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b. COAST GUARD PERMITS (where reaufred): <br />t. Ii the fireworks era to be displayed on or near the water, the following may 6e required: (Requests for permits must be filed <br />at least 60 days prior to the Display Data (� 35 days prior for 4th of July events). <br />2. Coast Guard Appitcatlon antl Permit to Handle Hazardous Materials. <br />3. Coast Guard Marine Event Permit. <br />c SPONSOR RESPON3IHILFTIES AND EXPENSES (The followfna sarvfoes need to be orovided and paid for by the <br />SPONSOR In addition to the Fireworks D(snlav Price. <br />1) SECURITY: MUST BE PROVIDED FOR FIREWORKS EQUIPMENT AND TO MAINTAIN THE FIRE SAFETY ZONE AT <br />STAGING AREA FROM FIREWORKS TRUCKS) ARRIVAL, UNTIL COMPLETION AND CLEAN -UP OF DISPLAY AREA <br />ANO TRUCK DEPARTURE. <br />2) Sand: Please provide ^O_ yawls of sand. <br />3) Leborer(s): _O_ laborers to arrive at fireworks site on (They will not handle fireworks). <br />4) Hotel Room(s): _O_ hotel rooms. <br />5) Vahicle(s): Four -wheel drive vehicle for movement on send: Yes No XX <br />6) If you have ordered a set plece(a), you are responsible for erecting the scaffolding end It must be ready when the <br />craw arrives <br />d. RADIO 91MULCAST EXPENSES (!f apollceblel: <br />t) Sat up end staff a fireworks simulcast commantl canter on site by t:1� PM on the display date. <br />2) Provide broadcast relay to PEI Firing Center_ Call our offlt:a for details_ <br />3) Spaekar system for VIP viewing stands. <br />a_ INSURANCE: Please list below the addNional tnaured, sa they should appear on lha Insurance certificate: <br />1. <br />3. <br />2, <br />4. <br />Name of onsor <br />Stale of _ <br />County of <br />On the _day of in tho your _before me, the undersigned, n Notary Public in and for said State, personalty appeared <br />,personally known to me or proved to me on the basis ofsatisfactory evidence to be the indiv[duel(s) whose neme(s) <br />is (are) subscribed to the within instrument and acknowledged to rite that fidshdlhey executed the same in his /hedtheir capacily(ies), and that by <br />his /herhhefr signatures) on the instrument, the individua[(s), or fife person upon behalfoF which the indlvidual(s) acted, executed the instn�ment. <br />Signature and Of7ice oof individual <br />taking acknowledgment <br />Pbesa labial each p �pe(j _ i�l � a , 7i <br />InRial Mete: �/�•�J f�iJ{j '//11�J(/��/�/ <br />sponsor <br />�iJ MAR . H I R� <br />CLERK OF THE COUNCIL <br />Name of onsor <br />Data <br />P En 1 n f net <br />Data <br />B : -1 <br />SI a on b alf f S onsor SI nature <br />ame <br />Title of authorized re reaentative of S onsor <br />Title <br />Stale of _ <br />County of <br />On the _day of in tho your _before me, the undersigned, n Notary Public in and for said State, personalty appeared <br />,personally known to me or proved to me on the basis ofsatisfactory evidence to be the indiv[duel(s) whose neme(s) <br />is (are) subscribed to the within instrument and acknowledged to rite that fidshdlhey executed the same in his /hedtheir capacily(ies), and that by <br />his /herhhefr signatures) on the instrument, the individua[(s), or fife person upon behalfoF which the indlvidual(s) acted, executed the instn�ment. <br />Signature and Of7ice oof individual <br />taking acknowledgment <br />Pbesa labial each p �pe(j _ i�l � a , 7i <br />InRial Mete: �/�•�J f�iJ{j '//11�J(/��/�/ <br />sponsor <br />�iJ MAR . H I R� <br />CLERK OF THE COUNCIL <br />