BRIDGE BANNER REQUEST

Please ensure that you have electronic copies of both your Certificate of Insurance and Banner Proof prior to completing this form.

Non-Profit Organization/Agency:

Registration Number:

Contact Details

First Name

Last Name

Phone

Email

Organization/Agency Address:

Address:

City:

Province:

Postal Code:

About the Banner(s)

Event/Campaign Name:

Estimated Attendance:

For Year:

Additional Information:

Number of Banners:

Banner Length and Width: (please indicate feet or metres)

Banner Material:

Attachment Material:

Attachments

Scaled banner proof attachedCertificate of insurance attached

Attach Files (Proof of Insurance and Banner Proof:

Terms & Conditions

Bylaw #5590:

A banner will be removed if it does not comply with the guidelines or if the banner exceeds its approved time frame. If the City of Edmonton is required to remove a banner there will be a fine of $250.00 per banner.

Authorization:

I/We, on behalf of our organization accept all conditions as stated above.

Name:

First

Last

Collection Statement
Personal information is collected for the purpose of requesting a bridge banner program and will be used for the administration of transportation programs including the bridge banner program. Collection is authorized under section 4(c) of the Protection of Privacy Act (POPA) and is managed and protected in accordance with the Act. The City intends to input the information into an automated system to generate content or make decisions, recommendations or predictions in accordance with the City of Edmonton Generative AI Standard (see Council Policies, Standards section). For questions about the collection, please contact Michaela Pfluemer at 780-508-9352.

Banner Location(s) & Dates

DATES DESIRED: by week, banners put up on Sunday, removed on Saturday 5pm.

Summer (April to September): applications accepted for a two-week time

Winter (October to March): applications accepted for a four-week time frame

Area

From (Sunday):

To (Saturday):

1st Preference of Location:

2nd Preference of Location:

3rd Preference of Location: