Satellite Site Template
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3Satellite Site Template
The [Name of Program] Program provides for partnerships whereby the program routinely uses
specific services or activities that cannot be provided at the program site itself. For locations that are
another location (controlled by the program contractor or another organization) in order to offer
not controlled by the contractor, the only role of the satellite site is to provide space. This agreement
confirms that the program Contractor and the Satellite Site Partner identified below will comply with the
terms as stated in the agreement. This agreement also confirms that there is liability insurance at the
Satellite Site that covers the premises and program operations and names the City of New York as
Additional Insured. The Parties acknowledge and understand that this Satellite Site Agreement does not
establish a contractual relationship between the Satellite Site Partner and the New York City Department of
Youth and Community Development (DYCD).
__________________________________________ (SATELLITE SITE PARTNER) confirms that it has control over the
facility located at ___________________________________________________ (ADDRESS OF SATELLITE SITE) and that it
will
make
the
facility
available
for
the
use
and
benefit
of
participants
of
the
______________________________________
program located at ____________________________________ on the following
terms:
A. Description of services/activities to be provided at the Satellite Location:
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
___________________________
B. Maximum No. of Participants: _________
C. Start Date: __________________
End Date: ______________________
D. Space(s) requested: (please circle) Gym Classroom Cafeteria Auditorium Other
_______________________
E. Facility Hours available for the use:
Day of the
Start Time
End Time
Day of the
Start Time
End Time
week
AM/PM
AM/PM
week
AM/PM
AM/PM
Monday
Friday
Tuesday
Saturday
Wednesday
Sunday
Thursday
F. The Satellite Site Partner confirms that participants will be properly supervised at all times when they
are present at the satellite site and will adhere to the DYCD Social Media Policy attached as Appendix A.
List the program staff who will supervise the activities at the satellite site.
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