1

Contact Information

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Contact Information

Name:

Phone Number:

Complete Street Address:

E-mail:

2

Eligibility 

Select only the statements that apply to you. 

Eligibility Select only the statements that apply to you.

I am a resident 60 years old or older

OR - I have a physical disability that prevents me from shoveling

My property is within the Commerce City boundary

I am an owner or occupant of this property

This house is on a corner lot

3

Identify your race (This data helps define eligibility for grant funding but is optional):

Identify your race (This data helps define eligibility for grant funding but is optional):

White

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or Other Pacific Islander

Hispanic or Latino

Prefer not to answer

4

Acknowledgements

Please read each acknowledgement and mark as completed before submitting the form. 

 *

Acknowledgements Please read each acknowledgement and mark as completed before submitting the form.

I acknowledge that if I need services in the future, I must submit a new request.

I understand that if my property is not located in Commerce City or is in an unincorporated area, I am not eligible for this service.

I understand the Snow Guardians Program is a city initiative to clear ONLY the public sidewalk associated with my property of snow, sleet, hail, and/or ice within 24 hours immediately following the last snowfall.

I understand that the sidewalks along the perimeter of my property must be clear of clutter and/ or obstructions.

I understand that on days when the program is unable to clear my snow, I am still responsible for removing the snow from the public sidewalks in front of my property.

I understand if the snow is likely to melt within 24 hours, my property will not be visited.

I understand applications will be processed as they are received and that submitting this application does not guarantee services will be available to clear my sidewalks.

I understand I must submit an individual request per snow event.

I understand my name and phone number will be shared to allow communication while my property is being cleared.

I understand I am responsible for notifying the City of Commerce City if I no longer require assistance.

I certify that the information I have provided on this application is true to the best of my knowledge and welcome any further communication needed to verify eligibility.

5

Signature

 *

Signature

Applicant Signature

Date

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