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Official Use Only Event: "~ Attachments Submitted \__ Indemnification Agreement Certificate of Insurance x__ 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 _X__ Recommended or Not recommended by the Recreation Department. Action by Aurora Town Board The Aurora Town Board, upon review of the application reqnest # 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 . X__ Arsenal Soccer Contacted --No Conflicts. Date: 12 //7/45" Other