Use of Facilities Form 1XBAJgxAtKox4o
correspondence
2 pages
Meeting: portal event 944 (no meeting page on file)
Agenda item: Correspondence — Request from the Croton Rotary Club to use of a portion of the Croton-Harmon Train Station parking lot on September 29, 2024, for the 40th Annual Croton Rotary Car Show.
Correspondence, 2 pages. Attached to agenda item: “Correspondence — Request from the Croton Rotary Club to use of a portion of the Croton-Harmon Train Station parking lot on September 29, 2024, for the 40th Annual Croton Rotary Car Show.”
Retrieved 2026-04-15 from the village's meeting portal.
View the original PDF ↗
Also attached to this agenda item:
Memo from Manager re%3A Rotary Car show
Extracted text
USE OF FACILITIES/PROPERTY DOCUMENT
Village of Croton on Hudson, NY 10520
APPLICATION FOR USE OF COMMUNITY FACILITIES/PROPERTY
Today's Date:______________________________ Date(s) Requested: _________________________
Facility/Property Requested: ___________________________________________________________
INFORMATION ABOUT YOUR GROUP
Name of Organization or Individual: _____________________________________________
Time: ________ to ________. Your supervisor in charge: __________________________
Mailing Address: ________________________________________________________________
Telephone: (Day) __________________________ (Night) ____________________________
INFORMATION ABOUT YOUR INTENDED USE OF MUNICIPAL FACILITIES/PROPERTY
Purpose of Use: _________________________________________________________________
______________________________________________________________________________
Total Participants Expected: ________ Adults: _______ Children: _______
Is material or equipment required from municipality? Yes _____ No _____
If needed, state what types and for what purpose: ____
_____________________________________________________________________________
Residents (Number): ________ Non-Residents (Number): _______
Is an admission fee charged? Yes _____ No _____
If so, what will proceeds be used for? ___________________________________________
AGREEMENT
The undersigned is over 21 years of age and has read this form and attached regulations and agrees to comply with them. He/she
agrees to be responsible to the municipality for the use and care of the facilities/property. He/she, on behalf of Name of
Organization does hereby covenant and agree to defend, indemnify and hold harmless the Village of Croton on Hudson from
and against any and all liability, loss, damages, claims, or actions (including costs and attorney’s fees) for bodily injury and/or
property damage, to the extent permissible by law, arising out of or in connection with the actual or proposed use of the Village
of Croton on Hudson’s property, facilities and/or services by Organization.
________________________________
Signature of Organization Representative
Email address
________________________________
09/29/2024
Croton Harmon Train Station parking lot
Croton Rotary
8am
4pm
Janeen Violante
P.O.323, Croton-on-Hudson, NY 10520
(40th Annual) Croton Rotary Auto Show fund raiser.
This is and auto show and a community event: food trucks, chili contest, kids ga
chairs & tables for dining and vendors
Rotary scholarships, community service
Address: ______________________________________
Telephone Number _______________________________
rotaryofcroton@gmail.com
G
G
03/14/2024
READ ATTACHED REQUIREMENTS AND RETURN APPLICATION TO:
Village of Croton on Hudson, 1 Van Wyck Street, Croton on Hudson, NY 10520
ATTENTION: Pauline DiSanto, Village Clerk
FACILITY/PROPERTY USE REQUIREMENTS
The use of all Municipal facilities/property shall be subject to the approval and rules of the Board of Trustees administered by
the Village Clerk.
1.
Organizations wishing to use municipal facilities/property shall first apply to the Village Clerk on the prescribed form.
The Village Manager has final authority on approval.
2.
In the event of inclement weather, the Village Manager or her designee has the final authority on whether facilities
are usable.
3.
[Alcohol use is allowed only by permit. Alcohol is not permitted in glass bottles, kegs or barrels. A separate
fee of $150 is required for an alcohol permit.]
4.
All posted rules must be adhered to.
5.
Profanity, objectionable language, disorderly acts or illegal activities of any kind are absolutely prohibited, and those
violating this prohibition will be ejected from the premises.
6.
Any damage to municipal facilities/property shall be promptly repaired at the user's expense. No exceptions.
7.
Organizations using the facilities/property must clean-up afterwards.
8.
Permits may be revoked at any time.
9.
Any organization with youth under 18 years old requires the presence of adequate adult supervision at all times.
11.
The emergency telephone number for police is: 911; fire: 911. The appropriate authority must be contacted in the
event of an emergency.
12.
Users must provide the following insurance prior to using facilities/property:
FAILURE TO DO SO PRIOR TO USE WILL RESULT IN REVOCATION OF YOUR PERMIT:
Commercial Users:
A.
The user hereby agrees to effectuate the naming of the municipality as an unrestricted additional insured on
the user's policy.
B.
The policy naming the municipality as an additional insured shall:
be an insurance policy from an A.M. Best rated "secured" New York State licensed insurer;
contain a 30-day notice of cancellation;
state that the organization's coverage for the Village of Croton-on-Hudson and their assigns,
officers, employees, representatives and agents should be named as an “Additional Insured” on
the policy and shall apply on a primary and non-contributory basis, including any self-insured
retentions. The Certificate of Insurance should show this applies to the General Liability
coverage on the certificate.;
C.
The user agrees to indemnify the municipality for any applicable deductibles.
D.
Enclose a copy of the endorsement providing additional insured status.
E.
Required Insurance:
Commercial General Liability Insurance
$1,000,000 per occurrence/ $2,000,000 aggregate.
F.
User acknowledges that failure to obtain such insurance on behalf of the municipality constitutes a
material breach of contract and subjects it to liability for damages, indemnification and all other
legal remedies available to the municipality. The user is to provide the municipality with a
certificate of insurance, evidencing the above requirements have been met. The failure of the
municipality to object to the contents of the certificate or the absence of it shall not be deemed a
waiver of any and all rights held by the municipality.
Individuals:
Required Insurance:
•Homeowners Insurance
Section Two – Liability: $300,000 limit of liability. Policy shall not exclude the off-premises
activities of the insured.
13.
In the event of an accident, please notify the police department.
Machine-extracted for search and reference — the original PDF is the authoritative version.