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January 2025 <br />Library Meeting Room <br />Reservation Agreement <br />400 Old Bernal Ave. Pleasanton, CA 94566 <br />Mailing address: P.O. Box 520 Pleasanton, CA 94566 <br />Email: recreation@cityofpleasantonca.gov Phone: 925-931-5340 <br />MEETING ROOM / DATE / TIME INFORMATION <br />Large Meeting Room Capacity: 64 (16 tables and 64 chairs) // 130 (chairs only) // 200 (no furniture) <br />Date(s) Day of Week Rental Start Time Meeting Start Time Meeting End Time Rental End Time <br />APPLICANT INFORMATION <br />Name of Organization/Company: ______________________________________________________________________________ <br />Name of Responsible Party: __________________________________________________________________________________ <br />Phone: _____________________________________________ Email: ________________________________________________ <br />Address: __________________________________________ City/State _______________________________ Zip ____________ <br />MEETING INFORMATION <br />Type of Event: ______________________________________ Estimated Attendance: ____________ <br />Equipment Needed: Projector Sound System Podium <br />Organization/Applicant is responsible for event setup/clean up and for returning tables/chairs to original setup. <br />MEETING ROOM RESERVATION PROCEDURE AND GENERAL RULES <br />Initial_________ I have read the Library Meeting Room Procedure and Rules, and agree to, and will abide by those rules. <br />Initial_________ I agree to provide a valid copy of a Certificate of Liability Insurance with the Additional Insured Endorsement <br />page no later than five (5) business days before the event date. <br />HOLD HARMLESS AND COMPLIANCE AGREEMENT <br />I certify that the above information is accurate. I certify that I have read the Rules and Regulations pertaining to facility use and <br />agree to comply with the Rules and Regulations. I further agree to be personally responsible for informing those using the facility <br />as scheduled in the Agreement of the rules and regulations of the City. I, or organization, through me, agree to be responsible <br />for any damage sustained by the facility, equipment, or furniture during use of the facility and further agree to release and hold <br />harmless the City of Pleasanton from any and all liability for damage or injury to person or property of the undersigned due to <br />use of said facility. Evidence of this Hold Harmless and Compliance Agreement shall be provided through a Certificate of Liability <br />Insurance from any insurance carrier, or, if available, through special facilities insurance purchased through the City of <br />Pleasanton. <br />_________________________________________ ________________ ________________________________________________ <br /> Signature of Responsible Party Date Organization/Responsible Party <br /> <br />Permit #: __________ <br />Insurance <br />Due: ____________ <br />Staff Use ONLY: <br />Approved <br />Staff: __________ Comments: _________________________________________________________________________ <br />______________________________________________________________________________________________________ <br />Page 23 of 39