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2. Signature Date*
   Signature Date
4. Organization Name / Applicant Signature*

   TERMS OF AGREEMENT:

   • The City of Peoria holiday lighting schedule will supersede any requests.
     
     
   • The United States Coast Guard has passage rights to the Illinois River and, therefore, full access to the Murray Baker Bridge lights. Lighting displays may be terminated for the purpose of safe river passage of barges, as needed. This is unscheduled and beyond any programming control of the City of Peoria.
     
     
   • The Murray Baker Bridge lights operate daily from sunset to sunrise.
     
     
   • This program does not allow lighting for political events and/or political campaigns.
     
     
   • Lighting requests will be granted on a first-come, first served, basis.
     
     
   • Applicants should verify availability on www.peoriagov.org/public-works/bridge-lights/ or contact Peoria Public Works at (309) 494-8800 or publicworks@peoriagov.org.
     
     
   • Completed applications and fees must be received no less than 30 days in advance of the requested date. The City has the right to waive the 30-day requirements under special circumstances.
     
     
   • Upon approval of a display request, an email will be sent to the primary contact listed on the application.
     
     
   • Once approved, changes to the application form will not be permitted.
     
     
   • Select the color requests from the published list of light scenes on the City website and the application form.
     
     
   • If a different color scene is desired, contact Public Works for availability, cost, and schedule.
     
     
   • Custom programming has a minimum fee of $800.
     
     
   • Program participation does not constitute exclusive and/or private use of the bridge.
     
     
   • Any false, unauthorized, or misrepresented bridge lighting requests will not be honored. 

   If the application is approved, you will be notified via email.

   RATES:

   • Per evening $200 ($150 for non-profit organizations). 
     
     
   • Five consecutive evening maximum.
     
     
   • Special programming requests/additional colors are available for an additional fee. Contact Public Works for more information at (309) 494-8800 or publicworks@peoriagov.org.

   PAYMENT:

   Upon approval, payment must be made five (5) business days before the requested date. Payments can be made or mailed to the City Treasurer’s Office, 419 Fulton Street, Room 100, Peoria, IL 61602.

6. Today's Date*
   Today's Date
8. Date of Event (One Evening And Overnight)
   Date of Event (One Evening And Overnight)
10. Date of Event (Only Fill Out For Multiple Evenings And Overnights - Up To Five Consecutive Dates)
    Date of Event (Only Fill Out For Multiple Evenings And Overnights - Up To Five Consecutive Dates) Start Date

    —

    Date of Event (Only Fill Out For Multiple Evenings And Overnights - Up To Five Consecutive Dates) End Date
12. Application / Organization Name*
14. Authorized Contact Person*
16. Address*
18. City*
19. State*
20. Zip Code*
22. Phone Number*
24. Email Address*
26. Type of Event (Please Select One)*

    1. Public Awareness
    2. Public Event

    1. Private Event
    2. Personal

    1. Other
28. Type of Event Description*
30. Non-Profit*

    1. YES

    1. NO
32. *If a Non-Profit, Please Provide 501(c)(3) Identification Number
34. Requested Light Scene from List (Please Select ONE)*

    1. 1. White
    2. 2. Red
    3. 3. Orange
    4. 4. Yellow
    5. 5. Green
    6. 6. Teal
    7. 7. Cyan
    8. 8. Blue
    9. 9. Purple
    10. 10. Magenta

    1. 11. Bradley Red
    2. 12. Caterpillar Yellow
    3. 13. Pink
    4. 14. Blue/Green
    5. 15. Blue/Purple
    6. 16. Blue/Red
    7. 17. Blue/Yellow
    8. 18. Blue/Orange
    9. 19. Blue/Gold
    10. 20. Green/Purple

    1. 21. Green/Yellow
    2. 22. Green/Orange
    3. 23. Green/Red
    4. 24. Yellow/Orange
    5. 25. Yellow/Red
    6. 26. Yellow/Purple
    7. 27. Orange/Red
    8. 28. Orange/Purple
    9. 29. Red/Purple

    1. 30. Red/Gold
    2. 31. Rainbow
    3. 32. Sunset Fall
    4. 33. Red/White/Blue
    5. 34. Blue/Green/Yellow
    6. 35. Black/Red/Green
    7. 36. Red/Yellow/Green
    8. 40. Dark Red/Green/Cyan/Blue
    9. 41. Light Blue, Orange, Light Green
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field