Public Art Request Name of Applying Organization/Business:(Required)Contact Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Contact Email Address Contact Phone Number(Required)Business/Organization Website Type of project requesting:(Required) Mural Functional Art (park benches, seating, railing) Interactive Art Temporary Art Environmentally Friendly Art (trash receptacles, recycle bins, etc) Other Medium Requested(Required)(i.e. outdoor acrylic paint, mixed media, watercolor, wood, metal)Where will the proposed project be located? Indoors, climate controlled space. Covered, but open air. Outdoors, exposed to the elements. Other Surface for mural Canvas Cinderblock Painted Cinderblock Brick Painted Brick Painted Textured Concerte blocks Textured/rough concrete blocks Wood Painted Drywall Other Project Goals: (select all that apply) Maintain/Create a Sense of Place Celebrate Key Resources of the Specific Location Enhance the Visitors Experience Take Views into Consideration for the Context of the Art Encourage Interaction (i.e. photos, etc.) Please explain a little bit more about your project goals.Please provide any specific requests, needs, or details that are important to the project.Final project dimensionsPlease outline what materials and/or support will be provided by the contracting entity.Please outline what the contracted artist is expected to provide.Are there specific elements, colors, objects, etc. that the contracting entity would like to specifically exclude?Scaffolding No scaffolding or ladders needed Scaffolding will be needed and the contracting entity will provide. Scaffolding will be needed and the cost should be built into the artists quote. The need for scaffolding is uncertain at this time. How is maintance to be handled and for how long?Proposed Start Date MM slash DD slash YYYY Proposed Project Completion Date MM slash DD slash YYYY Project Location:Reference Photos Drop files here or Select files Max. file size: 50 MB. Acknowledgment of Artist Rights and Site Responsibilities I agree to the terms and conditions.Acknowledgment of Artist Rights and Site Responsibilities By submitting this request, the requesting or contracting entity acknowledges and agrees to the following: All artwork, designs, sketches, renderings, concepts, and other creative materials submitted during the proposal process remain the intellectual property of the artist unless and until the artwork is formally selected, a contract is executed, and the artist is compensated in accordance with that contract. Proposal materials may not be reproduced, modified, distributed, installed, or otherwise used without the artist’s prior written permission. The contracting entity is responsible for ensuring that the designated surface or installation area is structurally sound, clean, accessible, and otherwise properly prepared before the artist begins work, unless alternative arrangements are specified in the final contract. All costs associated with cleaning, repairing, priming, or otherwise preparing the site are the financial responsibility of the contracting entity. The contracting entity is also responsible for any additional costs, repairs, deterioration, or ongoing maintenance resulting from an inadequately prepared or unsuitable surface or installation area. Unless otherwise stated in the final contract, the contracting entity assumes responsibility for the ongoing care and maintenance of the completed artwork.