Town Hall Rental Agreement NOTE: Payment for your rental should be sent to: PGCICPO Box 284Pine Grove, CA 95685 PGCIC Rental Agreement Pine Grove Civic Improvement Club Rental Agreement Please answer all questions to process your application online. Date(s) of Desired Rental * Hours of Use (from - until) * RENTER'S CONTACT INFORMATION Name of Renter (Individual Person or Responsible Person for Organization) * Street Address * Street Address Street Address Street Address City City State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip Code Zip Code Email Address * Phone Can the Deposit Refund be mailed to this address? * Yes No, I have a different mailing address. MAILING Address to be used for Deposit Return * MAILING Address to be used for Deposit Return MAILING Address to be used for Deposit Return MAILING Address to be used for Deposit Return City City State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip Code Zip Code REQUIRED INSURANCE Type of Activity * Insurance Carrier and Policy Number * RENTAL FEES / DEPOSIT / PAYPAL FEE OPTION Rates: Please select one below based on your intended usage. * Select BelowOne Hour $25 plus $150 refundable cleaning depositTwo Hour $50 plus $150 refundable cleaning depositHalf Day $150 plus $150 refundable cleaning depositFull Day $300 plus $150 refundable cleaning deposit Quantity * Total Would you like to help lower our operating costs by covering the PayPal fees for the rental portion only of this transaction (fees are calculated only on the rental - excludes the refundable deposit in calculating fees) * Yes No thanks (OPTIONAL) one-hour rental donation: $0.99 (OPTIONAL) Two-hour rental PayPal Fee Donation: $1.49 (OPTIONAL) PayPal Fee Donation for half-day rental: $3.48 (OPTIONAL) PayPal Fee Donation for full-day rental: $6.46 TERMS AND CONDITIONS Alcoholic Beverages are permitted but you must have an Alcohol Beverage Control license if you will be selling alcohol. Cleaning Deposit A cleaning deposit of One Hundred Fifty Dollars ($150.00) is required on all rentals. The Cleaning Deposit will be refunded within fifteen (15) days after inspection. Any costs incurred by the Club to restore the rented area to pre-rental condition will be deducted from the Cleaning Deposit. Insurance A Certificate of Public Liability and Property Damage Insurance, indemnifying both the Pine Grove Civic Improvement Club and Amador County in the amount of $1,000,000, shall be submitted to the Pine Grove Civic Improvement Club; P.O. Box 284, Pine Grove, California 95665; no less than 15 days prior to use of the rented facilities. This is a requirement of our Insurance Carrier and Amador County. Cancellation A Fifty dollar ($50.00) cancellation fee will be charged if the event is canceled less than ten (10) calendar days before the event. Damage/Hall Property The undersigned is responsible for any damage to the building, its facilities, property, and for proper cleaning of all rented areas, inside and outside, and for material used. All property shall be replaced/restored to their proper storage place. The piano, if moved, shall be returned to its original location. All restrictive signs shall be adhered to. Hall property will not be removed from the Hall at any time. All lights, heat, stoves and coolers shall be turned off after facility use. Keys Keys to the facility are a part of this agreement, and all keys issued are to be returned at the conclusion of the rental agreement. A $20.00 charge will be made for each lost key. Keys may be picked up 1/2 hour before the rental period. Other arrangements are at the discretion of the rental agent. Parking The property adjacent to the hall on either side is not Hall Property. The emergency exit east and rear of the building exits to private property and may be used in an emergency. "Emergency" is defined as fire or persons needing ambulance service. Disabled persons may enter and exit via the lift at the front of the building. The driveway on the east side of the Hall is private property; it shall be kept clear at all times. Remove vehicles after unloading. Parking is permitted on the side of the highway or in the Community Park parking lot. Vehicles parked in the east or west sides of the building may be towed at the owner's expense. Lift The lift may not be used before receiving specific operating instructions from the rental agent. It may not used for transporting materials of any sort up to the Hall. No more than two people at a time may occupy the lift. Wood Floor The hall floor is highly finished at great expense. To clean, use the brooms or oiled dust mops stored in the broom closet. Use a damp mop to clean spills. Do not wet mop the hall floor. Use NO detergents to clean the hall floor. Plumbing This building uses a septic tank. Kleenex, feminine hygiene products, or any other items not intended to be flushed down the toilet may plug the system. If the plumbing becomes clogged during the rental period, you will be responsible to obtain and pay for a plumber to perform the needed repairs. You will also be responsible for any water damage repairs. Garbage All Hall users are required to remove their garbage and trash. Any remaining on the premises after expiration of the rental shall be charged at the rate of $25.00 per can or fraction thereof. This charge will be deducted from the cleaning deposit. Decorations No nails, sharp objects, or tape of any kind will be placed in or on the walls, floor, ceiling, or fixtures of the building. Light decorations may be hung from the picture rail only with attachments provided by request to the rental agent. Any other methods of hanging are not allowed. Terms and Conditions * I have read, understood, and agree with the Terms and Conditions as stated above. SIGNATURE OF PERSON RESPONSIBLE FOR RENTAL AGREEMENT Renter's Signature Clear Date Rental Agent Signature (if applicable) Clear Date Cleaning Deposit, insurance rider, and rental fee may be mailed to:Pine Grove Civic Improvement ClubP.O. Box 284Pine Grove, CA 95665 The street address of the Hall is: 19889 Highway 88. If you are human, leave this field blank. Submit Start Over Δ