HomeMy WebLinkAboutMINUTES - 03011994 - 1.69 1 Q
TO BOARD OF SUPERVISORS
F13aM ra
MARK FINUCANE, HEALTH SERVICES DIRECTOR 1.�,l.J,I��.I}t,,
_ CWS
DATE: FEBRUARY 1, 1994 CQ^
SUBJECT: USE OF OAKLEY UNION SCHOOL DISTRICT FACILITY FOR
IMMUNIZATION ASSISTANCE PROGRAM-PUBLIC HEALTH DIVISION
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECOMMENDATION:
Authorize- the Director of County Health Services Department or his
designee to hold harmless and indemnify Oakley Union School District facility
Oakley, California indefinitely for use of their premises by the Public
Health Division Immunization Assistance Program for administering flu shots
and pneumonia vaccines to the public.
II. FINANCIAL IMPACT:
None
III. REASON FOR RECOMMENDATION:
The Public Health Division of the County Health Services Department
will administer vaccines to the public at Oakley Union School District
facility, '91 Mercedes Lane, Oakley, California.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR ._.-_.- RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE S :
ACTION OF BOARD ON �+ .- APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
1' HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION TARN
AYES;_ NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
contactperson: Dottie La thorn 313-6767 ATTESTED
CC—R-ir-sk Management
Public Health Administration PHIL BATCHELOR, CLERK OF THE BOARD OF
Acute Communicable Disease Program SUPERVISORS AND COUNTY ADMINISTRATOR
Immunization Assistance Program
Health Services, Director
BY ,DEPUTY
M382/7-83
-A•r.`.4 - 27 - 94 THU 1 0 03 H HA P. I_TTS BURG P . 02
t OAKLZY UNION SCHOOL DISTRICT
r • ' P.O. Box 7
Oakley, Californian 2806
APPLICATION AND PERMIT FOR USE OF SCHOOL PROPERTY
equest is hereby made for the use of the following school property at School
:heck Facilltles Needed) (Check Equipment Needed) TIME INDICATE TIME
(Multi-purpose Room only ❑ Folding Chairs—Number
I Classroom No ❑ Tables MONTH DAY FROM TO
I library ❑ Public Address System with operator
I Music Room ! __; ❑ 16 mm Projector
I Auditorium ❑ Slide projector with operator
Playfield ❑ Projection Sween
Football Pield —Game Use Cl Record Player
Football Field — Other Use ❑ Piano -
Baseball Field ❑ speakers Stand
Kitchen — For the use of kitchen facilities or ❑ stage Facilities
equipment, arrangements must be made with ❑ Special affects stage lighting (including spot
the office
lights)with operator
Other ❑ Other
I
rganization or Sponsor_. _
ipe of Organization: — Educational (] School Connected I] Recreational C3 Youth Character Building
Religious ❑ Political J - Private Other A e4,1.9 C�<.,i u'4_Zm ivuaryr
ascription of activities to be conducted ,L rr/iYl,C.c Iii Zw'? .�
Meeting Open to Public? qe-5 Attendance Expected � ' �Uy Will paid entertainers, speakers, callers, i
-c., be used?_ �A — Will anything be offered for sale?_ 21 in
an admission charge, donation, collection, dues or tuition fee required or solicited?
rnouni _ Proceeds to be used for
I hereby certify that I shall be personally responsible. on behalf of my organization. for any damage sustained by the
scnool premises, furniture, or equipment because of the occupancy of said premises by our organization and further agree to
reimburse the district for any costs of repair for damage incurred. I agree to abide by and to enforce the rules, regulations
and policies of the Oakley Union School District governing the use of school premises or equipment. (SEE REVERSE SIDE)
I also agree to hold the Oakley Union School District, its Governing Board. the individual members thereof, and all
District Officers. agents. and employees free and harmless from any loss. damage. liability, cost. or expense that may arise
during or be caused in any way by such use or occupancy of school property, i!
i
f
�_ arON�TU RE TITLE ON OFFICE HELD
idress _______—...—_— _ Phone
STREET NUMBER
_— Date i
clTr i
Esse
APPLICATION APPROVED
ncipa)____ Guarantee Deposit i
Perintendent -Rental Pee ±
STODIAN'S REPORT €
s above organization used the school facilities as listed above and followed the rules regarding their use with this exception:
le—--- — •—_--�— Custodian
Reviewed by Principal
Ie.District Office yellow.Principal Pink-Applicant Geld-Moint. Superintendent