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Official Use Only | Event: Attachments Submitted VA Indemnification Agreement v___ Certificate of Insurance Map with area(s) requested to be used indicated *_ Parking and Traffic plan _ Copy of application for sign permit, if applicable. (Upon application approval copy of approved sign permit must be filed with the Town Clerk NO LATER THAN 5 days prior to scheduled event.) . Copy of this application to NYS Parks and Recreation c/o Evangola State Park Application 'S ‘Recommended or Not recommended by the Recreation Department. Action by Aurora Town Board The Aurora Town Board, upon review of the application request # submitted by . (organization or individual) took the following action with or without conditions (as applicable) noted below: Approved: Date: Supervisor’s Signature Denied: Date: - Supervisor’s Signature Conditions: Police Department Approval Highway Department Approval Building Department Approval Requesting organization shall attach a completed Certificate of Insurance with minimum limits to include public liability coverage with limits of $1,000,000 each occurrence; property damage insurance with limits of $1,000,000 each occurrence. Policy shall be endorsed to include the Town of Aurora as an additional name insured . Requesting organization or individual shall submit an Indemnification Agreement signed by authorized applicant or officer of company and duly notarized. ___ Approval of parking and traffic plan . . y, Arsenal Soccer Contacted —~ No Conflicts. Date: f Z2oc6 _ Other