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Large Special Event Application Form

A fully completed event application form and certificate of indemnification insurance must be received by the City of Warren in order for your permit to be processed. The submission of documents does not guarantee the city granting a permit. Fields marked with (*) are required fields to be filled in.

Event Information

Name of Event:(*)

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Expected Attendance:(*)

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Start Date:(*)

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End Date:(*)

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Start Time (Daily):(*)

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End Time (Daily):(*)

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Set-Up Start Date:(*)

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Set-Up Start Time:(*)

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Tear Down Date:(*)

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Clean-up Completed Time:(*)

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Event Contact Information

Contact:(*)

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Phone:(*)

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Email:(*)

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Address:(*)

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City:(*)

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State:(*)

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Zip Code:(*)

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Operations

An Operations Department employee must be present at your event if you need in a building, have electrical hook-up, road closings, use of sound system at the amphitheater etc.

Once your event is set-up, our employee is not required to sit at your event. If something comes up during your event that requires assistance, please make sure you keep the City Events number on hand (330) 717-4125.

Cost can be up to $45.00 an hour minimum, with four (4) hour minimum, per worker.

Street Closings

List below the streets you intend to close, including the dates and times necessary for the closing and re-opening of streets.

If the event is a parade, road race, etc. describe in detail the route. The city shall close and open the streets in accordance with the permit, using the necessary barricades, signs and safety lights. All Street closings require a seventy-two (72) hour public notice. All street closings and detours must be approved by the City Engineering Department, Traffic Department and Fire Department.

Street Name:

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From (intersection):

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Date & Time of Street Closure:

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To (intersection):

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Date & Time of Street Re-open:

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Cones & Barricades

Number of Cones Needed:

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Number of Barricades Needed:

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Where should they be placed?:

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Alcoholic Beverages

Alcoholic beverage or intoxicating liquors of any type, shall not be sold, distributed or donated without the proper permits to do so as issued by the Ohio Department of Liquor Control as listed hereafter and pursuant as stated in the Ohio Revised Code Section 4303.

THE OHIO DEPARTMENT OF LIQUOR CONTROL
2323 WEST FIFTH AVE.
COLUMBUS, OHIO 43266-0701
(614) 644.2360

All alcoholic beverage sales and consumption will be confined to a predetermined fenced in area. No alcoholic beverages will be sold, consumed or be permitted outside of the specified area.

Abuse of alcohol policy will be grounds for termination of event.

A copy of the license from the State MUST BE RECEIVED in the Director of Public Service and Safety’s office no later than a week prior to the event. If the copy is not received no alcoholic beverages will be permitted at the event.

Parade

The parade will be a part of your event permit that you receive. There is an additional $40.00 parade permit that will be applied to your final bill. Additional charges may apply depending on the need of the event/parade at the time.

Name/Theme of Parade:

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Parade Route:

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Number of units/people in parade:

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Date of Parade:

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Start time of Parade:

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End time of Parade:

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Line-Up time of Parade:

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Food Vendor(s)

A food service application must be obtained by EACH vendor. Each food vendor that participates in the event must make an appointment with the Health Department if they need a temporary food license, this must be done a minimum of 10 days prior to the event, in accordance with the Ohio Administrative Code, to the City Health Department. Failure to notify, include, or submit applications on time will be grounds for refusal of participation of vendor (s) in said event. There will be no exceptions.

To get your temporary license you must call and make an appointment a minimum of four days prior to your event. Applications are only taken Monday through Friday 7:30 am-9:00 am, by appointment only.

CITY HEALTH SANITARIAN
258 E. MARKET ST
WARREN, OH 44481
330.841.2595

Portable Restroom Facilities

Placement location:(*)

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Number of portable restrooms being delivered:(*)

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Arrival Date:(*)

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Removal Date:(*)

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Portable restrooms must be removed from City Property within 24 hours of the end date and time of the event. If not, the event sponsors/organization will be fined $50.00 per day they are left on City property.

Environmental Services

Event site maintenance and cleanup is the sole responsibility of the event leadership. Waste grease and/or cooking oil must be disposed of in separate containers supplied by the event organizers.

The Environmental Services Department will provide trash removal if so desired by the event committee.

Event site maintenance and cleanup is the sole responsibility of the event leadership. All trash, garbage, refuse, etc. should be deposited in appropriate containers and placed in the dumpster for pickup. Waste grease and/or cooking oil must be disposed of in separate containers supplied by the event organizers. Cooking grease and/or oil cannot be disposed of in the City Environmental Services Dumpsters or in the City Sewer System.

The final bill will be determined once the event is complete and will be included in your final billing invoice. If you get twelve (12) toters or less you will be charged a flat fee of $50.00.

Total Dumpsters Requested:

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Total Toters Requested:

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Where should they be placed?:

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Do you have other arrangements for refuse service?

Yes

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Name of Company:

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Contact:

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Phone:(*)

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Address:(*)

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City:(*)

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State:(*)

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Zip Code:(*)

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Water Department

The City will provide water from the nearest fire hydrant, using a reduction adapter supplied by the city. The adapter will accommodate standard size recreation vehicle type hoses. The adapters will be installed and removed by the City Water Department during normal work hours.

It is the sole responsibility of the event organizer for the distribution of water throughout the grounds with the appropriate materials supplied by the event or its participants.

A flat fee of $100.00 per day will be charged.

Installation Date & Time:

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Removal Date & Time:

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Electric Service Request

The event organizers will be responsible for the payment of electricity used during their event. It is understood that the event organizers will be responsible for the distribution of electrical power throughout the event using proper wiring and methods meeting the Ohio State Electrical Code and electrical code of the City of Warren. All connections and distributions will be subject to approval of the City’s Electrical Inspector.

All electrical disconnects WILL be completed correctly by the licensed event electrician with two (2) hours after the official closing time of the event. It is the responsibility of the licensed event electrician to ensure that all city electrical panels are properly secured. NO EXCEPTIONS!!

The City will provide electric connection. The charges are $75.00 per 24 Hour Day.

Licensed Electrical Contractor Information

Name:(*)

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Phone:(*)

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Address:(*)

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City:(*)

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State:(*)

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Zip Code:(*)

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By agreeing below, you understand the daily cost for electricity, and you must contact the City of Warren Engineering, Planning and Building Department at (330) 744-5238 to schedule your electrical inspection.

540 Laird Ave. SE Warren, Ohio 44484
Paul Makosky, Director of Engineering, Planning and Building
Chris Taneyhill, Chief Building Official

Re-Inspection Fees are:
Commercial $56.65
Residential $50.50

Fireworks

Name of Event:(*)

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Date & Time of Fireworks Display:

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Location of Fireworks Set-Off:(*)

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Fireworks Company:(*)

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Host of Fireworks:(*)

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Contact:(*)

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Phone:(*)

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Address:(*)

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City:(*)

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State:(*)

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Zip Code:(*)

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No explosives shall be stored within the corporation limits prior to the actual day of the display.
An on-site inspection of the shooting site shall be required prior to display by an officer of the Fire Prevention Bureau.
The display company shall complete this application for a permit to be issued. All forms must be turned in thirty (30) days prior to the display date.
Copy of current state license must be submitted with this form.

Police Department

Regardless of the duration or size of the event, the presence of a Warren City Police Officer is mandatory during the hours of operation, unless otherwise waived by a representative, Director of Service and Safety or the Mayor. The officer will be furnished by the event organizers, at their expense.

Private security will only be used during the non-operational hours and furnished by the event organizers at their expense.

If alcoholic beverages are to be served during this event, the presence of an additional Warren City Police Officer is mandatory. This will be done at the expense of the event organizers.

The cost for a Warren City Police Officer is $40.00 an hour with a minimum of four hours. Police are to be paid at a minimum of two (2) weeks prior to the event. All payments must be paid in check or money order. If payment is not received within the time allotted your event is subject to cancellation. Please contact Chris Clemente at 330.841.2656 for scheduling and payment arrangements.

Total number of Warren City Police Officers at an event is subject to the Chief of Warren City Police Department or his designee.

Indemnification

The organizer/licensee shall, and hereby expressly binds itself to, release, protect, defend, indemnify and save and have absolutely harmless the City of Warren (including the City of Warren itself and its past, present and future divisions, departments, boards, agencies, branches, officers, representatives, officials, agents, attorneys, employees, servants, and assigns) against all claims, damages, losses, expenses (including attorney’s fees), and description whosesoever brought against the City of Warren (or any of the aforementioned affiliates of the City of Warren) arising out of or resulting from the Event (s), provided that any such claim, damage, loss, expense, demand, suit, action or proceeding is caused by or results from, in whole or in part, any negligent or willful act or omission of the organizer/licensee or any party directly or indirectly employed by the organizer/licensee, or anyone for whose acts the organizer/licensee may be liable, regardless of whether or not it is caused in party by a party indemnified hereunder.

Organizer/licensee, at its sole cost and expense, and prior to commencement of the Event (s), shall procure and maintain at all times during the Event (s), general and public liability insurance covering liability assumed by organizer/licensee with a limit of not less than Five Hundred Thousand Dollars (500,000.00) for all City Facilities except for the Amphitheatre which is One Million Dollars ($1,000,000.00) for personal injury and property damage. The City of Warren shall be named as an additional insured for purposes of such insurance. Organizer/licensee shall furnish the City’s Director of Public Service and Safety with a certified copy of said liability insurance policy, showing the type, amount, class of operations covered, effective dates and date of expiration of policy. The policy shall also be endorsed to provide for thirty (30) day notice to said Director of Public Service and Safety prior to termination of, change in, the coverage provided. Furnishing of this insurance by organizer/licensee shall not limit organizer/licensee’s liability but shall be additional security.

Insurance Company Name:(*)

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Agent:(*)

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Phone:(*)

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Email:(*)

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Fax:

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Digital Signature:

By digitally signing below, you agree that you have read and agree all the guidelines and terms, put forth in this form as well as also stated in the WARREN COMMUNITY EVENTS GUIDELINES document. For reference as well as for you to retain for your records a copy of the WARREN COMMUNITY EVENTS GUIDELINES can be found here: WARREN COMMUNITY EVENTS GUIDELINES - (Click Here)

Do you agree to all terms set forth?(*)

I agree

I do NOT agree

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Your First Name:(*)

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Your Last Name:(*)

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Todays Date:(*)

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*You MUST Agree to the terms guidelines and requirements set forth by the Warren Community Events Guidelines Document.