LEEDY GRANGE # 339, located at: 835 NW Saltzman Road, Portland, Oregon,
hereafter referred to as “Owner”, AND
Name of individual, group, or organization actually using this facility,
Name of Person authorized to represent User (ODL# )
Address of User City State Zip + 4
Home Telephone Work or Daytime Telephone Cell Phone
hereafter referred to as “User”, hereby agree to the following:
To use the above named Grange Hall, or such portions thereof as described in the following (hereafter the “Premises”) (list the
portions of the hall to be used):
Please initial all appropriate lines. Restroom use is included with any or all areas.
Dining area Yes ___ No ___ Kitchen Yes ___ No ___
Main Hall Yes ___ No ___ Stage Yes ___ No ___
All of the above. Yes ___ No ___
___________________________ Yes ___ No ___ Other special areas as noted in space at left.
Solely for the purpose of ______________________________________________
The use period shall:
Commence on _______________ the _______ day of ______________201__ And
Terminate on _______________ the _______ day of ______________201__
___Mondays ___ (am) (pm) to ___ (am) (pm): ___Tuesdays ___ (am) (pm) to ___ (am) (pm):
___Wednesdays ___ (am) (pm) to ___ (am) (pm): ___Thursdays ___ (am) (pm) to ___ (am) (pm):
___Fridays ___ (am) (pm) to ___ (am) (pm): ___Saturdays ___ (am) (pm) to ___ (am) (pm):
___Sundays ___ (am) (pm) to ___ (am) (pm)
Rental shall be for no longer than six months from date of first use, renewable according to terms in effect at time of renewal,
including rates and conditions, if both parties agree.
Custody begins the moment user takes possession, which includes setup and clean up.
There will be a $30.00 per hour or any portion thereof, non-refundable service fee for access prior to the agreed time,
or for use extending beyond the agreed time.
USE Fee (rental fee) $____________ x ____________ (hours / days) = $______________
Refundable Cleaning Deposit = $ 50
Refundable Damage, and Security Deposit = $ 250
Key deposit = $ 20
Advanced funds required to secure this agreement = $_____________________
All required Funds shall be tendered 72 hours prior to the commencement of this agreement along with evidence of required
insurance and, if applicable, required OLCC license(s)