2021 day of event schedule july 4th fireworks
TRANSCRIPT
2021 Day of Event Schedule JULY 4th Fireworks
13:00 Watson lake close all vehicles of site.
15:00 Gates open
17:30 Army Ranger Helicopter Repelling (Subject to Deployment)
18:00 Highway 89 shuts to Traffic
19:00 Highway 89 opens to Parking
19:30 ERAU National Anthem Flyover
20:45 Waterslides End
21:00 Fireworks
~------ -· - - -
l·\IR lilHU· l 'SJ' C)1 'l 'i Re,«·iwd: --------
City of Prescott
Recreation Services: Special Events
824 E. Gurley St• Prescott, AZ 86301
(928)777-1552 l 'ni.1ikd..:.
2021 SPECIAL EVENT APPLICATION The City of Prescott reserves the right to approve or deny any application that affects City property or City
right-of-way. Applications must be received no later than 60 days prior to Event Start Date
Incomplete applications will not be processed. If the question does not pertain to your event, please annotate N/ A A non
refundable Application Processing Fee (varies based on the level of your event) will be due upon receipt of application.
Complete application. additional documentation and deposit fees must be received at the Recreation Services Office in the
Grace Sparkes Activity Center, 824 E. Gurley Street, Prescott, AZ 86301, prior to the start of your event, in accordance with
the deadline specified in the Special Event Policies and Procedures Manual. Applications are subject to approval by
meeting with the Special Events Committee. Applicant will not be seen unless all appropriate documents are submitted.
Please remember to print out you r application and attach any additional permits or permit applications included in this
packet that you need for your event. Faxed or emailed applications will not be accepted. Contact Michelle Stacy-Schroeder
at (928)777-1552 or email to: [email protected] with any questions regarding this application.
Section 1. Event Information
Name of Event: Wp{T$.Ot-J \........~ 14. C
Event Organizer:$\" S?\.l\E C:.c:n-'\1--t...c:!l!.
Event Date(s): -:i' v '-'1 Y""' L_o-Z..... \
Description of Event: f°'?:,.."2...~t;)Z."-,S 0-CS-:.t' 1-r.i..'c'
Event Set-Up Date: '""! u'-'l' J , ·"Lo'2-\ ' Event Tear-Down Date: Xu'--i' S' L..o'"L \
I
'
Organizer Contact Number: C'.c LJ'b "Y '1 't -9 6 Y 'Actual Event Times: 3 ~~PM to IO'·OO?M.
14'.-.;.Q C. 'lQµ!Z" , v ·J: p Q ~ C::.'A-12-0t::JV. vc...J.r M LA -C:.C...
' Event Set-Up Time: b'• oo ,..M (Y:-a~o~i&..~ LoA t> ._..,.;')
Event Tear-Down Time_: -~-·-· O_O_A-"-'-t':=\~------*Event Clean-Up: Event clean-up and equipment removal must be completed by 8:00am the day following your event.
This includes, but is not limited to, removal of stages, barricades, fences, portable toilets, other event production
equipment, trash removal, street sweeping, power washing and other clean-up/grounds maintenance stipulations. Signs
and banners must be removed upon completion of your event. If City crews are required to perform any type of clean-up
service due to your event, you will be billed and required to pav for services rendered.
Event Location/ Street Address: \.V Pl'\~01>-l LA Ke PA f2-\.(
Are you the property owner? D Yes ~ Name of property owner where event is to be held:. _ _...;;<...;;...i::..=-~-~'---"""'O ........ F _ _.._f_'2-C ___ -_..,.;._c._o_-r_-r _________ _ NOTE: A letter of permission and approval for this event, signed by the property owner, must he attached to this
application.
*Events held on/around Courthouse Square: If your event is proposed on the Courthouse Square, please contact the
Prescott Downtown Partnership at (928)443-5220 or email to: [email protected] prior to submitting your
application. **For-Profit events will not be allowed on the Courthouse Square** per Yavapai County policv.
*Prescott Regional Airoort: Events proposed at the Prescott Regional Airport are subject to compliance with Federal
requirements including, but not limited to, the Airport Supplemental Application packet available from the Airport
Administration office at 6546 Crystal Lane, Prescott, AZ 86301.
Expected daily attendance: I 0 I ooD Peak attendance: $' ' 0 oo ~--t;~~~~~~~~
(NOTE: The City of Prescott Fire Department is the final authority on medical-stand-by requirements based on
attendance; City of Prescott Police is the final authority on Security requirements based on attendance). If required, an
estimate of cost will be provided to you
0Yes Has this event ever been held at other location(s)?
If yes, where and when? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-
Will there be an admission charge? 0No
Section 2. City Facilities/City Utilities Note: Events on City property require use of City trash/recycling
Services. Per City Code 2-13-23, no person or entity shall collect and transport or cause to be transported, any solid
waste, on or along any public street or alley in the City without such person or entity obtaining and maintaining a solid
waste license from the City of Prescott.
Will you be using City Sanitation Services? (Fees Will Apply)
Phone Number ~~~~~~~~~-
If no, name of company ~~~~~~~~~~~~~~~~-
1'°1oVO C...:,µ '1 ~ S > kW\.E <::::,Per< A":> '2.-0 \CJ\
Quantity: Type: Size: Frequency of collection: (ZS *Events at Prescott Mile High Middle School using City Sanitation must have dumpsters, cans, etc. JiCk;d up on Sunday
Will City water connections be needed? Subject to fees
and fees will apply.
If yes, please describe: S ~ S L...-rii:" 1-:) i_.,At..J
G:rt'es
Will electrical connections/ generators be used? Grfe's D No
D N o *Use of fire hydrants require an application
lf yes, please describe (include 1 lOv or 220v, number of amps per item of equipment and total amperage. Submit an
electrical service plan): ~EL-F ~"-'€12.A-IET.:> fo"'-'e:f2-. \HfC.DIJC:l-1+ +1<../f:'l.'>'"C-~-r-7:-./VCr Powdl.. *Generators: If you are planning to use a generator, please indicate on your site plan where it will be located. If your
generator is 20kW or greater, you will be required to obtain a minimum electric generator permit (fees may apply). The
name of the licensed contractor must be known at the time of permit issuance. An electrical service plan must be
provided.
*City Parks: Large scale events (rental of two or more park areas within a park complex, i.e Ramadas, grass area, etc) are
permitted at Watson Lake and Granite Creek Park. If you would like to hold your event at a City lake or park, please
contact the Recreation Services office at (928)777-1552 or email to: [email protected]. Large scale events held at
Watson Lake during peak season (Memorial Day to Labor Day) will be subject to a 25% fee increase. Parking fees will be
assessed (via car counter) at Watson Lake for all vehicles entering your event. To request camping for your event (at
Watson Lake ONLY) you will need to fill out the Campsite application and fees will be charged. City electrical pedestals
will not be included. Event organizers must set up a site meeting with Recreation Services staff NL T 10 days prior to the
event start date. Unless otherwise stated, playground areas, boat ramps, trailheads and trails must be available to the
general public at all times.
ls the C ity of Prescott Portable Stage requested (fees will apply)? ~ D No clL\ \ v lr a~w \)~ ()")'\ 7 (3 (Note: Portable Stage contract must be completed, signed and turned in with the application along with a $500
refundable deposit.) Sound Equipment and Generators are not included.
WILL THE EVENT REQUIRE STREET OR PARKING CLOSURE(s)? ~ 0 No
Street and parking closures will be listed on Citv's website and require 75% approval from ALL businesses per street
requested. NOTE: 2°d year events will be evaluated on !''year attendance before being allowed to close down streets
around the Courthouse Square. Street closures are subject to approval by the City Traffic Engineer, and may be denied
based on other special events, construction activity or to assure traffic flow. *Barricade set-up must be done by a licensed
and bonded company and billed to the event organizer.
Barricade/f raffic Control Company lnfo:_/._~_ll-;.....;.Pr...;.;...~....;.r--_.1:r:;.....;C..-;;....;..A-...;P;......;~----------- Phone: -----------If yes, please list accurate streets and accurate closure times:
Street Name Actual C losure Time Actual Re-Open Time Example: Cortez St from Goodwin St to Gurley St 8:00 am 6:00 pm
S"e-~ -rrz..~-z:_(....p..0 € s -C..-ri." PLA-f'..)
For questions regarding special event street closures, please contact the City of Prescott Traffic Engineering at (928)777·
1130. All street closures must maintain a 20-Foot Fire Lane. The event organizer will be responsible for keeping any
required fire lanes clear from blockage during a permitted Special Event street closure. Failure to properly abide by the
fire lane requirements will result in citations being issued for any such violations. Fire lanes impeded by structures, fixed
or temporary objects will result in the Special Event permit holder being issued a citation pursuant to Prescott Citv Code
6-1-1. IFC 503.4. Fire lanes impeded by motor vehicles or trailers will result in the registered owners receiving a citation
pursuant to Prescott Citv Code 9-1-12(F). Whatever object that is impeding the fire lane that is not immediately moved
after citations, may be removed, towed and impounded at the owners expense, pursuant to law. A citation will be issued
for each fire lane violation that takes place during a permitted Special Event.
Section 3. Event Equipment *Open Flame/Inflatables/fents/Pvrotechnics: If you check yes to any of the
following items fees may be applied. Please refer to the C ity of Prescott Fire Department Special Events Permit Application
included with this application, or contact the Office of Fire Prevention at (928)777-1760. Inflatables must be rented by a
licensed vendor and provide evidence of insurance naming the City as the additional insured.
Will any of the following items be used at your event? *Event structures (EZ.Ups, tents, fencing, etc) must be at least ten
(10) feet away from traffic control barricades. Inflatable vendors must provide a Certificate of Insurance.
Open Flame/ Cooking
Tents/Canopies/El Ups (400 >Ft)
Temporary Fencing
Carnival/ Amusements/ Inflatables
0No 0No
0No
0No
($ ~ S-z::.=7 e-- ~ '-A"-' ) Explain: _______________ _
Quantity: ____ _ Size(s):. _____ _
Quantity: _______________ _
Quantity: _____ (COI required from Provider)
Please provide vendor name: ___ .,,,../'::.:._ _________________________ _
Fireworks/Pyrotechnics @"~ Portable Toilets G2f Yes
0No
0No Quantity: -----------
Quantity:------ Company:
(Event Organizer will be responsible for portable toilets at event. For ratio of people to portables required for event,
please refer to the attached schedule.)
Section 4. Food, Tax and Entertain1nent
Food and/ or Drinks: If food and/or drinks of any kind will be served you must contact the Yavapai County Health
Department at http://www.co.yavapai.az.us or call (928)771-3149, and the following forms will need to be submitted:
•!• Event Coordinators: Coordinator Packet
•!• Food Vendors: Vendor Packet
The County Health Department requires food venders to submit permit applications 21 days prior to event date to avoid
any late fees incurring. Coordinators should provide food vendor lists to the Health D epartment 3-6 weeks prior to date
of event. Health Department Paymen ts WILL NOT be accepted at the event, n or will licenses be issu ed on-site.
Vendors will be required to leave the event if payment/ license has not been received/issued prior to the even t.
**Trash/Recycling Service will be mandatory and paid by the event organizer**
Will there be any permitted food vendors or caterers present at your event?
Will there be any items (t-shirts, CD's, DVD's, non-food items) sold? D Yes
Transaction Privilege (Sales) Tax:
~0No [2t'No
How many \ D
All vendors, merchan ts, sponsors/pro m ote rs, and the Applicant/Event O rganizer must comply with the C ity Tax Code. Non-profit sponsored events no longer have separate guidelines. Businesses or individuals conducting taxable activities will be required to obtain a transaction privilege tax license through the Arizona Department of Revenue (ADOR). The license can be applied for and taxes reported online at www.aztaxes .gov.
The Applicant/Event Organizer must furnish a list of all vendors participating in the event. Please include each
vendor's transaction privilege tax number (if applicable) no later than 10 days prior to the start of the event. The
Tax and Licensing Division can be reached at (928)777-1268 orvisithttp :/ bvww.prescott-az.gov/business·
developmen t/ licenses-and-sales-tax/business-licen ses/ fo r mo re in fo rm atio n. )
Applicant/Event Organizer's ADOR Transaction Privilege Tax Number: ('Sa A.-rAC..I~ t. u c
Will there be amplified sound? (For Noise Ordinance, please see City Code 5-4) Ul'fes 0No
If yes, please provide name and phone number of sound technician: P/2..c:..-t;co-r-r f'(L.o S ov ND
Will there be live entertainment? ~Yes D No
lf yes, please provide group(s)/ individual(s) name: _'-1 O..;.....o~'---A_l<.._M_'-( __ l!>-=-A-~N .......... A=-----------
Section 5. Alcohol Information Note: Please attach a copy of your Liquor License Application. If alcohol is
present. off-clutv law enforcement personnel are mandatorv and paid for by the event organizer. A copy of your approved
license will be required prior to approval. Must be received no later than 90 davs prior to your event and filled out in
black ink.
Actual Alcohol Sales Time(s) Start: -z.:.oo P"'t Last Call: 9 ·. o 0 r:'ivt
Will there be any form of alcohol at your event? (lf no, please continue to the Security Section)
Will alcohol be sold at your event?
Will alcohol be given away/ sampled at your even t?
Will attendees be allowed to bring alcohol to the event?
Will alcohol be included in ticket/admission price?
ls the event within 300' of a church and/ or school?
Will 50% or more of the gross revenues from the event be derived from alcohol sales?
G'.TYes
~s 0Yes
0Yes
0Yes
0Yes
0Yes
Has applicant/organization had a liquor license or event permit denied, revoked or suspended? 0Yes
If yes, please explain:-------------------------------------
How will attendees of legal drinking age (21) be identified? -Z:.... D. C-\-t-CC...f.,_ + ""-' (2...~-r~A-t-J D .S
Will all alcohol consumption be held in an enclosed area or allowed through the entire event? ~0No **A double barrier to define a designated alcohol consumption area is recommended and has been successful in the past
in maintaining th.e safety for the event, compliance with liquor laws, as well as for th.e off duty officers. A 4' tall double
rope, banner, ribbon other similar type material barrier encompassing the area with a separation of 4-5 feet is effective
for this purpose.
Temporary extension of premises/ Special Event Liquor License: A permit is required by the Arizona Department of
Liquor Licenses & Control (www.azliquor.gov) in order to temporarily expand or enlarge th.e area which is covered by
your current liquor license. This permit will need to be reviewed by the Prescott City Clerk, approved by Prescott City
Council, and a recommendation will be made to the State. Please provide a copy of your completed Extension of
Premises form \vith this application. Special Event liquor licenses are only available to qualified charitable, civic,
fraternal, political party/ campaign committees or religious organizations. Any questions regarding alcohol licensing,
please contact the City Clerk, at (928)777-1272 or at (928)777·1313. All license applications must be submitted to the
City Clerk's office at 201 S. Cortez, Prescott, AZ 86301 (City Hall) no later than 90 days prior to th.e event. (Fees apply
for all liquor licenses).
Section 6. Sponsorship/ Advertising Note: Signs/banners are limited to a maximum of six. They may be located
on the event site or at other locations. Signs/banners may be located on private property with the owner's permission.
Signs/banners may not be located on public right-of-way. The proposed locations for signs/banners must be shown on a
plan or clearly described in a narrative. C ity staff will review the proposed locations of signs/banners to ensure that public
safety is not compromised by the placement. The combined total of signs/banners cannot exceed six. Each sign/banner is
Will you be advertising or promoting the event prior to/during your event? 0 Yes D No
If yes, which media outlets will you be using? Explain P~~ / S o c... -c A~ II""\ l;: D-.:z:.. A
Will banners be used for advert isement? ~ 0No
Point of Contact for public information inquiries: --:'>;...T...;._~_...;~;._..._...;<2-<:>;;...:;_~_1..;..,;;..'-_~_...;;;;.. ___ ~;;;:.~-.....;;.)_l.f_9..1...°t_-_c:r_...;(:,;...'--f_~_ Name Phone
Section 7. Security/Public Safety Information: As an event organizer, you are required to provide a safe and
secure environment for your event through sound preparation and by anticipating potential concerns. The Citv of
Prescott Police Department has the final authoritv to determine your event securitv requirements. The Citv of Prescott
Fire Department has final authority on fire code enforcement, fire lane integrity and medical standby requirements. For
many events you will be required to pay off-duty officers to provide needed security. The Prescott Police Department
will determine which events will require off-duty officers and th.e number of officers at each event. Contact the Prescott
Police Department Patrol Secretary at (928)777· 1940 for costs and requirements associated with. hiring off-duty law
enforcement personnel. Arizona law requires that the security company and security personnel be licensed through th.e
Arizona Department of Public Safety. This license requirement does not apply to in-house security or volunteers
provided by the business or organization hosting the event. For additional information regarding private security
company licensing, contact the Arizona Department of Public Safety at (602)223-2361.
Security
Name of responsible person to be present for duration of event: '5~evC"N Gro---i-<'--~€0
Home Address: ·2-'1 o S. M cc...o{Z "'-'Z:..c..-'S ~ y P ~-S C.C;::>..-\ '°r-~
Business Address: ~ .g..."""\,~ ~':> I\ 8ov €
-Home Phone Number: (q.,_'2)) ~ 99-q pt,,;f E:> Alternate Phone Number: ·---------------Type of Private Security Personnel/ Company Name: _l?s=_._:::C.-='---fl:...___,A'""'""N::..:;~;.:...;;;;;.._....;;;.. ____________ _
I plan to use:
g/n-house staff or volunteers. Estimated number: __ !_'-___ _ Q/" Hired security personnel. Estimated number: 2> ------
Company Name: f¥l= f>-PT,..,c.:n:::ILS. Contact Person 1~1Vil f'?-.~K $c,..j
Phone Number: '\ ""2.-!e:> S ~ 3.- ·s ~-=l.S ~ Prescott Police Department off-duty officers. Estimated number: -----
*Off-duty Prescott police officers will be assigned based on occupancy of the event and what the security tequi.rements
are determined to be. Payment for off· duty officers is due at the conclusion of the event. If an invoice is needed to
secure payment, one will be provided to you. This type of arrangement needs to be known prior to your event. You will
be required to submit payment within seven days of receipt of invoice. Payment should reflect the hours your event is
under operation. In the event officers are needed to hold over or if your event runs over the allotted time, the event
applicant is responsible for any additional payment.
In case of an after hours emergency, please list names and phone numbers of additional responsible persons who will have
access to the event area and could respond if req uested.
1. 5> -c ~C c~-r-T\ .. ~ ( <=\ --z_ce, ") \..\ 9 '1 -~ b ~ -b
2. !M c,-.-r s~ A-a..~ ( ~ '1.-!0) ..-?_.. )";J. ..... o l t:. 'J
3.w-y~ LAv<:M-tL~ (&\'"2--'C>) ~ 1-t"""L- ?.-'2.Sg>
Medical Standby NOTE: Your event is required to have a First Aide Station or Medical Standby
First Aide Station: Qty Medical standby will be provided? ~s
Please provide the following information:
Agency/Company name: M -;t..1 .... ( f'(t...OS""( {-r 13-""\.C..) / .... ~\ e0~ _ -L fl ,. f"1.
Phone Nu mberL_~q"'"'.__~.....:C-J:;..')...,,__,,_:;;...,_..;.._ 1_--'1_0 __ "-
Please describe any additional plans for security/public safety/emergency reunification: A-\...L \.... O~"T fllc-~.5 -ro ~ ~-r~
Section 8. Parades, Motorcades, Running/Walking/Cycling/Skating Events Note: If your parade/
race route enters the jurisdiction of Yavapai County, a special events permit will be required through the Yavapai County
Development Services Office at (928)771-3216. Location of staging area: _____________ _ Start Time_· -----
Disassembly time: ____ _ # of Parade units: __ _
Description of participating units (motorized, ani
Section 9. Illustrative Site Plans (All plans to be submitted on 8 Yz x 11 paper and turned in with this application)
Site Plan: Please provide a site plan of the event area indicating the location(s) of equipment and activities. *Event structures
(EZ-Ups, tents, fencing, etc) must be at least ten (10) feet away from traffic control barricades. Please include the fo llowing:
Stage(s)/ Amplified Sound Equipment
Controlled Access/ Admission Area(s)
Merchandise/Food Vendors
Open Flame/Cooking Area(s)
T ems/Canopies
First Aide/Emergency Station(s)
CarnivaVAmusement Rides
Handicap Parking/ Access Area(s)
Activity/ Amusement Area(s)
Portable Restrooms
Water Service
Trash/Recycling Receptacles
Emergency Access
Liquor Distribution/Control Area(s)
Fencing
Closure of Public Access: Any business that may be affected by possible street/parking closure must be notified prior to
submittal of application. Please include the business name, contact name and phone number of each business contacted,
with approval/disapproval with this application signature form. Once the application is approved, it is the responsibility of
the event organizer to notify businesses of approval. The Special Events Committee recommends providing a copy of the
application and/ or approval permit. Street closures require 75% approval from ALL businesses on requested street(s) to be
closed.
Traffic Control Plan Overview: A Traffic Control Plan is used to indicate vehicle/pedestrian traffic control, detour routes,
directional signs, barricades, and street closures for your event. The applicant is responsible for providing all required
barricades and traffic control signs at no cost to the City. Barricades must be set-up by a licensed and bonded traffic control
company. All No Parking Barricades must be in place no later than 4:00PM the day before your expected closure. Prescott
Regional Communication Center (PRCC) shall be contacted at (928)445-3131 to confirm that barricades are set. Applicants
failing to contact PRCC or setting barricades late r than listed could be held liable for tow bills. AT raffic Control Plan must
be submitted for the proposed closure of any street, sidewalk, alley, right-of-way, parking lot or similar public access area.
Include/indicate the proposed parade/race route, if applicable. *Event structures (EZ.Ups, tents, fencing, etc) must be at
least ten (10) feet away from traffic control barricades. Traffic Control Plans must comply with the current Manual on
Uniform Traffic Control Devices and be approved by the City Traffic Engineer. Once approved, the Traffic Control Plan
must be executed by a certified technician from a licensed and bonded barricade company. Please note: Applications will
not be processed without a Traffic Control Plan approved by the City Traffic Engineer. For more information, please
call (928)777-1692.
Parade or Race Route: Please provide a separate plan indicating the proposed parade or race route, including assembly and
disassembly areas. If your parade/ race route enters the jurisdiction of Yavapai County, a special events permit will be
required through the Yavapai County Development Services Office at (928)771-3216 and requires a certificate of
insurance naming Yavapai County as the additional insured.
Electrical Service Plan: An additional plan must be submitted for electrical service usage showing the layout of extension
cords, spider boxes, generator(s), and anticipated amperage draw.
Section 10. Applicant Information
Street address: Z. ~ Q So v"T i.t
State: t\-- .::e Zip: SG)03
Primary Phone{ C\ ")....'&) '19 C{-C( 6 Yb Secondary Phone.·_---------
Name of Corporation/Organization (include D.B.A. n ame if applicable) ~~-~-,~~~~--------
State oflncorporation: Tax I.D. No. ~--------- -----,,L---
Business Street Address: ------------------------~,,;:_ ______________________________ _
Mailing Address (if different fro m above): ---~'--------------------------
Zip: ---------- -------------Section 11. Insurance For events occurring on C ity-owned property, the applicant must provide a Certificate of
Insurance for commercial general liability, auto liability, and liq uor liability (if applicable) n aming the City of Prescott as
certificate holder and additional insured. The certificate must indicate the dates, times, and location of the event. The C ity
also requires an "Additional Insured Endorsement" along with the Certificate of Insurance. Both the Certificate of
Insurance and the Additional Insured Endorsement must be provided at least thirty (30) days prior to the event. The
person/ organization listed on the certificate must be the appl icant. Please have your insurance provider address the
certificate to the attention of Recreation Services: Special Events. Minimum limits are as follows:
$ 1,000,000.00 per occurrence
$2,000,000.00 aggregate General Liability
$1,000,000.00 automobile liability (or non-owned automobile liability)
$1,000,000.00 liquor liability
<SEEATICHED SAMPLE ... Pgs 13 & 14)
*Events Held at Prescott M ile High Middle School must provide a Certificate of Insurance and Additional endorsement
to PUSD 300 E. Gurley St, Prescott, AZ 86303.
The following applies to Amusement R ides: • The State of Arizona through Statute- ARS 44-1799.61 - 1799.64 requires an amusement ride operator have $2 million CSL liability limits (or split limits of $1 mil Bl & $500,000 PD). • This Statute requires the operator to provide documentation of insurance, inspection and permit to each sponsor, lessor or property owner o f the property were the amusement ride is operated
The following applies to Inflatable's: • Documentation of insurance is required fro m the inflatable vendor showing $lmillio n/ $2million liability limits with
an excess policy of $2million.
• The special event applicant is responsible for ensuring the vendor of the inflatab le's has sufficient training in the installation and operation of the device(s), and will comply with all manufacturers' directives, including but not limited to, proper staking and ensuring adult supervision when children are utilizing the inflatable's.
The Applicant's insurance coverage shall be primary insurance and non-contributory with respect to all other available
sources. Policy shall contain a waiver of subrogation against the City of Prescott for losses arising from participation in
the Special Event contained in this Application.
Additional limits may be required by the City of Prescott Risk Management office pending review. Providing the above
listed insurance does not in any way reduce or eliminate any responsibility assumed under the indemnity agreement
statement. For more info rmation regarding insurance, please call Risk Management at (928)777-1257.
Section 12. Indemnification
Applicant agrees to defend, indemnify, and hold harmless the City of Prescott, its agents, representatives, officials, and employees,
from and against any and all claims, damages, losses, and expenses (including, but not limited to, attorney fees, court costs, and the cost of
appellate proceedings), relating to, arising out of, or alleged to have resulted from the acts, errors, mistakes, or omissions of the applicant, its
agents, employees, contractors, subcontmctors, customers, invitees, guests, participants or other persons doing business with the applicant, in
connection with the Special Event described in this Application, provided, such claims, damages, losses and expenses are attributable to
bodily injury, up to and induding death, or to injury to or destruction of property.
Section 13. Certification
Applicant has read and understands all of the attached policies and will abide by all policies, rules, regulations, and conditions of
use as written. Application is subject to approval hy the Special Events Committee. Applicant understands that the special event permit is
not transferable to any other individual or group. Applicant certifies that all information on this application farm is complete and
accurate. Applicant understands that any omissions or misstatements of facts are cause for rejection of the application.
~fl;'#d; ---Applicant's Signature Date
Please sign and mail this and all subsequent applications to City of Prescott. Attn: Recreation Services
Special Events at 824 E. Gurley St. Prescott. AZ 86301. Emailed and faxed copies of this application will
not be accepted.
CITY OF PRESCOTT SPECIAL EVENT COVID MITIGATION FORM Please complete and submit this form with your special event application EVENTORGANIZERNAME ~ "1~~"""'~ t ic:v~ L.LL
PHONE NUMBER ( q'l.fi) '14Q 4"' Y '- EMAIL ~ G-crrr L---c...d.S q-ve, 0 b-"'1f¥""t.. "-. Lo"'"' EVENT NAME "'S°,J._-< I.-\~ ,~~"'-'-'02-""-~ EVENT DATE 'S0 1--'-1' '-\~ --z....o..,_\ EVENT ADDRESS vJA-C >oiU t...-CS:,,,\t:...€"
The minimum mitigation measures required to host your public event of more than so guests within the City of Prescott are listed below. Please review and check each box to indicate you agree to implement and enforce the foll~g guidelines: ~dvise individuals to stay home if they are showing COVID-19 symptoms or have come into close contact with a person with COVID-19 symptoms in the past 14 days
~ sufficient hand sanitizer in visible areas for attendees
~uire use of masks for staff and vendors
~recommend masks for attendees
~tain a physical distance of at least 6 ft . Should this proximity be impossible, then masks should be worn
~nage in highly visible locations that promote social distancing and masks
~tendance or seating capacity to allow for social distancing if necessary
~e physical markings (i.e. tape, barriers, cones) to ensure individuals remain at least 6 ft. apart in lines
Describe additional mitigation measures in place at your event f!i<PO-i -r -z... ~v f.\-1...... 6- f;;X:1\ v.J 4"' t::'"'I'-. P., A--S "Z-N S Y:o a_
CHEj;l«IST ~omplete the Arizona Department of Health (ADHS) Mitigation Measures form online here NOTE: Save PDF of receipt to email City of Prescott.
~ii a copy of this completed form to Yavapai County Health Services at [email protected]
~a copy of this completed form AND PDF of ADHS confirmation receipt to the City of Prescott with your Special Event Application to [email protected]
By completing and signing this form, you are stating you agree and will adhere to the above listed terms. i--::......--~ i"\A-'ll--W 3 'lrC L. \
EVENT ORGANIZER SIGNATURE DATE
City of Prescott Fire Department Special Event Application (Required for ALL Events)
Permits shall be obtained for the Prescott Fire Department for any event or display us ing open flames, cooking or heating appliances, tents, canopies or E-Z Ups, air-supported and inflatable devices or structures (jump castles, slides, etc), combustible decorative materials, consumer fireworks and display fireworks, compressed gas or the blocking of emergency access roads. Complete tl1e application form and return it to the Office of Fire Prevention, 1700 Iron Springs Road, Prescott, AZ 86305, between 8:00am and 5:00pm Monday through Friday, or fax to 928-776-1890 a minimum of 30 days prior to
the scheduled event. A site plan drawn to scale, showing the display or event location is required to be submitted
with the application.
An inspection by the Building Department shall be completed prior to scheduling a Fire Prevention inspection for tent permits. Inspections may be scheduled prior to the opening of an event by contacting Fire Prevention at 928-777-17 60. Special events/ displays are subject to a fire department fee. Please the fire department fee schedule for details
("'-'A--rSo~ '-C\-""-e-) Event Name: ""l~-:i_ '-'°""' ~v,S,. Event Date: _:J_'-''-"'5_ L\~_'"2-0'L\ Event Location: -~ ~'"!:~~-"=='-~~_L_f' A~-------------Contact Name: ~.s:".JLC _ ___G:21-n .. -c::X!3. Phone: Cf~_ 4 ~ -q '-~Brief description of event: _i:::~--~ (-tOV..l _[(3_-t:'l:;..-rz. Or-Vlf2-0-t:f'-J
-~\I e=__~y_s_"".(._t;,,,,,_=-Z_'.T-8-~7-~~.e ___ _20-N e:Q.... __ _
Check the following only if they apply to your display or event.
~of heating or cooking equipment '2f' Tent or canopy, indicate size __ -z <'-_ 'X_.G.Q__£~o~~ ~-r~ ll:rkJCS [;V'f\ir-Supported or air-inflated structures D _9isplay of liquid- or gas-fueled vehicles, boats or other motor craft Gr",.Compressed gas, LPG or other hazardous material [i('" Open or exposed flame D Combustible decorative materials ~mporary electrical power ~otechnic special effects D Special amusement building D Trade show or exhibit D Temporary consumer firework sales uvBlocking of street or emergency access road
D Other -----------------------------------------
Important Prescott Gateway Note: For the purpose of providing required egress in the mal~ there shall be a minimum of 1 O'
clear exit width between any storefront or kiosk and the nearest display. Displays and events may Not obstruct the means of egress travel.
FD Use Only Date Approved: --------------------- Reviewed By: ____________ _ Inspection Date: ----------------- Inspector: --------------
_____ __, ~'----..__,~ (
1 1' FY o F J-=>J => ]~ S (_; 0 ']-,']-, 7.-::_y, ·rf/h;~;:;'r / ~'hu "(r.' 1v/I
2021
CITY OF PRESCOTT Portable Stage Rental Agreement
Date of Requested Use: -S 0 • .. : { 'ift.\ ""2.0"2--.._
Set-Up Time: r u\...."i ~,.ei "Z...o"Z-~ '7 ~ Tear-Down Time: -sv ~-< ~ A+>Y/.;,t:..M C Delivery Location: w 1>s-n o"1 \,...i:::-.~
Tear down time is the actual time staff can begin tear down. If tear down cannot begin at the specified time event promoter will be assessed a $75 per hour stand by fee.
RATES AND FEES (X those that apply)
Portable stage: 0Private/Commercial DNonprofit/Service Groups Basic Portable Stage Set-Up c;a---- DAILY 0 FOR TWO DAYS 0 ADDITIONAL DAY
$325 $475 $100
Refundable Damage and Security Deposit: $500
Extended Portable Stage Set-up Options:
~ $375 $100
.. Q ErleRdea Stage PlatforcQ_ ·Add $100.00 per day .... CJ.--- Theatre Lighting Package: Add $100.00 per day
Set Up Charges: includes set-up and take down only. This does not include city staff remaining with the portable stage for the duration of the event. If city staff is required to stay the duration, a request with explanation must be submitted to the Recreation Services Director and an additional fee of $36 per hour will be assessed.
Basic set-up (2 employee minimum)-$350 Extended stage set-up (3 additional employees minimum)-$600
For outside of Prescott $150 Flat fee for out of Prescott Area $95 per hour for transport of stage to and from $40 per hour- Wait on location time $65 per hour for additional transport (for extensions setup) to and from $45 per hour for additional staff (for extensions setup) Starts when leave Prescott
Rental amount will be billed after event. Payment of any outstanding balance (after crediting any remaining damage and security deposit) is to be made within 30 days of billing. Refunds of any unused damage and security deposit will be made by the City within 30 days of billing .
Renter must provide a Certificate of Insurance showing the City of Prescott as the Certificate Holder and the additional insured. The City also requires an "Additional Insured Endorsement" along with the Certificate of Insurance. Both the Certificate of Insurance and
1
the Additional Insured Endorsement must be provided at least two (2) weeks prior to the event. The person/organization listed on the certificate must be the applicant. Minimum limits are as follows:
Public Liability:
Property Damage:
$1 ,000,000.00 per occurrence $2,000,000.00 aggregate $100,000.00
Damage and Security Deposit must is due upon request of the reservation. Failure to comply will result in cancellation of reservation. Cancellation must be received by Recreation Services Office at least one week prior to event for renter to receive full refund of damage, failure to notify the Recreation Services Office one week prior to cancellation will result in forfeiture of damage deposit.
Please call 777-1552 for Portable stage availability or to request a formal application. Recreation Services Staff will meet with the renter prior to event to approve set up location unless said event is a repeated event. At this time, Recreation Services Staff will advise the renter of any additional equipment that may be required .
In the event of scheduling conflicts, City of Prescott events have priority over any and all other events. Renter assumes responsibility and insurance coverage for the Portable stage at moment of drop-off until pick-up has been made by Recreation Services Staff. If the event is scheduled to run past 11 :OOpm, said renter is required to provide overnight security for the portable stage up to the time City of Prescott retrieves the portable stage. Renter is responsible for any and all damage which occurs to the Portable stage during the period of rental. NO DUCT TAPE, masking tape, nails, screws, staples, paint, or any other damaging material may be attached to the interior or exterior surface of the stage. Such damage will be assessed a fee and will result in forfeiture of the damage and security deposit equal to the damage. Hooks are provided for hanging banners. The City of Prescott logos on the interior of the open stage must be exposed at all times. Chairs, tables, music stands and other furnishings are not included in rental costs. The City is not responsible for items or equipment left on the Portable stage. Pre- and post-event inspections of the Portable stage will take place with both Recreation Services Staff and renter present.
Renters must provide their own pre-approved power supply. Power supply must be protected by a 50-amp breaker or fuse. City of Prescott will provide .Q.!!! 100-ft. cord, 2 spider boxes and 25 feet of cord protectors. The cord is to be plugged into no greater than 50-amp receptacle protected by breakers or fuses. Tampering with the Portable stage and/or equipment will result in forfeiture of $500 of the damage and security deposit. City Staff will approve final portable stage set-up.
The Portable stage shall not be used in winds exceeding 30 mph, or in severe weather warnings or storms. If inclement weather cancels event, renter may receive pro-rated refund of rental fee; however, renter still must pay any staff costs. Refund schedule of charges is as follows:
Weather prevents site delivery, event canceled 100% refund Site delivery accomplished, weather prevents set-up 100% refund Set-up completed, weather cancels event 75% refund
In the case of a rental of more than one day, pro-rated schedule of refunds will consider length of time in use vs. length of time of rental period.
2
Recreation Services Staff reserves the right to cancel the stage rental for unforeseen circumstances. Refund schedule of charges as above will apply.
Renter agrees not to keep or have on the Portable stage any article or item of a dangerous, flammable or explosive character that might unreasonably increase the danger of fire or explosion, or that might be considered hazardous or extra hazardous by any responsible insurance company.
The City shall not be liable for any personal injury to Renter or his agents, or to any other occupant or invitee of any part of the Portable stage, or for any damage to any property of the Renter or of any other occupant or invitee of the Portable stage, irrespective of how such injury or damage may be caused, whether from action of the elements or acts of negligence of the Renter or the City.
To the fullest extent allowed by law, Renter hereby agrees to indemnify, defend and hold harmless the City, its departments and divisions, its employees, agents, representatives, officers, officials and volunteers from any and all claims, liabilities, expenses or lawsuits resulting from the Renter's use of the Portable stage, whether said claims, liabilities, expenses or lawsuits arise by the acts or omissions of the Renter or his/her agents, or whether by the acts or omissions of third persons. The Renter further releases and discharges the City, its departments and divisions, its employees, agents, representatives, officers, officials, volunteers and any and all persons legally responsible for the acts or omissions of the City, from any and all claims which the Renter has or may have against the City, its departments and divisions, its employees, agents, representatives, officers, officials and volunteers, arising out of or in any way connected with the Renter's use of the Portable stage.
Renter further agrees that it will neither hold itself out nor claim to be an officer, agent, representative or employee of the City by reason of this agreement. This Agreement is not transferable to any other party. There can be no third-party beneficiaries to this Agreement.
I UNDERSTAND AND AGREE TO ABIDE BY THE PROVISIONS OF THIS AGREEMENT.
THIS AGREEMENT entered into this the , ,ci day of M Afl-.L"-4- , 20 ~'
Signatur4·.::::11-------=_A:;;.__~-'---------- ( C<'""l-CO'j \.-\ C\ 9 - ~ 6 4-6 Daytime Phone
Name (Printed)__:::S_~..::==..:::-v::...:~=---G.:::::m~crz.-L....:.L_-c...e__::;g_...e:_ _______________ _
Name of Organization (if applicable) ___________________ _
'?,.-'{ 0 s i-1 c. Lb~ W\--t:...C../.L.. :ft Y: Street Address Mailing Address (if different)
City/State/Zip
For the City or Recreation Services Department Date
3
Special Event Information-Yavapai County Community Health Services To be Supplied by Event Coordinator Please complete and return this form at least forty-five (45) days before the start of the event. Please submit vendor lists and event maps no later than five (5) week days before the start of the event.
Pl~e return this sheet to: ra" 1090 Commerce Dr., Prescott, AZ 86305 (928) 771-3149 ...... ....... FAX (928) 771-3369 D 3212 N. Windsong, Prescott Valley, AZ 86314 (928) 583-1015 ............. FAX (928) 771-3379 D 10 S. Sixth Street, Cottonwood, AZ 86326 (928) 639-8138 ............. FAX (928) 639-8140
General Event Information
Name of Event "5" \..."1 4 ...,. F~ll-~012..Joir.C::, -------------------------=~
Sponsoring Organization __ .... £ ....... ~1-1...~"--"'-- -------------Date(s) '3'..; ...... --c 4 t4f to S°v1..-""'(" ""'...., Time( s) .., o~ to LO p"'°\
Location u-i ~-rc;.o"'"' L.-A-1-<..C Facility Name Address - Physical Location
Brief Description of Event Site Conditions: (i.e. dirt, grass, pavement)
Cs~
Estimated event attendance ) ooo Additional Event Information
Anticipated number of food and beverage booths/concessions --------------------D~e and time cl eve~ s~ up __________________________ _
Restroom facilities for patrons r::iY'Public restrooms D Chemical toilets
Will an approved water source be available for food vendors? ~es Quantity to be supplied "2--5
D No
What method of wastewater disposal will be provided for food vendors? ___ (._fi'\u-"'--'....::~=-----------
Will electricity be provided to food vendors? D Yes ~o
Will back-up refrigerated storage be provided to food vendors? D Yes ~
Contact Information
Event Coordinator - Food & Beverage Chairman OR responsible individual
Name ~.&c-r ..... ~ Address~~(;) 5. '""cc.o~i:..(.,~ ~ Name ___________ Address f~a;r7'7' 14--~ 86'"SO~ Phone ____ _
Scheduled food and beverage concession meetings-------------------
Supplemental Information
Are dumpsters provided? ____ Where? ---------------------
List of food and beverage vendors D Enclosed ~ill mail/fax by -~-'"""'""--~-<_$ _____ _
Map-Location of Temporary Food Vendors: D Enclosed ~I mail/fax by ___;-S:...,_=.o_"--J8 __ •5.:...__ ____ _
Application prepared by ---------------------------~ SE-Coordinator Pack 7-16
2021 Food Truck List
VIP
ChefShax
Papa Johns
Papa Nachos
Safari Samosas
King Pin BBQ
Gringo Taco Truck
Outlaw Dounuts
Wild West Concessions
Momo Korean Kitchen
Marino's Mob Burgers and Ice cream l-< o GV Do<:.-w--~
Hungry Badger
Stack'd
Fireworks 2021 Electrical Needs
Area
Stage
VIP Area
Water Sliders
Hideaway Arcade
Need
SO foot twist (1) Spider box
100 Foot twist (1) Spider Box
100 foot twist (1) spider box
SO Foot Twist (1) Spider Box
Provider
COP
COP
COP
COP
- FENCE WITH SECURITY
HANDICAP PARKING
VIP AREA
GENERAL PARKING
VIP PARKING
FRIENDS OF PRESCOTT SCOUTING INC. 1085 SCOTT DR. PRESCOTT, AZ. 86301-1731
91- 2/1 221 102
DATE ~111lta21 6~:;'~~· ~~ LLL I$ '}5.~ c=:~ t''" ~ irx- oo•~" fil e.>.::-JPMorgan Chase Bank. N.A. www.Chase.com
MEMO ~o~11A\~ \:vJ ~-~clt-14L~c)
FRIENDS OF PRESCOTT SCOUTING INC. 1085 SCOTT DR. PRESCOTT, AZ. 86301-1731
~-/ -----·-""
91-211221 101
DATE t\t>v- II , io 'LI r-7
${£,~ 0. ._..,.,,. __
I ,.._,.,_,..-, yv- - IA)\, ' DOLLARS W - • .......,v J 1 c..ill s.dL.
JPMorgan Chase Bank, N.A. www.Chase.com
MEMO 4~ cf(k\~ ~vJVJ;$if 1: Ii 2 2 1.000 2t.•:
L1M AILJJ-tt , b lBB Sb 7b ;-~J:~----------~
Arizona Department of Liquor Licenses and Control 800 W Washington 5th Floor
Phoenix, AZ 85007-2934 www.azliquor.gov
(602) 542-5141
APPLICATION FOR SPECIAL EVENT LICENSE
FOR DLLC USE ONLY Received Date:
Job#:
CSR:
License#:
Fees: $25.00 per day for 1-10 days (consecutive) Cash Checks or Money Orders Only A service fee of $25.00 will be charged for all dishonored checks (A.R.S § 44-6852)
SECTION 1 Applicant must be a member of a qualifying nonprofit organization, political party, or Government entity and authorized by an Officer, Director, or Chairperson of the Organization.
1. Applicant: b:o\IL..'"C--€B S-r6'JQ'-J P,. P......1--JOO"--f>\--\ l D /oq ( t·'1 fo '-t Last First Middle Dale of Birth
2.Applicant'smailingaddress: 1.....\.-\0 S . f/lc..c.o«,.M-r.LK ~ '-t P(l...0Co--r"'\ . AV....J:..-7::..t>-JPt SG.303 Street City / Slate Zip
3. Applicant's home/cell phone: (q1~) ~~~ - ct b \..\C. Applicant's business phone: ~) Y~~.-. 9'6. '"-< b
4. Applicant's email address: G:o-rr L'"Le:& a;~B <@? C::rM~-t:-l..- ~ l.D"'-".
SECTION 2 Name of Organization, Candidate or Political Party/Gov.: i:::-a.-:z_eY9S oF ~OO\;)~t:r ~C....
SECTION3No~~ofil~~fux&em~Numbe~~e~~~-~y~g_g~~~~~~~-'~~~~~~~~~~~~~~~~~
SECTION 4 Event Location: w P.'"f'SO~ L-P-~~ ~Po..~\(..
Event Address: 4 l Cl \.u A•$' ON
SECTION 5 Dates and Hours of Event. Days must be consecutive but may not exceed 10 consecutive days.
12/1/2020
See A.R.S. § 4-244(15) and (17) for legal hours of service.
DAY 1:
DAY2:
DAY3:
DAY 4:
DAY 5:
DAY 6:
DAY 7:
DAY 8:
DAY9:
DAYlO:
PLEASE FILL OUT A SEPARATE APPLICATION FOR EACH "NON-CONSECUTIVE" DAY
Date Day of Week
Page 1of4
Event Start Time AM/PM
"Z ~ Do ?'"'1
Event End Time AM/PM
Individuals requiring ADA accommodations call (602)542-2999
Numbers of Attendees (Each Day)
5 oc:s=>
SECTION 6 What type of security and control measures will you take to prevent violations of liquor laws at this event? (List type and number of police/security personnel and type of fencing or control barriers, if applicable.)
L..- Number of Police @, Number of Security Personnel ~cing Osarriers
Explanation: l..L~<'-"-'t" ~~eo P(l..~-c:.sf . V<)£° OF -z:.... _D. <-l-t-€""c...I<,
w 1... -r'1 'vJ {L-i:,..5, \!>A-,...,VS .. \..V~....S~ v3A"'-'DS ""Z:.. Q~-r~i:::-Y EL-Z::..G::-Z:-.BL~
A L.('2 Ho'- Co...:> s..., M CJ?.--'>
SECTION 7 Will this event be held on a currently licensed premise and within the already approved premises? 0Yes 0No (If yes, Local Governing Body Signature not required)
Name of Business License Number Phone (Include Area Code}
SECTION 8 How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors? Please read R-19-318 for explanation and check one of the following boxes.
0Place license in non-use QD~ense and serve all spirituous liquors under retailer's license Uk5ispense and serve all spirituous liquors under special event Osplit premise between special event and retail location
{IF USING RETAIL LICENSE, PLEASE SUBMTr A LETTER OF AGREEMENT FROM THE AGENT/OWNER OF THE LICENSED PREMISES TO SUSPEND OR RUN CONCURRENT WTrH THE PERMANENT LICENSE DURING THE EVENT. IF THE SPECIAL EVENT IS ONLY USING A PORTION OF THE PREMISES, AGENT/OWNER WILL NEED TO SUSPEND THAT PORTION OF THE PREMISES.)
~What is the purpose of this event?
Gan-site consumption [})ff-site (auction/wine/distilled spirits pull) []Both
SECTION JO
1. Has the a~cant been convicted of a felony, or had a liquor license revoked within the last five (5) years? [Jy es ~o (If yes, attach explanation.)
2. How many special event days have been issued to this organization during the calendar year? _;.._,...S_o_N_E.::.._ ____ _ (The number cannot exceed 10 days per year.)
3. Is t~ Organization using the services of a Licensed Contractor?
[}(yes 0No If yes, please provide the following : Name of Licensed Contractor: S-r~ G-t:.~1-.~
4. Is the org;rnization using the services of a series 6, 7, 11 , or 12 licensee to manage the sale or service of alcohol?
OYesGfNo If yes, please provide the following: Name of Licensee License#: ______ _
5. List all people and organizations who will receive the proceeds. Account for 100% of the proceeds. The organization applying must receive 25% of the gross revenues of the special event liquor sales. Attach an additional page if necessary.
~ _,_,..,, r L "" ....,5 <::>/D Name f(.'.(""J:_e:NP.S -0 ~ PfL.<~<-o · ' .) c.ou-t ;::.t...J(:r L._ Percentage: ___ '--__:_7-=r~------
Address I 0 £3 ') S' c. o-rr
Name ep..ea-L.£ fvl A"-'~l.L1 ~ 4 €\JtelVf 5
Address "2... '-Io ~, µ c. <:.oQ.1"-1--Z:..L.U. J:b ... 1 Street
12/1/2020
LLL. ,<O>/o Percentage: ~--~--_J_r-=';_ _____ ~
np
Page 2 of 4 Individuals requiring ADA ac commodations call (602)542-2999
Please read A.R.S. § 4-203.02 Special event license: rules and Rl 9-1-205 Requirements for a Special Event License.
Note: ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY.
NO ALCOHOLIC BEVERAGES SHALL LEAVE A SPECIAL EVENT UNLESS THEY ARE IN AUCJ!ON WINE OR QISTILLEQ SPIRITS PULL SEALEQ CONTAINERS OR THE SPECIAL EVENT LICENSE IS STACKEQ WITH WINE /CRAFT QISI!LLERY FESTIVAL LICENSE
SECTION 11 License premises diagram. The licensed premises for your special event is the area in which you are authorized to sell, dispense or serve alcoholic beverages under the provisions of your license. Please attach a diagram of your special event licensed premises. Please show dimensions, serving areas, fencing, barricades, or other control measures and security position.
Iii ATTACH DIAGRAM Ill If the special event will be held at a location without a permanent liquor license or if the event will be on any portion of a location that is not covered by the existing liquor license, this application must be approved by the local government before submission to the Department of Liquor Licenses and Control. Please contact the local governing board for additional application requirements and submission deadlines. Additional licensing fees may also be required before approval may be granted. For more information, please contact your local jurisdiction.
Attestation for Special Events Licenses Executive Order ("E.O.") 2020-59
Further Mitigation Requirement for Events
On December 2, 2020 Governor Ducey issued E.O. 2020-59, Further Mitigation Requirement for Events. Pursuant to E.O. 2020-59, beginning on December 3rd, an applicant for a series 15, Special Event License or series 16, Festival/Fair License are required to submit an attestation acknowledging that public health requirements issued by ADHS will be followed by attendees and enforced by event organizers prior to receiving the license.
I hereby attest, by submitting this form, that as the applicant listed below I acknowledge that I understand that as a condition of the series 15, Special Event License or series 16, Festival/Fair License issued to me by the DLLC, I shall ensure compliance with the applicable requirements issued by ADHS and any other requirements or guidelines incorporated therein related to mitigating the transmission of COVID-19 during my event, including that as the event organizer I will implement and enforce the following:
At all times: • Require the use of masks at all times by event organizers, staff and attendees except while actively eating or
drinking. • Promote healthy hygiene practices. • Ensure cleaning and disinfection practices and ventilation. • Ensure adequate supplies of hand sanitizer and cleaning supplies. • Monitor all persons in the business premises for sickness. • Ensure physical distancing by spacing chairs and tables at least 6 feet apart. • Limit the congregation of groups during the event. • Eliminate instances where attendees serve their own food.
By submitting this attestation, the applicant is agreeing to meet the applicable guidance in the ADHS Requirements for thebusiness located at www.azhealth.gov/businesscovid19, as may be updated or modified from time-to-time.
Notwithstanding the submission of this attestation, if DLLC becomes aware of actions taken by the applicant that may take jeopardize the health, safety, and welfare of the public or that the representations in this attestation are false, DLLC additional action as necessary to protect the health, safety and welfare of the public.
To review up-to-date information regarding ADHS' emergency response to COVID-19 and information for businesses, please visitwww.azhealth.gov/businesscovidl 9.
1, (Print full Name) <;"T'c;,'Vt.~ fl.-A:.A.)(}o 1.....PJ\ 4crffc...~ , hereby swear under penalty of perjury and in compliance with A.R.S. § 4-210(A)(2) and (3) that I have read and understand the foregoing and verify that the information and statements that I have made herein are true and correct to the best of my knowledge. ~}?,( • ~
Applicant Signature:~--->.J.~---~--=~=------=-----
12/1/2020 Page 3of 4 Individuals requlrinr:i ADA accommodations call 16021542-2999
LOCAL GOVERNING BOARD
Date Received:--------
!. ____________ _ ____________ recommend 0APPROVAL 0 DISAPPROVAL (Government Official) (Title)
On behalf of ___________ ----------- _____ ---------(City, Town, County) Signature Date Phone
DLLC USE ONLY
~ 0APPROVAL 0DMPPROVAL BY: ___________________ DATE:__J__J __ 11
A.R.S. § 41-1030. Invalidity of rules not made according to this chapter: prohibited agency action: prohibited acts by state employees: enforcement: notice
B. An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a basis for imposing a licensing requirement or condition unless a rule is made pursuant to that general grant of authority that specifically authorizes the requirement or condition.
D. THIS SECTION MAY BE ENFORCED IN A PRIVATE CIVIL ACTION AND RELIEF MAY BE AWARDED AGAINST THE STATE. THE COURT MAY AWARD REASONABLE ATTORNEY FEES, DAMAGES AND ALL FEES ASSOCIATED WITH THE LICENSE APPLICATION TO A PARTY THAT PREVAILS IN AN ACTION AGAINST THE STATE FOR A VIOLATION OF THIS SECTION.
E. A STATE EMPLOYEE MAY NOT INTENTIONALLY OR KNOWINGLY VIOLATE THIS SECTION. A VIOLATION OF THIS SECTION IS CAUSE FOR DISCIPLINARY ACTION OR DISMISSAL PURSUANT TO THE AGENCY'S ADOPTED PERSONNEL POLICY.
F. THIS SECTION DOES NOT ABROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.01OR12-820.
12/1/2020 Page 4 of 4 Individuals reaulrina Af)A nc:c:ommorlntiom c:nll 160?\.'i.4?-?999
'-nli) IRS DEPARTMENT OF THE TREASURY ~p INTERNAL REVENUE SERVICE
CINCINNATI OH 45999-0023
FRIENDS OF PRESCOTT SCOUTING INC 1085 SCOTT DR PRESCOTT, AZ 86301
Date of this notice: 02-27-2020
Employer Identification Number: 84-4892421
Form: SS-4
Number of this notice: CP 575 E
For assistance you may call us at: 1-800-829-4933
IF YOU WRITE, ATTACH THE STUB AT THE END OF THIS NOTICE.
WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER
Thank you for applying for an Employer Identification Number (EIN) . We assigned you EIN 84-4892421. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records.
When filing tax documents, payments, and related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear-off stub and return it to us.
When you submitted your application for an EIN, you checked the box indicating you are a non-profit organization. Assigning an EIN does not grant tax-exempt status to non-profit organizations. Publication 557, Tax-Exempt Status for Your Organization, has details on the application process, as well as information on returns you may need to file. To apply for recognition of tax-exempt status under Internal Revenue Code Section 50l(c) (3), organizations must complete a Form 1023-series application for recognition. All other entities should file Form 1024 if they want to request recognition under Section 50l(a).
Nearly all organizations claiming tax-exempt status must file a Form 990-series annual information return (Form 990, 990-EZ, or 990-PF) or notice (Form 990-N) beginning with the year they legally form, even if they have not yet applied for or received recognition of tax-exempt status.
Unless a filing exception applies to you (search www.irs.gov for Annual Exempt Organization Return: Who Must File), you will lose your tax-exempt status if you fail to file a required return or notice for three consecutive years. We start calculating this three-year period from the tax year we assigned the EIN to you. If that first tax year isn't a full twelve months, you're still responsible for submitting a return for that year. If you didn't legally form in the same tax year in which you obtained your EIN, contact us at the phone number or address listed at the top of this letter.
For the most current information on your filing requirements and other important information, visit www.irs.gov/charities.
(IRS USE ONLY) 575E 02-27 - 2020 FRIE 0 9999999999 SS-4
IMPORTANT REMINDERS :
* Keep a copy of this notice in your permanent records. Thi s noti ce i s issued only one time and the I RS will not be able to generate a dupl i cate copy f or you. You may give a copy of this document to anyone asking for proof of your EIN.
* Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms.
* Refer to this EIN on your tax-related correspondence and documents.
* Provide future officers of your organization with a copy of this notice.
Your name control associated with this EIN is FRIE. You will need to provide this information, along with your EIN, if you file your returns electronically.
If you have questions about your EIN, you can contact us at the phone number or address listed at the top of this notice . If you write, please tear off the stub at the bottom of this notice and include it with your letter. Thank you for your cooperation.
Keep this part for your records . CP 575 E (Rev. 7-2007)
Return this part with any correspondence so we may identify your account. Please correct any errors in your name or address .
CP 575 E
9999999999
Your Telephone Number Best Time to Call DATE OF THIS NOTICE: 02-27-2020 ( )
INTERNAL REVENUE SERVICE CINCINNATI OH 45999-0023 1.1 •• 1.1.1.1.1 •• 1.1 •• 1.1 .. 11 ... 11 ... .. 1.1 .. 11.1 .1 •• 1
EMPLOYER IDENTIFICATION NUMBER: 84-4892421 FORM: SS-4 NOBOD
FRIENDS OF PRESCOTT SCOUTING INC 1085 SCOTT DR PRESCOTT, AZ 86301
MANAGEMENT AGREEMENT
This Promoters Management Agreement (the " Agreement") is entered into effective as of the
11 day of April, 2021 (the "Effective Date" ) by and between Friends of Prescott Scouting Inc. (FPS) and
Eagle Management Events, LLC, an Arizona limited liability company (" EME"), and is made with
reference to the following recitals:
RECITALS
A. FPS is an IRS non-profit corporation organized and formed for the purpose of providing
not-for-profit services and benefits in compliance with applicable law and regulations.
B. EME is a for-profit limited liability company that provides management services for
events sponsored by non-profit companies.
C. FPS and EME desire to enter into a mutually agreeable terms and conditions upon which
EME will provide profit management services for and on behalf of BGCCA in connection with event
identified herein below.
NOW, WHEREFORE, in consideration of the mutual covenants and conditions contained herein,
FPS and EM E agree as follows:
1. THE EVENT. This Agreement is entered into in connection with the FPS sponsoring the
event commonly known as "Fireworks At Watson Lake" to be held on July 4th., 2021, in the City of
Prescott, Arizona (the " Event" ). At the Event, EM E shall meet all of the responsibilities set forth in this
Agreement and use reasonable good faith efforts to promote, set up and hold the Event.
Watson Lake Park is (the "Location") of the event.
2. INTELECTUAL PROPERTY. FPS acknowledges that they do not have, have never had, and
shall not claim to have, any ownership or other equitable or legal rights in the intellection property in
or of the event, including but not limited to name, logo, design, know-how, reports, drawing,
inventions, copyrights or models.
3. RESPONSIBILITIES. In connection with the Event, FPS shall use good faith efforts to provide the following items and services set forth hereunder,
(a) Secure and pay all fees associated with a special event liquor license from the City of Prescott and the State of Arizona. Fees not to exceed $200 per licensed day.
(b) Provide 40 Volunteers to assist in running the event.
(c) Complete all assigned tasks in a mutually agreed upon in a volunteer task list. This list to be produced and agreed upon no later than 30 days prior to event.
4. EME RESPONSIBILITIES. EME shall be responsible for providing the following:
(a) Barriers to prevent unauthorized access to the locations at which alcoholic
beverages are being served at the Event;
(b) An adequate number of portable rest room facilities;
(c) Wristbands or other identifiable items that security personnel shall issue to those persons of lawful age to consume alcoholic beverages;
(d) Provide fireworks and waterslides sufficient to operate the event.
(e) Any liquor items to be provided at the locations serving alcoholic beverages;
(f) Any uniforms that EME desires staff to wear during the Event. (i.e. T-shirts/Vests)
(g) An adequate number of supervisory personnel as required by applicable law or any governmental entity or agency with jurisdiction over the operation of the Event; and
(h) Compliance with all applicable governmental statutes, laws, ordinances and
regulations regarding the promotion, set up and holding of the Event.
(i) Secure the location of the event.
5. PROCEEDS FROM EVENT. FPS shall receive twenty-five percent (25%) of the gross
proceeds of the liquor sales as required by A.R.S. 4-203.02. Additionally, FPS shall be paid $60 per
volunteer provided to run the event. A shift shall comprise of 2:30pm to 9:45pm. FPS shall pay all city
and state fees to secure the liquor license. EME will meet with a representative of FPS within (10) ten
days after the event to reconcile liquor proceeds and shall pay FPS its 25% share at that time. FPS shall
agree to a shared revenue plan for corporate sponsorship of the VIP Corporate tables. The revenue for
these corporate tables will be held by FPS. All corporate checks will be made out to FPS. Within ten
days after the event FPS and EME will meet to split the proceeds of the corporate table sponsorship.
The split shall be gross proceeds from corporate table sponsors minus all expenses for VIP area. The
remaining fund shall be divided 50% to FPS and 50% to EME. If no remaining funds (profit) occurs, EME
will be responsible for expenses.
6. CONFIDENTIALITY. Each of the parties (the " Receiving Party" ) shall maintain the
confidentiality of this Agreement and all confidential information of the other party (the "Disclosing
Party" ) and shall not release, disclose or divulge any such confidential information without the prior
written consent of the other party. The Receiving Party may only use and copy such confidential
information as is necessary to carry out its activities contemplated by the Agreement (but subject to
the provisions thereof) and for no other purpose. The Receiving Party may disclose confidential
information to its employees, personnel, subcontractors and representatives on "need to know basis" ,
provided that it shall first instruct such employees and personnel to maintain the confidentiality
thereof. A Disclosing Party ' s confidential information shall not include information that: (a) is or
becomes a part of the public domain through no act or omission of the Receiving Party; (b) was in the
Receiving Party' s lawful possession prior to the disclosure and had not been obtained by the Receiving
Party either directly or indirectly from the Disclosing party; (c) is lawfully disclosed to the Receiving
Party by a third party without restriction on disclosure; (d) is independently developed by the
Receiving Party; or (e) is required by applicable law to be disclosed.
7. INDEMNIFICATION; LIMITATION ON LIABILITY. EME agrees to indemnify, defend and
hold the FPS harmless from and against any and all claims that may be brought against the FPS for any
personal injury or property damage arising in connection with the Event except to the extent that such
injury or damage is the result of the gross negligence or willful misconduct of the FPS or its
representatives.
Prior to commencement of the Event, EME shall obtain general liability bodily injury/property
damage, personal injury insurance with coverage in the amount of the greater of $1,000,000 per
occurrence or in such amount as may be required by the governmental entity or agency having
jurisdiction over the operation of the Event.
8. GENERAL
(a) Survival. Except as specifically provided herein all provisions of this Agreement
shall survive completion or termination of the Event.
(b) Independent Parties. FPS is sponsoring the event and EME is acting as an
independent contractor. At no t ime shall either party be deemed to be the agent, partner or joint
venture of the other party, and each party and its employees shall always remain independent of the
other party.
(c) Non-Waiver. The failure by either party to exercise any right, power or option
given hereunder, or to insist upon the strict compliance with the terms and conditions hereof by the
other party shall not constitute a waiver of the terms and conditions of this Agreement with respect to
any other or subsequent breach thereof, nor a waiver by such party of its right any time thereafter to
require strict compliance with all terms and conditions hereof.
(d) Force Majeure. Neither party shall be liable for any delay or failure to perform its
obligations hereunder due to strikes, labor disputes, riots, storms, floods, explosions, accidents, acts of
God, acts or orders of government, war, terrorism, the failure of vendors or other sponsors to perform,
the loss, destruction, breakdown, seizure or confiscation of vehicles or equipment, media event
cancellations or any other cause or causes which are beyond its reasonable control.
(e) Notice. Any notice, request, demand, consent or other communication provided
or permitted hereunder shall be in writing and given by courier delivery, or sent by registered mail,
postage prepaid, or transmitted by facsimile or electronic mail (e-mail) to the parties at the addresses
set out on the signature page hereto and shall be deemed to have been received on the date on which
it was delivered or transmitted by facsimile or electronic mail, or on the third day following mailing.
(f) Entire Agreement. This Agreement, including any exhibits hereto, contains the
entire agreement between the parties with respect to the subject matter hereof and supersedes all
prior negotiations, representations and proposals, written or oral, relating to such subject matter. No
supplement, modification or waiver of this Agreement shall be binding unless executed in writing by
both parties.
(g) Assignment. This Agreement and all rights and duties under this Agreement are
personal to EME and shall not be assigned. Any such assignment made in violation of this Agreement
shall be null and void and of no force or effect.
(h) No Third Party Beneficiaries. No provision of this Agreement, express or implied,
is intended to confer upon any person other than the parties to this Agreement any rights, remedies,
obligations, or liabilities.
(i) Governing Law. This Agreement shall be governed by the laws of the State of
Arizona, as applied to agreements made, entered into and performed entirely in Arizona by Arizona
residents.
(j) Binding Effect. This Agreement inures to the benefit of and is binding upon the
parties and their successors and permitted assigns.
IN WITNESS WHEREOF the parties hereto have executed this agreement as of the date first
written above.
EME:
By: Steve Gottlieb
Its: Owner/CEO
HANDICAP PARKING
YIP AIEA
GENHAL PARKING
YIP PARKING