HomeMy WebLinkAboutMINUTES - 01261999 - C91 8
TO: BOARD OF SUPERVISORS CONTRA COSTA
COUNTY
FROM: William Walker, M.D.
Health Services Director
DATE: January 13, 1999
SUBJECT: Use of the City of Walnut Creek's Civic Art Education Center
Facilty for Health Services sponsored event
SPECIFIC REQUEST($)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
Rerm mendativn:
Authorize the Health Services Director or his designee, Wendel Brunner, M.D., to bold harmless and
indemnify the City of Walnut Creek and its Civic Arts Education program for the use of their Shadelands
facility, located in Walnut Creek, on January 29, 1999 for the Family, Maternal and Child Health
Programs all-staff meeting.
Bach r� Quind:
None.
Fiscal lrn acct:
Funding for room rental is included in the State allocation for Maternal & Child Health Programs
CONTINUED ON ATTACHMENT: YES ONO SIGNATURE
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
ACTION OF BOARD ON ,,ianr nary 26 7 1999 APPROVED AS RECOMMENDED___ OTHER
VOTE OF SUPERVISORS
X UNANIMOUS (ABSENT m ® m - _ - - - } i HEREBY CERTIFY THAT THIS IS A TRUE AND
CORRECT COPY OF AN ACTION TAKEN AND
AYES: NOES: ENTERED ON THE MINUTES OF THE BOARD OF
ABSENT: ABSTAIN: SUPERVISORS ON THE DATE SHOWN.
ATTESTED jantlary 26, 1999
CONTACT PERSON: CHERI PIES(313-6254) PHIL BATCHELOR,CLERK OF THE BOARD OF
SUPERVISQR6 AND COUNTY ADMINISTRATOR
CC: Public Health Director
Health Services Director +
FMCH
BY: EPUTY
(
CITY OF WALNUT CREEK
CIVIC ARTS EDUCATIONISHADELANDS USE PERMIT
Return all copies of this forrn to Civic Arts Education, P.O. Box 8039, Walnut Creek, CA 94596 with
your $200 security deposit and your Rental Balance no later than -
Checks: Made payable to City of Walnut Creek +sem
Visa or MC #
FAX: (510) 937-2787
(Board Room and Back Room) 10:OOAM To 1:OOPPi
1. Date of use January 29, 1999 From 7:OOAM To 5:OOPM
2. AUDITORIUM X PLEASE REMEMBER THAT YOUR TABLE AND CHAIR
SET UP WILL BEGIN AT 7:OOAM Set up will be done
WHICH IS YOUR RENTAL START TIME. THE FACILITY
BOARD ROOM WILL NOT BE OVEN PRIOR TO THAT TIME FOR YOU,
YOUR CATERERS, BANDS, DECORATORS, ETC.
3. Type of Activity meeting Estimated Attendance
4. Name of Organization Contra Costa County Health Services
5. name of Applicant Diane Woloshin
6. Phone: Home Work 313-6308 Fax 313-6708
7. Private Individual? OR
Non-Profit? X _ (must show 501(c)3 statics
e. Mail security Deposit to: Contra Costa County Health Services
9. Address 597 Center Avenue, Suite Nartinez 94553
10. Person in charge the day of event
11. Will alcoholic beverages be served? Yes No
and do you understand the policies regarding the use of Alcohol? Yes—No-
12.
esNo12. Decorations: Yes No V Explain
13. Name of Caterer _ TQ , .^ Phone
14. Rental Balance Due Main Room - ;605 (Includes m hour to set up & take down)
TOTAL DUT-: wo Break out Rooms $200 (Includes set up and take down
f05 pIUS00 Date .Balance Due /31/ 9 (90 days prior to event
Damage Depose. Rental for Additional Hour(s) $55/hour auditorium
25 break out ams
Equipment Requested: FLOOR PLAN NEEDED 1 WEED PRIOR TO EVENT
No. Of Chairs
No. Of 6°Tables
Kitchen
Podium
Movie Screen
VCR ($25 per use)
Piano ($50 per use)
Slide Projector ($25 per use)
Overhead Projector ($25 per use)
. LICENSEE shall be responsible for all acts and conduct of LICENSEE and
LICENSEE's auests, invitees, employees and agents while on the premises, including the
parking lot. This provision includes the acts of all children,and yo
2. The rental includes only portions) of the facility covered in the agreement, normal
glean-up, heating and air conditioning, and use of kitchen facilities. Permit does not
include any-soeaal services, tabor or equipment not supplied under the terms of this
'license agreement.
3. Written approval by Civic Arts Education representative must be received prior to
adachi , installs or affixing of any items including decorations to the dos,walls ceilint
anchor floors. LICENSEE or
EE must place o r remove all such items on the premises withfn the
contracted rental hours.
4. LICENSEE will not permit any activity during the event which would disturb the peace,
cause injury to MY OF WALNUT CREEK, '
or the property of adjoining
landowners, or which would be a violation of any Local, state or federal law.
5. Consumption of food and beverages Is restricted to the auditorium end patio areas.
No beverages are allowed In parking tot. Please advise ytiwr guests of this rule.
6. Concessions and sales or commercial activities within the facility are not ppanitted
without written approval of the CITY CP WALNUT CREEK.
7. LICENSEE shall be bound by. the Pee Schedule in existence on the date of this
License Agreement. LICENSEE acknowledges receipt of current Pee Schedule and Menta
Information Including Rules.
S. LICENSEE shall remove all of LICENSEE's property at the conclusion of LICENSEE'!
permitted use of the premi*es.
9. Services of a Caterer are contracted for and the financial responsibility of LICENSEE.
10. LICENSEE shall pay, as rental, the balance due at least 60 days prior to the first
scheduled date of LIC ENgEE`s use of the Premises.
tity signature certifies that I have read the conditions as set forth by the Civic Arts Education r ram
of%C[ty of WAWA Creels governing the use of the Items ed on this application, mat i wilt
to I responsibUity for assuring•that the use of-owse fa itiestareas by tote �tneizattiWgroxrp I
r t Is In full adherence and compliance with tote conditions started above that l will defend,
lndernnlfy and hold the City harmless from any damage claim or actions for personal Injury or death,
damage to or loss of property,ctairns for darttbt to or joss of Incuded In the use of these
facllitiW areas; that rf there are any mirrors In W group using fac titiestareas, I will accept full
responsibility for therm throughout the period covered by this AppticationtPermit
Dated: 19
LICENSEE: _ --
Signature
Printed Name:
For the City of Walnut Creek:
Name:
Printed am& J a c q u e] t n e L i e t z
Phone: 510/943-5846