2. Applicant Information
4. Business/Organization Name (Legal and DBA):*
6. Business/Organization Address:*
8. City:*
9. State:*
10. Zip:*
12. Status of Organization:*

    1. For Profit
    2. Non-Profit

    1. Individual
    2. Other
13. Upload proof on non-profit or 501(c)3 status:
15. Name of Applicant:*
16. Email Address:*
18. Phone Number:*
19. Cell Phone Number:
21. List Additional Organization Contacts -
23. Name:
24. Phone:
25. Email:
27. Name:
28. Phone:
29. Email:
31. Event Information Part I
33. Event Name:*
35. Event Location / Address:*
37. Event Location Description / Type: *
39. Event Date(s): *
41. Event Day 1
43. Set Up Begin Time:*
    Set Up Begin Time:
44. Actual Event Time:*
    Actual Event Time: Start Time

    —

    Actual Event Time: End Time
45. Cleanup / Load Out End Time:*
    Cleanup / Load Out End Time:
47. Event Day 2
49. Set Up Begin Time:
    Set Up Begin Time:
50. Actual Event Time
    Actual Event Time Start Time

    —

    Actual Event Time End Time
51. Cleanup / Load Out End Time:
    Cleanup / Load Out End Time:
53. Event Day 3
55. Set Up Begin Time:
    Set Up Begin Time:
56. Actual Event Time:
    Actual Event Time: Start Time

    —

    Actual Event Time: End Time
57. Cleanup / Load Out End Time:
    Cleanup / Load Out End Time:
59. Expected Number of Attendees: *
60. Name of On-Site Contact During Event: *
61. CellPhone: *
63. Will any City of Wilton Manors equipment be requested for use during event?

    1. Yes
    2. No
64. If yes, describe request:
66. Description of Event: *
68. Event Information Part II
70. Event Insurance: *

    1. Yes
    2. No
71. Insurance Limits:
72. Admission Fees: *

    1. Yes
    2. No
73. If yes, how much:
75. Select all that apply: *

    1. Alcohol for Sale **
    2. Alcohol for Free **

    1. Food Being Served **
    2. Food Being Sold **
76. Type of food and/or beverage vendors:
78. **

    *All serving and sales of alcohol require proper licensing according to Florida Law.

    *All vendors preparing food are required to have a Health Department Permit from a county in Florida and a certificate must accompany vendor at the time of the event. All vendors must adhere to Broward County Health Department guidelines.

    
    

80. Indicate if event includes any of the below categories and give detailed information as well as include these items in your site plan to be submitted with this application.

    1. Stages and/or Platforms
    2. Bleachers
    3. Generators and/or Additional Electricity

    1. Amplified Music and/or Sound
    2. Portable Toilets

    1. Canopies and/or Tents
    2. Dumpsters and/or Additional Trash Services
82. If yes to any, describe:
84. Parking & Street Closures
86. Where will event patrons park:*
87. Will you use offsite/outsourced or independent parking locations:

    1. Yes
    2. No
88. Do you plan to shuttle from offsite parking locations?

    1. Yes
    2. No
89. If yes to either, where:
91. Street closures requested? List all streets/intersections this applies to, specify exact dates and times.
93. Emergency Management Plans
95. Police:
96. Fire:
98. Paramedics:
99. Other (i.e. Security):
101. Application Document Uploads
103. Site Plan and/or Layout of Event Areas

     Be sure to include event space, parking, trash/dumpsters, stages/platforms, booths, bleachers, music/sound location, and areas with temporary structures such as tents or canopies, fencing, desired entrance and exit areas, areas for portable restrooms, ADA accessible areas. Please be as thorough as possible with site plan.

104. Copy of Commercial General Liability:

     ($1,000,000 Aggregate/$1,000,000 each occurrence)

     Please have document list:

     City of Wilton Manors, 2020 Wilton Drive, Wilton Manors, FL 33305 as named certificate holder and additional insured.

     The insurance coverage shall be for any and all associated activities related to the event. Certificates of Insurance will be reviewed and approved by the City’s Risk Management Department and may request increased level of coverage based on type of event and attendance.

Leave This Blank:


106. 1. Receive an email copy of this form.
107. Email address

     This field is not part of the form submission.

108. Submit Submit and Print

* indicates a required field