HomeMy WebLinkAboutMINUTES - 01101995 - 1.83 To: BOARD OF SUPERVISORS
Contra
FROM: f i \\\\' Costa
ry� MARK FINUCANE, HEALTH SERVICES DIRECTOR ' ••�+• °� Count
DATE: Tr+cBii�r �
December 21, 1994
SUBJECT:
USE OF CITY OF CONCORD SENIOR CITIZEN'S CENTER FOR CENTRAL
COUNTY COMMUNITY HEALTH FORUM - JANUARY 14, 1995
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
I. RECOMMENDATION:
Authorize the Director of the County Health Services
Department or his designee, Wendel Brunner, M.D. to hold
harmless and indemnify the City of Concord, Concord Senior
Citizen's Center at 2727 Parkside Circle, Concord, California
on January 14, 1995 from 9:30 a.m. to 12:30 p.m.
II. FINANCIAL IMPACT:
None
III. REASON FOR RECOMMENDATION:
The Contra Costa County Public and Environmental Advisory
Board (PEHAB) will be holding a Central County Community Forum
to discuss health care issues on Saturday, January 14, 1995,
from 9:30 a.m. - 12 : 30 p.m. , at the Concord Senior Citizen's
Center at 2727 Parkside Drive in Concord, California.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE (S):
ACTION OF BOARD ON JAN 10 1995 APPROVED AS RECOMMENDED OTHER .�.._
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
Contact Person: Wendel Brunner, M.D. JAN 10 1995
CC: ATTESTED.
Health Services Administration PHIL BATCHELOR,CLERK OF THE BOARD OF
Public Health Administration SUPERVISORS AND COUNTY ADMINISTRATOR
M382 (10/88) BY DEPUTY
J
A HOUSING&COMMUNITY SERVICES
SENIOR CENTER RENTAL APPLICATION
ion"�d
City of Concord • Senior Citizens Center• 2727 Parkside Circle • Concord, CA 94519-2523 • (510) 671-3320
NAME OF ORGANIZATION Contra Costa County Health Dept./ ADDRESS OF ORGANIZATION
kiblic & Environmental Health Advisory Bo an3 597 Center Avenue, Suite 200, Martinez 94553
NAME OF APPLICANT HOME PHONE BUSINESS PHONE
Suzanne Teran 1 313-6712
ADDRESS OF APPLICANT CITY STATE ZIP
597 Center Avenue, Suite 200, Martinez, CA 94553
DESIGNATED PERSON IN CHARGE OF ACTIVITY HOME PHONE BUSINESS PHONE
DATE(S)REQUESTED BETWEEN HOURS OF
1/14/95 9:30 MM [ ]PM to 12:30 [ ]AM [X]PM
NATURE OF PLANNED ACTIVITY
Com pity forum to discuss health care issues
WILL ANY SPECIAL EQUIPMENT BE BROUGHT IN(i.e.,MICROPHONES,LOUDSPEAKERS,AMPLIFIED SOUND SYSTEM)? IF YES,EXPLAIN:
[X]YES [ ] NO Event will be taped for airing on CCTV. CCTV will bring recordi-nq/tapinq eauiumr
OTHER CITY SERVICES REQUESTED
[X]YES [ ]NO We would like to borrow a microphone for presenters
ADMISSION CHARGE? AMOUNT CHARGED ANTICIPATED ATTENDANCE? ALCOHOLIC BEVERAGES? WILL THERE BE DECORATIONS?
[ ]YES k ]NO $ 100 [ ]YES (K] NO,- [ ]YES [X]NO
RENTAL FEES:
I ] NON-RESIDENT........................................... $ [ ] SET-UP&TAKE DOWN............................... $
ROOMS: [ ] BALLROOM................................. $ TOTAL FEES ..................................................... Is
[ ] BLUE............................................ $
I1 CORAL......................................... $
[ ] SECURITY DEPOSIT(separate check due
[ ] GOLDEN...................................... $ 14 days before day of event)
[ ] SILVER ....................................... $ CENTER ........................................................ $ 100
[ ] ENTIRE BUILDING(add$10.00 per/hr.) ..... $ KITCHEN ....................................................... $ 200
If permission to consume and possess alcoholic beverages is granted then such permission is conditional and the permit may be revoked forthwith
by the Director of Housing&Community Services or duly authorized representatives for the violation of any law,rule or regulation relating to the
consumption and possession of alcoholic beverages and/or any other violation of the terms of the permit granted herein.
My signature certifies that I have read the conditions as set forth by the City of Concord governing the use of the Senior Center;that I and my
organization will take full responsibility for seeing that the use of these facilities/areas by the organization I represent is in full adherence and
compliance with these conditions,that I will hold the City harmless from any damage,claim for damage for personal injury or death,damage to
or loss of property, claims for damage to or loss of property incurred in the use of these facilities/areas;that I will not discriminate against any
person because of their race,religion, sex, national origin or cultural background;that if there are any minors in the group using these facilities
or areas, I will accept responsibility for them throughout the period covered by this Use Application. NO REFUND WITHOUT A 30-DAY NOTICE.
A non-refundable service charge of$5 will be charged for all cancellations.
DATE SIGNATURE OF APPLICANT
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.:::.:.:....:. ..;..:::.:;:
RECEIPT NO. CHECK NO. DATE PERMIT APPROVED AUTHORIZED BY SENIOR CENTER STAFF
HCS-38 JUN 92 WHITE-APPLICANT CANARY-SENIOR CENTER PINK-FINANCE