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2. Disclaimer
   Information submitted on this form will be sent via unsecured email. To protect sensitive information, do not enter the following items or similar information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, credit card numbers, medical information, passport numbers, and passwords. Please review our privacy policy located at www.jeffco.us/privacy. By submitting this form, you acknowledge and accept the terms listed in the privacy policy.
4. Commercial Activity Application - Other
   Permitted activities must be appropriate to the mission of Jeffco Open Space; complement resource protection, visitor protection and interpretation goals; and not pose any potential for derogation of values or purposes for which JCOS was established.

6. In order to ensure sufficient time to process your permit, please submit this form no less than ten business days prior and no more than six month in advance of your event or reservation date. Please allow up to ten business days for processing and response.

8. This form should be filled out when your activity does not fall into one of the below categories. If the proposed activity does fall into one of the below categories, please complete the appropriate application for that activity. Guided Rock/Ice Climbing; Guided River trips including: Rafting, Kayaking, SUP, etc.; Guided Mountain Biking; Commercial Tours; Guided Hiking; Guided Fishing; Guided/Instructional Hang-gliding and para-gliding; commercial filming and photography

10. Company/Organization Name*
12. Company/Organization Website
14. Contact Information

    Annual permits will be mailed to this address

16. First Name*
17. Last Name*
19. Address*
21. Address Line 2
23. City*
24. State*
25. Zip Code*
26. Country*
28. Phone Number*
29. Email Address*
31. Permit Type*

    1. Annual - Expires Dec. 31
    2. Single Day
32. Permit Delivery*

    Would you like to pick up your permit at the Jefferson County Open Space office, or have it mailed to the above address?

    1. Pick Up
    2. Have Mailed
33. Park(s) Requested*
34. Date and Time*
    Date and Time Start Date

    Date and Time Start Time

    —

    Date and Time End Date

    Date and Time End Time
    For Single Day Only
38. Please describe, in detail, the activity or business that you wish to conduct*
    If you are requesting multiple dates or date ranges, please reflect those here
42. Attachments
44. Certificate of Insurance*

    Please upload your Certificate of Insurance. Jefferson County must be added as an additional insured to general liability policies. Certificate Holder must be:

    Jefferson County, Colorado
    c/o IMA Certificate Compliance
    1705 17th Street, Suite 200
    Denver, CO 80202 

45. Predicted Use Report*

    Please attach your predicted use report of anticipated dates, parks, and numbers of participants

46. Year-end Report

    If your organization operated last year, please submit a post-use report of all services rendered on JCOS managed land with total number of clients, park locations and revenue. The standardized form can be found on the JCOS Permits page and must be returned as a .xlsx file type.

50. Terms and Conditions*

    1)Permit must be on-hand and visible during all portions of events 2)All commercial vehicles with logos must display JCOS vehicle tag (will be provided) while parked on JCOS managed land 3)Annual permits are valid through December 31; Daily permits are valid only for the date and time requested. 4)Permit does not grant exclusive access to any area, trail, or route 5)All vehicles must be parked in a legal manner and outside of designated lanes of traffic 6)Permit is for your group, and your group only. Additional companies or organizations may not be added and must apply for their own permit 7)No trails will be closed for event(s), and all participants are expected to abide by proper trial etiquette and yielding practices 8)All JCOS Park Regulations apply, outside of those which are specifically addressed in this permit. Rules and Regulations can be found at https://www.jeffco.us/1583/Regulations 9)Permit may be revoked by JCOS at any time for any reason, including cases of misconduct

    1. I agree.
52. Electronic Signature Agreement*

    I (we) hereby swear or affirm, under penalty of perjury, that the information given here is true and correct. The typed signature below indicates this individual, or the legal entity the individual represents (as applicable), accepts responsibility for the activity and agrees to the terms and conditions of this agreement.

    1. I agree to the terms and conditions
54. Electronic Signature*
58. Receive a Copy of Your Submission
    By checking the box below, you will receive a copy of the application you are submitting; however, this does not mean that your application has been approved. We will contact you within 10 business days to let you know the status of your application.
Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit

* indicates a required field