2. 
3. Rotational Art Display Application

   
   Artists must complete this form to submit a proposal for consideration as part of Coon Rapids Art on Display, the rotational art display program at Coon Rapids City Hall.

   
   

   All artists must complete the following application in its entirety.

5. Artist Information
7. First Name*
8. Last Name*
10. Address
12. City
13. State
14. Zip
16. Phone Number*
17. Email*
21. Description of Art
23. Name of Art Display:*
25. Type of Artwork:*

    1. 2D art (exhibited on wall of display case)
    2. 3D art (exhibited on pedestal or base of display case)
27. Please provide a written description of the Public Art:*
29. Upload a photo/illustration of Public Art:*
30. Additional support documentation (if necessary):
32. Appraised value of the Public Art:*
34. Description of materials used to create the Public Art (include materials needed to display/secure the Public Art):*
36. Description for interpretive signage (include materials, dimensions, wording, location):*
38. Statement regarding the relationship of the Public Art to the proposed site (include aesthetic, cultural, historic ties):*
40. Is this Public Art unique or does it duplicate other work by the same artist:*
44. Site Specifications and Installation Information

    Applicant is responsible for the installation and removal of Public Art.

46. 
47. Site Acknowledgement*

    This is the display case designated for Rotational Public Art at Coon Rapids City Hall.

    Dimensions: 
    21' (width) x 6' (height) x 20" (depth)

    I acknowledge the designated display site and agree the proposed Public Art can be displayed appropriately within the allotted space.

    1. YES, it can be displayed in the space.
    2. NO, it can't be displayed in the space.
49. Amount of space needed in display case:*

    1. Fill entire display case
    2. Partially fill display case
50. If requesting partial use of display case, please indicate how much is needed (half, quarter, etc.):
52. Dimensions of the Public Art (include appropriate base materials needed at the public site):*
54. Brief description of plans for installing and removing the artwork (include dates, times and measurements):*
56. Upload drawings/illustrations of installation plans:
57. Additional support documentation (if necessary):
59. As the artist applying to have my artwork displayed, I agree to the following:*

    • I am responsible for the installation and removal of my artwork on the provided dates.
    • I will ensure that the site is not harmed in the installation or the removal of my artwork.
    • I will keep the artwork on display at the site until the end of its term, even if I sell the artwork before the term ends.
    • I assert and attest that I am the creator and owner of the artwork I am displaying.

    1. By checking this box, you agree to all of the above.
63. Certificate of Insurance OR Waiver of Coverage
65. All artists are required to provide ONE of the following:*

    • Certificate of Insurance naming the City as an “additional insured.” 
    • Waiver of Insurance Coverage (sample waiver printable template available here).

    Please select one:

    1. I am submitting a Certificate of Insurance naming the City as an “additional insured.”
    2. I am submitting a signed Waiver of Insurance Coverage.
67. Upload certificate OR signed waiver here:*
71. Acknowledgement of Risks, Release of Claims, and Indemnification*

    
    As the artist applying to have my artwork displayed, I acknowledge an affirm the following:

    The artwork to which this application relates is owned only and entirely by me. No one else has any claim of interest or right to all or any part of the artwork or materials used to make it, either now or during the term it will be displayed.  

    I acknowledge and assume all risks, known and unknown, inherent or otherwise, associated with the display of my artwork. I acknowledge the risk of loss due to damage or theft. I understand in signing this document that I surrender my right to make a claim or file a lawsuit against the City, its past, present, or future appointed or elected officials, employees, representatives, agents, insurers, affiliated agencies, organizations, successors, and assigns (collectively “the City”,) for personal injury or property damage. I hereby release and forever discharge the City of and from any and all claims, demands, actions, causes of action, obligations, liabilities, expenses, costs, attorneys’ fees, proceedings, and judgements, both known and unknown, fixed or contingent, liquidated or unliquidated, direct or derivative, and of whatsoever kind, nature, and description, under the Constitution of the United States or any state, or any state or federal law or laws or of the common law, concerning, arising from, or related to the display of my artwork. In the event that any claim or demand should be made or litigation instituted against any party or parties arising out of or with respect to the artwork to which this application relates, I must indemnify and hold the City harmless from and against such claims, demand or litigation, including all attorneys’ fees and costs incurred with respect to such matters.

    1. By checking this box, you agree to all statements in this application and acknowledge that the information provided in this application is accurate and complete.
73. Signature of Applicant*

    Type your name to provide an electronic signature of acknowledgement.

77. Government Data Practices Act - Tennessen Warning*

    
    Click the box to acknowledge that the data you supply on this form will be used to process this application. You are not legally required to provide this data, but the City will be unable to proceed without it. The data will constitute a public record.

    1. I acknowledge the Government Data Practices Act - Tennessen Warning.
Leave This Blank:


79. 1. Receive an email copy of this form.
80. Email address

    This field is not part of the form submission.

81. Submit

* indicates a required field