PCEC application for use 5.1.14

Page 1

Pierce College Equestrian Center Application For Use

A Non-­‐Refundable $300 Booking Fee is required at time of estimate to hold your date Permit for Use will include Additional Payment Terms including a security deposit due 30 days prior to your event.

Application Date:

Requested Event Date(s): Begin mm/dd/yy:

End mm/dd/yy:

Name of Event:

Organization Name / Promoter DBA:

Daily Event Open and Close Time(s)

Participant Arrival Begins Date / Time

Participant Arena Access Dates / Times

Management Arrival Date:

Time:

Management Departure Date:

Time:

Mailing Address:

Zip:

Contact person:

Phone Land Line:

Cell phone:

Email address:

Organization Website:

Estimated Number of Participants:

Estimated Number of Spectators:

Estimated # trailer parking

Estimated # passenger vehicle parking

Estimated Overnight RVs

Estimated Number of Overnight Horses:

Estimated Number of Day Haul-­‐In Horses:

Estimated Number -­‐ Cattle or other animals: #

Type:

A Certificate of Insurance and an accompanying endorsement that includes the following is required: General Liability – Comprehensive or Commercial Form, minimum limits each occurrence $1,000,000, General Aggregate $2,000,000. Certificate must endorse Pierce College and Los Angeles Community College District as additionally insured. A copy of insurance must be submitted 2 weeks in advance of event. Proof of Worker Compensation Insurance (if applicable) and Automobile liability insurance required.

All parties doing business with the LACCD and Pierce College must have Vendor Information on file. Legal Name of Promoter / Organization

Tax Status of Promoter / Organization (partnership, non-­‐profit, etc.)

Taxpayer I.D. (SS# or EIN#)

Review Date: Submitted Date:

By: To:

5/1/2014 Version PCEC Application for Use


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