K-2 - Special Events Application - Lions Blood Drive

Event Description: Blood Drive Name of Applicant: Pat Higby for Lions Club Phone: 319-266-4934 Location of Event: City Hall parking lots, rest rooms, and meeting room Date of Event: November 10, 2022 Time of Event: 8 am to 8 pm Estimated Number of Participants: Unsure, 50 to 100? Person Responsible for Monitoring Event: Pat Higby Plan for Restroom Facilities: We need access to City Hall restrooms Plan for Police Protection: Not needed Describe Clean Up Plans: Replace tables and chairs, pick up any trash Parking Plan: The Blood Mobile will be in the parking lot, and participants' cars as well. Description of Mechanical or Electronic Equipment to be used for Sound Amplification: not applicable Number and Type of Vehicles Including Bicycles to be Used in Event: Blood Mobile and cars of participants. Temporary Signage Request: Not sure—signs in grass by street? Special Circumstances Requested from City: None Proof of Insurance Attached: ☐ or not applicable? Not applicable. I certify that I am the person authorized to act on behalf of the event to request this permit and understand and agree to pay on behalf of the City all sums which the City shall be obligated to pay by reason of any liability imposed upon the City for damages of any kind resulting from use of public property and the public right of way, whether sustained by any person or persons, caused by accident or otherwise and shall defend as its own expense and on behalf of the City any claim against the City arising out of the use of public property and the public right of way and agree to follow all other ordinances that shall pertain including Ordinance 2006-277, City of Tiffin, Iowa. I understand that I will not erect any temporary signage for the event prior to City Approval of signage. [Signature] Patricia Higby 10-12-2022 For City Use: Authorized City Signature Date Copy to Applicant _____ Johnson Co. Sheriff Notified _____ Fees Collected _____ Public Works Notified _____ Tiffin Fire Department Notified _____ Council Approval _____