2013-10-09 MAPAThe undersiKtaA her by req � is use oft the Blair
Chambers by �, A ni
(pergon /organization) for the purposes o
. For and in consideration of the use of said chambers, the
undersigned hereby specifically agrees to the following terms and
conditions and specifically shall be bound by all provisions of this
agreement.
1.* The premises shall be used only for the purposes as specified
hereinabove.
P9
The ar mises shall be used for such purpose
on ` 2+0 13 , from
14 .M. to "It o'clock .m.
3. Configuration of the premises including placement of tables or
chairs shall be restored to the condition prior to the use of the
premises.
4. No alcoholic beverages or liquor shall be possess or consumed on
the premises and the undersigned shall take all reasonable
precautions and actions to enforce such prohibition.
5. The undersigned shall further be responsible for enforcing the
City's "No Smoking" policy in the chambers or any part of the City
Hall premises for -which utilization is permitted to the undersigned.
6. - The undersigned shall be specifically responsible for locking and
securing the facilities upon termination of the use, No decorations
including but not limited to use of nails, tacks, staples, other
metal penetrating objects, tapes, or adhesives may be used
without prior permission from the City Administrator. Any
decorations or other display for which authorizations has been
granted shall be removed upon termination of the use by the
undersigned.
by the undersigned
o'clock
If. The premises shall be utilized for the occupancy of no more
than-J-S-)— persons which the undersigned specifically
acknowledges is the maxiinum number of persons for which
authorization is in compliance with the State Fire Marshall's
regulations.
9. The undersigned warrants and represents the use of the
premises is by an organization as marked below and further agrees
to remit the rent, if any, as indicated herein below.
Non Profit Organizations
Public/ Governmental Organizations
Political Organizations,
Public Informational Forums
Political Rallies
Business or Commercial Organizations
No Charge
No Charge
I
No charge
$50.00
$50.00
10. THE UNDERSIGNED SHALL SPECIFICALLY BE RESPONSIBLE
AND LIABLE FOR ALL DAMAGES TO THE PREMISES AND ITS
CONTENTS CAUSED BY THE UNDERSIGNED'S GUESTS OR
PERSONS OCCUPYING-THE PREMISES WITH THE
UNDERSIGNED'S INVITATION OR PERMISSIONS.
11. This agreement shall. be binding upon the heirs, personal
representatives, successors, and assigns of the undersigned.
12. The undersigned hereby specifically acknowledges a copy of the
foregoing agreement and that the undersigned has read,
understands, and agrees to comply with all of the terms and
conditions as set forth in this agreement.
Dated: a —12