City of Boynton Beach Art in Public Places Artwork by Artist Name Final Artwork Information

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Art in Public Places Artwork by Artist Name Final Artwork Information Completed by Owner Building Name Building Permit Number Public Art Name Building Street Address Building Owner s Name Owner s Contact Person Mailing Address (Street, City, Zip) Email Engineer of Record (If hired by owner) Firm Name, City Contact Name Email Project Costs Total construction cost 1% Public Art Fee 70% Public Art Budget 30% Public Art Fee Public Art costs Public Art Fabrication Costs Artwork Price (Paid to Artist) Escrow Collected Page 1

Completed by Public Art Administrator Art Commission/City Commission Approvals and Significant Dates Dates Art Site Approval Call to Artists Panel Selection Building Permit Payment Artist Approval by Arts Commission Proposal Approval by Arts Commission Revised Proposal Approval by Arts Commission Project Approved by City Commission Installation Final Artwork Install Approval Temporary Certificate of Occupancy Certificate of Occupancy Return of Escrow Funds Site Approval Issues and Requirements Site Location Description (Attach Drawings or Photos) Site Lighting Description (Attach Drawings or Photos) Artwork Description (Attach Drawings or Photos) Other Comments Page 2

Completed by Artist Artist Contact Information Artist Name Business Name (if Different) Address #1 Address #2 City State Zip Code Business Cell Business FAX E-Mail #1 E-Mail #2 Website Basic Artist Resume Information (Attached FULL Resume) Date of Birth Place of Birth Short Biographical Paragraph Artworks in Other South Florida Public Places or Public Museums Attach resume Artwork Plaque and Basic Publicity Info. Artist Name for Publication Title of Artwork Year of Completion Dimensions Overall Materials (Maximum 5 words) General Description of Artwork (Maximum 15 words) Sponsors of Art Added by City if Applicable Page 3

Full Artist Statement regarding the Artwork Statement Artwork Components (Every physically separate item) Title or Five Word Identifier Foundry Materials Height, Width & Length Key Information for Removal and Attachment Title or Five Word Identifier Materials Height, Width & Length Key Information for Removal and Attachment Title or Five Word Identifier Materials Height, Width & Length Key Information for Removal and Attachment Engineer of Record (If hired by Artist) Firm Name, City Contact Name Email Page 4

Fabricator(s) and/or Finishing Fabricator #1 Name, City, State, Fabricator #1 Name, City, State, Fabrication Method (Attach Dwgs) Show or Describe Internal Structure of Connections Installation Installer Name, City, State, (List artist, if artist installed) Installation Method (Attach Dwgs) Foundation or Other Construction Drawings (Attach) Note on How to Lift Artwork Note on De-installation Sequence Operation Parameters Description of Physical Position on Site including viewing height Description of Environmental Factors. Example: Tree Trimming Site Specific Artwork (If Applicable) Description of Site Specific Elements (Must Attach SIGNED agreement between Artist and Owner) As per proposal Maintenance Routine Maintenance Description Cleaning Solution and Frequency Protective Coating, Application Method and Frequency Schedule of Replaceable Parts (light bulbs, etc) Item(s) to Check at Every Routine Field Examination Long Term with Future Dates Exterior (i.e. repainting) Internal Page 5

Appearance (Photos) Note on Ideal Appearance of Artwork Publishable Photos of Artwork (Attach at minimum 300 dpi) Photographer (Attach Release Form) Electronic Components of Artwork (If Any) Name of Item Manufacturer Name, City, State, Supplier Name, City, State, Frequency of Replacement (Repeat as necessary) Digital Copies for Future Repair (list & attach digital copies) Sound Art Description Graphics Descriptions Artist Attachment Checklist Electronic Attachments Full Artist Resume Publishable Digital Photographs Fabrication Drawing and/or Photos Installation Drawing and/or Photos Foundation or Other Construction Drawings Digital Sound Art Digital Graphic Art Physical Attachment Paint Chips for Future Color Restoration Material Sample with Correct Finish for Maintenance Contractually Agreed Replacement Parts, If Applicable Signed Release from Photographer of Publishable Photographs Page 6