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Facility Use Application - Outdoor

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The Corporation of the City of Brockville will review this application and forward an Acceptance or Denial for this event.

  • Please allow at least 14 days for processing.
  • Third Party Liability Insurance naming the Corporation of the City of Brockville as an additional insured is required for all events.

  • A Site Layout detailing the location of all logistics/elements of your event must be included with this application

Applicant

Address*

Event Dates

Start Date*
Start Time
:
End Date*
End Time*
:

Set Up and Tear Down Dates

Set Up Date*
Set Up Start Time*
:
Tear Down End Date*
Tear Down End Time*
:

Event Details

Include all participants (volunteers, guests, instructors, etc.)
Drop files here or
Accepted file types: png, jpg, pdf, Max. file size: 8 MB, Max. files: 3.
    Street closure(s) required

    Third Party Liability Insurance

    Third party liability insurance naming the Corporation of the City of Brockville as an additional insured, is required for all events. Please select from one of the two options below (take note that Certificates of Insurance must be submitted with the Facility Use Application):

    Option 1: Companies/Organizations: Certificate of Insurance

    Please provide your insurance provider with the City of Brockville’s standard insurance requirement information which is listed below:

  • Commercial General Liability Insurance issued on an occurrence basis for an amount of not less than $5 million per occurrence / $5 million annual aggregate for any negligent acts or omissions relating to their activities/ event.
  • Such insurance shall include, but is not limited to, bodily injury and property damage including loss of use; personal injury; contractual liability; premises, property & operations; non-owned automobile; broad form property damage; occurrence property damage; products; broad form completed operations; employees and volunteers as Additional Insured(s); tenants’ legal liability; cross liability and severability of interest clause. Where applicable, the City will also require owners & contractors protective and/or contingent employers’ liability extensions.
  • If applicable, the Commercial General liability insurance policy shall not contain an exclusion pertaining to liquor liability.
  • Such insurance shall add the Corporation of the City of Brockville as Additional Insured subject to a waiver of subrogation with respect to the operations of the renter. This insurance shall be noncontributing with and apply as primary and not as excess of any insurance available to the City. All deductibles applicable to the above noted insurance shall be the sole responsibility of the Named Insured and the City shall bear no cost towards such deductible.
  • The Named Insured is responsible to keep their property/assets insured; failure to do so shall not impose any liability on the City.
  • The Named Insured shall provide The Corporation of the City of Brockville with a certificate of insurance evidencing coverage as noted above. Such policies shall not be cancelled, changed or lapsed unless the Insurer notifies the City in writing at least thirty (30) days prior to the effective date of such cancellation, material change or lapse. The insurance policy will be in a form and with a company licensed to write business in the Province of Ontario and which are, in all respects, acceptable to the City.
  • The City also reserves the right to request additional insurance and/or higher limits of insurance or otherwise alter the types of insurance coverage requirements as the City may reasonably require from time to time
  • A Certificate of Insurance has been provided with this application
    Accepted file types: jpg, doc, docx, png, pdf, Max. file size: 8 MB.

    Option 2: Individuals/Private Users: Third Party Insurance Program

    The Corporation of the City of Brockville coordinates a Third Party Insurance Program for low-risk users of municipal facilities. The policy covers any individual or community group renting a municipal facility to run an event or activity.

    This Program is in place for the everyday resident who would not otherwise have insurance in place as requested above. This coverage cannot be used for corporate entities or in addition to other policies of the renter. This coverage automatically adds the municipality as additionally insured on the policy. This program is a low-cost solution to protect residents of the community and provides coverage for the person in control of the event.

    Renters that do not have Third Party Liability Insurance as listed above will be charged the appropriate fees based the size and risk level of their event, under this program.

    Upon application acceptance, a sales summary clearly indicating the charge will be provided. Upon payment, a Memorandum of Insurance will be provided to the renter as proof of insurance

    Applicant will utilize Third Party Insurance Program for Private Users

    Indemnification

    The renter shall defend, indemnify and save harmless the Corporation of the City of Brockville, their elected officials, officers, employees and others who the City is responsible from and against any and all claims, actions, losses, expenses, fines, costs (including legal costs), interest or damages of every nature and kind whatsoever, including but not limited to bodily injury or to damage to or destruction of tangible property including loss of revenue arising out of or allegedly attributable to the negligence acts, errors, omissions, whether willful or otherwise by renter, their officers, employees, agents, or others who the renter is legally responsible. This indemnity shall be in addition to and not in lieu of any insurance to be provided by the renter in accordance with this agreement and shall survive this agreement.

    Custodial Damages

    The applicant/organization is responsible for all clean up and disposal of refuse related to the event detailed in this agreement. Should the City of Brockville determine that the applicant/organization did not take due care to adequately return the facility to the condition in which it was found prior to the event, the City of Brockville reserves the right to bill associated custodial or damage charges to the applicant/organization.

    Cancellation

    This contract cannot be cancelled for convenience.

    In the event of an event cancellation, the City and the Renter will review options for rescheduling the event. If the event cannot be rescheduled, the City reserves the right to charge the Renter for any fees that may occur due to the event cancellation. The City reserves the right to retain deposits and/or charge administrative fees due to the rescheduling of an event.

    Under this contract, the Renter and the City will take practicable efforts, following guidelines set out by Public Health and the Province, to reduce the transmissibility of a communicable disease. The City or the Renter may cancel this contract in whole or in part due to unforeseen illness, guidelines, or Public Health measure at any time, where the illness, guidelines or Public Health measure will affect the event from continuing. Cancellation cannot be due to reduced capacity limits at the venue, only a full closure of the facility.

    General

    1. The City will always have access to and control of its facility.
    2. The Applicant hereby agrees to observe and comply with any and all fire regulations and codes, Provincial, Federal or other regulations, statues and by-laws pertaining in any way to the use of the facility.
    3. The Applicant waives the right to assign this Agreement in whole or in part, nor sublet all or any parts related to the leased space or building to any other person.
    Date*

    Addendum - Street Closure(s)

    • A six (6) metre clearway (as measured equidistant from the centerline of the traveled portion of the roadway) must be maintained at all times on each closed street for emergency vehicles
    • The City requires a non-refundable $226.50 deposit to be submitted with the completed addendum
    • Following the event, the City will prepare a statement and the Applicant will be billed for any costs that exceed $226.50 (i.e. City Staff labour, trucks etc.)

    Applicant

    Address

    Street Closures

    Closure #1
    Date
    Start
    :
    End
    :
    Closure #2
    Date
    Start
    :
    End
    :
    Closure #3
    Date
    Start
    :
    End
    :
    Closure #4
    Date
    Start
    :
    End
    :
    Date of submission

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