Meeting Rooms Rental Agreement Form - East Orange Public Library Page 3
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3Meeting Room Application
Name of Organization: __________________________________________________________________________________________________
Address: _____________________________________ Zip Code: _____________ Fax: _______________________________________________
Purpose: ___________________________________________________ Topic: _____________________________________________________
Name of Individual Applicant:
Address: ______________________________________________________________________________________________________________
Phone: ________________________________________________________________________________________________________________
Email:_________________________________________________________________________________________________________________
Dates Requested: _________________________________________________
Room Request: (circle one) East Orange Room; Small Conference Room
Do you plan to distribute literature? Yes ______ NO ______
Set-up Style Requested: _______ Auditorium/Theatre style (chairs in rows) ________ Classroom style (tables with chairs)
_______ Conference style (U-shape)
Additional Information and request:
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
SERVICE: FEE:
Room Use: (local, non-profit) None (attach proof of 501c3 nonprofit status)
Room Use: (non-local, non-profit) $250.00 (4.5-7 hours) ($150.00 ½ day=4 hrs.)
Room Use: (Business or Commercial) $500 (4.5-7 hours) ($300.00 ½ day=4 hrs.)
LABOR:
Maintenance assistance (extra-setup) $52.00/hr. (min. four hours)
Overtime Fee (after library closes $76.00/hr. (min. four hours)
Guard Fee (by special request) $50.00/hr. (four-hour min.)
Microphone, screen use or A/V equipment (by special request only) requires $175.00 non-refundable deposit
FOOD USE:
Local, non-profit $100.00 non-refundable deposit
Any damage to or loss of A/V equipment or library property
will be assessed at a fee of $100.00 and up.
It is hereby understood and agreed, if this application is granted, the undersigned will assume all and exclusive responsibility for the preservation of
order and the sole and exclusive liability for any injury to persons, and any damage to, or loss of property that may result from this use; and for the
due observance of all regulations of the Board of Library Trustees. The organization agrees to indemnify the Library and the City of East Orange and
hold the same harmless against all claims, demands, damages, costs and expenses including reasonable attorneys’ fees for the defense of such
claims, arising out of the organization’s of the meeting room.
Also it is understood and agreed between the applicant and the East Orange Public Library that the applicant has read the regulations governing the
rental of the room (s) and that the condition contained therein will be observed. If Applicable, payment must be received promptly once you
have received confirmation that your application has been approved.
Signature of Organization’s Executive Officer/Applicant: ________________________________ Date: ______________________________
Please address this application to: Director, East Orange Public Library, 21 S. Arlington Ave., East orange, NJ 07018. Telephone: (973) 266-5607,
Fax (973) 675-6128.
Note: Your organization is responsible for alerting the East Orange Parking Authority of your meetings.
Otherwise, you will be ticketed (973-672-1116).
Office Use Only
CONFIRMATION OF RESERVATION
Reservation is hereby approved and confirmed of the space required as indicated above.
Payment if applicable $_______________________ has been received. ______ Cash Check __________
Date: ______________________ Authorized Staff Signature: ___________________________________
Approved by the Board of Trustees on October 11. 2012.
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