Form Center

2. 
4. Contact Name*
6. Contact Phone*
   Include Area Code
8. Contact Email*
10. Contact Address*
12. Contact City*
14. Contact State*
16. Contact ZIP Code*
18. Event Name*
20. Event Location*
22. Event Description*
24. Sponsoring Organization*
26. Number of Days*

    1. 1
    2. 2
    3. 3 or More
28. Day 1 Set Up Date and Time*
    Day 1 Set Up Date and Time

    Day 1 Set Up Date and Time
30. Day 1 Opening Date and Time*
    Day 1 Opening Date and Time

    Day 1 Opening Date and Time
32. Day 1 Closing Date and Time*
    Day 1 Closing Date and Time

    Day 1 Closing Date and Time
34. Day 1 Breakdown Date and Time*
    Day 1 Breakdown Date and Time

    Day 1 Breakdown Date and Time
36. Day 2 Set Up Date and Time*
    Day 2 Set Up Date and Time

    Day 2 Set Up Date and Time
38. Day 2 Opening Date and Time*
    Day 2 Opening Date and Time

    Day 2 Opening Date and Time
40. Day 2 Closing Date and Time*
    Day 2 Closing Date and Time

    Day 2 Closing Date and Time
42. Day 2 Breakdown Date and Time*
    Day 2 Breakdown Date and Time

    Day 2 Breakdown Date and Time
44. Total Number of Days*
46. List of Dates and Times*
    Include Set Up, Opening, Closing and Breakdown times for each date
48. Estimated Attendance*
50. Previous Year Attendance*
52. Name of Emergency Medical Service Provider
    (If the estimated attendance of the event is more than 1,500 people)
54. Number of Volunteers/Workers*
56. Does the event take place in or run through a Park?*

    1. Yes
    2. No
58. Location in Park*
60. Attach Map of Location in Park
62. Does the Event require Water Access?

    1. Yes
    2. No
64. Does the event require the RCWJ Centennial Park Pavillion?*

    1. Yes
    2. No
66. Nature of Event*
    -- Select One --City HallCompetitionConcertFestivalMarketing (Food Trucks)Flag RaisingParadeProcessionRace/WalkRally/VigilReunionOther
68. Description of Nature of Event*
70. Location of Formation*
72. Formation Time*
    Formation Time
    Must be at least 1 hour before Kick Off
74. Kick Off Time*
    Kick Off Time
76. Distance*
78. Attach Map Route and Turn-by-Turn Directions*
80. Is route different from last year?*

    1. Yes
    2. No
82. Number of On-Street Volunteers*
84. Number of Marchers/Runners*
86. Number of Floats*
88. Number of Musical Units*
90. Number of Cars*
92. Number of Trucks*
94. Number of Other Vehicles*
96. Attach Impacted Business/Neighborhood Notification

    (Attach the notification that is given to any businesses/residences/buildings impacted by the road closure/moving event)

98. City Hall Space Requested*
    -- Select One --Basement LobbyCouncil ChambersFront Floor LobbyPortico and StepsObservation Deck
100. Number of Tables Required*
102. Number of Chairs Required*
104. Does the event require Electricity*

     Sponsor must supply extension cords

     1. Yes
     2. No
106. Does the event require closing streets*

     If the event is involves a parade/motorcade and the street will re-open immediately following the event, click "No"

     1. Yes
     2. No
108. Number of Blocks Closed*
110. List of Closed Streets*
     Ex. -- Delaware Avenue between Virginia Street and Allen Street. If closing Niagara Square, all 8 blocks will be closed automatically
112. Closed Street Start Date and Time*
     Closed Street Start Date and Time

     Closed Street Start Date and Time
114. Closed Street End Date and Time
     Closed Street End Date and Time

     Closed Street End Date and Time
116. Attach NFTA Notification
     (Only if the parade route or road closure impacts any bus routes or Metro Rail)
118. Does the event require 'Do Not Stand' signs?*

     1. Yes
     2. No
120. How many 'Do Not Stand' signs?*
122. Location of 'Do Not Stand' signs?*
     Ex. -- Delaware Avenue between Virginia Street and Allen Street.
124. 'Do Not Stand' Start Date and Time*
     'Do Not Stand' Start Date and Time

     'Do Not Stand' Start Date and Time
126. 'Do Not Stand' End Date and Time*
     'Do Not Stand' End Date and Time

     'Do Not Stand' End Date and Time
128. Additional Information on 'Do Not Stand' Signs*
130. Does the event require City of Buffalo Garbage/Recycling Totes?*

     All Park Events Require City of Buffalo Garbage and Recycling Totes

     1. Yes
     2. No
132. Disclaimer*

     The City of Buffalo has the right to determine how many totes as well as pickups are needed for every event. After the conclusion of the event, all totes must be returned to their original location by the event organizer. Garbage left outside of totes will be subject to additional clean up fees and or summons. Every event must request Recycling totes. If Recycling totes are contaminated with garbage, a summons will be issued. You must include a map marking the exact location of your tote drop off/pick up. If a tote is deemed damaged or missing at the conclusion of an event, the event sponsor will be responsible for a replacement in the assessed amount of $55 per tote. Due to staffing requirements, SUNDAY PICK- UPS are a minimum $1,000.

     1. Agree
134. Number of Garbage Totes Required*
     1 Garbage Tote for every 25 estimated attendees. $10 per tote fee includes 1 pick-up day
136. Number of Recycling Totes Required*
     1 Recycling Tote for every 5 Garbage Totes
138. Drop-Off Address*
140. Drop-Off Date*
     Drop-Off Date
142. Number of Additional Pick-Up Dates

     Ex. -- 4 totes with one pickup day is $40/two pickup days is $80

     1. 1
     2. 2
     3. 3
     4. 4 or More
144. Pick-Up Date*
     Pick-Up Date
146. Pick-Up Date 2*
     Pick-Up Date 2
148. Pick-Up Date 3*
     Pick-Up Date 3
150. List of Pick-Up Dates*
152. Attach Map of Garbage/Recyling Tote Drop Off*
154. Does the event require the use of the City of Buffalo Bandshell?*

     1. Yes
     2. No
156. Bandshell Drop Off Location*
158. Bandshell Drop Off Date and Time*
     Bandshell Drop Off Date and Time

     Bandshell Drop Off Date and Time
160. Bandshell Pick Up Date and Time*
     Bandshell Pick Up Date and Time

     Bandshell Pick Up Date and Time
162. Does the event require the use of Fire Hydrants?*

     1. Yes
     2. No
164. Will Items be sold at the event?*

     1. Yes
     2. No
166. Will Food be sold at the event?*

     1. Yes
     2. No
168. List of Food Items that will be sold*
170. Number of Food Booths*
172. List of Non-Food Items that will be sold*
174. Number of Non-Food Booths*
176. Does the event require Tents?*

     1. Yes
     2. No
178. Number of Tents*
180. Attach Map of Tent Placement*
182. Tent Rental Company Name*
184. Tent Rental Company Phone*
186. Tent Rental Company Email*
188. Tent Rental Company Address*
190. Does the event require Propane?*

     1. Yes
     2. No
192. Number of Propane Locations*
194. Propane Rental Company Name*
196. Propane Rental Company Phone*
198. Propane Rental Company Email*
200. Propane Rental Company Address*
202. Name of Portable Toilet Provider*
204. Will Fireworks be used at the event?*

     1. Yes
     2. No
206. Disclaimer

     Only a licensed pyrotechnician is permitted to submit a Fireworks Application. To apply for a Fireworks Permit, please contact the Bureau of Fire Prevention at (716) 851-5707 x 752

     1. Acknowledge
208. Will Amusement Rides be used at the event?*

     1. Yes
     2. No
210. Will any device that amplifies sound be used at the event?

     Ex. -- DJ or PA System

     1. Yes
     2. No
212. Is the event Handicap Accessible*

     1. Yes
     2. No
214. Will Alcohol be served at the event?*

     1. Yes
     2. No
216. Attach proof of submitted SLA application*
218. Attach signed Landlord Authorization form*
220. City of Buffalo Website Calendar Consent*

     1. Yes
     2. No
222. Public Contact Phone Number*
224. Public Contact Email*
226. Attach Security Plan
228. Attach Part 18 Form
     (If the estimated attendance of the event is more than 5,000 people)
230. Hold Harmless Agreement*

     By accepting a CITY OF BUFFALO, BUFFALO CITY PARKS, SPECIAL EVENTS AND OR PARADE PERMIT, the undersigned PERMIT HOLDER hereby agrees to defend, indemnify and hold harmless the CITY OF BUFFALO, its officers, and employees, against any and all claims, lawsuits, causes of action, judgments, or other liability, arising from injury to person or property, sustained by any person, association, partnership, corporation, or other entity, arising directly or indirectly from the acts or neglect of the PERMIT HOLDER, its officers, agents, employees, or members, participants, guests, invitees, or persons under the control of the PERMIT HOLDER. In furtherance of the foregoing indemnification, the PERMIT HOLDER also hereby agrees to provide evidence (in the form of an ACORD certificate of liability insurance) of insurance policies of General Liability and/or Special Event Liability and Liquor Liability insurance (applicable whenever alcohol is served or sold as part of the permitted event) and agrees to maintain said policies of insurance in force during the course of the permitted event, including the opening date, closing date, set-up date and breakdown date. Said policies of insurance shall protect against liability arising from all matters in connection with the permitted event and or in any way relating to PERMIT HOLDER’S activities in connection therewith. Said policies of General Liability and/or Special Event Liability and Liquor Liability insurance coverage shall each be maintained in the sum of not less than $1,000,000 per occurrence (or higher amount at the sole discretion of the City). The City of Buffalo shall be named as an additional insured and certificate holder under the General Liability, including any Excess/Umbrella Liability policy, and/or Special Event Liability and Liquor Liability insurance policies (with the permitted event being set forth or described in the description of operations box of the certificate of insurance). In the event the permitted event is to be held in a City Olmsted Parks, the Buffalo Olmsted Parks Conservancy must also added as an additional insured under said policies and as an indemnitee. In the event the permitted event is to be held in an area or areas under the management of Buffalo Place, then Buffalo Place, Inc. must also added as an additional insured under said policies and as an indemnitee. At its own expense, the PERMIT HOLDER shall indemnify, defend and hold harmless in any and all causes of action, lawsuits or claims brought against the CITY OF BUFFALO, its officers or employees, and also, where applicable, the Buffalo Olmsted Park Conservancy or Buffalo Place, Inc.

     1. Agree
232. List of Olmsted Parks
     Delaware Park (includes Ring Road, Parkside Lodge, Rumsey Woods, Hoyt Lake, History Museum, Albright Knox on Lincoln Parkway side, Buffalo Zoo) Cazenovia Park South Park (including Botanic Gardens) MLK Park (including Science Museum) Riverside Park Front Park Columbus/Prospect Park Days Park Heacock Park Bidwell, Lincoln, Chapin, McKinley, RedJacket, & Humboldt Pkwys Soldier, Colonial, Gates, McKinley, McClellan, Ferry & Symphony Circles
234. Buffalo Place Map
     
236. Hold Harmless Agreement PDF
     Hold Harmless Agreement PDF
238. Attach Signed Hold Harmless Agreement*
240. Attach Insurance Certificate*
242. Electronic Signature Agreement

     By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

     1. I agree.
244. Electronic Signature
Leave This Blank:


246. 1. Receive an email copy of this form.
247. Email address

     This field is not part of the form submission.

248. Submit

* indicates a required field