NEWBERRY STATION HOMEOWNERS ASSOCIATION
CLUBHOUSE
USE/RENTAL CHECKLIST
AFTER HOURS EMERGENCY NUMBER - 703-352-8441
PART A OPENING PROCEDURES Date: ___________________________
Time In: ________________ Time Out: _________________ **Key must be returned: ____________
We hope that you enjoy your use of the clubhouse. Before the festivities begin and guests start to arrive, we would appreciate a quick look around the room to ensure that everything is as it should be. This will also help prevent problems during your event.
MAKE SURE TO LOCATE THE FOLLOWING:
______ General cleaning equipment can be found in the utility closet located in the
bathroom and under the kitchen sink - papertowels, toilet paper, and hand towels.
Garbage bags are in the kitchen cabinets.
______ Thermostat should be adjusted to what you believe will be a comfortable setting
once the guests arrive.
GENERAL CLEANLINESS:
______ Is all of the equipment in working order with no damage?
______ Is the room ready for use trash empty, room clean?
PRE-INVENTORY:
______ 4 tables (30 x 72)
______ 34 chairs
______ Refrigerator in working order
______ Vacuum cleaner in utility closet
______ Broom
______ Mop-Bucket
______ Window shades in working order need instructions
______ Light bulbs to be replaced
______ Stains/burns in carpet
______ Bathroom/plumbing problems
______ Patio door closed and shades in working order
This room should be inspected after every use; sometimes the room is rented out so close together that an inspection is not possible. Please be sure to write down any existing problems before your guests arrive so that we can take the appropriate action.
EXISTING DAMAGE:
____________________________________________________________________________________
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Please ensure that the clubhouse is left in as good or better condition than it was when you entered. Thank you.
To assist you in closing the room the following checklist is provided. Please ensure that the following is completed.
_____ Clean floors (vacuum, sweep & mop, as necessary)
_____ Clean kitchen area & sink
_____ Clean bathrooms sink, toilet & floors (as necessary)
_____ Clean table tops and chairs, as required
_____ Remove all garbage from the center and replace container liners, as necessary (reminder there is
no scheduled trash pickup for the room. Please take your garbage with you and place it out for
pickup on a scheduled pick up date. This con not be placed at the top of Ainsley Court, if it is not
a pick up date.)
_____ Remove all garbage generated by your gathering from the surrounding area. If this is not picked
up, the cost of the clean up for that area will be deducted from your deposit.
PLEASE BRIEFLY COMMENT ON ANY PROBLEMS THAT YOU ENCOUNTERED, RECOMMENDATIONS FOR IMPROVING THE CLUBHOUSE, OR ANY DAMAGE THAT YOU NOTICED.
ON YOUR WAY OUT:
_____ Refrigerator settings initial setting 5
_____ Kitchen water off
_____ Room thermostat setting, as posted (Winter, 55 degrees Summer, 85 degrees. The fan should
never be left in the run position).
_____ Clubhouse lights all off
_____ Door to utility closet closed
_____ Rest rooms
_____ Trash removed and room clean
_____ Water off in sink
_____ Lights off
_____ Bathroom fan off
_____ Door open
_____ Windows closed & locked
_____ Window blinds closed
_____ Tables returned to original positions
_____ Chairs stacked neatly against the wall but not touching the wall. That may cause damage to the
paint.
_____ Patio door locked and charley bar secured
_____ Patio door blinds closed
PLEASE MAKE SURE YOU LOCK THE DOORS ON YOUR WAY OUT!!!!!
NAME: _______________________________________________
SIGNATURE: __________________________________________ DATE: _________________
**Return the keys to the issuer along with the pre- and post-inspection sheets. Keys must be returned by day and/or time noted or you will be charged $25.00 and $5.00 for each day thereafter until the keys are returned.
The Newberry Station Clubhouse is for the sole use of residents. Examples of permissible use are: meetings of the Board of Directors or committees related to the management of the community, a social gathering sponsored by a resident, or events related to the Lorton Community.
The Room is not for ongoing or regularly scheduled meetings that are not related to residents of Newberry Station. Nor is holding personal or business meeting an acceptable use of the facility, i.e. sales meeting, non-related board meeting, or other functions related to conducting business.
Rental of the Room must be by a member in good standing who is current with his/her monthly dues and who has no violation issues with the community.
The Board of Directors shall adopt procedures and charges for the use of the community room and make those readily available to the residents.
Reservations for the community room will be on a first come-first serve basis. No more than two consecutive rentals may occur in a two-month period without specific approval of the Board of Directors.
Hours of availability shall be from 8:00 AM to 11 PM daily.
1. Contact Charyl Ferguson at Cardinal Management Group, Inc., and submit an application not less than 10 days prior to the date of the proposed rental, along with payment of $40.00 for rental fees and a refundable deposit of $150.00, in two separate checks.
2. Approval or disapproval will be granted within 10 days of the request based upon: whether or not the resident is in good standing, the request is in compliance with the policy statement, and the availability of the room.
3. Returned checks will be cause for denial of rental agreement and a service charge of $30.00 will be required of the member. Failure to comply may result in the members rental privileges being removed.
4. If your application is accepted, pick up or arrange for the receipt of a key and directions for entrance to the Community Room, as well as instructions for clean up and securing the room after usage.
1. The renter must be a principal household member and eighteen years of age or older.
2. The resident must be in attendance during the reserved hours.
3. The renter shall be responsible for the conduct of their guests, damage or loss to the building, furniture, furnishings, or equipment within the control of the renter.
4. The number of persons in attendance shall be no greater than forty (40) people.
5. Use of Alcoholic beverages and/or Illegal drugs will not be permitted and will be cause for having your rental privileges revoked and loss of security deposit.
6. Smoking is not permitted and would be cause for having rental privileges revoked.
7. The renter must comply with Fairfax County Noise and Nuisance Ordinances.
8. No advertising and no charges will be allowed for the event being conducted in the community room.
9. Before accepting responsibility for the room, look over the room and report any damages or malfunctioning equipment to Charyl Ferguson or, in her absence, to a Board member.
10. The renter must supervise functions involving children under the age of 18 at all times during the rental period.
11. Review and comply with all clean up procedures. If a resident fails to adequately clean the room, the amount for the clean up will be deducted from the security deposit.
12. Return the contents of the room to its original set up.
13. Parking of more than 2 cars is not permitted at any point and if the clubhouse is in use while the pool is open, parking will not be permitted at all due to the fact that the parking is for lifeguards. (The chain across the entrance to the emergency road should be replaced after entering and remain closed during the event.) If it is discovered that you have more than 2 cars in the parking lot of the clubhouse, you will be assessed a $50 charge.
14. Return the heating/air conditioning to their unoccupied settings. Heat or air conditioning shall be set at a low setting with the minimal amount of heat or cooling being called for.
15. Turn off lights and secure the building as instructed.
16. Report any repairs, which may need to be made to Charyl Ferguson, or any Board member.
*______ Please initial after reading this page.
(Initials)
The Newberry Station Homeowners Association Clubhouse may be reserved by an eligible resident or community organization at any time the Room is not previously scheduled for use.
If you wish to cancel your reservation, Management must be notified no less than 72 hours prior to rental or your rental fee will be forfeited.
The security deposit will be refunded within (30) thirty days after the date of usage provided that the premises, facilities, and equipment are left in satisfactory order and that you have abided by all of the rules provided within this agreement.
The Association will refund a security deposit payable to the resident whose name appears as the responsible party on the Permit for the room. The Association reserves the right to deduct from the deposit any amount necessary to cover the costs of repairs or replacements of any property occasioned by the use of the party room. If the security deposit does not fully cover the costs, the Permit Holder will be billed for the difference, and future use of the Clubhouse will be denied until these costs are paid.
NO Smoking or Lighted Products. This is a smoke free building and the use of tobacco, candles, and like products is prohibited in the building.
NO alcoholic beverages of any kind are to be used or stored on the premises.
NO illegal drugs of any kind will be permitted; therefore the sale, possession of any narcotic, or other substance subject to the Federal Controlled Substance Act will not be permitted on the premises.
Gambling may not take place on the Clubhouse premises.
Animals, except guide dogs used by the visually or hearing impaired, are not permitted in the Clubhouse.
Rental of the Clubhouse does not include the pool adjacent to the clubhouse. If you enter the pool area, you will be asked to leave and must comply with the orders of the lifeguards or your rental privileges may be revoked.
Under no circumstances will chairs, tables, or other equipment be removed from the room. If decorations, auxiliary lights, or sound equipment are contemplated for any program, the Association must be notified 72 hours in advance of the nature of the decorations. The Association reserves the right to have an inspection made by a representative of Fairfax County Fire Department or by a licensed electrician of the decorations or equipment to be used. All decorations used in the building must be fire retardant, and nails and screws or scotch tape are not permitted for hanging decoration. Decorations may not be placed on or near the ceiling fans. Under no circumstances will the group make any structural or electrical alterations in the building.
The Permit Holder is responsible for keeping the number of people attending the event below the fire maximum specified in the permit.
The Association, its Trustees, Agents, Officers and Board Members assume no responsibility for the personal property of the permit holder. The Permit Holder will remove all of such property, food, or other such things belonging to the Permit Holder from the premises immediately following the termination of the event for which the Clubhouse is reserved.
The time duration stated in the permit is firm. The Resident should be ready to leave the building with equipment removed and clean up completed at the end of the rental period. The keys must be returned to the issuer prior to 5:00 p.m. two (2) days after your event (unless otherwise advised) or a fine, of $25.00 and $5.00 each day thereafter will be deducted from your security deposit until the key is returned.
At gatherings of persons under the age of majority (as defined by State Law), adequate adult supervision must be provided.
If any of the specifics regarding this Permit are altered in any way from the original statement of intent by the Permit Holder, as shown on the Permit, it is the responsibility of the Permit Holder to submit any such change to the Association (10) ten days in advance for approval. In the event the Permit Holder gives no notice or no clearance is received from the Association when the modification has been made, the Permit Holder will be held liable.
If any adverse situations arise as a consequence of inadequate notifications and/or approval of Permits by the Association, the Association will make the final determination concerning whether additional charges to the Permit Holder are necessary.
This permit is non-transferable.
The Permit Holder agrees to comply with all applicable Federal, State and Local Laws and with all of the rules and regulations, procedures and policies (6 pages) pertaining to this permit.
Signed: ______________________________________
(Permit Holder)
Witness: _____________________________________
Date: ________________________________________
*Please
be sure to initial (bottom of previous page) after reading Rules of the
Community Room.
Name: ________________________________________________________ Date: _______________________
Address: _________________________________________________________________________________________
Home Phone: ____________________________________ Business Phone: ____________________________
Type of Activity: _____________________________________ Date of Event: _____________________________
Time of Activity: From: ________________ am ____ pm ____ To: __________________ am ______ pm ______
Number of Persons: _________________
Permit Holder will be responsible for adherence to regulations for the use of the Newberry Station Clubhouse and all areas used by their guests. It is understood that Newberry Station Homeowners Association, its Trustees, Officers, Directors or Agents shall not be liable for injury to persons or property occurring in or about the premises, including but not limited the walkways, roads, and/or ingress/egress, into and out of the clubhouse, from any cause whatsoever. The Permit Holder will indemnify Newberry Station Homeowners Association and save it harmless from and against any and all claims, actions, damages, liability and expense in connection with injury to persons or property arising from or out of the use or occupancy of the Permit Holder or the premises, including but not limited to the walkways, roads, and/or ingress/egress, into and out of the clubhouse, or occasioned wholly or in part by any act of or omission of the Permit Holder, its agents, or invitees.
Date: ______________________________ Signature: ______________________________________________
Permit Applicant
Denied: ______________ Approved: ________________ By: ____________________________________________
Agent for Newberry Station HOA
Reason for Denial: ________________________________________________________________________________
Rental Amount $ $ 40.00 Check/MO # ____________________________________________
Clean Up Fee $ ____________
Damages $ ____________
Deposit Received $ $150.00 Check/MO # ____________________________________________
Balance Returned $ ____________ Deposit less any damages, clean up or rental over run
Key # _________ Received by: ________________________ Returned on: _______________________
Facility Inspection: Pre Rental Date: _______________ By: _____________________________________
Post Rental Date: _______________ By: _____________________________________
Comments:
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NEWBERRY STATION HOMEOWNERS ASSOCIATION CLUBHOUSE AGREEMENT Last Update 04/10/04