<p> Special Events Permit Application Return to: City of Fairfield Attn: City Clerk P.O. Box 336 Fairfield, ID 83327 (208) 764-2333</p><p>Name of Event: ______Sponsor: ______Location: ______Date: ______Setup: ______Breakdown: ______Hours of Operation: ______Est. Crowd Size: ______</p><p>Name: ______Address:______Title: ______Phone #:______</p><p>Name: ______Address:______Title: ______Phone #:______</p><p>Event will include: (check all that apply) _____N/A Food Vendors: Number of Vendors: ______@ $15.00 per vendor N/A Non-Food Vendors: Number of Vendors: ______@ $10.00 per vendor N/A Fireworks: Give Name of Company: ______</p><p>Vendors APPLICATION MUST BE ACCOMPANIED BY ALL FEES PERTAINING TO THIS EVENT and INSURANCE CERTIFICATE IN THE AMOUNT OF $500,000.00. INSURANCE CERTIFICATE MUST NAME “THE CITY OF FAIRFIELD, ITS OFFICERS, AND EMPLOYEES AS A CO-INSURED”. NOTHING ELSE WILL BE ACCEPTED.</p><p>SERVICES REQUESTED FOR YOUR EVENT:</p><p>POLICE SERVICES NEED: YES NO ______THIS IS FOR A PRIVATE PARTY Signature of Applicant NOT A PUBLIC EVENT ______Print Name</p><p>______Date of Application</p><p>FOR OFFICE USE ONLY: DO NOT WRITE IN THIS SPACE BELOW _____ Fees Collected _____ Site Review _____ Departments Notified _____ Insurance Certificate _____ Final Review _____ Notes: Created on 7/28/2004 4:36 AM</p>