HomeMy WebLinkAboutMINUTES - 09091997 - C136 c7w 13 1::9
-TO: BOARD OF SUPERVISORS
FROM: William Walker, M.D., Health Services Director Contra
Costa
DATE: August 1, 1997 County
SUBJECT: USE OF DELTA COMMUNITY SERVICE CENTER IN BRENTWOOD FOR
IMMUNIZATION ASSISTANCE PROGRAM-PUBLIC HEALTH DIVISION
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 Delta Community Service Center,
Brentwood, California indefinitely for use of their premises by the Public Health Division,
Immunization Assistance Program for administering flu vaccines to the public.
FINANCIAL IMPACT:
None
REASON FOR RECOMMENDATION:
The Public Health Division of the County Health Services Department will administer
vaccines to senior citizens and/or the public at Delta Community Service Center,
730 Third Street, Brentwood, California.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE _OTHER
SIGNATURE (S):
ACTION OF BOARD ON ,��� 9 . 1997 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. J q p
CC: Health Services Administration ATTESTED T
Immunization Assistance Program PHIL BATCHELOR,YCLERK OF THE BOARD
Public Health Administration OF SUPERVISORS AND COUNTY ADMINISTRATOR
BY ja MA A , DEPUTY
L)O i Ld Cuuunun 1.Cy bU v.LC;e
r" 730 Third Street
436, Brentwood, Calif. 94513
Application for Facility Use
510-634-8275
NAME OF APPLICANT Contra Costa County Public Health DATE R-1-97
NAME OF ORGANIZATION (if applicable)
ADDRESS 597 Center Ave. 200A CITY - Martinez ZIP 94553
PHONE(H) (W) 313-6767 DATES) OF USE 10-07-97
(Check)
FACILITIES REQUESTED: MULTI-PURPOSE ROOM X KITCHEN
AM AM AM AM
HOURS OF EVENT PM :30 PM 3.30 TOTAL HOURS OF USE PM 1:30 PM 4:00
(INCLUDES SET-UP & CLEAN-UP
Set-up, event and clean-up must- be scheduled for consecutive hours.
PARKING FACILITIES ADJACENT TO THE DELTA COMMUNITY SERVICE CENTER ARE FOR
PUBLIC USE AND ARE NOT UNDER THE JURISDICTION OF TI•IE CENTER. THEREFORE,
AVAILABILITY OF THESE LOTS CANNOT BE GUARANTEED.
CLASSIFICATION Non-Profit X Commercial Private
MULTI-PURPOSE ROOM $30/HR. 9:50/HR. $50/HR
(Includes Kitchen) (Includes Kitchen) (Includes Kitchen)
5 hrs4max.
KITCHEN (only) $15/HR. $15/HR. $15/HR.
CLEAN UP $50 FLAT FEE $50 FLAT FEE $50 FLAT FEE
One ( 1 ) hour minimum charge for non-profits. Four (4 ) hour minimum charge
for private and commerical events.
DEPOSIT
FOOD ONLY $75 $75 $75
FOOD & ALCOHOL $150 $150 $150
Type of Event: Flu vaccine to he admjn;ctPrPr1 to oenior citizens and/er th Tblic.
WILL MEETING/EVENT BE OPEN TO THE PUBLIC? yes ATTENDANCE EXPLCTED 250
WILL ADDITIONAL EQUIPMENT BE BROUGHT IN FOR THE EVENT? No
WHAT? DESCRIBE:
WILL ALCOHOLIC BEVERAGES BE SERVED?. No_ WILL THERE BE DECORATIONS_
EXPLAIN
I hereby certify that I shall be .responsible on behalf of my
organization for damage sustained or costs incurred by the Delta Community
Service Center because of the occupancy of said premises by myself or my
organization. I have read all the Rules & Regulations of the Delta
Community ServiceCenter and aciree to abide by them. (ATTACHED) .
I also agree to hold •t-he Delta Community Service Center and its Board
and the City of Brentwood, 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 Community Service Center.
DATE APPLICANT'S SIGNATURE
DATE DCSC STAFF SIGNATURE
CENTER SUPERVISOR TOTAL OF USE FEE
SUPERVISOR TELE(( DATE USER FEE DUE
ARRIVAL TIME DATE RECD SPECIAL PERMIT(BPD)
Delta Community Services, Inc. requires that a center trained supervisor be on site for all
events held at the center. The center supervisor has the authorization to close down the event
if the rules & regulations are not abided by.