HomeMy WebLinkAboutMINUTES - 08062002 - C112 TO: BOARD OF SUPERVISORS Contra
, .
FROM: William Walker, M.D. ,t
Costa
DATE: July 1, 2002
SUBJECT: Use of Martinez Unified School District County
{Martinez Adult Education Auditorium}
Facility for Health Services/Public Health
Sponsored Event
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
AUTHORIZE the Health Services Director or his designee, Wendel Brunner, M.D. to sign a
hold harmless agreement indemnifying Martinez Unified School District for the use of the
Martinez Adult Education Auditorium located at 600 F Street on August 20, 2002.
BACKGROUND:
The facility will be used to hold an educational forum.
FISCAL IMPACT:
None
CONTINUED ON ATTACHMENT: ,_,_,_YS SIGNATURE:
-"9ECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
—,,—APPROVE —OTHER
SIGNATURE(S):
t.ism _
ACTION OF BO ON APPROVE AS RECOMMENDED . —'OTHER
VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE
AND CORRECT COPY OF AN ACTION TAKEN
UNANIMOUS(ABSENT - {. ) AND ENTERED ON THE MINUTES OF THE
BOARD OF SUPERVISORS ON THE DATE
AYES: NOES: SHOWN.
ABSENT: ABSTAIN:
K
ATTESTED
CONTACT: Francle Wise 313-6740 J JOHN SWEETEN,CLERK OF
THE BOARD OF SUPERVISORS AND
CC: Health Services Director COUNTY ADMINISTRATOR
Public Health Director
Communicable Disease Programs Director
BY >' £ # s :'. DEPUTY
MARTINEZ UNIFIED SCHOOL DISTRICT
REQUEST FOR OEOF SCHOOL PREMISES
IN CASE OF CANCELLATION
TELEPHONE: 313-0480, ext.224
Martinez Adult Education 6/5/02
Business Office DATE
Martinez Unified School District
921 Susana Street
Martinez, California 94553
The Contra Costa Public Health
through Its authorized agent requests the use of the school premises listed below. (School functions shall have priority,
which may result In cancellation of an approved date.)
NAME OF SCHOOL Martinez Adult Education Month Dates Month Dates
FACILITY IN SCHOOL. Auditorium
HOURS DESIRED 1 - 5 PM
NO.OF ADULTS 60 NO.OF CHILDREN Q
C�KITCHEN TO OPEN(hours) to KITCHEN IS Wn OMEN.
ALL EQUIPMENT AND UTENSILS AVAILABLE!CAFETERIA WORKER ONLY COFFEEMAKER MAY BE USED.NO CAFETERIA WORKER IS
PRESENT.COFFEE OR OTHER BEVERAGE,WITH COOKIESICAKE
SHOULD REPORT TO: SERVED ON PAPER PLATES.
TYPE OF FOOD SERVICE
(Dinner,Potiuck,Light refreshments)
ESTIMATED NUMBER TO BE SERVED ESTIMATED NUMBER TO BE SERVED
The purpose of the meeting Is department meeting Admission Charge: Yes No X
Proceeds will be used for
SPECIAL EQUIPMENT: Tables 2 Chairs 60 P.A.System Yes Other
Stage Lighting(Alhambra) (Only trained crew Is to be Inside the"caged"area tktat houses the stage righting
switches. If these tights are required,a.student operator will have to be paid.)
1. The using organization Is expected to pick up major debris after using school facilities,unless special cleaning arrangements have been
made with the Business Office.
2 Any change in the hours desired must be arranged ahead of time through the Business Office.
Telephone(313-0480,ext.229)
3. The organization Is expected to provide reasonable supervision of minors.
s
4. The organization Is expected to terminate Its activity at the hour Indicated on the Request Form.
S. Any furniture moved by the organization Is to be returned to its original arrangement.
We hereby undertake and agree that the above named organization and Its members shaalII be responsible and pay for any damage caused to the
school premises,furniture or equipment because of the use or occupancy of said premises by said organization.
Signature of Authorized Agent
(Print or Type Name} --
Address City Zip
Telephone: Business Home
(test phone number where you may be reached during the day)
Certificate of Insurance Is on file in the business Office($1 million, naming the District as additional Insured.) 0
REQUESTAPPROVEDIA REQUEST DENIED ® RENTA E $ 65.68 LABOR FEE
Director of rise*!serviee
Form*110 2194 GG:ho R. Marshall Burgamy, Director, Martinez Adult
Educatioi
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