Home: (808) TAXES $0.00 $0.00 RESERVATIONS

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1 Waipio Peninsula Soccer Park c/o District V Office Waipio Point Access Road Waipahu, HI (808) THIS IS NOT A PERMIT AYSO Region Kolea Pl. Waipahu, HI Customer Type: Regular Authorized Agent: James Fernadez Home: (808) Reservation Request Status: All Approvals Received - Awaiting Decision DATE/USER REQUEST NUMBER CHARGES DISCOUNT TAXES REFUNDS & CREDITS PAYMENTS REQUEST EXPIRES BALANCE DUE 07/24/2018 Ramachandran Sudharshan $ $0.00 $0.00 $0.00 $ /20/2019 $ Training Attendance: 99 WPSP Field #02 RESERVATIONS EVENT NAME FACILITY CENTER Type: Fitness/Sport Event Waipio Peninsula Soccer Park Waipio Pt. Access Road Waipahu, HI DATES RESERVED HRS DATES RESERVED HRS Monday - 10/1/ :30 PM to 06:30 PM 2 Tuesday - 10/2/ :30 PM to 06:30 PM 2 Wednesday - 10/3/ :30 PM to 06:30 PM 2 Thursday - 10/4/ :30 PM to 06:30 PM 2 Friday - 10/5/ :30 PM to 06:30 PM 2 Monday - 10/8/ :30 PM to 06:30 PM 2 Tuesday - 10/9/ :30 PM to 06:30 PM 2 Wednesday - 10/10/ :30 PM to 06:30 PM 2 Thursday - 10/11/ :30 PM to 06:30 PM 2 Friday - 10/12/ :30 PM to 06:30 PM 2 Monday - 10/15/ :30 PM to 06:30 PM 2 Tuesday - 10/16/ :30 PM to 06:30 PM 2 Wednesday - 10/17/ :30 PM to 06:30 PM 2 Thursday - 10/18/ :30 PM to 06:30 PM 2 Friday - 10/19/ :30 PM to 06:30 PM 2 Monday - 10/22/ :30 PM to 06:30 PM 2 Tuesday - 10/23/ :30 PM to 06:30 PM 2 Wednesday - 10/24/ :30 PM to 06:30 PM 2 Thursday - 10/25/ :30 PM to 06:30 PM 2 Friday - 10/26/ :30 PM to 06:30 PM 2 Monday - 10/29/ :30 PM to 06:30 PM 2 Tuesday - 10/30/ :30 PM to 06:30 PM 2 Wednesday - 10/31/ :30 PM to 06:30 PM 2 Thursday - 11/1/ :30 PM to 06:30 PM 2 Friday - 11/2/ :30 PM to 06:30 PM 2 Monday - 11/5/ :30 PM to 06:30 PM 2 Tuesday - 11/6/ :30 PM to 06:30 PM 2 Wednesday - 11/7/ :30 PM to 06:30 PM 2 Thursday - 11/8/ :30 PM to 06:30 PM 2 Friday - 11/9/ :30 PM to 06:30 PM 2 Monday - 11/12/ :30 PM to 06:30 PM 2 Tuesday - 11/13/ :30 PM to 06:30 PM 2 Wednesday - 11/14/ :30 PM to 06:30 PM 2 Thursday - 11/15/ :30 PM to 06:30 PM 2 Friday - 11/16/ :30 PM to 06:30 PM 2 Monday - 11/19/ :30 PM to 06:30 PM 2 Tuesday - 11/20/ :30 PM to 06:30 PM 2 Wednesday - 11/21/ :30 PM to 06:30 PM 2 Thursday - 11/22/ :30 PM to 06:30 PM 2 Friday - 11/23/ :30 PM to 06:30 PM 2 1 of 9

2 Monday - 11/26/ :30 PM to 06:30 PM 2 Tuesday - 11/27/ :30 PM to 06:30 PM 2 Wednesday - 11/28/ :30 PM to 06:30 PM 2 Thursday - 11/29/ :30 PM to 06:30 PM 2 Friday - 11/30/ :30 PM to 06:30 PM 2 Monday - 12/3/ :30 PM to 06:30 PM 2 Tuesday - 12/4/ :30 PM to 06:30 PM 2 Wednesday - 12/5/ :30 PM to 06:30 PM 2 Thursday - 12/6/ :30 PM to 06:30 PM 2 Friday - 12/7/ :30 PM to 06:30 PM 2 Monday - 12/10/ :30 PM to 06:30 PM 2 Tuesday - 12/11/ :30 PM to 06:30 PM 2 Wednesday - 12/12/ :30 PM to 06:30 PM 2 Thursday - 12/13/ :30 PM to 06:30 PM 2 Friday - 12/14/ :30 PM to 06:30 PM 2 Monday - 12/17/ :30 PM to 06:30 PM 2 Tuesday - 12/18/ :30 PM to 06:30 PM 2 Wednesday - 12/19/ :30 PM to 06:30 PM 2 Thursday - 12/20/ :30 PM to 06:30 PM 2 Friday - 12/21/ :30 PM to 06:30 PM 2 Monday - 12/24/ :30 PM to 06:30 PM 2 Tuesday - 12/25/ :30 PM to 06:30 PM 2 Wednesday - 12/26/ :30 PM to 06:30 PM 2 Thursday - 12/27/ :30 PM to 06:30 PM 2 Friday - 12/28/ :30 PM to 06:30 PM 2 Monday - 12/31/ :30 PM to 06:30 PM 2 2 of 9

3 Total Number of Dates: 66 Total Number of Hours: of 9

4 NOTES: Please remember to submit your field usage request to me at least three weeks before the start date of the permit. Reminder: If there is anything wrong with your Reservation Request please let me know "As Soon As Possible" so I can fix it before you take it to the permit office for payment and processing! THE ATTACHED IS NOT A PERMIT PLEASE READ FURTHER FOR INSTRUCTIONS! The person named on this request is the only person that can sign for the field usage permit and or concession permit. Attached is your "reservation request" for the area(s), date(s), and time(s) that you requested. Some of these dates and times may have changed. Please verify and corrections back to me if needed. Please take this request with you to the permit section at the Frank F. Fasi Municipal Building, 650 S King St to obtain your permit. Parks Permit Office hours are 7:45 a.m. to 4:00 p.m. weekdays. The office is closed on weekends and holidays. If you are requiring a concession permit (see below), you must initiate that request at least three weeks prior to your event at this same permit office (Frank F. Fasi Municipal Building, 650 S King St)(see below for further instructions). Please have your original, signed, approved permit(s) available for inspection during your event. Please call or if you have any questions. Temporary Concession Request! This request should be received by the parks permits office at least three weeks prior to the first requested date of park use. NOTE: An appointment should be made with the permit office regarding the temporary concession application, call NOTE: An IRS 501C3 (non-profit status determination) letter is required in the same name of the non-profit organization making the temporary concession request. Insurance naming the same non-profit as an insured is required and the insurance also needs to name the City and County of Honolulu as an additional insured (see below). The temporary concession application form requires that a current original Certificate for Comprehensive General Liability Insurance including products liability in the following minimum amounts: Bodily Injury $300,000 per occurrence Property Damage $ 10,000 per occurrence The Purchasing Division requests a $1,000,000 aggregate coverage or better. Certificate of Insurance shall name the CITY AND COUNTY OF HONOLULU as an additional insured. The form is to be submitted NO LATER than TWO (2) weeks prior to the event date. An original multi-part form must be signed by the authorized non-profit organization. REMINDERS: WE RECOMMEND THAT SPECIAL DUTY OFFICERS ARE HIRED AT YOUR EXPENSE TO CITE PARTICIPANTS AND SPECTATORS WHO DISREGARD RULES SUCH AS ILLEGAL DRINKING, ILLEGAL PARKING, AND LOUD MUSIC. THESE VIOLATIONS MAY LEAD TO THE SUSPENSION OF PERMITS AND/OR NON RENEWAL OF PERMITS. The league/tournament director/permit-e is responsible for the permit application and the management of the league/tournament to insure all teams and members of the organization comply with all field rules and regulations. FIELD USAGE IS LIMITED TO TOURNAMENT, LEAGUE AND SCRIMMAGE GAMES. NO ALCOHOLIC BEVERAGES ALLOWED ON PARK PREMISES. NO DRIVING ON THE GRASS, PARK IN MARKED STALLS ONLY. No sales of any kind are allowed without an approved Temporary Concession application form (see form for requirements and submit no later than two weeks prior to the event). NOTE: Food sold to the public also requires Department of Health clearance (call for information). Clean up of all litter created by players and spectators, place bagged trash next to trash receptacle. For Tournament Play: Rubbish bags must be pulled and placed in dumpster. Fields will be closed due to inclement weather or wet field conditions. PERMITS MAY BE REVOKED OR REVISED FOR THE FOLLOWING REASONS: Failure to comply with the Rules and Regulations. Official Department of Parks and Recreation activities. Community-wide special events. EVENT NAME FACILITY CENTER 4 of 9

5 Training Attendance: 99 Type: Fitness/Sport Event WPSP Field #04 Waipio Peninsula Soccer Park Waipio Pt. Access Road Waipahu, HI DATES RESERVED HRS DATES RESERVED HRS Monday - 10/1/ :30 PM to 06:30 PM 2 Tuesday - 10/2/ :30 PM to 06:30 PM 2 Wednesday - 10/3/ :30 PM to 06:30 PM 2 Thursday - 10/4/ :30 PM to 06:30 PM 2 Friday - 10/5/ :30 PM to 06:30 PM 2 Monday - 10/8/ :30 PM to 06:30 PM 2 Tuesday - 10/9/ :30 PM to 06:30 PM 2 Wednesday - 10/10/ :30 PM to 06:30 PM 2 Thursday - 10/11/ :30 PM to 06:30 PM 2 Friday - 10/12/ :30 PM to 06:30 PM 2 Monday - 10/15/ :30 PM to 06:30 PM 2 Tuesday - 10/16/ :30 PM to 06:30 PM 2 Wednesday - 10/17/ :30 PM to 06:30 PM 2 Thursday - 10/18/ :30 PM to 06:30 PM 2 Friday - 10/19/ :30 PM to 06:30 PM 2 Monday - 10/22/ :30 PM to 06:30 PM 2 Tuesday - 10/23/ :30 PM to 06:30 PM 2 Wednesday - 10/24/ :30 PM to 06:30 PM 2 Thursday - 10/25/ :30 PM to 06:30 PM 2 Friday - 10/26/ :30 PM to 06:30 PM 2 Monday - 10/29/ :30 PM to 06:30 PM 2 Tuesday - 10/30/ :30 PM to 06:30 PM 2 Wednesday - 10/31/ :30 PM to 06:30 PM 2 Thursday - 11/1/ :30 PM to 06:30 PM 2 Friday - 11/2/ :30 PM to 06:30 PM 2 Monday - 11/5/ :30 PM to 06:30 PM 2 Tuesday - 11/6/ :30 PM to 06:30 PM 2 Wednesday - 11/7/ :30 PM to 06:30 PM 2 Thursday - 11/8/ :30 PM to 06:30 PM 2 Friday - 11/9/ :30 PM to 06:30 PM 2 Monday - 11/12/ :30 PM to 06:30 PM 2 Tuesday - 11/13/ :30 PM to 06:30 PM 2 Wednesday - 11/14/ :30 PM to 06:30 PM 2 Thursday - 11/15/ :30 PM to 06:30 PM 2 Friday - 11/16/ :30 PM to 06:30 PM 2 Monday - 11/19/ :30 PM to 06:30 PM 2 Tuesday - 11/20/ :30 PM to 06:30 PM 2 Wednesday - 11/21/ :30 PM to 06:30 PM 2 Thursday - 11/22/ :30 PM to 06:30 PM 2 Friday - 11/23/ :30 PM to 06:30 PM 2 Monday - 11/26/ :30 PM to 06:30 PM 2 Tuesday - 11/27/ :30 PM to 06:30 PM 2 Wednesday - 11/28/ :30 PM to 06:30 PM 2 Thursday - 11/29/ :30 PM to 06:30 PM 2 Friday - 11/30/ :30 PM to 06:30 PM 2 Monday - 12/3/ :30 PM to 06:30 PM 2 Tuesday - 12/4/ :30 PM to 06:30 PM 2 Wednesday - 12/5/ :30 PM to 06:30 PM 2 Thursday - 12/6/ :30 PM to 06:30 PM 2 Friday - 12/7/ :30 PM to 06:30 PM 2 Monday - 12/10/ :30 PM to 06:30 PM 2 Tuesday - 12/11/ :30 PM to 06:30 PM 2 Wednesday - 12/12/ :30 PM to 06:30 PM 2 Thursday - 12/13/ :30 PM to 06:30 PM 2 Friday - 12/14/ :30 PM to 06:30 PM 2 Monday - 12/17/ :30 PM to 06:30 PM 2 Tuesday - 12/18/ :30 PM to 06:30 PM 2 Wednesday - 12/19/ :30 PM to 06:30 PM 2 Thursday - 12/20/ :30 PM to 06:30 PM 2 Friday - 12/21/ :30 PM to 06:30 PM 2 Monday - 12/24/ :30 PM to 06:30 PM 2 Tuesday - 12/25/ :30 PM to 06:30 PM 2 Wednesday - 12/26/ :30 PM to 06:30 PM 2 Thursday - 12/27/ :30 PM to 06:30 PM 2 Friday - 12/28/ :30 PM to 06:30 PM 2 Monday - 12/31/ :30 PM to 06:30 PM 2 5 of 9

6 Total Number of Dates: 66 Total Number of Hours: of 9

7 NOTES: Please remember to submit your field usage request to me at least three weeks before the start date of the permit. Reminder: If there is anything wrong with your Reservation Request please let me know "As Soon As Possible" so I can fix it before you take it to the permit office for payment and processing! THE ATTACHED IS NOT A PERMIT PLEASE READ FURTHER FOR INSTRUCTIONS! The person named on this request is the only person that can sign for the field usage permit and or concession permit. Attached is your "reservation request" for the area(s), date(s), and time(s) that you requested. Some of these dates and times may have changed. Please verify and corrections back to me if needed. Please take this request with you to the permit section at the Frank F. Fasi Municipal Building, 650 S King St to obtain your permit. Parks Permit Office hours are 7:45 a.m. to 4:00 p.m. weekdays. The office is closed on weekends and holidays. If you are requiring a concession permit (see below), you must initiate that request at least three weeks prior to your event at this same permit office (Frank F. Fasi Municipal Building, 650 S King St)(see below for further instructions). Please have your original, signed, approved permit(s) available for inspection during your event. Please call or if you have any questions. Temporary Concession Request! This request should be received by the parks permits office at least three weeks prior to the first requested date of park use. NOTE: An appointment should be made with the permit office regarding the temporary concession application, call NOTE: An IRS 501C3 (non-profit status determination) letter is required in the same name of the non-profit organization making the temporary concession request. Insurance naming the same non-profit as an insured is required and the insurance also needs to name the City and County of Honolulu as an additional insured (see below). The temporary concession application form requires that a current original Certificate for Comprehensive General Liability Insurance including products liability in the following minimum amounts: Bodily Injury $300,000 per occurrence Property Damage $ 10,000 per occurrence The Purchasing Division requests a $1,000,000 aggregate coverage or better. Certificate of Insurance shall name the CITY AND COUNTY OF HONOLULU as an additional insured. The form is to be submitted NO LATER than TWO (2) weeks prior to the event date. An original multi-part form must be signed by the authorized non-profit organization. REMINDERS: WE RECOMMEND THAT SPECIAL DUTY OFFICERS ARE HIRED AT YOUR EXPENSE TO CITE PARTICIPANTS AND SPECTATORS WHO DISREGARD RULES SUCH AS ILLEGAL DRINKING, ILLEGAL PARKING, AND LOUD MUSIC. THESE VIOLATIONS MAY LEAD TO THE SUSPENSION OF PERMITS AND/OR NON RENEWAL OF PERMITS. The league/tournament director/permit-e is responsible for the permit application and the management of the league/tournament to insure all teams and members of the organization comply with all field rules and regulations. FIELD USAGE IS LIMITED TO TOURNAMENT, LEAGUE AND SCRIMMAGE GAMES. NO ALCOHOLIC BEVERAGES ALLOWED ON PARK PREMISES. NO DRIVING ON THE GRASS, PARK IN MARKED STALLS ONLY. No sales of any kind are allowed without an approved Temporary Concession application form (see form for requirements and submit no later than two weeks prior to the event). NOTE: Food sold to the public also requires Department of Health clearance (call for information). Clean up of all litter created by players and spectators, place bagged trash next to trash receptacle. For Tournament Play: Rubbish bags must be pulled and placed in dumpster. Fields will be closed due to inclement weather or wet field conditions. PERMITS MAY BE REVOKED OR REVISED FOR THE FOLLOWING REASONS: Failure to comply with the Rules and Regulations. Official Department of Parks and Recreation activities. Community-wide special events. 7 of 9

8 CHARGES CHARGE DESCRIPTION FACILITY/EVENT UNIT FEE QTY TAX TOTAL DISCOUNTED/ CHARGED PAID BALANCE DUE District V Fees WPSP Field #02 - Training $ $0.00 $ $0.00 $ District V Fees WPSP Field #04 - Training $ $0.00 $ $0.00 $ PAYMENTS AND REFUNDS RECEIPT NUMBER DATE CHARGE DESCRIPTION FACILITY/EVENT AMOUNT TERMS AND CONDITIONS 1. Revocation. The Department of Parks and Recreation shall have the authority to revoke a permit and/or stop a use in progress upon reasonable notification and the opportunity to cure a violation of the conditions or standards for issuance as set forth in Revised Ordinances of Honolulu Chapter 10, and the rules and regulations promulgated pursuant to Revised Ordinances of Honolulu Section (b), as amended. 2. No Assignment. Permittee shall not transfer, assign, sell or grant use of any or all of the days or all or any portion of the facility/park site granted to permittee under this permit. 3. Laws and Rules. Permittee shall comply with all state and federal laws, including law s prohibiting discrimination against persons with disabilities, City ordinances, rules and regulations of the Department of Parks and Recreation applicable to activities in City parks; permittees to whom such permits are issued shall be bound by such laws, ordinances, rules and regulations as though the same were incorporated in such permits. 4. Damages. a) Except for public assemblies, permittee shall be liable for loss, damage or injury to persons or property resulting from permittee's use of the park or park facility under such permit, as well as any breach of City regulations or ordinances, to the person or persons suffering such loss, damage, or injury, and to the City in the event the City shall become liable for such loss, damage or injury. Any and all damage to the park and/or park facilities must be fully and completely restored within 7 days after the end of the permitted event. b) For DOE events identified in attached list: The State shall indemnify, defend, and hold harmless the City and County of Honolulu, its officers, employees, and agents, from any and all claims of liability for any damage to real or personal property or injury to or death of any persons when such damage, injury or death arises out of the action or omission of the State, its officers, employees, agents, consultants, contractors, or invitees in conjunction with the specific activities at the specific facilities on the specific dates and at the specific times listed on the attachment entitled Department of Education Use of City and County of Honolulu Facilities from through ; provided that the State shall not be required to indemnify, defend, or hold harmless, the City and County of Honolulu, its officers, employees and agents, from any claims of liability for any damage to real or personal property or injury to or death of any persons, when such damage, injury or death arises out of the action or omission of the City and County of Honolulu, and/or its officers, employees, agents, consultants, contractors, or invitees, regarding the maintenance and repair of the specific facilities listed on the attachment entitled Department of Education Use of City and County of Honolulu Facilities from through. This provision shall not be read or interpreted to create any liability of the State or any person or entity to any person or entity, except for the duties to indemnify, defend, and hold harmless set forth herein. This provision is not intended to and shall not be interpreted to benefit any third person, or to benefit or create any third-party beneficiary. 5. Responsibility. Permittee assumes responsibility for all activities it conducts during the permitted event, including but not limited to, supervision and control to prevent injury or damage; maintenance of the premises during the use, including removal and disposal of debris and refuse. Upon expiration of the permit, permittee shall promptly return the premises in as good condition as received, reasonable wear and tear excepted. 6. Cancellation. Cancellation or changes in schedules must be promptly reported to the Department of Parks and Recreation. 7. Fees. Charging admission or the sales of goods and services is prohibited, unless prior written permission has been obtained from the Department of Parks and Recreation. 8. Fires. Only charcoal may be used for cooking fires which must be placed in barbecue stoves where provided. If private barbecue stoves are used, they must be lifted at least 12 inches above the grass and kept away from tree trunks and other plants. 9. Permittee shall not take possession of any equipment in the park. Pavilions may be not reserved for exclusive use by a permittee. 10. Alcohol. The consumption or possession of alcoholic beverages other than in a container in the manufacturer's sealed condition, is prohibited. 11. Animals. Animals are prohibited from all parks except by permit. Dogs are permitted in areas designated as off-leash parks or in designated areas for leashed dogs. 8 of 9

9 12. Utilities. Utility hookups are by special permit only. 13. NO DRIVING OR PARKING ON THE GRASS. 14. Noise. Noise exceeding the standards set forth in Revised Ordinances of Honolulu Section (b)(8) is prohibited except as authorized by permit. 15. Additional Terms and Conditions. This permit is subject to the additional terms, conditions and covenants which are attached hereto and incorporated herein. 16. NO SMOKING. Smoking is prohibited at all City and County of Honolulu parks, beaches and park facilities. Permittee agrees to comply with City ordinances, including Revised Ordinances of Honolulu Chapter 10, the rules and regulations of the Department of Parks and Recreation, and the terms and conditions of this permit. Permittee understands that non-compliance may result in revocation of this permit. If Permittee is an organization, the undersigned certifies that he/she is authorized to sign on behalf of Permittee. By Signature Organization: Date: 9 of 9