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Miami Dade Public Housing Accommodation Forms 2010-2023
Subject to the provisions shown on the reverse side of this form
and to the charges indicated below. An approved copy will be returned to the organization requesting the use of the building facilities.
FOR OFFICE USE
INDIVIDUAL
REPETITIOUS
GROUNDS ONLY
SCHOOL ALLIED
GOVERNMENT
OTHER
INSURANCE
BLANKET/GROUP INS
Work Location Number .................. Name of School Requested ............................................................................................... Start Date...
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