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									                                 CELEBRATE YOUTH DAY
                                         Flagstaff Mall
                                        January 23, 2010
                           Application for permit to use Flagstaff Mall

Group Name:
Name of Person Responsible:
Address:                                                        Telephone:
City/State:                                          Zip:

Event Date: Saturday, January 23, 2010
                             Hours of Event: 10:00 a.m. to 9:00 p.m.
                   Set Up, Date & Time: Saturday, January 23, 2010 8:00 a.m.
                            Set-up MUST be completed by 9:30 a.m.!
Tear Down, Date & Time: Saturday, January 23, 2010 9:00 p.m.
Event Location:   Flagstaff Mall

Type of Area Desired:
           Booth or Display
           Stage                     (Stage will only be set up if there is enough interest)
           Action Area
           If performing (Stage or Action Area), please list performance length, number of performances
you plan & desired performance times
           *Volume of performance music will be controlled by staff putting on this event
 *No more than 20 performers per performance. Due to fire and safety codes, the walkways around
             the stage must be clear at all times, this includes instrument cases and coats.
*Please note that the action area dimensions will be similar to last year. The area will be a wedge
shape on the side of the new play area at the mall (in front of Penneys. Part of this area has carpet.
The blue lines are the boundaries. Call the CASA office (779-5361) if you need more information.
                         December 23 , 2009
Physical Requirements - This is critical in assigning space so please be specific. (Please use separate
sheet if necessary)
How much room do you need?
Do you need Electricity?
Number of Tables:             (Each vendor will receive one table to start... Additional tables will be
assigned depending on available space)
TABLES AND CHAIRS WILL BE PROVIDED on a first come first serve basis. Please bring table
covering if appropriate (a project that will require protection of mall table covers).

Description of Activity: Please give a description of how you will participate:
__________________________________________________________________ (Continued on reverse)
PLEASE NOTE: The event will begin at 10:00 a.m. and end at 9:00 p.m. You may not pack up and
leave early. All organizations must make arrangements for their table/display be represented by
staff/volunteers until 9:00 p.m. All display items must be brought into the Mall through the delivery
entrances. No one may bring materials and display space supplies through the main Mall entrances.
All signs for tables/displays must be TYPED and Professionally Prepared – NO HANDWRITTEN or
HANDMADE SIGNS are permitted. It is the responsibility of the contact person to see that
organization/agency staff or volunteers are aware of all rules. No vendor balloons will be permitted.
You will receive a written notice if your organization’s application is accepted.
 Very Important: The Mall requires all participants/exhibitors provide CASA with a certificate of
    insurance. The certificate of insurance must have an A or better rating and a financial rating of
    not less than “Class IX” in the current Best’s Key Rating Guide. Further, the certificate of
    insurance’s Cancellation Box should have the following deleted:
        * words “endeavor to” and
        * “but failure to mail such notice shall impose no obligation or liability
           of any kind upon the company, its agents or representatives.”
The exhibitor shall at its cost, and at all times, maintain Public Liability and Property Damage and
Comprehensive General Liability insurance with a single limit of not less than $2,000,000.00 per
accident or occurrence, insurance against any and all liability with respect to or arising out of or in
performance of the indemnity set forth above, shall be issued by an insurance company reasonably
satisfactory to the owner and shall have The Macerich Company; Macerich Westcor Management LLC;
Flagstaff Mall SPE LLC; and Macerich Partnership LP; and Citizens Against Substance Abuse
(CASA) as additional insured thereunder. Additional insureds should be listed in the “special items”
section of the policy. Your insurance agent should be able to help you with the insurance certificate and
requirements. CASA understands that many do not have a high liability policy. CASA will
                                                              However, you
provide the umbrella policy for those who do not have the larger coverage.
will still be required to provide a certificate of insurance for the amount
of liability insurance that you carry and CASA and the Mall Entities
must be listed as additionally insured. See Attached.
PLEASE NOTE: The certificate of insurance is to be mailed or faxed (928-779-5422) to
CASA, attention Connie, NOT to the mall.
Last year, vendors failed to follow this directive and the certificates were lost and exhibitors were
required to have their insurance companies prepare another certificate. Save yourself, your insurance
agent, and Connie extra time and effort by sending the certificate to CASA with your
application for participation.
If you have questions, please call Connie at CASA at (928) 779-5361. We look forward to seeing you
at Celebrate Youth Day.
Your signature insures that you have read and agree to the above conditions and requirements.

Exhibitor Signature:                                       Date:
Applications (both sides) and a certificate of insurance are due to CASA (PO Box 1650, Flagstaff,
AZ 86002) by December 23, 2009. If you mail the application, please make a copy for your
For your convenience, you can give this page to your insurance agent. Because of the number of
additionally insured, your agent can attach the following to your certificate of insurance. Please, no
short cuts! ALL OF THE FOLLOWING businesses must be listed as additionally insured.

We are including this extra page to make it easier on you and your agent. Your agent will know up
front what we need so that we do not have to return your certificate of insurance to you for additions or

Exhibitor shall at its cost, and at all times, maintain Public Liability and Property Damage and
comprehensive General Liability insurance with a single limit of not less than $2,000,000.00 per
accident or occurrence, insurance against any and all liability with respect to or arising out of or in
performance of the indemnity set forth above, shall be issued by an insurance company reasonably
satisfactory to owner.

Required Coverage                                                   Minimum Limits
Worker’s Compensation                                               Statutory
Employer’s Liability                                                $500,000/$500,000/$500,000

Commercial General Liability
     Each Occurrence                                                $2,000,000
     General Aggregate                                              $2,000,000

Commercial Automobile Liability (combined single limit)             $2,000,000

Endorsements and Certificate Notations
The CGL and AL policies must include the following additional insureds, by endorsement or evidence of
broad form coverage. A notation on the certificate is not sufficient.

   the policy shall name as additional insureds the owner of the
   Center, Macerich, The Macerich Partnership, LP; The Macerich
   Company; and, all owned, managed, controlled, and subsidiary
   companies, corporations, entities, joint ventures, LLCs and
   partnerships, all of their constituent partners and members and
   Citizens Against Substance Abuse.

The cancellation clause on the Certificate of Insurance must evidence fifteen (15) days. The certificate
cancellation clause must strike through “ENDEAVOR TO” and everything including and after “BUT
FAILURE TO” must be deleted.

A waiver of subrogation endorsement in favor of the certificate holder and additional insured must be
included. A notation on the certificate is not sufficient evidence.

Send certificate of insurance to:
Citizens Against Substance Abuse
Attn: Connie Leto
PO Box 1650
Flagstaff, AZ 86002
(928) 779-5361          FAX (928) 779-5422

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