HomeMy WebLinkAboutMINUTES - 08052003 - C.134 TO BOARD OF SUPERVISORS Cr
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FROM: William B. Walker, M.D. ` -- -'•
DATE: June 12, 2003 6` ® ; '
Costa
County
SUBJECT: USE OF CITY OF BRENTWOOD COMMUNITY �-t�
CENTER, FOR PUBLIC HEALTH DIVISION-
IMMUNIZATION ASSISTANCE PROGRAM
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
Authorize the Director of County Health Services Department or his designee, Wendel
Brunner, M.D., to hold harmless and indemnify the City of Brentwood, Parks and Recreation
for use of their community center on October 20, 2003, by the Public Health Division,
Immunization Assistance Program.
REASON FOR RECOMMENDATION:
The Public Health Division of the County Health Services Department will administer flu
vaccines to senior citizens and/or the public at the Community Center, 730 Third St.,
Brentwood, CA.
FINANCIAL IMPACT:
none
CONTINUED ON ATTACHMENT: _YES SIGNATURE: G✓�
-----------—-------_� -------_.._--------------------------------------------------------------- ----.�._------------------------------------------
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
.,APPROVE OTHER
SIGNATURE(S):-I
------.- _ -------------------------------_ ------------------------- ------------
ACTION OF 13 ONAUC,7.TST 5, 2003 APPROVE AS RECOMMENDED X OTHER
,a
VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE
AND CORRECT COPY OF AN ACTION TAKEN
UNANIMOUS(ABSENT_ 1 ) AND ENTERED ON THE MINUTES OF THE
AYES:_ NOES:
BOARD OF SUPERVISORS ON THE DATE ABSENT: ABSTAIN: SHOWN.
ATTESTED4WST 5,2003
CONTACT: Angela Pepsin JOHN SWEETEN,
313-6767 CLERK OF THE BOARD OF SUPERVISORS AND
COUNTY ADMINISTRATOR
CC: Health Services Administration r;
BY 7 -- -- � •._ DEPUTY
Sent By: City or Brentwood; 925 516 5445; Jun-4-03 9:17AM; Page 1
CITY Of .
(w17 K i,.- '' "f,,;;,•.n.ji`,y-'day{s�
'Providing ioxcellence in Care d Service for the People.Issues 6 Resources of our Community
FACILITY USE APPLICATION—COMMUNITY CENTER
736 Third Street,Brentwood,CA,54513 (925)516.5444,FAX(925)516-5445
Applicant Name_`: . ': . t I�E to Application Filled Ou ` `
s� 4–
Organization Name >;� r1`'t € �}.__ o Date of Function 1 � ' =f
Address ; s icx t 1 City i y. Zip �f -I
(H)Phone {w)PhoneC�1
Contact erson durinj course of event if other than a lican
Room Copaelty: . Multipurpose Room-, 375 auditorium sea,ing
200 table seatirig
Blue Room .::40 auditorium seating
30:tgbleseating
RESERVATION–
One(1)hour minimum charge for Non-Profits
4 Four(4)hours minimum charge for private and commercial events.
•:a Five(5)hours maximum charge for private and commercial events.
Events(Actual Event Hours)must end at 12 Midnight to be followed by take down time.
Rental Time: Set-up AM/ to AMO %
Actual Event His. G r-, AM M.to
Down
Take DowF AM ~tc L= AMtil >
(Set up,event and closure must be scheduled for consecutive hours)
1. Brief description of event to be held fb;i. t ;)i €`t f —Expected#Attendance ;
2. describe decorations M _
3. What additional equipment will be brought in?When?By Whom?
4. Will alcohol be served,sold or on the premises? n
Anyone sem, 'no or safffno afcahot must Cal a:Rpicjnl Events Permit om the Erentwavd CftV notice
Dek,9 finent;500 Chestrtut Mmdf,
5. Will the meeting be open to the public?—--'--fe, >
6. Will you need the PA system? - ra 0
7. Will the event involve a BBQ,catering or cooking the meal in the kitchen?
9. Will you need the la5a coffee ot? fV10
Parking tots adjacent to the Brentwood Cbmmunity Center.are for;;pubife use and are not under the jurlsefietion
of the Canter. `herdwe;avgitab lliy pf these lots cannot be:+guaraMeed.
I hereby certify that I shall be responsible on behalf of my organization far damage sustained or cost incurred by the City
of Brentwood because of occupanoy of said premises by myself or my organization. I have read and received all tr,e
Rules and Regulations of the City of Brentwood and agree to abide by them.
I also agree to hold the City of Brentwood and it's employees;the individual members thereof agents,and employees
free and harmless from any damage,liability,cost or expense that may arise during or be caused in any way by such
use or occupancy of the Brentwood Community Center,
Applicant Signature Date
fie artment Aproved' Date
Assigned Facility Supervisor SupeMsor Phone Number
Copy-of Special EventsPermi)Received by_Center Date Received
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