Information

  • Document No.

  • Audit Title

  • Conducted on

  • Prepared by

  • Location
  • A CURRENT Public Liability Certificate of Currency in the amount of $20,000,000.00 is required before confirmation is given.

  • REQUEST BY: (School or Organisation)

  • CONTACT NAME:

  • CONTACT NO: (Daytime No.)

  • EMAIL:

  • PARK/OVAL NAME:

  • Will Lights be Used?<br>($25 / hr for 1/2 bank of lights & $50 / hr for full bank of lights)

  • Booking Start Date & Time

  • Booking Finish Date & Time

  • PARK/OVAL NAME:

  • Will Lights be Used?<br>($25 / hr for 1/2 bank of lights & $50 / hr for full bank of lights)

  • Booking Start Date & Time

  • Booking Finish Date & Time

  • PARK/OVAL NAME:

  • Will Lights be Used?<br>($25 / hr for 1/2 bank of lights & $50 / hr for full bank of lights)

  • Booking Start Date & Time

  • Booking Finish Date & Time

  • SPECIAL REQUIREMENTS NEEDED:

  • PURPOSE / ACTIVITY

  • CERTIFICATE OF CURRENCY PUBLIC LIABILITY

OFFICE USE ONLY

  • Public Liability

  • Copy given to Parks & Gardens

  • Booked on Computer

  • Booking Confirmed (Fax sent)

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