Pole Banner Application

(*) Denotes Required Field
EVENT INFORMATION
Name of Event:(*)
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Date(s) of Event:(*)
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Description of Event:(*)
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ORGANIZATION HOLDING EVENT
Name of Organization:(*)
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Name of Contact Person:(*)
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Address:(*)
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Telephone #:(*)
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State:(*)
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Zip:(*)
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Fax:
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Email:(*)
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CONTRACTOR INSTALLING AND REMOVING BANNERS
Contractor Name:(*)
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Name of Contact Person:(*)
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Address:(*)
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Telephone #:(*)
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State:(*)
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Zip:(*)
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Fax #:
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Email:(*)
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BANNER INFORMATION
Total Number of Banners:(*)
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Date Banners to be installed(*)
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Date Banners to be Removed(*)
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BANNER LOCATIONS
Please list all locations(*)
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DEPOSIT AND FEES

Download Fee Schedule PDF >>

Please send check or money order payable to "City of Long Beach" to:

Special Events and Filming
Attn: Pole Banners
211 E Ocean Blvd., Suite 410
Long Beach, CA 90802-4850

Note: Permit will not be processed until payment is received

ATTACHMENTS
Please provide the following items with this application:
Banner Art - sketch or photograph of banner art. Please show banner dimensions. (JPEG or PDF file only)
Please attach a JPG or PDF file under 4MB.

Please provide evidence of Contractor's Insurance if not on file. (JPEG or PDF file only)
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List of sponsor names that will appear on the banners (if applicable).
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I certify that the above information is true and correct. Permittee agrees to indemnify, hold harmless, save and defend the City, its boards and their officials, employees and agents from and against any and all demands, claims, causes of actions, liens, liability, loss, damage, cost, and expenses (including attorneys’ fees) arising from or in any way connected with the activities described in this application for permit, and from any acts or omissions, willful misconduct, or negligence (active or passive) by or alleged by permittee, its employees, agents, or subcontractors, either as a sole or contributory cause, sustained by any person or entity (including employees or representatives of Permittee). Permittee shall be responsible for all costs incurred by City departments for use of City or City Light and Power personnel and/or equipment.
(*)
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Signature:(*)
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Title:
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Today's Date:(*)
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Please mail check to the following address: Manager of Special Events — 211 E. Ocean Blvd., Suite 410 Long Beach, CA 90802 (562)570-5333
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