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Mobile Stage Application July 09

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					    Mobile Stage Hire Application Form
    Mobile Stage Hire Application Form
After completion return to:
                                             Events Administration Officer
                                             Newcastle City Council
                                             PO Box 489
                                             NEWCASTLE NSW 2300

                                                                                               Tentative Booking No.

Organisation ..........................................................................................................................................
Name: ....................................................................................................................................................
Postal Address: …………………………………………………………………….. Postcode: .....................
Phone: (Business Hours): ................................................. (Mobile): .....................................................
Fax: .......................................... Email: ...................................................................................................
Event Name: .........................................................................................................................................
Location of Event: ...................................................................................................................................
Date/s of Hire: ........................................................................................................................................
Times of Hire: Set up by: ........................................... Dismantled after: .........................................
Type of Function: ...................................................................................................................................
Event(s) to be held on the stage: ............................................................................................................
Approximate Number of People Attending:..............................................................................................

Backdrop:                                              Required                      Not Required

Steps to be positioned (please clarify on site plan – 2 Available): Front                              Back          or Side: Left            Right
Disabled Access – Do you require disabled access?                                       Required                      Not Required


Fees and Charges are detailed on the conditions attached.


Please attach the following:
        A Certificate of Currency for Public Liability Insurance to the value of $10,000,000, indemnifying
        Newcastle City Council.
        A map detailing the location of the stage and access routes to the venue including a separate
        diagram showing the exact position proposed for the stage and the preferred position of the stairs.
        Completed Occupational Health and Safety Risk Analysis with control measures.

      For further enquiries during business hours, phone 4974 2862 or fax 4974 2803 or email jonslow@ncc.nsw.gov.au




Applicants Signature: ....................................................................... Date: ........................................




                                                              Page 1 of 7                                                        Last updated 20/07/09
     Mobile Stage Hire Conditions of Use

              Your full compliance with the schedule of conditions is required.

1.     Fees and charges 2009/10, GST inclusive


 Hiring Categories                                                           Fee Applicable
 Within Newcastle Local Government Area                                                     $2200.00
 Service Clubs, Community Groups, non-profit organisations for use within                   $1100.00
 the Newcastle Local Government Area
 Outside Newcastle Local Government Area:
 • up to 1 hour travelling time                                                             $3000.00
 • over 1 hour travelling time ( additional $300.00 per hour)                               $3300.00


       The normal hire period is calculated on a per day basis and costs are based on this
       period of time.
       This rental covers the delivery, erection, dismantling and removal of the mobile stage by
       Council staff.


2.     Payment
       The full amount of rental shall be paid not less than three (3) days prior to the
       commencement of the hire.
3.     At least four (4) weeks notice must be given for hire of the mobile stage.
4.     Cancellation
       (a)    Intention to cancel to be indicated by telephone and confirmed in writing no later
              than one (1) week (7 days) prior to the arranged commencement of hire.
       (b)    By Council:
              Council reserves the right to cancel any booking where upon any payment shall
              be refunded in full.
5.     Transport
       (a)    The mobile stage shall be delivered by Newcastle City Council inclusive of
              transport charges within the Newcastle Local Government Area. Transport fees
              outside the Newcastle LGA are shown in the Fees and Charges table.
       (b)    Only an authorised Newcastle City Council truck may be used to tow the
              mobile stage.
6.     The Council’s personnel will set up, set down and move the mobile stage and the hirer
       will not interfere with the location, setting up, setting down or removal of the mobile
       stage.


                                             Page 2 of 7                            Last updated 20/07/09
7.    The hirer will obey all reasonable directions given by the Newcastle City Council, in
      respect of the use and location of the mobile stage or for the cessation of use of the
      mobile stage.
8.    Newcastle City Council shall have the right to enter the location and the mobile stage for
      the purpose of inspection, giving reasonable directions as stated above and erecting,
      dismantling and removing the mobile stage.
9.    Occupational Health and Safety
      The hirer shall be responsible for all Occupational Health and Safety Requirements as
      set out in the NSW OH&S Act 2000 and NSW OH&S Regulation 2001 associated with
      use of the mobile stage, other than set-up and pack-up.
      The hirer shall complete a Risk Assessment to identify risks and controls associated with
      use of the stage at their event. A risk analysis template is provided, however it is the
      responsibility of the hirer to complete the template, ensuring all risks are identified,
      assessed and controlled. The completed risk assessment must be provided to
      Newcastle City Council prior to the use of the mobile stage.
      The hirer shall be responsible for supervising event staff, volunteers, participants and
      audiences to ensure the risk controls identified in the risk assessment are met. Adequate
      staff/volunteers must be present and available for crowd control for the event and
      emergencies.
      The hirer shall conduct and document (by way of sign off) an Occupational Health and
      Safety briefing/induction conveying the identified risks and controls to all staff and
      volunteers using the stage and/or supervising the event.
10.   Damage
      The hirer will be responsible for any damage to the mobile stage and loss or damage to
      the equipment during the hire period. Damages will not be charged for fair wear and
      tear. Damages shall be assessed by the Fleet Manager at Newcastle City Council.
11.   Security
      The hirer shall be responsible for the security and protection of the mobile stage during
      the entire hire period. Where applicable, it is your responsibility to arrange overnight
      security.
12.   Insurance - Public Risk and Property
      (a)      Public Risk
               It is imperative that individuals, organisations and committees hiring the mobile
               stage ensure they are adequately covered by a public risk insurance policy to the
               value of $10 million, to safeguard them in the event of claims by any person using
               the mobile stage for damages or other expenses incurred due to accident or
               damage sustained during the conduct of the period of hire. The insurance policy
               should be endorsed to include Newcastle City Council as insured. A copy of the
               Certificate of Currency indemnifying Council must be attached to the Mobile
               Stage Hire Application Form.
      (b)      Property
               The mobile stage is insured by Newcastle City Council.
13.   Power
      Power may be used on the mobile stage providing:
      •     the supplying lead is supported in an appropriate manner at a minimum height of 2.4
            metres above the ground with a maximum span of 10 metres; and

                                          Page 3 of 7                             Last updated 20/07/09
          •    A suitable earth leakage circuit breaker is used at the source of power i.e. To provide
               protection of the supplying lead and the connected apparatus.
          •    OH&S safety controls are identified for the event of wet weather.
14.       Weight Limit
          The weight capacity for the stage is as follows and must not be exceeded:

      •   Centre stage- 3200kg
      •   Rear stage extension- 5600kg
      •   Front stage extension- 5600kg
      •   Fold out stage- 1500kg each

          Note: the above loads include loads due to people. It can be assumed that 1000kg =
          12people.

      •   Roof Lighting & attachments- 200kg (this includes, lighting, banners, backdrops and
          other devices that can be attached to the roof)



                                      Technical Information
          1.      Opens out to a performance space measuring 7.3 metres wide x 6 metres deep.
          2.      Sound wings 1.5 metres x 1.9 metres on each side at the front to provide a total
                  width of 10.3 metres.
          3.      Approximate mobile stage height above ground is 1.2 metres.
          4.      Canopy (roof) clearance above mobile stage floor is 3 metres.
          5.      Mounted on a tri-axle trailer.
          6.      Towed by a 5 tonne Newcastle City Council truck.
          7.      Approximate weight is 4.2 tonnes.
          8.      Substantial space is required to manoeuvre the mobile stage into position.




                                              Page 4 of 7                              Last updated 20/07/09
                            OHS Form
   Mobile Stage Hire Application Risk Assessment Template                                                                                         ELIMINATION
                                                                                                                                                 SUBSTITUTION
                                                                                                                                                   ISOLATION
                                                                                                                                            ENGINEERING CONTROLS
                                                                                                                                           ADMINISTRATIVE CONTROLS
                                                                                                                                      PERSONAL PROTECTIVE EQUIPMENT (PPE)



 PROCESS/TASK        Use of mobile stage                                                                      Date of Event
 SITE LOCATION
 NAME OF EVENT                                                                                                Date of Risk Analysis


         ACTIVITY                          HAZARD               RISK          RISK                   CONTROL MEASURES                                         RISK
                                                               RATING       PRIORITY                                                                         RATING
                                                                (MAJOR,      (1 – 25)       Controls must be effective and acceptable                         (MAJOR,
                                                               MEDIUM, or                                                                                    MEDIUM, or
                                                                 MINOR)                                                                                        MINOR)

 Placement of banners       Manual Handling/lifting
                            Working at heights (fall hazard)
                            Other:
 Set up of sound and        Working at heights
 lighting equipment
                            Manual Handling/lifting
                            Electrical hazard
                            Trip/slip/fall
                            Water on stage and equipment
                            Other:
                            Other:
 Use of stage (including    Slip/trip/fall
 props)
                            Water on stage and equipment
                            Emergency
                            Weight capacity of stage hazard
                            Manual handling/lifting
                            Security
                            Other:


OH&S Documentation                                                            Page 5 of 7                                                        Last updated 20/07/09
 Use of equipment (i.e.
 ladders, trucks etc)
 List of equipment:




 Taking banners down              Manual Handling/lifting
                                  Working at heights (fall hazard)
                                  Other:
 Dismantling of sound             Working at heights
 and lighting equipment
                                  Manual Handling/lifting
                                  Electrical hazard
                                  Trip/slip/fall
                                  Water on stage and equipment
                                  Other:
                                  Other:
 Other activities:

 Other activities:
         The following people were consulted when assessing risk levels and deciding relevant control measures:
            NAME                                                 SIGNATURE                                                           NAME                               SIGNATURE
  RISK RATING
                 Catastrophic     Major       Moderate     Minor      Insignificant   CONSEQUENCES                                         LIKELIHOOD
    MATRIX
Almost certain       25            23           20          16             8          Catastrophic: death, permanent disability/disease    Almost certain: is expected to occur in most circumstances
Likely               24            21           17          13             7          Major: extreme injury, long term illness             Likely: will probably occur in most circumstances
Possible             22            18           14           9             4          Moderate: medical attention, several days off work   Possible: might occur at some time
Unlikely             19            15           10           5             2          Minor: first aid                                     Unlikely: could occur at some time
Rare                 12            11            6           3             1          Insignificant: no injury                             Rare: may only occur in exceptional circumstances
   MAJOR RISK                   MEDIUM RISK              MINOR RISK                   The Higher the number, the Higher the priority for implementation of controls


                                                                                       Page 6 of 7                                                                     Last updated 20/0709
   Mobile Stage Hire Application Form
OCCUPATIONAL HEALTH AND SAFTEY
RISK MANAGEMENT BRIEFING

NB: Staff and volunteers involved in setting up and using the mobile stage should be
briefed on risks and control measures identified in the completed Risk Assessment form
and sign below.


                       This form is for your own records only.


Event Name:                                     Event Date:
Organisation:                                   Location:

The hazards, risks and safety control measures for using the Mobile Stage have been
explained to me by a supervisor and I agree to follow these directions.


Name (staff, volunteers)                        Signature




OH&S Documentation                Page 7 of 7                           Last updated 20/07/09

				
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Description: Mobile Stage Application July 09