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2. I have read, understand and accept the terms of this Application and represent that I am the owner, artist, or owner and artist of the artwork which is the subject of this application.*

   1. Owner
   2. Artist
   3. Owner and Artist

4. 1. Type Of Donation

5. 4.3. Public Art Policy

7. Type Of Donation:*

   1. Temporary Loan

   1. Permanent Loan
9. Artwork*

   1. Outdoor

   1. Indoor
11. Monument

    1. Outdoor
13. Who/what is the monument for?*

    1. A person
    2. A group
    3. An organization

    1. A Place
    2. An Event
15. Why is this monument important to our community?*
17. How will the monument commemorate the memory of the person, group, organization, place, event?*
19. How will the monument communicate across generations. In 10 years to 100 years, how will it continue to connect with the community? *

21. 2. Donor

22. 4.4. Public Art Policy

24. Name*
26. Organization (if applicable):
28. Please check one:*

    1. Individual
    2. Corporation

    1. Not-for-profit
    2. Other (specify)
30. Contact Information
32. Address*
34. City*
35. State*
36. Zip Code*
38. Phone Number*
39. Email Address*

41. 3. Artwork

42. 5.3. Public Art Policy

44. Title:*
46. Artwork Type:*
47. A. Brief Statement of Intent from the artist including any message or theme that the proposed work is intended to convey. (Please Attach)*

    5.3A Public Art Policy

49. B. Adequate visual representation of the proposed work in drawing(s) and/or photographs and/or model(s), with scale and materials indicated.*

    5.3B Public Art Policy

50. C. A scale drawing showing the proposed work as it will be sited.*

    5.3C Public Art Policy

52. Structural Integrity and Materials - Describe materials and construction used to create and install the proposed work.*
54. D. A comprehensive budget, with projected cost for the project, funds committed to date, proposed source(s) of funds, approach and funding for ongoing maintenance.*

    5.D Public Art Policy

56. Describe existing artwork construction proven longevity, if any.*

    e.g. Other installations / how many years installed using like materials and construction.

58. E. Artist’s resume and any additional supporting material relevant to the artist’s experience.

    5.E Public Art Policy

60. Name*
62. Address*
64. City*
65. State*
66. Zip Code*
68. Phone Number*
69. Email Address*

71. 4. Formal Agreement

72. 5.4. Public Art Policy

74. If the proposal is approved by City Council, a formal agreement will be executed between the City and the donor and/or artist.   This agreement will include terms and conditions as outlined in the Public Art Policy, in addition to other conditions as adopted by City Council.

    Ownership                                                                                                                  5.4B Public Art Policy             

    Ownership of the work, including certain rights under federal law, is relinquished to the City of Holland.

    Eligibility Costs                                                                                                         5.4C Public Art Policy            

    The City will consider proposed gifts of art with the understanding that no City funds will be required for the fabrication, siting or installation of the work.  Additionally, when accepting a gift into the City’s collection, the PAAC may require that the donor sign a maintenance agreement or establish a maintenance endowment to ensure an adequate quality of care for the artwork.   The Committee is unlikely to consider any donation that requires immediate or extensive maintenance.

    All costs associated with transportation, installation and maintenance will be the responsibility of the Donor/ Artist.

    Insurance                                                                                                                     5.4D Public Art Policy            

    The donor provides any insurance required by the City of Holland.

76. 5. Provide, if any, a proposed location in the City you want considered to locate your artwork or monument.

78. Description of proposed location.*

80. 6.  Donor’s authorization to initiate a donation review.        

82. By signing this Application below and in consideration for participating in the City’s Public Art program on City-Owned property, the artist / owner hereby acknowledges and understands that upon completion and installation of the artwork, and upon its acceptance by the Holland City Council, the work shall become the property of the City of Holland.   The City retains the right to remove or relocate the artwork in its sole discretion as the interest of the public welfare and safety may require.

    If the artwork is damaged, defaced, altered or destroyed by human acts or by acts of nature, the City retains the right to remove, restore, repair or replace the artwork at any time in keeping with the artist’s original design intent, without consulting the artist, or his or her heirs or assigns.  The City will make reasonable efforts to contact the artist, or if unavailable, another design professional, to advise or assist in any restoration work.

84. 7. Review Process - This application will be evaluated by the Holland Area Arts Council and by the Public Art Advisory Committee.

86. Electronic Signature*
87. Title*
89. Today's Date*
    Today's Date
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91. 1. Receive an email copy of this form.
92. Email address

    This field is not part of the form submission.

93. Submit

* indicates a required field