean up after your event and or repair damaged property, the applicant acknowledges that he/she is responsible for full restitution.

     1. I Agree
139. ATTENTION!
     This special event permit application does not cover licensing for merchandise/food vendors and providing free food to the public. Vendors associated with your event, or individuals providing free food are required to obtain individual licensing as follows:

     This special event permit application does not cover licensing for merchandise/food vendors and providing free food to the public. Vendors associated with your event, or individuals providing free food are required to obtain individual licensing as follows:

141. FOOD VENDORS/FREE FOOD TO THE PUBLIC:
     The Pinal County Health Department inspects and approves all food vending/gifting to the public. The event sponsor is required to contact the health department at 520-866-6864 to coordinate licensing of all food vendor/providers at least 3 weeks prior to the event. In addition, each individual food vendor is required to obtain a vendor permit through the City of Eloy’s Finance Department at 595 N. C Street, Suite 103, Eloy, Arizona 85131, 520-464-3401.

     The Pinal County Health Department inspects and approves all food vending/gifting to the public. The event sponsor is required to contact the health department at 520-866-6864 to coordinate licensing of all food vendor/providers at least 3 weeks prior to the event. In addition, each individual food vendor is required to obtain a vendor permit through the City of Eloy’s Finance Department at 595 N. C Street, Suite 103, Eloy, Arizona 85131, 520-464-3401.

143. MERCHANDISE VENDORS:
     Merchandise vendors are required to obtain a vending permit through the City of Eloy’s Finance Department at 595 N. C Street, Suite 103, Eloy, Arizona 85131, 520-464-3401.

     Merchandise vendors are required to obtain a vending permit through the City of Eloy’s Finance Department at 595 N. C Street, Suite 103, Eloy, Arizona 85131, 520-464-3401.

145. THE EVENT SPONSOR WILL BE REQUIRED TO SHOW PROOF OF REQUIRED LICENSING, PRIOR TO APPROVAL OF THE SPECIAL EVENT PERMIT.

     THE EVENT SPONSOR WILL BE REQUIRED TO SHOW PROOF OF REQUIRED LICENSING, PRIOR TO APPROVAL OF THE SPECIAL EVENT PERMIT.

147. USE OF PUBLIC FACILITIES/EQUIPMENT

149. Park Facility
     -- Select One --Central (Main) Street ParkEloy Memorial Park Jones (Little League) ParkNorth Toltec ParkShumway (North) ParkTrekell Park

     Deposit = $100.00 (Refundable deposit)

150. Date/Time requested
     Date/Time requested Start Date

     Date/Time requested Start Time

     —

     Date/Time requested End Date

     Date/Time requested End Time

152. Electricity
     Hourly Rate: $10.00/hr

     Hourly Rate: $10.00/hr

153. Date/Time requested
     Date/Time requested Start Date

     Date/Time requested Start Time

     —

     Date/Time requested End Date

     Date/Time requested End Time

155. Vendor Spaces
     Vendor spaces are no longer available to purchase through the City of Eloy. Applicant must provide their own spaces/booths.

     Vendor spaces are no longer available to purchase through the City of Eloy. Applicant must provide their own spaces/booths.

157. # of Private For-Profit Booths

158. # of Private Non-Profit Booths

160. Equipment
     $50.00 Refundable deposit

     $50.00 Refundable deposit

162. # of Tables

     Tables=$2.00/table

163. # of chairs

     Chairs=$.50/chair

164. Fee

166. Digital Signature*

     All statutes and ordinances of the Federal, State, County and City governments shall be complied with in the use of the parks and recreation facilities. Participants shall adhere to all rules, regulations, policies and procedures with regard to the use of the parks, and other recreational facilities. Prior to the event the City of Eloy Community Services Department will ensure that the park facility is cleaned and prepared for the event. All decorating and clean-up is the responsibility of the permit holder. Park facilities left in unacceptable condition will be cleaned by the Department staff. Cleaning deposits will be returned at the prorated cost of staff cleaning. The consumption of alcoholic beverages is prohibited in public areas. Smoking is not permitted in public facilities. All participants of parks, facilities, and/or equipment usages do so at their own risk. The City of Eloy shall be held harmless of all liability pertaining to injury or accident and/or arising from the participation in permit usage. The City of Eloy retains priority of all parks, facilities and equipment for use of City functions and or/activities. Failure to adhere to permit regulations may result in revocation, City Ordinance 79-164A. By agreeing to this special events permit application, the listed permit holder agrees to abide by all use policies and shall be held responsible for all aspects of the listed special usage. The special events permit must be approved by the Community Services Director upon application of permit.

     1. I Agree
168. SPECIAL EVENT APPLICATION-DIAGRAM OF PREMISES (PDF Format)*

     Special Event Diagram: Use this to upload a site plan and set-up drawing for you special event. The site plan must show property dimensions, adjacent streets, driveways, serving areas, vendor booths, on-site structures/trailers-temporary or permanent, fencing, barricades, closure of streets, location of port-a-johns, location of dumpsters/trash receptacles, security positions, entertainment stages, bleachers/seating, parking facilities, and other control measures. Show nearest cross streets, highway, or road if location doesn’t have an address. Approval of this application by the City of Eloy is conditioned upon applicant obtaining any and all other required permits and licenses, including but not limited to liquor, health, fire, business, right-of-way, temporary use and building. If such required permit(s) are not obtained, approval of this application by the City is deemed withdrawn.

170. Upload the Certificate of Insurance (PDF Format)

     A special event permit will not be issued without a certificate of insurance naming the city as additional insured.

172. City of Eloy Certificate of Insurance Requirements
     Certificate of Insurance Requirements

173. Tenant User Liability Insurance Program
     TULIP Insurance

Leave This Blank:


175. 1. Receive an email copy of this form.
176. Email address

     This field is not part of the form submission.

177. Submit Submit and Print

* indicates a required field