by Leon Younger & PROS; Jeff Coates, creator and field tester
7168 North Graham Rd., Suite 150
Indianapolis, IN 46250
Telephone 317-578-7881
The following organization is entering into agreement with Park and Recreation Department:
Contact Persons
Park and Recreation Division Responsible: ____________________________
Contact Name: __________________________
Phone #: ____________________________
Fax #: ____________________________
Address:___________________________
City:____________________________
State: ____________________________
Zip Code: ____________________________
Location of Project/Program
Venue Name: ____________________________
Department Venue? ___ Yes ___ No
If not, who owns? ____________________
Address:___________________________
City:____________________________
State: ____________________________
Zip Code: ____________________________
Public Served (Target Market) By Project/Program
Families (parents and children together) ___ Yes ___ No
Age Group (check all that apply):
___ Youth (17 & under)
___ Young Adult (18-24)
___ Baby Boomer (25-50)
___ Senior (50 & over)
Sex (check only one):
___ Male Only
___ Female Only
___ Both Male and Female
Geographic Target: ____________________________
Other Demographics of Target Group:
____________________________
____________________________
Start/End of Working Agreement
Start Date: ____________________________
End Date:____________________________
Goal Measurement
Park and Measurement | |||
Park & Recreation
Goals |
How Measured? |
By Whom? |
When? |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
Community Partner | |||
Community Partner's
Goals |
How Measured? |
By Whom? |
When? |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
| x | x | x | x |
DOLLAR VALUE OF CONTRIBUTIONS
Park & Recreation Dollar Value Contribution | ||
| Personnel Services (staff consulting, labor, volunteer time, etc.) | Date Contribution Committed | Dollar Value of Contribution |
| Full time staff time @ $___/hour | x | x |
| Seasonal staff time @ $___/hour | x | x |
| Volunteer time @ $___/hour | x | x |
| x | x | x |
| x | x | x |
| Supplies/Material/Items (Consumable) | x | x |
| x | x | x |
| x | x | x |
| x | x | x |
| Equipment (Non-Consumable) | x | x |
| x | x | x |
| x | x | x |
| x | x | x |
| x | x | x |
| Facilities | x | x |
| x | x | x |
| x | x | x |
| x | x | x |
| Other | x | x |
| x | x | x |
| x | x | x |
| x | x | x |
| Cash Commitment | Date Committed | Cash Amount |
| x | x | x |
| Total Park & Recreation Contribution | Grand Total (Cash + Dollar Value) | |
| x | x | x |
Community Partner Dollar Value Contribution | ||
| Personnel Services (staff consulting, labor, volunteer time, etc.) | Date Contribution Committed | Dollar Value of Contribution |
| Full time staff time @ $___/hour | x | x |
| Seasonal staff time @ $___/hour | x | x |
| Volunteer time @ $___/hour | x | x |
| x | x | x |
| x | x | x |
| Supplies/Material/Items (Consumable) | x | x |
| x | x | x |
| x | x | x |
| x | x | x |
| Equipment (Non-Consumable) | x | x |
| x | x | x |
| x | x | x |
| x | x | x |
| x | x | x |
| Facilities | x | x |
| x | x | x |
| x | x | x |
| x | x | x |
| Other | x | x |
| x | x | x |
| x | x | x |
| x | x | x |
| Cash Commitment | Date Committed | Cash Amount |
| x | x | x |
| Total Park & Recreation Contribution | Grand Total (Cash + Dollar Value) | |
| x | x | x |
EXPECTED REVENUE
Projected revenue to be kept for Park and Recreation: ____________________________
Projected revenue to be kept for Community Partner: _____________________________
ONGOING COMMUNICATION
Both parties agree to communicate in the following way:
__________________________
________________________________________________________
At the following intervals: ____________________________
INSURANCE
Complete the insurance information requested below in effect for this agreement.
Park and Recreation Department
Type of insurance offered: ____________________________
Who is covered: ____________________________
Limits & Limitations: ____________________________
Community Partner
Type of insurance offered: ____________________________
Who is covered: ____________________________
Limits & Limitations: ____________________________
AGREEMENT TERMS
Both parties agree to the following:
Community Partner Signatures: |
Park & Recreation Signatures: |
| _____________________________ Community Partner Executive |
_____________________________ Director |
| _____________________________ Title |
|
| _____________________________ Date |
_____________________________ Date |
| _____________________________ Partner Project Contact |
_____________________________ Park & Recreation Project Contact |
| _____________________________ Department/Title |
_____________________________ Department/Title |
| _____________________________ Date |
_____________________________ Date |