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PAGE | 3 OF 4 Date ______________ Time ___________ to __________ Number of Officers ________ Date ______________ Time ___________ to __________ Number of Officers ________ Date ______________ Time ___________ to __________ Number of Officers ________ Emergency Services If event security will be provided by the applicant, please explain arrangements: Park Use Name of Park __________________________________ If park shelter(s) are requested, please contact Community Services through the link below: https://stanthony.ce.eleyo.com/facilities/calendar Indemnification Agreement and Insurance Information The applicant hereby agrees to save, defend, hold harmless, and indemnify the City of St. Anthony Village and all of its officers, departments, agencies, agents, and employees (collectively the “City”) from and against any and all claims, losses, damages, injuries, fines, penalties, and costs, including attorneys’ fees, charges, liability, or other exposures, however caused, resulting from, arising out of, or in any way related to the applicant’s event as herein described and applicant’s use of City property and/or right-of-way. Nothing herein shall have any effect on the City’s right to assert any liability defense in accordance with Minnesota Statutes, Chapter 466. The City, in its sole discretion, may require the Applicant to obtain liability insurance coverage(s) for any event. If the City notifies the Applicant in writing that liability insurance is required, the Applicant must provide proof of the appropriate liability insurance(s) in the amount(s) provided herein. The Applicant must provide the City with a Certificate of Insurance showing proof of the required liability insurance(s). The City must be listed as an additional insured on all liability policies. Applicant’s insurance shall act as the primary insurance coverage for any claims of loss covered by the insurance policy. The City requires the Applicant to obtain any or all of the following insurance coverage, in at least the coverage amounts contained herein: 1.Commercial general liability insurance or equivalent special event coverage protecting Applicant and City from claims for damages or bodily injury and property damage which may arise out of or in connection with the event’s operation and use of the City’s property or right-of-way. This general liability insurance policy shall be in an amount not less than $1,000,000.00 per occurrence. 2. If Applicant will be using an automobile for any portion of the Applicant’s event, Applicant must obtain automobile liability insurance in an amount not less than $1,000,000.00 per occurrence. Such policy must include liability coverage for owned, nonowned, and hired automobiles. 3.If alcohol will be served or included in Applicant’s event, Applicant must obtain liquor liability (also known as dram shop) insurance in an amount not less than $1,000,000.00 per occurrence. Central Park Pavilion