(External Use Only)

~tion Today(s) Date

12-7-16_-~"";laden Cycling Tour Tierra Bella/Michael Hudick

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24030 Summit Woods Dr. Los Gatos, CA 95033Phone # 408-353-2668 I Non-Profit 10 # . Nature of use, title of performance, etc.Cel #408-309-4671 Bicycling EventName of Facility Requested Date(s) of Use Hours of Use (From and To) Est. Number in Attendance

*Tent that is currently buy food trailer Saturday: April 1, 2017 5:30a-6:00a (staff only) 2,000 + volunteers(Any additional tents will need to be provided 6am-6pm( event)by user) 6pm-9pm (cleanup)Parking Lots A, C, H, D, E Saturday: April 1, 2017 6:00a-7:00pm 2,000 + volunteersRestrooms: Art, Student Center, LS

****Food will not be served after 5:30pmNO RV parking on Campus

***"Staff' Spaces in Lot 'A' in front of Mayock House, and parking by Track in Lot 'H'(see map) Parking Lot'B' will be reserved for Gavilan Students & Staff Parking Only. Port-a-potty must not be on campus earlierthan 6pm on 3/31/17 nor later than 6am on 4/3/17. All Campus regulation and policies must be followed(parking regulations, no overnight parking, no dogs left in cars, etc) Due to the parking spaces on campusbeing modified for cars ALL RV's park off campus. Sheriff's Deputies DO NOT direct traffic at SantaTeresa/Mesa intersection (North Entrance).Classroom Seating Related Special Equipment Needs: Will Foodor Beveragebeserved?Yes

FoodPermit# GavilanCafeinformation: Do you require special equipment IsyoureventOpento thePublic?YesYssroom seat size: __ for your event? WillAdmissionbeCharged? Yes

Whatis theAmount?$__

Gavilan Office Use Only

Name Date Hours # Hours Fee Total

Attend. TBD Supervisor 4-1-17 5:30a-9pm 15.5 $25.00 $387.50

Parking Lots 4-1-17 6am-7pm 13 $400.00Utilities/Rental Fee (Tent) 4-1-17 5:30a-9pm 15.5 $49.32 $764.46Security (2) 4-1-17 5:30a-9pm 15.5 $28.00x2 $868.00Sheriff's Deputy 4-1-17 5:30a-7pm 13.5 $78.04x2 $2,107.08

Set-up/Clean-up 4-1-17 4pm-9pm 5 $25.00 $125.00Dumpster fee 4-1-17 $604.00Payment ReceivedlDate: Amount Waived: Date: Total Fees:

Fees waived by: $5256.04

~SQ}.mk. &¥\- d~J17 Availability of 0 RoutingGavilan Approval Signature: 0 Applicant

• ' . 0 Su ervisor

Gavilan College5055 Santa Teresa Blvd.

Gilroy, CA 95020 (408-846-4957)FACILITIES USE APPLICATION

(Date)Campus facilities may not be exactly as presented during scheduled use. Slight variations mayInclude posters and bannerswhich advertise events consistent with a Community College.Every reasonable effort will be made to provide campus facilities in the same condition asviewed upon signing the contract for use.

Signature below indicates that you have read and agree to the conditions on thereverse of this form. Request for space is confirmed only when an approved copyis urned to the applicant

Signature of Applicant. --:=- _(Date)

Proof of insurance may be required. See Reverse Side for details.

po Maintenanceo Securityo Info.Centero Cont.

Educationo Cafeteriao Other

Routed/ScheduleMaster

Initials/Date