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Temporary Usage Permit – Limited to 1 to 10 Days Per Year Board Of Education of the City Of Chicago

Form November2015

When to use this form: For any party using your school, grounds, or stadium (“Premises”) for purposes other than regular school purposes for ten or fewer days per year. This permit and proof of insurance (see page 2) are required even if no fee is charged. Do not use the form for the following:

If usage exceeds 10 days during a twelve-month period – contact Real Estate at (773) 553-2900 Film requests – contact Communications at (773) 553-1620 Health & medical services – contact Student Health & Wellness at (773) 553-3560 Unusual or potentially dangerous activities – contact Real Estate at (773) 553-2900

Instructions: Complete both sides of this form. Both Licensee and the school principal must sign page 2. Send both pages and the proof of insurance to Real Estate. Real Estate does not need to sign the permit unless the use involves a swimming pool, carnival, or stadium. If a party has already used the school ten times within the past year, do NOT fill out another permit – contact Real Estate. The School shall keep this original permit and proof of insurance on file for at least seven years. Stadium use: Contact Sports Administration at (773) 553-0700 to schedule and coordinate stadium use. Insurance: For questions about insurance or if the Licensee needs help finding insurance, contact Risk Management at (773) 553-3310. Other questions: Contact Real Estate at (773) 553-2900.

SECTION I – SCHOOL INFORMATION: Primary Contact at School: ______________________________________ School Name: __________________________ Street Address: ________________________________ Chicago, IL 606____ Telephone: (773)_________________ Email: ______________________________________ Fax: ____________________ SECTION II – LICENSEE INFORMATION: Primary Contact: _____________________________________________ Organization Name:___________________________________________________________ Not for Profit For Profit Address: _____________________________________________ City/State/Zip: ___________________________________ Telephone: _____________________ Email: ______________________________________ Fax: ____________________ Licensee charging admission? No Yes, $ _________________ Estimated number of participants: _____________ SECTION III – USAGE REQUEST INFORMATION: Building: Auditorium Gym Classroom(s) ___________ Other: ___________________________________ Grounds: Playground Field Parking lot Stadium name _________________ Other: _______________ Purpose: _____________________________________________________________________________________________

^ DO NOT LEAVE PURPOSE LINE BLANK ^

Dates of Use (“Use Time”)(10 day maximum)

Day of Week Start Time End Time Total Usage Hours

1 2 3 4 5 6 7 8 9

10

SECTION IV – LICENSE FEES: Waived Licensee shall pay $________________ payable to Chicago Board of Education/Account of [School]. License fees shall be retained by the School and used for costs incurred as a result of this permit and for School purposes. Fees may be waived if the Principal and Local School Council determine that educational purposes are served by a waiver. Stadium license fees and admission charges are to be retained by the Board and credited to the Department of Facilities.

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Temporary Usage Permit – Limited to 1 to 10 Days Per Year (page 2 of 2) 1. Prohibited Uses: Under no circumstances may Board Premises be used for any purpose which results in a material increase in therisk of personal injury or property loss or which is inherently dangerous. Fireworks, alcoholic beverages, smoking, usage exceeding ten(10) days per year, the provision of health and medical services, and filming of Board premises, Board staff, or CPS students arestrictly prohibited under this permit.2. Permitted Uses: School meetings which are approved by the Principal and Local School Councils do not require either a license orfee for the use of school facilities for meetings. All other uses, including but not limited to, fundraisers, parties, carnivals, sports eventsnot sponsored by the School, etc., require the execution of a Temporary Usage Permit as well as insurance.3. License Requirements: Licensee hereby agrees that:

A. Licensee has inspected the Premises and accepts the Premises with full knowledge of the condition thereof. Licensee shall returnthe Premises to the Licensor in the same or better condition than received.

B. If School determines that security is necessary during the permitted Use time, Licensee shall be required to provide securitypersonnel at its sole cost or reimburse School for such security costs, and the amount of security personnel necessary shall bedetermined in School’s sole discretion.

C. Licensee on behalf of itself and inclusive of its affiliates, employees, agents and invitees accepts and assumes sole responsibilityfor loss of life, injuries to persons and loss or damage to property due to the condition of the Premises or Licensee’s operations,activities or use of the Premises.

D. Licensee will fully defend, indemnify and hold harmless the Board of Education of the City of Chicago, and its members,officers, directors, employees, representatives and agents from and against all liability, loss, claim, demand, lien, damage,penalty, fines, interest, cost and expense (including without limitation reasonable attorney fees and litigation costs) incurred bythe Board of Education for injuries to persons (including loss of life) and for damage to or destruction, loss or theft of propertywhich is directly or indirectly due to the condition of the Premises or due the Licensee’s use of the Premises, including but notlimited to the acts or omissions of the Licensee, its successors, subsidiaries, affiliates, members, grantees, employees,representatives, agents, invitees and assigns. Licensee’s contractual obligation to defend, indemnify and hold the Board ofEducation of the City of Chicago harmless is in addition to and not in lieu of the obligation to provide insurance coverage.

E. Licensee agrees to provide at its own expense, standard Commercial General Liability Insurance naming The Board ofEducation of the City of Chicago, a body politic and corporate (and City of Chicago and Public Building Commission, astheir interests may appear), and their respective members, employees and agents as may be designated by the Board, asadditional insured on a primary basis without recourse or right of contribution from the Board with respect to this SchoolUsage Permit. Insurance Requirements: $1,000,000 General Liability for all events. Use of Swimming Pools requires 000,000General Liability, and carnivals/events with Inflatable Equipment require $2,000,000. A certificate of insurance must evidencecoverage and additional insured.

4. *Additional Approval: Specific approval by the Director of Real Estate or Chief Facilities Officer is required for:A. Stadium Use – Licensee shall be required to provide security personnel at its sole cost or reimburse School for such security

costs.B. Swimming Pools – Licensee agrees to provide an adequate number of properly qualified Life Guards and/or Water Safety

Instructors [Red Cross or YMCA certified] and to comply with all Board and Illinois Department of Public Health regulationsgoverning the use and operation of swimming pools. See additional insurance requirements in 3.E.

C. Carnival Operations – In addition, Licensee agrees to comply with the City of Chicago Special Event Permit Applicationprocedures and to provide documentation of such compliance to the Board’s Facilities and Operations department as a conditionof a receipt of license. See additional insurance requirements in 3.E.

5. License Modification – The Board retains the right to terminate, change, or modify this Temporary Usage Permit or require a specialpermit, license, or lease at any time without notice.

AUTHORIZATION AND AGREEMENT* This Temporary Usage Permit has been read and understood by the signatories.

Proof of insurance complying with paragraph 3 is attached.

Approved: ___________________________________________ Licensee: _____________________________________ School Principal (signature required) Date (signature required) Date

*AdditionalApproval: ___________________________________________ Print: ________________________________________

Director of Real Estate (*if required) Date (name)

Board Rules: 6-25 & 7-15 If any of the terms and conditions in this Temporary Usage Permit are deleted, modified, revised, or stricken through, those modified terms of the Temporary Usage Permit shall be rendered void and not accepted by the Board of Education of the City of Chicago.

Temporary Usage Permit – Limited to 1 to 10 Days (page 3 of 3)

EXHIBIT A

COVID-19 REQUIREMENTS

• If Licensor, in its sole discretion, determines that Licensee has failed to comply with any of the requirements of this

Exhibit, Licensor may suspend or terminate this agreement immediately. Licensor reserves the right to amend and

modify these requirements in its sole discretion in response to the COVID-19 pandemic to protect the health, safety and

well-being of persons.

• Licensee shall comply with all City of Chicago and CDPH recommendations and requirements now or hereafter in effect,

as may be amended from time to time, on matters including but not limited to physical distancing, use of face coverings,

hand washing, cleaning and sanitizing, screening, case reporting, contract tracing, and occupancy limits. Licensee

acknowledges these health and safety guidelines are subject to change.

• The proof of insurance required under the agreement must be provided to and approved by the Risk Management

Department prior to start of use.

• The School Engineer and Licensor’s Quality Manager (collectively “Facilities”) must approve of the use of the Premises.

Due to the evolving nature of the COVID-19 pandemic and the school district’s procedures in response, Facilities’

approval is required on an ongoing basis and suspension or termination may occur at any time.

• Licensee shall pay $50 per hour for any cleaning, moving, sanitizing, repair, or maintenance (collectively

“Maintenance”) that is required by Licensor as a result of Licensee’s failure to return the premises to the condition in

which it was found. Licensor shall remit payment for the additional cost of Maintenance within 30 days of Licensor’s

notice to Licensee of the cost.

Outdoor Rentals

• Licensee may not enter Licensor’s buildings or use the Premises in any manner that may compromise the health, safety

or security of any person.

Indoor or Indoor/Outdoor Rentals

Youth Programs Only

• Indoor usage is limited to youth programming in which no more than 25% of all persons who will be on the Premises are

18 years or older, and the Licensee’s purpose for the rental is youth-oriented.

• Licensee employees, staff, volunteers, visitors, and participants must complete a daily health checklist and comply with

all requirements listed therein prior to entering the School, using the CPS health screening questions. This checklist does

not need to be submitted. The checklist is available at: https://tinyurl.com/4wnhrjrh

• Licensee must report any positive COVID-19 test results to www.cps.edu/COVIDresults

• All persons must maintain at least 3 feet of social distancing. If this is not possible due to activities such as basketball or

wrestling, the usage must be limited to either no more than 25 persons in the room or 25% of the space’s capacity,

whichever is smaller. For example, if the room holds 200 people, the activities must be limited to 25 people even though

the room holds 50 at 25% capacity.

• For all other activities, the capacity limit is 50% of the space being used at any given time.

• All persons in the building must wear cloth face coverings over mouth and nose at all times while in the building

• All persons must maintain clean hands and observe respiratory etiquette (cover coughs and sneezes)

• Licensee shall pay, in advance, for at least one (1) engineer and one (1) custodian (collectively “Facilities”) to provide

any additional maintenance and sanitation required as a result of the Licensee’s Use, in addition to the License Fee. This

additional maintenance may include the 4-hour engineer union work minimum requirement for any overtime incurred on

weekends or after the engineer has left for the day. Approximate rates are subject to change and are as follows:

▪ Engineer overtime: $105 per hour for regular overtime or Saturday time, 4-hour work minimum

▪ Engineer Sunday overtime: $135 per hour for double time or Sunday/holiday time

▪ Custodian overtime: $42 per hour