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Private Fitness Contract

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Private Fitness Contract Powered By Docstoc
					         Outdoor Health, Fitness & Recreation Program (Pilot Program)
                      Temporary Concession Application



Applicant Information
Company Name:_________________________________________________________
Contact:________________________________________________________________
Address:________________________________________________________________
City:_____________________ State:______________ Zip Code:_________________
Phone Number:_________________ Alternate Phone Number:__________________
Fax Number:____________________________________________________________

Permit (check one)
Single day:________________
Temporary (Up to 12 Months):___________________
Please list date(s) you wish to be in the park:________________________________




Park Information

Park:___________________________________________________________________
Location within Park:_____________________________________________________
First alternative location within Park:_______________________________________




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Second alternative:_______________________________________________________
Second Park (if 1st choice is not available):___________________________________
Does each location meet the American’s with Disabilities Act requirements?______
Impact Concession will have on Park:
1. Traffic/Parking_______________________________________________________
Park Information cont.
2. Pedestrian/Bicycle Traffic______________________________________________
3. Trash________________________________________________________________
Do any other concessions operate in the area?_____ If yes, please
list_____________________________________________________________________


Concession Information
Please list the exact products you will offer and the prices of those products:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Days and Hours of operation:_______________________________________________
Description of Stand/Trailer/Equipment (include picture):
________________________________________________________________________
________________________________________________________________________
Utility requirements:______________________________________________________


Permits/Insurance Information
Do you have a food sales permit issued by the Austin/Travis County
Health and Human Services Department? _______If applicable, please list
permit number__________. If you do not have a health permit, you must
have one before you sign a contract.

At the time the contract is signed, the concessionaire must provide a
Certificate of Insurance listing the City of Austin as an additional insured
party and a State of Texas Sales and Use permit issued by the State
Comptroller’s Office. The Comprehensive General Liability Insurance
should have a combined single limit of $1,000,000 per occurrence.
Statutory Worker’s Compensation Insurance may be necessary.
Please Include Photo of exact park location with your application.




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At the time the contract is signed, the concessionaire must provide
documentation for the following:

Minimum program requirements
Health & Safety Requirements:
a) Certification from a reputable fitness training organization
b) Established Customer satisfaction and feedback
c) First Aid and CPR certified instructor; cell phone access to report medical
emergencies

Risk Management Requirements:
a) General Liability Insurance
b) Instructor and participant waivers

Business Experience Requirements:
a) At least one year of documented business experience
b) Documented customer satisfaction and feedback system
c) Current Sales Tax Permit
d) PARD Concession Permit
e) Reliable business contact information (phone, website, business hours
f) Class size limitations (per industry standards)
g) Program evaluation requirements



Please attach photo of requested location to your application.
Verification
I verify that all of the above information is true. I have also read, understand, and
I am willing to comply with the concession policies and procedures set by the City
of Austin Parks and Recreation Department.


Signature of Applicant                                                   Date


Please complete this application and return to the
City of Austin Parks and Recreation Department
Attn: David Coleman
Mailing Address:
200 S. Lamar
Austin, Texas 78704-1046
Fax: (512)974-6729
E-mail: david.coleman@ci.austin.tx.us



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Parks and Recreation Department Approvals: (office use only)



________________________________       __________________      _______________
 Verified Financial Services           Printed Name            Date
 Signature


________________________________       __________________      _______________
 Approved Financial Services            Printed Name           Date
 Signature


________________________________       __________________      _______________
 Approved Site’s Supervisor/Manager     Printed Name           Date
 Signature


________________________________       __________________      _______________
 Approved Site’s Division Manager      Printed Name            Date
 Signature




  Page 4                                                             2/14/08

				
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