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Special Event Application

  2. Event Type*
  3. Pending approval, please call City Hall at 515-262-9368 to check availability of your event location.
  4. **Please include time frame for delivery of amenities such as sanitation, temporary structures, vendors, etc.
  7. Are you requesting vehicles be permitted to drive or park on city park grounds?*
  9. Will you be using amplified sound/speakers, live music, and/or a public address system?
  11. Park trash cans are for daily park users. Event attendance over is over 75 additional trash cans will be required by the event organizers. Organizers must also remove their own trash collected.
  12. The applicant must provide portable restrooms at city approved locations for each 75 people expected in attendance. The units must be maintained throughout the event and removed the next business day upon completion of the event.
  14. No drilling or coring on any concrete or asphalt to secure a tent.
  17. Individual food vendors must obtain a Temporary Food License from the Iowa Department of Inspections and Appeals. The event organizer will be responsible for this information. Failure to do so may result in fines or closing of the vendor.
  19. **Any volunteers/event staff along a race route or road will be required to wear a reflective yellow vest on the outermost part of their clothing. Failure to have proper numbers of volunteers may result in the cancellation of the event or added costs to the event for city staff services.
  20. Fees associated with the event*
    • Shelter/Facility $40, if applicable
    • Liquor license required if applicable: Payable to the State of Iowa (Iowa Alcoholic Beverages Division)
    • Street Closure Permit, if applicable
    • Noise Permit $10, if applicable
    • Fireworks Permit $60, if applicable
    • Special Events Refundable Deposit $250
    • Police Services $55/hour/Officer – Billed to the event organizer after the event.
    • Fire & Rescue Services $55/hour/officer– Billed to the event organizer after the event.
    • Public Works/Parks Staff $55/hour/staff– Billed to the event organizer after the event.
    • City staff will try to provide event organizers an estimated cost for any services requiring city staff prior to the event; however this is only an estimate.
  21. Hold Harmless Agreement
    Applicant hereby agrees to indemnify, defend, protect, and hold harmless, the City, its agents, employees, representatives, and elected officials, from and against any and all claims, losses, demands, liability, lawsuits, damages, or expenses (including, without limitation, reasonable attorney's fees), relating to, resulting from, or arising out of, directly or indirectly, the promotion and/or conduct in any way related to the activities in connection with that event, including but not limited to the activities of applicants, employees, volunteers, contractors, vendors, attendees or participants in the event which is the subject of the application.
  22. Electronic signature*
  23. Provide a detailed map of the event site including the locations of: street closures, event parking, additional dumpsters, portable toilets, water, or electricity, overnight stay areas, temporary structures (including interior layouts), fireworks demonstration area, and vendor booths. Attach additional maps if needed.

    Event site map is required—failure to submit with application will result in the event application being rejected.

    Please use the following legend when labeling the map:
    • Label street names, etc.
    • Routes for races, parades, etc.---->
    • Fencing (_ _ _ _)
    • Restrooms/Portable toilets (R)
    • Temporary Structures (TS)
    • First aid facilities (1stA)
    • Alcohol serving/consuming area (A)
    • Street Barricades (B)
    • Trash Cans (TC)
    • Admission/registration fee collection (F)
    • Parking (P)
    • Vendors (V)
    • Volunteer Locations (X)
    • Fireworks/Pyrotechnics (FP)
    • Generator (G)
    General liability limit $500,000-$1,000,000
    A. Events with little or no impact on the public.
    B. Events in City parks or on public property without alcohol.
    C. Large picnics in parks exceeding shelter occupancy and using other park areas.

    All other events – minimum liability limit $2,000,000 (Additional insured and governmental immunities endorsement is required.)
    A. Firework/Pyrotechnic displays
    B. Fundraising walks/run
    C. Sports contests
    D. Parades
    E. Events requiring street closures
    F. Events that expect large crowds on public property
    G. Large events taking place for more than one day
    H. Large events that include alcohol on public property
    1. Additional Insured Endorsement:
    Except for Workers’ Compensation and Professional Liability, the policies shall include the City Additional Insured Endorsement of: The City of Pleasant Hill, Iowa, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions and /or authorities and their board members, employees, and volunteers, are included as additional insured with respect to liability arising out of the Insured’s work and/or Services performed for the City of Pleasant Hill, Iowa. This coverage shall be primary to the additional insured, and not contributing with any other insurance or similar protection available to the additional insured, whether available coverage be primary, contributing, or excess.

    2. Governmental Immunities Endorsement:
    A. Non-waiver of Government Immunity The insurance carrier expressly agrees and states that the purchase of this policy and the including of the City of Pleasant Hill, Iowa, as an Additional Insured does not waive any of the defenses of governmental immunity available to the City of Pleasant Hill, Iowa, under Code of Iowa Section 670.4 as it now exists and as it may be amended from time to time.
    B. Claims Coverage The insurance carrier further agrees that this policy of insurance shall cover only those claims not subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as may be amended from time to time.
    C. Assertion of Government Immunity The City of Pleasant Hill, Iowa, shall be responsible for asserting any defense of governmental immunity, and may do so at any time and shall do so upon the timely written request of the insurance carrier. Nothing contained in this endorsement shall prevent the carrier from asserting the defense of governmental immunity asserted by the City of Pleasant Hill, Iowa.
    D. Non-Denial of Coverage The insurance carrier shall not deny coverage under this policy and the insurance carrier shall not deny any of the rights and benefits accruing to the City of Pleasant Hill, Iowa , under this policy for reasons of governmental immunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s) of governmental immunity asserted by the City of Pleasant Hill, Iowa.
    E. No Other Change in Policy The insurance carrier and the City of Pleasant Hill, Iowa, agree that the above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy.

    Certificate of Insurance Requirements:
    A Certificate of Insurance is required evidencing all required insurance coverage as provided above with any required endorsements attached so as to evidence their inclusion in the coverage. The Certificate of Insurance is due 30+ days before the Special Event.

    The following format is required:
    1.List the name of the Event and Date in the Description of Operations section.
    2. The following address must appear in the Certificate Holder section: City of Pleasant Hill, Iowa Special Event Application 5160 Maple Dr. Suite A; Pleasant Hill, Iowa 50327
    3. The Producer’s contact person’s name, phone number and e-mail address is required.
    4. Endorsements, as required, shall be included with the Certificate of Insurance to evidence that the policy has been endorsed.

    Additional Special Event Information
    • Pleasant Hill Parks & Recreation Department: 515-262-9368
    • Pleasant Hill Police Department: 515-265-1444
    • Iowa Alcoholic Beverages Division: 515-281-7400 or
    • Iowa One-Call: 8-1-1 or
    • Polk County Public Health Department: 515-286-3798
    • Iowa Department of Inspections and Appeals - Food Safety
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