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City of Bonney Lake - Public Works

withersm@cobl.us

21719 96th ST E Buckley, WA 98321

253-447-4319

CITY OF BONNEY LAKE ADOPT-A-STREET PROGRAM

The Adopt-A-Street Program is a fun and worthwhile program that will give you, your company, school or organization recognition while saving taxpayer dollars. You can adopt a City street and beautify a part of Bonney Lake in partnership with the City. This is a great way to promote community pride, goodwill within your organization, and among family and friends. The City recognizes the organization's concern for the environment with a sign that identifies the organization responsible for the clean-up of that particular street segment.

Adopting a street requires a commitment of picking up litter on your designated street segment (usually a minimum of a 1 mile) quarterly and over a two-year period. The City will provide safety vests, hard hats, gloves, signage, trash bags and trash pickup tools. For complete information about the program, see the application packet (attached), which can also be downloaded from the City’s website at http://www.cobl.us

If adopting a street sounds like something you or your organization would like to get involved in, complete the application packet and return it to the City of Bonney Lake, Attn: Michelle Withers, 21719 96th ST E, Buckley, WA 98321. If you have any questions about the program, contact Michelle Withers via phone (253) 447-4319 or via email withersm@cobl.us.

Why should your company or group volunteer to Adopt-A-Street? 

  • Feel ownership and pride in one's community.
  • Set an example for others, especially children.
  • Show you care about environmental issues.
  • Improve the quality of life in your neighborhood.
  • Gain new knowledge about litter on roadways (what gets thrown out).
  • Experience the feeling of usefulness.
  • Deter crime with a cleaner environment.
  • Enjoy the outside with neighbors or co-workers.
  • Receive visible recognition.
  • Make a difference - TRASH AFFECTS EVERYONE!

APPLICATION FOR CITY OF BONNEY LAKE ADOPT A CITY STREET PROGRAM

The City of Bonney Lake will work with the adopting Individual or Group to determine the specific section of street to be adopted. 

Date of Application

Date Picker

Group's Mailing Address

Program Liaison

Liaison's Mailing Address

Bonney Lake City Street(s) you are interested in adopting (in order of preference):

CITY OF BONNEY LAKE ADOPT-A-STREET VOLUNTEER RELEASE WAIVER AND HOLD HARMLESS

The City of Bonney Lake Adopt-A-Street program is for volunteers who donate their time to help keep the City clean. Participants are advised that working adjacent to a City street or in a City park can be hazardous. Participants must exercise proper care in performing litter collection activities. Participants must wear the safety hat, vest and gloves furnished by the City, and must wear appropriate protective clothing such as long pants, long sleeve shirts, and thick-soled, close-toed boots or shoes. 

Participants may be entitled to receive cost only coverage for medical treatment required for injury incurred during participation in the Adopt-A-Street (Park) program under the medical aid provisions of the Worker's Compensation Act, which is administered by the Department of Labor and Industries, but not for loss of time because of injury or illness, or for lasting disability or death. I understand and acknowledge that the City provides no independent benefits, and does not ensure the provision of any benefit by any third party. 

As a volunteer for the City of Bonney Lake I agree to follow all of the rules outlined in the Volunteer Handbook and the Adopt-A-Street Program policy. I acknowledge that City personnel will provide direction and limited supervision regarding my duties as a volunteer. I will use all provided equipment appropriately and follow all safety practices. 

I am aware that the work contemplated in the Adopt-A-Street program involves certain risks of physical injury and death. Being fully informed as to these risks and in consideration of accepting the opportunity to participate in the Adopt-A-Street program, I hereby, on behalf of myself and my heirs, assume all risks in connection with my participation in this program and I further hold harmless the City of Bonney Lake, its officials, employees and agents for any injury or damages which may occur to me while I am participating in this program and I waive any right to bring claim or lawsuit against them for any such injury, damage or death. Furthermore, I agree to hold harmless, defend and indemnify the City of Bonney Lake, its officials, employees and agents from any and all claims and lawsuits for injury, loss, or damage to other persons or entities which may arise in the future as a result of or in connection with my participation in the Adopt-A- Street program except for injuries or damages caused by the sole negligence of the City. I authorize any necessary emergency medical treatment that might be required for me in the event of physical injury and/or accident to me while participating in this program.

 

Participant's Name

Is Participant Less Than 18 Years Old?

If participant is less than 18 years old:

I certify that I am the parent or legal guardian of the participant above-named; that I have read and understood the foregoing release and waiver; and that in consideration of allowing the participant to participate in the City's Adopt-A-Street program I join in the release and waiver without reservation and agree to release and waive any claim or legal cause of action that I might have arising out of any personal injury, damage or death of the participant as against the City of Bonney Lake, its officials, employees and agents. I further grant my full consent and authorization for the above-named participant to engage in the activity described above.  Furthermore, I authorize all reasonable medical treatment that may be necessitated in the event of injury or accident occurring to the participant named above while working in the Adopt-A-Street program.

Signature of Participant or Guardian if Participant is less than 18 years old

Choose how to sign

Date Signed

Date Picker

ADOPT-A-STREET AGREEMENT WITH THE CITY OF BONNEY LAKE

This agreement is made and entered into between the City of Bonney Lake, hereinafter called the “City” and

_____________________________________________________________.  

Hereinafter called the “Group”.  

Whereas City Resolution 1426 authorizes the City to establish a City-wide Adopt-A-Street program; and whereas the Group wishes to contribute toward the effort to reduce roadside litter.  

The section of street adopted herein is described as: ________________________________________

From __________________________________ To __________________________.                                  

The City does hereby authorize the Group permission to participate in the Adopt-A-Street program by picking up litter within the assigned sections of streets designated below, in accordance with the following terms and conditions:  

To obey, abide by and to ensure that each participant obeys all laws and regulations relating to pedestrian and traffic safety; all recommendations, terms and conditions set forth in the City of Bonney Lake Volunteer Handbook, the Adopt-A-City Street Program and such terms and conditions that may be required by the City of Bonney Lake Public Works Director, Program Coordinator or other designee (hereinafter collectively call “Public Works Director”) for such special conditions on particular adopted City Streets.  

Additionally the Group/Grantee agrees to the following:

  1. Conduct clean-up activities in a safe manner and comply with conditions maybe the City for the safety the participants.
  2. The Group will adopt at least one (1) mile of adjacent, connected or adjoining City streets for a minimum of two (2) years unless agreed upon with the Public Works Director.
  3. Assign a leader to the clean-up crew. The crew leader shall have a copy of this with him or her during the clean-up.
  4. Pick up litter no less than four (4) times per year. Additional clean-ups should be done as necessary to maintain a neat appearance. Recommended clean-up interval is once every three months (quarterly). One of the clean-ups will occur during the City's annual spring "Clean Up” event.
  5. All participants shall wear the safety hat, reflective vest and gloves furnished by the City during clean-up activities and must wear appropriate protective clothing such as long pants and a long sleeve shirt, and thick soled boots or shoes.
  6. The Group shall require the participants to work in the assigned area with a minimal number of vehicles. Vehicles should be parked clear of the City street's roadway and at least ten (10) feet from any shoulder or curb in an agricultural area. Groups are encouraged to work with nearby businesses, schools, churches, or others to utilize parking off of the City streets.
  7. The Group shall clean-up only one side of the adopted City Street at a time.
  8. Participants shall be at least 15 years old. The Grantee shall furnish supervision by one or more adults for every (8) minors (less than 18 years old) participating in the clean-up activity. 
  9. Obtain supplies and materials to the extent that they are available from the City during regular business hours. 
  10. Place filled trash bags and materials on the street shoulder for disposal by the City. 
  11. Call 911 (Police/Fire Emergency) in the event of any emergency during the clean-up. 
  12. Participants will not pick up syringes, hypodermic needles, broken glass, exceptionally large, heavy, or unwieldy objects or any other hazardous item. These kinds of materials should be flagged and the City notified as soon as possible to arrange for proper disposal. 
  13. Provide the City with a roster of individual participants in the clean-up and hours of participation in the clean-up within three (3) working days after the clean-up.
  14. The crew leader will report any injuries sustained by participants during clean-up activities to the City immediately upon notification. Notice will be provided on the Incident/Accident Report Form furnished by the City. 
  15. Return to the City within three (3) working days materials furnished by the City. 
  16. Our organization is responsible for directly supervising the activities of all the individuals in our group who will be doing volunteer work, and therefore, in consideration of our organization and members being permitted to perform services on City property, our organization agrees to defend, indemnify and hold harmless the City of Bonney Lake and its officials, employees and agents from any damage claim or lawsuit for injury, illness, damage or other loss of any kind to anyone including members of our organization that might arise out of our activities or the actions of any individuals of our group, except for injuries or damages caused by the sole negligence of the City. 
  17. The Group/Grantee has designated a contact person (hereinafter called “Liaison") on the application for the Adopt-A-Street program. The liaison will be responsible for the following:
    1. Notify the Public Works Director’s office of any changes in the designation of the contact person and of any changes in the contact person’s address and/or telephone number. 
    2. Notify the City before each clean-up event. 
    3. Notify the City of the precise location of any bags and heavy or hazardous trash found during the clean-up event.
    4. Prior to each clean-up event, distribute and collect signed “Release Waiver and Hold Harmless” from each participant and forward to the Public Works Director.
    5. Assure that all participants have reviewed the Adopt-A-Street program regulations and guidelines prior to the clean-up event.
    6. Provide the Public Works Director with information about the group, photos and notices of clean-up events and related activities to be posted on the City’s website.  

The City agrees to: 

  1. After completion of the first event, the City shall furnish and install an ADOPT-A-Street sign with the Grantee name or  acronym. The sign will be installed at one end of the section of street (one for each direction of traffic) the Group is responsible for. 
  2. Provide coverage on the City website for the Group including a brief biography, photos, and notices of clean-up events and related activities.
  3. Furnish the Group trash bags, safety hats, gloves, trash pickers, reflective vests and "Volunteer Litter Crew Ahead" advance warning signs and stands for the participants to use during the clean-up activity. 
  4. Remove the filled trash bags from the street shoulder. 
  5. Assist the Group in clean-up if necessary, i.e., when large, heavy or dangerous items are found.
  6. Provide the Group safety training and  materials as necessary to enable the participants to perform their volunteer services.
  7. Provide the Group with traffic control equipment. The equipment consists of an advance warning sign. The advance warning sign is diamond shaped, with black letters on an orange background that reads VOLUNTEER LITTER CREW AHEAD. The sign should be placed on the shoulder, approximately three feet from lane edge, and no farther than one mile from the nearest worker. 
  8. Maintain necessary records required to secure medical aid benefits under chapter 51.12.035 RCW for participants.  

The City recommends the Group have a first aid kit available at the clean-up site and at least one person with a valid first aid card be present during clean-up activities. The City also recommends the Group have a cellular phone or radio at the clean-up site.  

Recycling is an accepted and encouraged activity.  Recyclable items collected by participants may be removed from the site at the option of the Group. Profits from the sale of recyclable items shall belong to the Group.  

The City may suspend this agreement temporarily because of construction in the assigned area.  After the construction is complete the Group will be notified and the agreement restored.  

The term of this agreement shall begin on the date of execution indicated below and shall end on the date of termination unless terminated by the City or the Group upon 30 day written notice.  Upon termination of this agreement the ADOPT-A-STREET sign will be removed and remain the property of the city.

 

City of Bonney Lake

Public Works Department

21719 96th ST E, Buckley, WA 98321

253-447-4319

 

______________________________________

Name of Organization

 

 

______________________________________

Address

   

 

______________________________________

City, State, and Zip

________________

Date of Execution

 

 

________________________________________

Name of Liaison/Group Contact

________________

Date of Termination

 

 

________________________________________

Home Address

   

 

________________________________________

City, State, and Zip

   

 

_________________            _________________

Day Phone                             Evening Phone

__________________________

ADOPT-A-STREET Coordinator

City of Bonney Lake

 

 

________________________________________

Signature of Liason/Group Contact

   

 

________________________________________

Title

   

 

________________________________________

Email