2010-03-09 SAC PacketCITY OF
SOUTHLAKE
MEMORANDUM
March 5, 2010
TO: Senior Advisory Commission
FROM: Kari Happold, Deputy Director of Community Services
SUBJECT: Agenda Item Comments for Senior Advisory Commission Meeting
Tuesday, March 9, 2010 at 1:00 p.m.
Please note the meeting will be held at the usual time and location —.Tuesday, March 9,
2010 at 1:00 p.m. in the Senior Activity Center.
1. Agenda Item No. 2. Administrative Comments:
A. Senior Services Coordinator Position — Deputy Director Happold will provide an
update on the Senior Services Coordinator position.
B. CARS Report— This item is a standing item on the agenda to allow for an update
and report on the CARS program.
C. Southlake Senior Activities Report- This item is a standing item in order for the
Commission members to receive information about monthly events and activities.
D. Metroport Meals on Wheels Report - This item is a standing item on the agenda
to allow for an update and report on the MMOW program.
E. Facilities Update — Current & Future/New — This item is a standing item on the
agenda to allow for an update from staff and feedback from the Commission on
current and future facility needs, improvements and maintenance.
2. Agenda Item No. 3A. Consent: Approval of the Minutes from the February 9, 2010
regular Senior Advisory Commission meeting. Should you have any changes or
additions to these minutes, please include it as part of the motion during the
meeting.
3. Agenda Item No. 4. Public Forum — This is the public's opportunity to address the
Commission about non -agenda items. During this proceeding it is important that the
Commission not deliberate (discuss among yourselves) or take action on any item
brought up at this time. The Commissions' options during this topic are 1) to listen, 2)
ask questions and respond to the presenter only, 3) request staff to look into the
issue and report back to the Commission and/or 4) request that the Chair put the
item on a future agenda for the Commission to discuss or consider.
City of Southlake Values:
Integrity ♦ Innovation ♦ Accountability ♦ Commitment to Excellence ♦ Teamwork
Senior Advisory Commission
Meeting Date — March 9, 2010
Page 2 of 2
4. Agenda Item No. 5. Consider — There are no items on this agenda to consider.
5. Aaenda Item No. 6. Discussion:
A. Steering Committee becoming a nonprofit 501(c)3 named Southlake Senior
Funding, Inc. This item is on the agenda to discuss the Steering Committee
becoming a nonprofit entity.
B. Starlight Ball Committee— This item is to discuss the upcoming dance. Town Hall
has been reserved for April 10t". The Swing Band is going to perform. A
Committee needs to be established to plan the details of the event.
C. Senior Center Operating Budget- Staff will present the Senior Center operating
budget to the Commission.
D. Facility Use Policy — The City of Southlake has several facilities that offer
opportunities for public use. The "Facility Use Policy" is a guideline for the
management of these public facilities, including the Senior Activity Center. The
policy is attached for your information.
E. Multipurpose Facility Feasibility Study — Director Tribble will lead a discussion
related to the Multipurpose Facility Feasibility Study to obtain additional feedback
from the Senior Advisory Commission.
7. Other :
We appreciate your commitment and service to the City and the Senior Advisory
Commission. If you have any questions prior to the meeting, please feel free to call me.
As always, we appreciate your commitment and service to the City.
Kari Happold
STAFF CONTACT INFORMATION:
Telephone — (817) 748-8203
Facsimile — (817) 748-8027
400 North White Chapel, Southlake, Texas 76092-6242
Chris Tribble, Director of Community Services, 817-748-8021, (ctribble@_j
Candice Sanders, Assistant to the Director, 817-748-8311;
Kari Happold, Deputy Director of Community Services, 817-748-8018, (khappold@_j
Linda Carpenter -Elgin, Administrative Secretary, 817-748-8184; (Iarpenter@_j
City of Southlake Values:
Integrity ♦ Innovation ♦ Accountability ♦ Commitment to Excellence ♦ Teamwork
CITY OF
SOUTHLAKE
SENIOR ADVISORY COMMISSION: Tuesday, March 9, 2010
LOCATION: Senior Activities Center
307 Parkwood Dr
Southlake, Texas 76092
TIME: 1:00 P.M.
REGULAR SESSION:
1. Call to Order
2. ADMINISTRATIVE COMMENTS/REPORTS:
A. Senior Services Coordinator Position Update
B. CARS Report
C. Southlake Senior Activities Report
D. Metroport Meals on Wheels Report
E. Facilities Update — Current & Future/New
CONSENT AGENDA:
All items listed below are considered to be routine by the Senior Advisory
Commission and will be enacted with one motion. There will be no separate
discussion of items unless a Commission member or citizen so requests, in
which event the item will be removed from the general order of business and
considered in its normal sequence.
3. Consent
A. Approval of the February 9, 2010 regular Senior Advisory
Commission meeting minutes.
REGULAR AGENDA:
4. Public Forum
5. Consider: No items this agenda
6. Discussion:
A. Steering Committee becoming a nonprofit 501(c)3 named
Southlake Senior Funding, Inc.
B. Starlight Ball Committee
C. Senior Center Operating Budget
Senior Advisory Commission
Meeting Date — March 9, 2010
Page 2 of 2
D. Facility Use Policy
E. Multipurpose Facility Feasibility Study
7. Other Items: No items this agenda
8. Adjournment
CERTIFICATE
I hereby certify that the above agenda was posted on the official bulletin boards at Town
Hall, 1400 Main Street, Southlake, Texas, on February 5, 2010 at 5:00 p.m. pursuant to
Chapter 551 of the Texas Government Code.
Lori A. Payne, TRMC
City Secretary
If you plan to attend this public meeting and have a disability that requires special needs, please
advise the City Secretary 48 hours in advance at 817.748.8016 reasonable accommodations will
be made to assist you.
UNOFFICIAL MINUTES
Not Approved by the Senior Advisory Commission
CITY OF SOUTHLAKE
SENIOR ADVISORY COMMISSION
February 9, 2010
DPS Headquarters Building
MEMBERS AND ALTERNATES PRESENT: David Baltimore, Pat Burnett,
Marge Kyle, Jean Boland, Craig Hayes, Charlie Boyd, Nancy Sporn
MEMBERS AND ALTERNATES ABSENT: Richard McCauley
STAFF PRESENT: Kerry McGeath Deputy Director of Community Services
(Library & BJNCP), Kari Happold Deputy Director of Community Services (Parks,
Recreation and Senior Services)
GUEST Present: Council Member Carolyn Morris, Council Member Pamela
Muller
Agenda Item No. 1. Call to Order: Chairman David Baltimore called the meeting
to order at 1:15 p.m.
Agenda Item No. 2. Administrative Comments
A. Invitation Park Presentation — There was a presentation of
Invitation Park by the group proposing this facility. It is to be located
at Southlake Blvd and Carroll Ave. It would be an assisted living
facility and a nursing school. After the presentation there were
many questions from those present. This item will come before the
City Council again at their next meeting.
B. Staff Introduction - Kari Happold was introduced. She is the Deputy
Director of Community Services. She oversees Parks, Recreation
and will now also be responsible for Senior Services.
C. Senior Services Coordinator Position Update — There are
approximately 100 applications for the Senior Services Coordinator
position
D. CARS Report — No Report
E. Southlake Senior Activities Report — Activities Report — There were
100 more people attending the Center in January. We had 2
movies, bridge Monday and Wednesday, an exercise video on
Monday and Wednesday and an exercise instructor on Thursday.
Minutes of the February 09, 2010 Senior Advisory Commission
Page 1 of 2
3A - 1
UNOFFICIAL MINUTES
Not Approved by the Senior Advisory Commission
The Valentine's luncheon was full. 25 people attended the
breakfast at Bob Jones Nature Center.
F. Metroport Meals on Wheels Report — No Report
G. Facilities Update — Current & Future/New — A committee was
formed to inform the City of the needs of the Senior Center. Craig
is the chairman and Pat and Jean are members.
Agenda Item No. 3A. Consent: Approval of the Minutes from the January 1212
2009 regular Senior Advisory Commission meeting
A motion to approve the January minutes was made by Craig Hayes and
seconded by Pat Burnett. The minutes were approved unanimously.
Agenda Item No. 4. Public Forum
There was no one present to address the Commission at this meeting.
Agenda Item No. 5. Recommendation on proposed Invitation Park development
No Recommendation was made
Agenda Item No. 6. Discussion
No items
Agenda Item No. 7. Fire Services Presentation and Tour of DPS Headquarters:
A tour was given to SAC board members by Renni Burt, Community Initiatives
Officer (Fire)
Agenda Item No. 13. Adjournment
A motion was made and unanimously approved to adjourn the meeting.
David Baltimore, Chair
Kari Happold, Deputy Director of Parks and Recreation
Minutes of the February 09, 2010 Senior Advisory Commission
Page 2 of 2
3A-2
Policy:
Source:
Category:
Effective ❑ate:
City of Southlake
Policies and Procedures
Facility Use Policy
City Council
Facilities
March 2, 2010
1. Statement of Purpose
The City of Southlake has several facilities that offer opportunities for public use. The
Facilities Use policy is a guideline for the management of these public facilities. The
adoption of this policy will replace the Town Hall Use Policy as well as the DPS Use
Policy.
For information about available facilities and associated staff contacts, please see
Attachment A.
II. Definitions
a. Business Hours: Business hours for the designated public use rooms in Southlake
facilities are 8.00 a.m. — 5.00 p.m., Monday through Friday.
b. Depos Amount established in the City's fee schedule, provided at the time of the
room reservation, to be kept by the City in the event that after usage, the facility is
damaged beyond normal wear and tear and requires cleaning and/or repair.
c. Fee Schedule: The annual, City -adopted schedule which lists all fees associated
with reserving community rooms.
d. Not -for -Profit: A group organized for some charitable, civil or other social purpose
which does not entail the generation of profits for shareholders.
e. Off Duty Officer.- City of Southlake Department of Public Safety police officer hired
to attend meetings occurring outside of business hours.
f. Resident: Citizen who lives within the city limits of Southlake
Ill. Building Use Disclaimer
Use of all Southlake public facilities shall be for the primary purpose of conducting
official business on the behalf of the City of Southlake. Tarrant County also has a
priority to use public meeting rooms in Town Hall to conduct its business. Meetings of
the City Council and/or Tarrant County, City and/or County Committees, City and/or
County appointed boards and commissions and City and/or County departments shall
take precedence over other community uses of facilities.
The City of Southlake shall have the authority to schedule priority functions that may
necessitate the removal of community use activities previously scheduled. If such
change is required, the appropriate staff person shall notify the contact person
identified on the reservation request form as soon as possible and will attempt to
suggest and offer space in another City facility to hold the event.
As the county is a partial owner in the Town Hall facility, they may schedule events in
their areas (identified in the interlocal agreement entered into by the City and County)
as desired; however they will coordinate all scheduled meetings outside of their
designated areas with the City Manager's Office.
IV. General Guidelines
a. Building Use: City facilities are not available to for -profit, for commercial uses or
for the promotion or sale of products. Facilities are available for public uses,
community benefits and not -for -profit uses, unless otherwise restricted. Approval
for events or meetings in city facilities will be considered in accordance with the
following criterion:
i. The requesting organization is a not -for -profit organization.
ii. The request is reasonably related to City or County business.
iii. The requesting organization is based in Southlake, that is its Post Office
address is a Southlake address, or that a majority of its members, including
officers, reside in the City of Southlake, or that the proposed use is deemed a
community benefit.
iv. The event is requested in sufficient lead time for staff to determine impact on
the facility and previously scheduled events.
v. The sponsoring organization agrees to indemnify and hold harmless the City
and its agents and is capable of carrying sufficient liability insurance as may
be required.
vi. The sponsoring organization will provide a deposit and any other necessary
fees as may be required by the City's fee schedule.
vii. The event will not cause detrimental impact to City staff and available
resources, or to the physical capacity of the requested location to host the vent
including but not limited to:
1. The parking capacity at the requested location and the potential impact of
the requested event on other planned events
2. The number of planned participants and the traffic impact upon the
requested location
3. Other scheduled events and/or uses of the requested location that
increase the usage of the requested location above the recommended
capacity.
Appropriate staff as designated by the City Manager or her designee may approve
events that meet the criteria described. If the event does not meet these criteria,
or the application is denied, the requesting organization may petition the City
Manager for review and recommendation of approval or denial to the City Council.
The City Council's decision shall be final.
Use of the City Council Chambers and Executive Conference Room shall be
reserved for City of Southlake decision -making and other appointed bodies.
b. Apykation Submission: Written requests in the standard format for reservations
shall be submitted to the appropriate staff for review. In order to consider a
request, the City of Southlake must receive the Facility Use Request form within at
least ten (10) business days prior to the requested time. See Attachment B for
form.
c. Application Review: Staff shall review all requests and notify applicant of approval
or disapproval within two business days of submission.
d. Cancellation and Scheduling of Multi le Dates: The City of Southlake requires
notice of any cancellations within a forty-eight (48) hour period prior to the
reservation time. Failure to comply will be grounds for the City's denial of the
privilege or reserving facilities in Southlake in the future.
In order to maximize the availability of the facility for community use, consideration
of requests will be on a case -by -case basis. Multiple dates for community use
submitted at one time will not be approved. Community groups that would like to
use the rooms on an ongoing weekly or monthly basis may submit one reservation
request for three months worth of use. During the last month of the current
reservation quarter the group may then submit a request for another three month
segment of use.
e. Alcohol: The use of alcohol at City facilities is not allowed. However, for events
held outside of normal business hours, a variance to this requirement may be
granted upon request, at the discretion of the City Manager. A variance shall not
be .granted by the City Manager unless a written request is submitted which
demonstrates:
i. Special circumstances exist which are particular to the applicant's event,
ii. Applicant has agreed to hire an off -duty officer for the duration of the event,
iii. That the use of the facility by other groups will not be adversely affected by
granting the variance, and
iv. The organization has met the following insurance requirements:
Any organization or association that desires to serve alcohol while utilizing
public facilities belonging to the City of Southlake shall be required to provide
proof of insurance. Such organizations shall have a general liability policy,
naming the City as an additional insured for an amount of at least one million
dollars ($1,000,000) for personal injury or death arising out of any one
occurrence and property damage insurance in an amount of not less than five
hundred thousand dollars ($500,000) for damage to property arising out of any
one occurrence. Organizations subject to this provision shall be required to
submit to the City of Southlake proof of insurance in a form acceptable to the
City Attorney prior to approval of requested variance.
f. Smoking: Smoking is not permitted in City facilities.
g. Possession of Firearms: Civilian possession of firearms is prohibited in City
facilities.
h. Equiomenf: Due to the sophisticated systems within City of Southlake facilities and
limited staffing, utilization of facilities' audio I visual equipment is prohibited.
i. Amplification Duri m Business Hours: As community rooms are located in City
facilities where the business of the City and County is operated, amplification
through the use of microphones and speakers is not allowed during business hours
in order to minimize the disruption to those working adjacent to or in close
proximity of these community rooms.
V. Facilities: See Attachment A for a list of facilities available for public use.
VI. Fees and Deposit: A usage fee and deposit, as specified in the City's fee schedule,
is to be paid prior to the usage date and within forty-eight (48) hours of application
approval.
Proof of payment of the applicable fee must be received by the appropriate staff within
a forty-eight (48) hour period from the approval date, or the approved request is
subject to be invalidated. Deposits will be returned to the applicant upon staff review
and approval of the condition of the areas utilized by the individual and/or
organization. If a determination is made that the facility is damaged beyond normal
wear and tear, the submitted deposit will be retained by the City.
Vil. Requirement of Off -Duty Police Officer — At certain facilities, when events are held
outside of business hours with no staff member present, the person making the
reservation is required to hire an off -duty police officer to be present for the event. See
Attachment A for list of applicable facilities.
The organization submitting a reservation request must pay the cost of a Department
of Public Safety Police Officer to be present during the reservation period. Approval of
requests during non -business hours is subject to the availability of a police officer to
be present during this time. Forms for requesting an off -duty police officer are located
in Attachment C of this document.
Vlll. Signage and Decoration
Any interior or exterior decorations and signage may not be affixed to any walls,
furniture, finishings, equipment, or be placed in the ground inside or outside the City
facility unless prior approval is obtained.
IX. Public Art Displays
The display of public art is a permitted use in City facilities. Public art display requests
are subject to the public art guidelines as outlined by the Southlake Arts Council and
City Council. The placement of public art is left to the discretion of city staff, and will be
addressed in the approval process. Public art is subject to all terms within the
Facilities Use Policy.
X. Fundraisinn Events in Public Facilities
a. Authorized Fundraising Events: City -initiated events and events approved by the
City Council as a budgeted special event area allowed in City facilities. All other
fundraising events by outside organizations must meet the criteria of Section W a.
b. Fundraising Events by Not -for -Profit Organizations: Organizations requesting use
of public facilities for fundraising events shall complete and submit an application
to the appropriate staff as indicated in Attachment A. Generally, the City will grant
approval only for events which meet the criteria listed in Section /V.a of this policy.
Xl. Individual and/or Group Responsibilities
a. Facility Setup: The responsibility for setting up tables and chairs (if applicable)
shall remain with the individuals or the organization making the reservation. The
City does not provide staffing or materials to aid in the setup or cleanup of the
facility.
b. Damages: Individuals or groups making reservations are responsible for any
damage to the facility during the reservation period, and deposits may be retained
by the City for damages that exceed normal wear and tear. In addition, the City
reserves the right to assess additional charges for damages as warranted, and that
individuals and/or groups are subject to applicable criminal and/or civil penalties.
Finally, damages to the facility by individuals or groups may result in the denial of
future reservation requests.
c. Facility Clean -Up: If applicable, tables, chairs, and any provided equipment must
be returned to the original arrangement when the use of the facility is complete.
Individuals and organizations must remove all trash, equipment, and other items at
the end of the reservation time. Facilities must be left in good, clean condition
when the activity is complete. Individuals and/or organizations making the
reservation are responsible for turning off all lights and securing the facility.
XII. Compliance with Api2licable Procedures Policies and Pertinent Ordinances
Users of City facilities must comply with procedures, policies, restrictions, and all
pertinent ordinances of the City of Southlake. Any questions regarding items not listed
in this policy should be referred to the City Manager's Office,
XIII, Intent of Non -Discrimination
The City will not discriminate against any person or persons because of their age, sex,
race, religion, color, or natural origin, not will the City permit the individuals or
organizations making the reservations to engage in such discrimination.
XIV. Releases of Liability:
With submittal of the use application, the petitioner agrees to indemnify and hold
harmless the City of Southlake, its officers, agents, servants, and employees from and
against any and all claims or suits for bodily injury, illness, death, personal injury, or
property damage (including, without limitation, reasonable fees and expenses of
attorney, expert witnesses and other consultants) arising out of any negligent act or
omission committed by the petitioner, its officers, employees, agents, guests, and
invitees, in connection with the activities conducted under this agreement. This
indemnification shall specifically include any claims arising from the negligence or the
City, its agents, officials and employees.
The City assumes no responsibility for property placed in the facility in connection with
the use of the facility.
Attachment A
Dist of Available Facilities
Facility
Available Room
Staff Contact
Town Hall
Third Floor Training Rooms
Ci Mana er's Office Assistant
Town Hall
Foyer Area
City Manager's Office Assistant
DPS Headquarters
Community Room
Police Services Office Assistant
DPS West Station
Community Room
Police Services Office Assistant
Senior Activity Center
Meeting room
Communit Services Office Assistant
The Lode
Entire facility
Community Services Office Assistant
Attachment B: Facility Use Request Form
Please Note: All reservations are taken on a first -come, first -served basis. Rental Fee, Deposit, and Off -Duty Officer
Reservation (if necessary) are due prior to reservation confirmation.
Town Hall DPS Facilities Community Services
�rwv Training Room A Headquarters Community Room Senior Activity Center
Training Room B W West Community Room �P The Lodge
wTraining Room C
10-Training Room D (kitchen included)
41, Foyer
Person Responsible:
Cell Phone Number:
Address:
Alternative Contact:
Name:
CONTACT INFORMATION
E-Mail Address:
city
Phone Number:
Phone Number:
EVENT INFORMATION
State Zip
Requested Date: From: AMlPM To: AMlPM
Type of event/meeting/activity:
Detailed Information about the event, including planned activities or any equipment/special needs:*
Number of participants expected to attend:
Organization Represented:
Is this event a fundraiser? Yes No Please explain:
Does your organization maintain a Southlake Mailing address or PO Box?
Does your event provide a community benefit? If yes, explain below.
Non -Profit: Yes No
Yes No
Yes No
Do a majority of your members, including officers, reside in Southlake? Yes No
Will your event cause any impact on City Staff or City resources? Yes No
Is your group willing to indemnify and hold harmless the City of Southlake? Yes No
Does your organization carry liability insurance? Yes No Amount: $
Estimated space requirements for this event:
Estimated parking requirements
Number of planned participants
* If more space is needed, please continue on an additional piece of paper and attach to this form.
(continued on next page)
FACILITY USE POLICY COMPLIANCE:
Please thoroughly read through the Facilities Use Policy attached to this form. By signing below, you are stating that you
understand the rules and regulations pertaining to Southlake facilities and their proper use. Furthermore, you fully agree to abide
by and uphold these rules throughout your reservation and leave the facility in the same condition in which you found it. Failure
to abide by these rules may result in forfeiture of security deposit and denial of future use of City of Southlake facilities.
Signature of Applicant:
EVENTS REQUESTING TO SERVE ALCOHOL:
Date
With submittal of this application, the petitioner agrees to indemnify and hold harmless the City of Southlake, its officers, agents,
servants, and employees, from and against any and all claims or suits for bodily injury, illness, death, personal injury or property
damage (including, without limitation, reasonable fees and expense of attorney, expert witnesses and other consultants) arising
out of any negligent act or omission committed of the petitioner, its officers, employees, and agents, in connection with the
activities conducted under this agreement. This indemnification shall specifically include any claims arising from the negligence
of the city, its agents, officials, and employees.
The petitioner at its own expenses, shall obtain and keep in force during the term of the event public liability insurance as will
protect the petitioner and the City from all claims for damages to property and person, and such insurance policy shall carry the
City of Southlake as an additional insured.
Signature of Applicant:
Date
EhiIMOO �i�NTACT D P S A7;8'#� 743-�$2�L or 9
Attachment C
Southlake Department of Public Safety Off -Duty Work Agreement
The City of Southlake is pleased to offer opportunities to its police officers for off -duty
assignments.. However, the City must ensure that your business will agree to certain
conditions before it will allow the placement of off -duty officers. These conditions are as
follows:
Members of the Southlake Police Department are prohibited from accepting off -duty
assignments wherein the actual or potential use of law enforcement powers or other
public safety related authority is anticipated unless such assignments are scheduled
through the Southlake Department of Public Safety. Therefore, all requests for officers
to work such off -duty assignments must be made through the Southlake Department
of Public Safety by contacting Michael Bedrich at 8171748-8137. Any arrangements
made with any individual officer will not be honored.
Police Officers assigned to work off -duty assignments wherein the actual or potential
use of law enforcement powers or other public safety related authority is anticipated
will be paid by your business thirty-two dollars and fifty cents ($32.50) per hour for
every hour worked by the officer. The checks should be made payable to the
individual officer(s) and forwarded to the Southlake Department of Public Safety no
later than ten days following the date the off -duty assignment is performed. The
Southlake Department of Public Safety will forward the checks to the individual
officer(s).
The Department of Public Safety believes that compliance with these conditions is necessary
not only for the benefit of its officers, but also for the benefit of the public as whole.
Therefore, if your business is unable or unwilling to comply with these conditions, the
Southlake Department of Public Safety may not elect to authorize its officers to work off -duty
assignments for you.
Your signature below signifies that you have read this agreement and agree to comply with
the conditions set forth herein for the placement of off -duty police officers.
I have read the conditions set forth in this agreement for placement of off -duty police officers
and agree that _ (Insert as appropriate Ilmy business) will comply with them. I understand
that failure to comply with these conditions may result in the refusal by the Southlake
Department of Public Safety to authorize its officers to accept off -duty assignments _ (Insert
as appropriate 11my business) offer(s).
Printed Name Date
Title
Signature
Attachment C
Southlake Department of Public Safety Off -Duly Officer Reguest Form
Southiake:DPS
2100 W. Southlake l3lvd
Southlake; TX 76092
Off. -Duty Contact:
Corporal Bike Bedrich
Ph on e: 'ai 7-748-8137
rnbedrich @si.soutliEaketx.us
officer Roderick Page
817-748-8281
rpage u@ci.southlake.tc.us
After Hours Number:
Dispatch @ 817-743.4522
Fax: 817=748 d158
DPS USE ONLY
job #
Rate Rec,
Initial
Cancelled?
If so, when? _
Southlake Department of Public Safety
!Request for Off -Duty Services
bate of Request:
Company Name J Individual Requesting:
Mailing Address:
Contact Person:
Phone:. Fax:
Email:
Hate of Event:
I agree to pay the officer 1 s providirig the requested service within 10 business
days from the date of service. I understand that I may pay the officer at the
time of service, either by cash or check, or forward payment to the. officer 1 s
within 10 business. days. I understand that failure to. cancel the job at. feast two
hoursprior to the event will result In me I my company being. charged the offi-
cer's two. lour minimum. I further understand that officers .reserve the right.to
deny future requests for off duty services if payments are not made within the
designated time.
The current off -duty rate is $32.60 per hour with a two hour minimum.
Signature: