2. 
3. Hire an Off-Duty Officer
   Certain events required additional police services. Blaine Police Department officers can be contracted to cover your special event.
5. Contact Information
7. Full Name*
9. Business Name*
11. Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
18. Email*
22. Service Request Information
24. Start Date/Time*
    Start Date/Time

    Start Date/Time
25. End Date/Time*
    End Date/Time

    End Date/Time
26. Number of Officers*
27. Hours per Officer*
29. Expected Attendance*

    1. 0 - 999 People = $0
    2. 1,000 - 2,999 People = $100
    3. 3,000 - 4,999 People = $250
    4. 5,000 - 9,999 People = $500
    5. Over 10,000 People = $2,000
31. Location*
33. Description of Activity
    Please describe the type of activity.
37. Additional Information

    The requesting business will be billed by the City of Blaine for the above service. The requesting business agrees to reimburse the City of Blaine the current routine rate of $100/hour per officer or a holiday rate of $200/hour per officer, both with a three hour minimum. The payment shall be made within thirty (30) days of receipt of invoice. It is understood that the services requested are in addition to police services normally provided and not in lieu thereof, and that officers assigned are not subject to direct supervision or control by the requester, but will perform their function as duly licensed police officers.

    In addition to the hourly officer rate, your event may be subject to administrative fees. The administrative fees, if applicable, will be billed along with the officer invoice.

    Administrative Fees are based on estimated attendance:

    0 – 1000 . . . . . . . . . .$0
    1000 – 3000 . . . . . . .$100
    3000 – 5000 . . . . . . .$250
    5000 – 10,000 . . . . . $500
    Over 10,000 . . . . . . .$2000

    Refer to the City of Blaine Special Event Ordinance 70-42 for further details.

39. Electronic Signature*
    By typing my name in this form, I certify that I am voluntarily providing information required to request reimbursable police services. The requesting business further agrees to waive any and all claims against the City of Blaine, its Police Department and its officers for any form of damage or injury resulting out of the services provided or requested herein.
41. Title
42. Date*
46. For Internal Use Only
Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit

* indicates a required field