Fillable Printable Printable Blank Lease Agreement
Fillable Printable Printable Blank Lease Agreement
Printable Blank Lease Agreement
Jefferson Civic Center
Fee Schedule and Lease Agreement
1
Lessee/Contact Person: Date
Mailing Address:
Phone: Home: Cell: Work:
Fax: e-mail:
Person Responsible for bill: Phone:
Mailing Address:
Person(s) authorized to incur charges:
Type of event:
Date of event: set-up time: start time: end time:
*Set-up time and clean-up time are included in your rental time (ex. If you have a 5 hr. rental and your set-up time started at 5:00pm you must be out by 10pm.)
*No event shall start before 6:00 a.m. and all events shall conclude no later than 12:00a.m. Anything outside these hours must be approved by management
Number of guests expected: Will you use the kitchen facility: ( )Yes ( )No
Will the event be catered? ( ) Yes ( ) No Name of caterer and phone #:
Number of tables:
5' round 6' rectangular
8' rectangular
6
Number of chairs
225
Will alcohol be consumed? ( ) Yes ( )No
If so, alcohol consumption begins at: p.m. and will continue until p.m.
The serving of alcohol must stop one hour prior to end of event. Alcoholic beverages can not be sold in any way on Civic Center Property.
Check Facility/Items Total
$50.00 $35.00 $150.00 $50.00 $50.00
includes 5 tables & linens
120" cloths--$20.00 extra
$200.00 $50.00 $375.00 $60.00 $100.00
includes 15 tables & linens
120" cloths--$60.00 extra
$200.00 $50.00 $375.00 $60.00 $100.00
includes 15 tables & linens
120" cloths--$60.00 extra
$400.00 $75.00 $750.00 $85.00 $200.00
includes 30 tables & linens
120" cloths--$120.00 extra
Kitchen $50.00 $75.00
$475.00 $75.00 $950.00 $100.00 $250.00
TOTAL $0.00
I understand if I do not reserve the entire facility, the remaining rooms could be rented by other parties during the same period of time (including the kitchen).
***
Note: A $100.00 Damage/Clean-up deposit for the Wilkens Room and $200/$400 deposit for Ballroom A or B/A&B is required. It is refundable if the final
walk-through checklist is signed before departure by Lessee and Civic Center Staff. Some events may require a $500.00 refundable damage deposit. Please issue
a separate check for damage deposit and clean-up deposit. This check will be returned if final inspection of the facility is satisfactory to Civic Center Management
check # TOTAL
***
***
facility is rented for the same function, two or more officers will be required and a decision will be made by the Civic Center management. The Civic Center
management will make the necessary security arrangements. The fee for security is $25.00 per hour per security officer with a minimum of 5 hours for each officer.
# of officers # of hours TOTAL $0.00
is $100.00 per hour. Cost for a hold on the Civic Center for the day before or the day after your event is $150.00 for 3 hours only. Hold must be approved and
scheduled by the manager at least 5 days prior to the event.
# of hrs. before 6am or after midnight # of days requiring hold TOTAL $0.00
ADDITIONAL CHARGES:
54" x 12" tablecloth $6.00/ea. (# needed) $0.00
90" round tablecloth $8.00/ea. (# needed) $0.00
120" rnd or floor length $15.00/ea. (# needed) $0.00
stage $200.00 $0.00
Monday -
Thursday
(8am - 5pm)
Rental Rate
Additional
cost per hr
Mon. - Thurs.
(8am - 5pm)
Mon-Thurs.
Evening &
Weekend
Rental Rate
up to 8 hours
Additional cost
per hr Evening &
Weekend
Deposit
(goes toward fee)
Wilkens Room *3 hour minimum*
Ballroom A *5 hour rental*
Ballroom B *5 hour rental*
Ballroom A & B *5 hour rental*
Entire Facility *5 hour rental*
The City of Jefferson reserves the right to require the rental of the entire facility for large functions such as wedding receptions and on the weekends.______initial
I have been given a copy, read and understand he rules and regulations of the Jefferson Civc Center. ________initial
FUNCTIONS WITH ALCOHOL: If alcohol is served in the Jefferson Civic Center, a security officer is required. If Ballroom A and Ballroom B or the entire
ADDITIONAL HOURS: Please see the above fees for cost of additional hours for the day of the event listed. Cost for hours before 6:00am or after 12:00 midnight
Jefferson Civic Center
Fee Schedule and Lease Agreement
2
miscellanous charges
TOTAL $0.00
TOTAL LEASE AMOUNT $0.00
TOTAL LEASE AMOUNT $0.00
Lessee agrees to pay the Jefferson Civic Center any cost incurred for use of additional equipment and space not specified in the lease agreement.
Lessee agrees to pay deposit within 7 days of initial booking of the facilities. The balance of $0.00 shall become due
and payable on (date). Cancellation more than 15 days in advance of an event will result in the return of the deposit, less a
$50.00 cancellation fee. Cancellation within 15 days of an event will result in the forfeiture of the deposit. All deposits and advance fees will be
refunded if the Civic Center calls for cancellation of agreement. The Jefferson Civic Center reserves the right to cancel any and all agreements it
deems necessary. Lessee agrees to leave the facility clean and orderly. This includes all trash and debris put in garbage cans; no damage to tables or
chairs; and all decorations removed. Lessee agrees to abide by all conditions attached and all laws, rules and regulations of the City and State.
Prepared by: Lessee:
Date: Date:
*****************************************************************************************************************
PAYMENT SCHEDULE
DATE CHECK/CASH
TOTAL LEASE AGREEMENT $0.00
DEPOSIT
TOTAL BALANCE REMAINING $0.00
PAYMENT
BALANCE $0.00
Check Facility/Items or 8 hr. Rate
Wilkens Room 3 hour rental $75.00 $35.00 $150.00 $50.00
includes 5 tables & linens
120" cloths--$20.00 extra
Ballroom A 5 hour rental $300.00 $50.00 $375.00 $60.00
includes 15 tables & linens
120" cloths--$60.00 extra
Ballroom B 5 hour rental $300.00 $50.00 $375.00 $60.00
includes 15 tables & linens
Ballroom A & B 5 hour rental $600.00 $75.00 $750.00 $85.00
includes 30 tables & linens
120" cloths--$120.00 extra
Kitchen $75.00 $75.00
Entire Facility $725.00 $100.00 $950.00 $100.00
Per hr. Cost
over
Friday-
Sunday
Rental Rate
Monday -
Thursday Rental
Rate
Mon. -
Thurs.
Rental Time
Per hr. Cost
over 8 hours
Deposit
Total
$50.00
$100.00
$100.00
$200.00
$250.00
TOTAL 0
(goes toward
fee)
