9/12/2018
City of Fairfax
Intro. Activities
Permit Contract
ActiveNet - Online Recreation Activities
Reservations
City of Fairfax Parks and Recreation Department
10455 Armstrong Street
Suite 123
Fairfax, VA 22030
Phone: (703) 385-7858
FAX: (703) 246-6321
Email: parksrec@fairfaxva.gov
Michael E. Stone
P.O. Box 12222
Richmond, VA 23241
Emalk: office@vadp.org
Charges Taxes
$560.00 $0
RESERVATIONS
Event
Stone Nonprofit Group
Fundraising Reception
Type: Customer Rate
Attend/Qty: 1
Discounts Total Charges
$0 $560.00
Resource Center
BIC Alcohol Blenheim
Charge Interpretive Center
3610 Old Lee
Highway
Fairfax, VA 22030
(703) 385-7858
Sign In | Create an Account
‘BB My Cart
Permit #17499, Approved
Sep 12, 2018 4:33 PM
City of Fairfax
Customer Type: Customer rate
Prepared By: Kaveh Tajalli
Customer ID: 50992
Home: (804) 402-0552
more people requires a parking plan
Deposits Deposit Taxes Total Payments Refunds —_ Balance
$200.00 $0 (8760.00) $0 $0
Notes
17 paved parking spaces and 17 overflow turf parking spaces Uses of 102 or
Fairfax, VA 22030
(703) 385-7858
Days Requested Event . Event Ends
Duration
Day Date Begins Date Time
Friday Oct 19, 2018 6:00 PM 4 hours Oct 19, 2018 10:00 PM
Summary Notes
Total Number of Dates: 1 -
Total Time: 4 hours
RESERVATIONS
Event Resource Center Notes
Stone Nonprofit Group BIC Chairs Blenheim -
Fundraising Reception Banquet Interpretive Center 17 paved parking spaces and 17 overflow turf parking spaces Uses of 102 or
Type: Customer Rate 3610 Old Lee more people requires a parking plan
Attend/Qty: 40 Highway
Days Requested Event Event Ends
Duration
Day Date Begins Date Time
Friday Oct 19, 2018 6:00 PM 4 hours Oct 19, 2018 10:00 PM
Summary Notes
Total Number of Dates: 1 -
Total Time: 4 hours
RESERVATIONS
Event Resource Center —_— Notes
Stone Nonprofit BIC Indoor Package Blenheim
Group Fundraising Attached equipment: 5 BIC Tables 6' 2'6" Rectangular, 4 BIC Tables Interpretive 17 paved parking spaces and 17 overflow turf
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Reception 3' Round Cocktail, 1 BIC Alcohol Charge, 40 BIC Chairs Banquet, 4 Center —_parking spaces Uses of 102 or more people
Type: Customer _ BIC Tables 5' Round 3610 Old requires a parking plan
Rate Lee
Attend/Qty: 40 Highway
Fairfax, VA
22030
(703) 385-
7858
Days Requested Event Event Ends
Duration
Day Date Begins Date Time
Friday Oct 19, 2018 6:00 PM 4 hours Oct 19, 2018 10:00 PM
Summary Notes
Total Number of Dates: 1 -
Total Time: 4 hours
RESERVATIONS
Event Resource Center Notes
Stone Nonprofit Group BIC Blenheim -
Fundraising Reception Kitchenette Interpretive Center 17 paved parking spaces and 17 overflow turf parking spaces Uses of 102 or more
Type: Customer Rate 3610 Old Lee people requires a parking plan
Attend/Qty: 10 Highway
Fairfax, VA 22030
(703) 385-7858
Days Requested Event . Event Ends
Duration
Day Date Begins Date Time
Friday Oct 19, 2018 6:00 PM 4 hours Oct 19, 2018 10:00 PM
Summary Notes
Total Number of Dates: 1 ms
Total Time: 4 hours
RESERVATIONS
Event Resource Center Notes
Stone Nonprofit Group BIC Tables 3° Blenheim -
Fundraising Reception Round Cocktail —_Interpretive Center 17 paved parking spaces and 17 overflow turf parking spaces Uses of 102 or
Type: Customer Rate 3610 Old Lee more people requires a parking plan
Attend/Qty: 4 Highway
Fairfax, VA 22030
(703) 385-7858
Days Requested Event Event Ends
Duration
Day Date Begins Date Time
Friday Oct 19, 2018 6:00 PM 4 hours Oct 19, 2018 10:00 PM
Summary Notes
Total Number of Dates: 1 -
Total Time: 4 hours
RESERVATIONS
Event Resource Center Notes
Stone Nonprofit Group BIC Tables 5' Blenheim -
Fundraising Reception Round Interpretive Center 17 paved parking spaces and 17 overflow turf parking spaces Uses of 102 or
Type: Customer Rate 3610 Old Lee more people requires a parking plan
Attend/aty: 4 Highway
Fairfax, VA 22030
(703) 385-7858
Days Requested Event i Event Ends
Duration
Day Date Begins Date Time
Friday Oct 19, 2018 6:00 PM 4 hours Oct 19, 2018 10:00 PM
Summary Notes
Total Number of Dates: 1
Total Time: 4 hours
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RESERVATIONS
Event Resource Center Notes
Stone Nonprofit Group BIC Tables 626" Blenheim
Fundraising Reception Rectangular Interpretive Center 17 paved parking spaces and 17 overflow turf parking spaces Uses of 102 or
Type: Customer Rate 3610 Old Lee ——_-more people requires a parking plan
Attend/Qty: 5 Highway
Fairfax, VA 22030
(703) 385-7858
Days Requested Event - Event Ends
Duration
Day Date Begins Date Time
Friday Oct 19, 2018 6:00 PM 4 hours Oct 19, 2018 10:00 PM
Summary Notes
Total Number of Dates: 1 _
Total Time: 4 hours
CHARGES
Description Event! UnitFee Units Tax Charge
Resource
BIC Kitchenette Stone Nonprofit Group Fundraising Reception #17499 $50.00 1.00 ~ $50.00
BIC Kitchenette
BIC Indoor Package (Fri & Sun) Stone Nonprofit Group Fundraising Reception #17499 $90.00 4.00 ~ $360.00
BIC Indoor Package
BIC Alcohol Charge Stone Nonprofit Group Fundraising Reception #17499 $150.00 1.00 - $150.00
BIC Alcohol Charge
DEPOSITS
, Event/ .
Deposit Charge Breoccop Charge Tax Amountpaid Refunds Balance
BIC Security Deposit Stone Nonprofit Group Fundraising Reception #17499 $200.00 $0 $200.00 $0 $0
BIC Indoor Package
Payments and Refunds
. _ Resource
Receipt# Date Charge Description een Payment
1058949.002 Sep 12,2018 _BIC Kitchenette BIC Kitchenette $50.00
Stone Nonprofit Group Fundraising Reception #17499
1058949,002 Sep 12,2018 BIC Security Deposit BIC Indoor Package $200.00
Stone Nonprofit Group Fundraising Reception #17499
1058949,002 Sep 12,2018 _BIC Indoor Package (Fri & Sun) BIC Indoor Package $360.00
Stone Nonprofit Group Fundraising Reception #17499
1058949.002 Sep 12,2018 BIC Alcohol Charge BIC Alcohol Charge $150.00
Stone Nonprofit Group Fundraising Reception #17499
DISCLAIMERS
Access: The exhibit gallery in the Interpretive Center will be closed during rentals but can be shown during the rental for an additional fee. Please
reference the A La Carte Menu.
Additional Rental Spaces: These areas are only chargeable when: 1) Equipment is set up in these areas (tables, chairs, etc.) or 2) Decorations are set
up in these areas. 3) Food or beverage is served in these areas.
Alcohol: Alcohol is permitted but a banquet license must be obtained and posted at the bar throughout the event if: 1) The event is not private. Private
means invitations are sent out to a specific group of people and a guest list is available. 2) There is a cost to attend the event, there is a cost for food,
there is a cost for alcohol, or donations are suggested 3) The event is a fundraiser. 4) Alcohol will be taken or consumed outside
http:/www.abe virginia
Appointments: If you wish to view this facility for a potential rental please call or e-mail: Operations Manager, Brianne Baglini- 703-385-1703,
Brianne. baglini@fairfaxva gov or Facilities Coordinator, Kaveh Tajalli- 703-293-7119, Kaveh tajalli@fairfaxva.gov
Arrival at the Hall: Facility management must be informed of the arrival time of the first guest/vendor, Allow enough time for vendors to set up and clean
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up when establishing rental time. Your contracted time is the time you will be allowed access to the space(s) you have rented. Caterers and others
must be instructed not to arrive before the contracted rental time. Deliveries of rental equipment, cakes, flowers, etc., must be made during the rental
period unless Early Drop Off/Storage/Pickup has been paid for and scheduled. Delivery of rental equipment prior to contracted hours must be arranged
with facility management
Art Work: The art work in the Multipurpose Room and Atrium/Lobby remains up during ALL events.
Business/Non-Profit Rate: Businesses must provide a copy of their business license. Non-profits must provide evidence of their non-profit status, This
rate is only applicable to eligible groups Monday-Thursday and Friday until 3:00 p.m. To receive the profit rate, ONLY the
Room may be used.
c 1) If request for is sent in writing (e-mail is acceptable) 60+ days prior to the reservation date, customer will receive a full
refund minus a $100 processing fee. 2) Full payment is due 60 days prior to the reservation date. If the request for cancellation is sent in writing (e-mail
is acceptable) between 31 and 59 days prior to the reservation date, customer will be refunded the security deposit only. Or, the customer may choose
to switch their date with no penalty. 3) Full payment is due 60 days prior to the reservation date. If the request for cancellation is sent in writing (e-mail
is acceptable) 30 days or less prior to the reservation date, customer will be refunded the security deposit only. Or, the customer may choose to switch
their date for a processing fee of an additional 10% of all rental charges (calculated from the bottom line, not including the security deposit).
City Resident: To qualify as City Resident 1) Bride, groom, mother, father, or legal guardian of either bride or groom must reside within the City at the
time of the signing of the reservation agreement and at the time of the event. 2) Person whose name is on application resides within the City at the
time of signing the reservation agreement and at the time of the event.
Damages: User is responsible for all damages to the property and equipment. Damages will be deducted from the security deposit. If costs for
damages exceed the security deposit, the renter will be billed
Decorations: No decorations or other items may be tacked, taped, nailed, or affixed in any way to the walls or any other surface of the bullding inside or
out. No birdseed, rice, glitter, confetti, silly string, sparklers/fireworks, etc., may be used inside or outside of the building. No bubbles are allowed inside
the building. Balloons may not be allowed to float to the ceiling. Failure to abide by these regulations will result in partial or full loss of security deposit
DJ?s and Bands: DJ?s and Bands are permitted indoors ONLY.
Doors: Doors leading to the outside may NOT be propped open
Early Drop Off/Storage/Pickup: Drop off must be scheduled for the day before the event or the morning of the event (dependent on venue?s rental
schedule). Drop off must be scheduled through Brianne Baglini or Kaveh Tajalli one month prior to the reservation date. Drop off items must fit in the
Kitchenette with the exception of a vendor delivery. Drop off may not last more than one hour. No setup may be done during drop off. Only vendor
deliveries (tents, tables, chairs, etc.) may be stored overnight, All other property must be removed within the reserved hours. Any such items left
behind will be considered disposable. Pickup for vendor deliveries must be scheduled through Brianne Baglini or Kaveh Tajalli. Pickups will need to be
done and completed between 6:00 a.m. and 10:00 a.m. the day after the reservation. Any items needing to be picked up must be left outside.
Electricity/Utilities: Electricity is provided for outdoor tented events via exterior outlets at Interpretive Center; user must coordinate electrical needs
during application process
Equipment: Round table measurements are listed by diameter. The City of Fairfax?s equipment must remain inside. Any tables, chairs, etc. needed for
outside must be rented through an independent vendor.
Failure to Comply: Failure to comply with these policies and conditions will result in immediate termination of the event, with forfeiture of fee and
security deposit,
Fire Code: Failure to comply with the fire code capacity for each space will result in immediate termination of the event and forfeiture of fee and
security deposit
Ground Disturbances: The Blenheim property is sensitive ground di (other than tent stakes) are not permitted;
tent location will be approved during the application process.
Holidays: The venues in the City of Fairfax are not available for ions on Christmas, TI ving, and Day. The holiday rate will
be charged on New Year?s Eve, New Year?s Day, Memorial Day, and Labor Day.
Inclement Weather/Conditions: The City of Fairfax will do everything within its power, within reason, to accommodate events throughout inclement
weather and unforeseeable situations. Certain instances may arise in which it is unsafe for City staff to travel to the venue in question to open for the
rental. In these instances, renters will be afforded the opportunity to reschedule their event (subject to availability) or cancel with no penalties rendered.
Kitchenette: The Kitchenette is solely for warming and preparing dishes. No cooking is permitted
Liability/Injuries: User is responsible for all injuries to guests. The City reserves the right to require the User to furnish a ?Certificate of Insurance for
Public Liability Insurance? in the limit of $500,000. The user will save harmless the City of Fairfax, the lesser and the City?s and lesser?s officers,
employees, and agents on any and all claims whatsoever arising out of the use of Historic Blenheim, including any liability for death, personal injury or
property damage, where incurred by the lesser, lessee (or member if lessee is an organization or group) or any and all third parties. www.ebi-
ins.com/tulip
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Minimal Rental: All rentals must include either the Indoor Package, Outdoor Package, or the Lawn Area. Other areas cannot be rented unless in
conjunction with the rental of the Indoor Package or the Lawn Area.
Modification: City reserves the right to modify procedures, restrictions, and related guidelines as circumstances dictate
Moonbounces: Moonbounces are not permitted at Historic Blenheim
Noise: As the site is adjacent to a residential area, user must comply with City?s regulations pertaining to noise in all cases. Noise levels must not
exceed 55 decibels at the property line. For more info visit, http://ibrary.municode.com/index.aspx?clientld=101 gini
Open Flames: Any flames rising higher than their container are not permitted. Sparklers and other types of fireworks are not permitted inside or outside
the building.
Parking: There are 34 paved parking spots and the capacity for 16 overflow parking spots in the Lawn Area
Repeat Renter Discounts: After 3 rentals of Historic Blenheim Monday-Thursday, every additional rental of Historic Blenheim Monday-Thursday after
that within the calendar year receives a 20% discount from the hourly rate of the Indoor Package, Lawn Area, Pergola, Porch/Deck and Outdoor
Package (does not include security deposit). After 2 rentals of Historic Blenheim Friday-Sunday, every additional rental of Historic Blenheim Friday-
Sunday after that within the calendar year receives a 20% discount from the hourly rate of the Indoor Package, Lawn Area, Pergola, Porch/Deck and
Outdoor Package (does not include security deposit). Discount is applicable for customer rate and business/non-profit rate only. Discounts are offered
in sequential order (i.e. if customer rents August 4th, August 11th, August 18th, and August 25th, discount would apply to August 25th only). Repeat
renter discount cannot be combined with any other discount. Payment is due on the first of each month for that month (i.e. on June 1st, payment for the
month of June is due). Cancellations will be refunded in full unless cancellation is made 7 days or less prior to the reservation date in which case there
will be no refund.
Repeat Renter Parameters: Historic Blenheim:
7 After 3 rentals of Historic Blenheim Monday-Thursday, every additional rental of Historic Blenheim Monday-Thursday after that within the calendar
year receives a 20% discount from the hourly rate of the Indoor Package, Lawn Area, Pergola, Porch/Deck and Outdoor Package (does not include
security deposit or a la carte menu items/services)
2 After 2 rentals of Historic Blenheim Friday-Sunday, every additional rental of Historic Blenheim Friday-Sunday after that within the calendar year
receives a 20% discount from the hourly rate of the Indoor Package, Lawn Area, Pergola, Porch/Deck and Outdoor Package (does not include security
deposit or a la carte menu items/services).
? Discount is applicable for customer rate and business/non-profit rate only. Discounts are offered in sequential order (i.e. if customer rents August 4th,
August 11th, August 18th, and August 25th, discount would apply to August 25th only). Repeat renter discount cannot be combined with any other
discount, Payment is due on the first of each month for that month (i.e. on June ‘st, payment for the month of June is due). Cancellations will be
refunded in full unless cancellation is made 7 days or less prior to the reservation date in which case there will be no refund
for will be accepted on a first-come, first-served basis. The City reserves the right to cancel reservations if
agreement circumstances change or for a reasonable cause. All fees are due 60 days prior to the scheduled rental. Applicant must be at least 21 years
of age and accepts responsibility for supervision throughout the period covered by the agreement. Rentals are taken up to 2 years in advance.
Name(s) of person(s) who will be on the scene and in charge during the rental must be identified to the Facility Management individual present. Only
those parties specified by applicant, in addition to the applicant, will be permitted to make additions or changes to the signed agreement.
Restroom Facilities: Historic Blenheim provides ADA compliant restrooms.
Security Deposit: Security Deposit is due at the time of reservation and will be upon ion of the agreement. Charges for
damages, lack of required cleaning, or violation of the agreement, will be deducted from the deposit. Users exceeding their reserved time will be
charged the applicable hourly rate. Any charges in excess of the deposit will be billed to the applicant. The security deposit is refunded to the
individual/organization that made payment. If the deposit has been paid for by a check, the check reimbursement will take 4-6 weeks and will be sent
to the payer?s address on the agreement. Credit cards used to pay for the security deposit will be automatically charged for full payment 60 days prior
to the event unless the customer specifies that they wish to pay by a different form.
Setup & Clean-up: The diagram of your setup MUST be tumed in 5 business days prior to your rental. All A\V and sound requirements must be
established at this point also ? NO EXCEPTIONS. Last minute additions may not be able to be accommodated. City staff will set up tables and chairs
prior to event and will assist in setting up A/V upon arrival. However, customer must include any time they may need to set up or clean up in their
reservation hours. Renters and their guests/vendors will not be granted access to rented areas until the start time on the contract. Vendors could
include caterers, event planners, photographers, etc. User or user?s caterer will be responsible for setup that ensures minimizing the chance of
damage to the building, grounds, driveway, and walkways. Protective covering or bar mat must be put on the floor at points where beverages or ice
containers are located. All liquids and/or ice must be contained in watertight containers (not trash bags). User or user?s caterer must remove all food,
equipment, and property during the reserved hours. All trash and decorations must be cleaned up and placed in designated trash receptacles. The City
will provide trash receptacles and bags. Building must be left in same condition it was found in (including hallways, restrooms, and Kitchenette). All
guests must vacate by the end of the reserved hours. Setups will be completed by 3:30 p.m. at the earliest Tuesdays through Saturdays.
‘Smoking: Smoking is not permitted inside the building, but is permitted outside the building and on the grounds. Users must use ash urns provided on
site, Ash ums are located at the front entrance and on the Porch/Deck.
Tents: If tent needs to be delivered/setup prior to reservation hours, Early Drop Off/Pickup/Storage must be paid for. Drop offs and pickups must be
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scheduled through Brianne Baglini or Kaveh Tajalli and is dependent on venue?s rental schedule.
Violation of Law: Violation of any laws prevailing in the City of Fairfax by any person while in attendance will be sufficient grounds for termination of the
event, with forfeiture of fee and security deposit
CUSTOM QUESTIONS
Question Answer
In addition to the applicant, name(s) of person(s) who will be authorized to make changes or Kirstina Leslie 540-319-0820
additions to the contract: kristina.d.leslie@gmail.com
Will customer need to obtain banquet license? Yes
Will customer need to pay alcohol charge? Yes
What is the caterer’s name, phone number, and e-mail? TBD
How did you find out about us? Board member who lives in Fairfax County
Will customer be erecting a tent? No
Terms & Conditions: This Agreement, when signed by the applicant and a of the O stitutes a binding both
parties to certain obligations.
The applicant agrees to observe and obey all Organization Rules and Regulations. In addition, it shall be the responsibility of the applicant to pay the required
fee at the time of reservation. Balance due must be paid before the scheduled event. Deposits will be returned only in the case of conditions which force the
cancellation of the event
The Organization agrees to maintain the facility, to assure that the facility is prepared properly for the agreed-upon event, and to provide adequate sanitation
facilities, subject to available equipment, resources, weather conditions and time of year.
City Hall Office10455 Armstrong Street Methods of Payment
Visa, MasterCard, Discover, Other
Sherwood Community
Fairfax, VA 2:
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