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Park Use Permit - Top of the Lake Art FestivalCITY OF OKEECHOBEE 55 SE THIRD A VENUE OKEECHOBEE, FL 34974 Tele: 863-763-3372 ext. 218 Fax: 863-763-1686 e -mail: pburnette(a�cityofokeechobee. corn Park Use Permit Permit Number: 001 Permit Expiration: January 23 -24 11:59PM Purpose of Request: Top of the Lake Art & Chalk Walk Fest Property Owner: City of Okeechobee Address: 55 SE Third Avenue City: Okeechobee Date(s) of Event: January 23 -24, 2016 Applicant: Okeechobee Main Street Phone Number: 863 - 357 -6246 Current Zoning: P Subdivision: City of Okeechobee State: Florida Zip Code: 34974 Applicant's Address: 55 S. Parrott Avenue Address of Project: Park #3 FLU Designation: Public Restrictions /Remarks: All debris must be removed within 24 hours of expiration date. *Police Chief requests fence around entire beer tent area including entrance /exit with trash bins. All al oholic bevera • es m st be consumed within the fenc - • area an • debri • laced in trash receptacles. *Fire Chief requests final field inspection before event. Call 863 - 467 -1586 to arrange. ,jacki&Dcanhanv General Services Assistant December 17, 2015 Date Page 1 of 3 CITY OF OKEECHOBEE +',„:"M" -- 55 SE THIRD AVENUE ..r q'- OKEECHOBEE, FL 34974 Tele: 863 -763 -3372 ext. 218 Fax: 863 -763 -1686 y� PARK USE AND /OR TEMPORARY STREET/ ���rrsfiN ` 3 1�+� SIDEWALK CLOSING PERMIT APPLICATION Date Received: 11/20/2015 Date Issued: f;2 -1.7 -i 5 Application No: it, - pp 1 Date(s) of Event: January 23 & 24. 2016 Information: Organization: 1 Okeechobee Main Street 1 Tax Exempt No: Mailing Address: 55 S Parrott Ave. Okeechobee, FL. 34972 Contact Person: Jayce Fitzwater E -Mail Address: info@okeechobeemainstreet.org Telephone: Work: 863- 357.6246 f Home: I I Cell: I I Summary of activities: Top of the Lake Art Festival will include both gallery and chalk artists. Artists may decide to be a part of the juried show which included prizes and ribblons. Non Juried Will not compete but will be able to participate and hope to sell their pieces. Art Fest will include DJ and food of all kinds. This will be the second year of the Taste of Okeechobee. This event gives local restaurants a change to pair up with a Park St retailer and promote both businesses. The restaurants will also give samplings of their best dish to win the coveted "Best Taste of Okeechobee" award and bragging rights. This will include a live band and beer garden located next to 1 Stop Party Shop. It is understood that the entire beer tent area, including entrance /exit, must be fenced and trash receptacles conveniently placed inside fenced area. All alcoholic beverages will be consumed within the fenced area and debris placed in receptacles. If necessary, Main Street will provide an individual at the entrance /exit to ensure Alcoholic beverages are not taken out of fenced area. Proceeds usage: Proceeds for this evert will go to the operations and continuing efforts of Okeechobee Main Street to enhance downtown area as the heartbeat of the community. Please check requested Parks: Flagler Parks: ❑ City Hall Park ❑ #1 Memorial Park ❑ #2 II #3 ❑ #4 ❑ #5 ❑ #6 OR Address of event: Parcel ID: SW 4th Ave and the 300 block of Park street Page 2 of 3 TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (If not using Park(s), provide event address) Street Address City State Zip Code Street(s) to be closed: SW 4th Ave and 300 block of Park Street Date(s) to be closed: Friday January 22nd - Sunday January 24th Time(s) to be closed: Close streets Friday at 5pm and re -open at five pm Sunday Purpose of Closing: Top of the Lake Art Festival and Taste of Okeechobee Attachments Required: Charitable Function Temporary Street and Sidewalk Closing ► Site Plan ► Original signatures of all residents, property owners and business owners affected by the closing. ► Copy of liability insurance in the amount of $1,000,000.00 with the City of Okeechobee as additional insured. ► Copy of liability insurance in the amount of $1,000,000.00 with the City of Okeechobee as additional insured. ■Proof of non - profit status ■Letter of Authorization from Property Owner ■ If any items are being sold on City streets or sidewalks, a Temporary Use Permit (TUP) must be attached for each business. TLJP can be obtained from the General Services Department. ► State Food Service License, if applicable. ■ State Food Service License, if applicable. • State Alcoholic Beverage License, if applicable. (Alcoholic beverage can be served only on private property. No alcoholic beverages are allowed on City property, this included streets and sidewalks.) Note: ► Clean -up is required within 24 hours. ■ No alcoholic beverages permitted on City property, streets or sidewalks. ► No donations can be requested if any type of alcoholic beverages are served on private property /business unless you possess a State Alcoholic Beverage License. Please note there are inside consumption and outside consumption licenses. You must have the appropriate license(s). ► The Department of Public Works will be responsible for delivering the appropriate barricades. ► Dumpsters and port -o -lets are required when closing a street for more than three (3) hours. Applicant must meet any insurance coverage and code compliance requirements of the City and other regulations of other governmental regulatory agencies. The applicant will be responsible for costs associated with the event, including damage of property. By receipt of this permit, the applicant agrees and shall hold the City harmless for any accident, injury, claim or demand whatever arising out of applicant's use of location for such event, and shall indemnify and defend the City for such incident, including attorney fees. The applicant shall be subject to demand for, and payment of, all of the actual cost incurred by the City pertaining to the event including, but not limited to, Police, Fire, Public Works or other departmental expenses. The City reserves the right to require from an applicant a cash or cashier's check advance deposit in the sum approximated by the City to be incurred in providing City services. Any such sum not incurred shall be refunded to the applicant. Page 3 of 3 I hereby acknowledge that I have read and completed this application, the attached Resolutions 08 and 04 -03, concerning the use and the rules of using City property, that the information that I am the duly authorized agent of the organization. I agree to conform with, abide by rules and regulation, which may be lawfully prescribed by the City Council of the City of Okeechobee, its officers, for the issuance of this Charitable Function Permit. CERTIFICATE OF INSURANCE MUST NAME CITY OF OKEECHOBEE AS ADDITIONAL INSURED. , %` y n i /— 11/20/2015 No.(s) 03- is correct, and and obey all the or Appf icafit Signature Date ••••OFFICE USE ONLY•••• Staff Review Fire Department: Date: Ali Dec ao /5"" Building Official: :Pr= i* Date: 13 -g %/ Public Works: 0 Date: Date: 2- I -/ S / ` CV-7. Police Department: / , BTR Department: '/ V' l.. Date: a. - r-15 City Administrator: Date: /2../9// / /ilg-A05 AND TO 5// 5 City Clerk: / yak,(' /y/ Date: NOTE: APPLICATION AND INSURANCE CERTIFICATE MUST BE COMPLETED RETURNED TO THE GENERAL SERVICES DEPARTMENT THIRTY (30) DAYS EVENT FOR PERMITTING. Temporary Street and Sidewalk Closing submitted for review by City Council on Temporary Street and Sidewalk Closing reviewed by City Council and approved PRIOR / 2 // Date / ( / 5 // `,7 Date Go sic earth feet 100 50 4- 0 2 c . _ >, Co Tri To *ifs a) 0 > *4= t5 Co I 0 0 >-- E or) a) a E -= co E a o -a) o (3.) _in ci) To a o as a) o_ a -Ca) a) = 0 0 ca a) _a it 0a) 0 o_ _Ct o cri .15 a co o C.) :PL.. 'Es as 0 cn a) -0 a▪ ) a -io o = o cri C cn E Co a) 2 a) a) >. C ay = E. 0 E E cn a) w o a) b -= o a a) . 0) 0) 0 13 CO 0) P a) s) > Tij. --,=. "5 c, _c i) 73 -o 0 _I o ci) -II—J > (_, _ a as = e) < E a CO "E' as ..c C3 -2 cs co >, (- --4 cm cl a) i- 4-- a) o m "Ec C) u) M M •=1 .4.10 al E E E E E F E . O. c5_ ci_ ci ci_ 0 ci ..,_ Lc-) Lri ai cki a:i c.15 ci:i r:-: Form W-9 (Rev. August 2013) R�v. ( mxrla the Treasury Internal Revenue Service Request for Taxpayer identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. Name (as shown on your income tax return) Okeechobee Main Street, Inc. Business name/disregarded entity name, it different from above Check appropriate box for federal ter classification: ❑ Individual/sole proprietor • C Corporation gi S Corporation • Partnership ❑ Trust/estate © limited liability company. Etter the tax classification (C=C corporation. S =S corporation. P= partne:ship) • Exemptions (see instructions): Exempt payee code (if any) Exemption from FATCA reporting code (if any) IN Other (see Instructions) • Address (number, street, and apt or suite no_) 55 S. Parrott Ave Requester's name and address (optional) City, state, and ZIP code Okeechobee, Florida 34972 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other ontitioc it is yarn ernninunr iripntifiratinn number (EINI. If you do not have a number. see How to oat a social security number - - 77N on page 3. Note. if the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Employer identification number 6 5 0 8 8 7 9 2 9 Part tI Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) lam exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that l am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. i am a U.S. citizen or other U.S. person (defined below), and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TiN. See the instructions on page 5. -- Sign Here Signature of U.S person ► Date I. General Instructions Section references are to the internal Revenue Code unless of ierxlse noted. Future developments_ The IRS has created a page on IRS.gov for information about Form W -9, at wwsv.irs.govlw9. information about any future daveiopments affecting Farm W -9 (such as legislation enacted after we release it) will be posted on that page. Purpose of Form A person who Is required to Me an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, payments made to you in settlement of payment card and third party network transactions, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correctTlel to the person requesting it (the requester) and, when applicable, to: 1. Certify that the T6+I you are giving is correct (or you are waking fora number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this farm (if any) indicating that you are exempt from the FATCA reporting, is correct. Note. If you are a U.S. person and a requester gives you a form other than Form W -9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W -9. Definition of a U.S. person. For federal tax purposes, you am considered a V.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation. company. cr association created or organized in the United States or under the laws of the United States. • An estate (other titan a foreign estate), cr • A domestic trust (as defined in Regulations section 301.7701 -7). Specie) rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners' share of effectively connected taxable income from such business. Further, in certain cases where a Form W -9 has not been received, the rules under section 1446 require a partnership to presume that a partners a foreign person, and pay the section 1446 withholding tax. Therefore. it you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W -9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income. Cat. No. 10231X Form W -9 (Rev. 9- 20133) INTERNAL REVENUE SERVICE P. 0. BOX 2508 CINCINNATI, OH 45201 Date: APR 2 9 2095 OKEECHOBEE MAIN STREET INC 111 NE 2ND ST OKEECHOBEE, FL 34974 Dear Applicant: RECEIVED JAN 1 4 2015 DEPARTMENT OF THE TREASURY Employer Identification Number: 65- 0887929 DLN: 17053329002014 Contact Person: DEBRA JOHNSON ID# 75126 Contact Telephone Number: (877) 829 -5500 Accounting Period Ending: September 30 Public Charity Status: 509(a)(1) Form 990 Required: Yes Effective Date of Exemption: November 22, 2004 Contribution Deductibility: Yes Advance Ruling Ending Date: September 30, 2009 We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Organizations exempt under section 501(c)(3) of the Code are further classified as either public charities or private foundations. During your advance ruling period, you will be treated as a public charity. Your advance ruling period begins with the effective date of your exemption and ends with advance ruling ending date shown in the heading of the letter. Shortly before the end of your advance ruling period, we will send you Form 8734, Support Schedule for Advance Ruling Period. You will have 90 days after the end of your advance ruling period to return the completed form. We will then notify you, in writing, about your public charity status. Please see enclosed Information for Exempt Organizations Under Section 501(c)(3) for some helpful information about your responsibilities as an exempt organization. Letter 1045 (DO /CG) OKEEMAI -01 SFISHER o° AC CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) 7 /7/2 7/7/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Maury, Donnelly & Parr 24 Commerce St. Baltimore, MD 21202 CONTACT NAME: PHONE 410 685 -4625 FAX (410) 685 -3071 No, Est): ( ) lac, No): ( ) E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Transportation Insurance Services, Inc 20494 INSURED Okeechobee Main Street 55 S. Parrott Avenue Okeechobee, FL 34972 INSURER B : 4025933977 INSURER C : 07/01/2016 INSURER D : $ 1,000,000 INSURER E : $ 1,000,000 INSURER F : CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSD swvD POLICY NUMBER (MMIDDY/YYYY) (MN DDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 4025933977 07/01/2015 07/01/2016 EACH OCCURRENCE $ 1,000,000 pREMSES EaEoccuDnoe) $ 1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE X 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ _ SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAR EXCESS LIAR _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PEATUTE 1 0TH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The City of Okeechobee is an Additioanl Insured with resepcts to the Labor Day Celebration being heldp 9/6/15 - 9/7/15, and hte Top of the Lake Christmas Festival being held 12/4115 - 12/5/15. a.Gf 11r1Vf\ I L I IVLYVI• City of Okeechobee 55 SE 3rd Avenue Okeechobee, FL 34974 I _. -.-___— - - - -- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) -2014 ACORD CORPVIZATION. All nghts reserved. The ACORD name and logo are registered marks of ACORD Jackie Dunham From: Sent: To: Subject: Jackie Dunham < jdunham @cityofokeechobee.com> Tuesday, December 01, 2015 11:08 AM jayce @okeechobeemainstreet.org Re: Top of Lake Art Festival Jayce, I sent the Park Use Permit/Street Closing application to the weekly Staff Meeting today for signatures. Well, there's a little issue. If you wouldn't mind re- submitting just the first page of the application and under Summary of Activities I need you to type the following statement from Main Street. It is understood that the entire beer tent area, including entrance /exit must be fenced and trash receptacles conveniently placed inside fenced area. All alcoholic beverages will be consumed within the fenced area and debris placed in receptacles. If necessary, Main Street will provide an individual at the entrance /exit to ensure alcoholic beverages are not taken out of fenced area. This information was typed on the permit last year. If you have any questions please advise. Otherwise I will be looking for a revised first page. Thank you. eeee6vcatuuy 100'Zfeandf Jackie/0 evtera.L S ery ice,- S ecreta.ry Cray of okeeehai 55 SE Th+,rdiAvevute, OlceecholYee,, FL 34974 Tee 863 - 763 -3372 eut 217 Fouw 863-763-1686 jdunham @cityofokeechobee.com f-U.CL( I s Website: http: / /www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. i DECEMBER 15, 2015 - REGULAR MEETING - PAGE 5 OF 6 DA JNCIL ACTT IJSS N - VOTE VII. PUBLIC HEARING CONTINUED. A.1.c) Vote on motion for proposed Resolution No. 2015 -07. CLOSE PUBLIC HEARING - Mayor VIII. NEW BUSINESS A. Motion to adopt proposed Resolution No. 2015 -08, opposing legislation that restricts a municipality's home rule authority to set municipal election dates (Committee Bill PCB SAC 16 -04) — City Administrator (Exhibit 2). B. Consider a Temporary Street Closing Application submitted by Okeechobee Main Street to close Southwest 4th Avenue and the 300 Block of Park Street from 5 P.M. on January 22, 2016, to 5 P.M. on January 24, 2016, for the Top of the Lake Art Festival — City Administrator (Exhibit 3). VOTE: KIRK - YEA RITTER - YEA CHANDLER - YEA WATFORD - YEA O'CONNOR - YEA MOTION CARRIED. MAYOR KIRK CLOSED THE PUBLIC HEARING AT 7:06 P.M. (Attorney Cook exited the Chambers at this time). Motion and second by Council Members Watford and Chandler to adopt proposed Resolution No. 2015 -08, opposing legislation that restricts a municipality's home rule authority to set municipal election dates (Committee Bill PCB SAC 16 -04). In the absence of Attorney Cook, Administrator MontesDeOca read proposed Resolution No. 2015 -08 by title only as follows: "A RESOLUTION OF THE CITY OF OKEECHOBEE, FLORIDA, OPPOSING LEGISLATION THAT RESTRICTS A MUNICIPALITY'S HOME RULE AUTHORITY TO SET MUNICIPAL ELECTION DATES; PROVIDING FOR DISTRIBUTION BY CITY CLERK; PROVIDING FOR CONFLICTS; PROVIDING FOR SEVERABILITY; AND PROVIDING FOR AN EFFECTIVE DATE." Council Member Watford relayed this item was a topic of opposition at the Florida League of Cities and Legislative Delegation meeting. This could have a big impact on our City depending on the final language of the bill, and it is another example of State Legislation eroding Home Rule Power. Administrator MontesDeOca will forward a letter with the resolution to the Florida League of Cities, who is collecting them to assist municipalities in their stance against the proposed bill, to be considered during the 2016 Legislation. VOTE: KIRK - YEA RITTER - YEA CHANDLER - YEA WATFORD - YEA O'CONNOR - YEA MOTION CARRIED. Council Member O'Connor moved to approve the Temporary Street Closing Application submitted by Okeechobee Main Street to close Southwest 4th Avenue and the 300 Block of Park Street from 5 P.M. on January 22, 2016, to 5 P.M. on January 24, 2016, for the Top of the Lake Art Festival; seconded by Council Member Watford. There was a brief discussion on this item. VOTE: KIRK - YEA RITTER - YEA CHANDLER - YEA O'CONNOR - YEA WATFORD - YEA MOTION CARRIED. DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF ALCOHOLIC BEVERAGES & TOBACCO ODP APPLICATION# 116061 FILE # 29979 TEMPORARY LICENSE /PERMIT EFFECTIVE DATE: JANUARY 23, 2016 EXPIRATION DATE: January 23, 2016 DATE RECEIPT NBR FEE LICENSE NBR SERIES CLASS 01/1412016 150220369 $25 ODP5700094 ODP NON- TRANSFERABLE, DISPLAY CONSPICUOUSLY, VALID ONLY FOR THE DATE AND PLACE INDICATED TASTE OF OKEEECHOBEE OKEECHOBEE MAIN STREET INC SW PARK ST WEST OF 319 S PARK ST OKEECHOBEE, FL 34972 CONTROL NUMBER: 1696257/ J ` �• L VD, L67 XLE.E E �E; �. c . AS mac. e I o r O c h A L1 O J= F 5f, A'-- • `>• erttittate 10/12/2011 ,-,•--.^ 'w• 'ma* -a- 1 1C AZTEC TENTS 2665 COLUMBIA ST TORRANCE, CA 90503 (800) 278-3687 TAYLOR RENTAL CENTER-4'15490-9 C/O TRUE VALUE P•0 80X31850 Chicago, IL 60631 zr,a!: nc.,fec:J 'ro:o (Tleiter al 'estered acipr'Dve0 tr? rip heen ;f^stol NICA chirt rviht tra0s,2 ro.sr.le of ,:ofer0r,red tante PAGE 1 NU M 0 NUMBER_ oSTOMEk THE FLAME RETARDANT PROCESS USED WILL NOT BE REMOVED BY WASHING Da. id Bradie■ tit General Manager- Nianufacturing *^, rx,".■ A \ ITEMS MANUFACTURED 07,40 hri7a ^ ' ;.-"to 40'x Uw AtV a f",1--04 !OMER AMP F • poie 7, PO4, WA( TYPE PRODUCED 4-, co C Ci- C CD- E 0 U Addington Sate C (1) (f) U Custom Grap U CU 0_ 0 _0 E 4- 0 C 0 4- - 0 ro 4-, to -C -o C CU C13 C 016 starting Friday January 0 co CU C n:1 4- -0 co a) (3) U (0 L- 4• E L.r) CO C r's1 Taylor Rental - Okeechobee 523 HWY 98 North Okeechobee, FL 34972 www. toylorrento lokeechobese. c om Okeechobee Main Street 111 NE 2nd St. Okeechobee, FL 34972 863 -467 -2239 Phone 863467 -2631 Fax Customer*: 14.823 -763 -3437 Phone -763 -3783 Fax Qty Key Items Rented Part# I TenldOhex096 40' Hexagon Tent - 496 Excellent Absolutely NO GRILLS are to be under tent. initial Taylor Rental Center is NOT responsible for damage to items left under tents, or for damage to customers property from weather related events. Intiat 6 2^ten40hexsw 5 2 ^TABBR60 Side Wall - 40' Hex - %Mndow Table, 60" Round 70 -0105 DAMAGE WAIVER DOES NOT COVER WEATHER RELATED DAMAGE! DO not USE STAPLES ON TABLES OR $5.00 PER TABLE WILL BE CHARGED! Qty Key Items Sold 1 132 - Okeeco Delivery, 0-3 Miles Delivery and Pickup Delivery: Fn 1/22/2016 8:00AM Pickup Date: Mon 1/25/2016 12:00PM Delivery Notes: Park Signature: Pare Contact: Phone: Printed On tie 1/14/2016 928Afe Okeechobee Main Street Software try Poee.or -Rental Software www poke-of-reran! core Status: Reservation Contract #: 274103 -2 Reserved Date: Fri 1/22/2016 8 :00AM Operator: Shallna Penney Terms: On Account Status Agreed Return Date Reserved Mon 1)25/2016 800AM Reserved Mon 1/25/2016 6:00AM Reserved Mon 1125/2016 8 - -00AM Status Selling Each $35.00 Price $651.00 $219.00 $45.00 Price $35.00 Rental: $915.00 Delivery Charge: Subtotal: Sales Tax: Total: Paid: Amount Due: $35.00 $950.00 $0.00 $950.00 $0.00 $950.00 Modification # 3 Gontra0-Params rpt (10) DBPR ABT -6003 - Division Of Alcoholic Beverages and Tobacco Application for One/Two/Three Day Permits or Special Sales License STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION NOTE - This form must be submitted as part of an application packet DBPR Form ABT- 6003 Revised 09/2010 If you have any questions or need assistance in completing this application, please contact the Department of Business and Professional Regulation or your local district office. Please submit your completed application to your local district office at least (7) days prior to the first date of the event to insure the permit is issued by the event date. This application may be submitted by mail, or it can be dropped off. A District Office Address and Contact Information Sheet can be found on AB &Ts page of the DBPR web site at the link provided below. http: //www. state .fl.us /dbpr /abt/contact/index.shtml SECTION 1.- :CHECK TRANSACTION REQUESTED Type: ® One/Two/Three Day Permit ❑ Special Sales License SECTION >2:. LICENSEINF,.,ORMATION' Full Name of Applicant Organization (This is the name the license /permit will be issued in) Oi! eee.ho(oee Ma ‘‘h 3kr&r tnC- De artment of State Division of Corporations Document # 1j qG oodo©ooye, FEIN Number 65 - O7fl- q Business Name D /B /A)or Name of Event i ocsl -e . olkeeeJ d e- Location of Eve t (Street and Number) 3tq St.0 Pa (-IL SAY'Pei City O(w.e.kOtote County Okeie / obee_ State FL Zip Code -31-Ver4 a Mailing Addre s (Street or P.O. Box) 5 5 S \a rmk\ Rv-t- City ()LW �'1O�.e • State FL Zip Code 3Vg7a Contact Person r- r,001.. r y ee , Telephone Number $(05.357.6 Date(s) Permit Desired .arItAart.4 ,93rd , Qb1 Auth: 61A- 5.0013, FAC 1 ABT District Office Received / Date Stamp SECTION 5 .. DESCRIPTION O F PRMISES O BE LICENSED AB &T AUTHORIZED REQUIRED Business Name (D /B /A) or Name of Event CAW c ot / ! / l�Y)a ►vl r fe.. iG 4e_ 4 d ku tc t ee.. Neatly draw a floor plan of the premises in ink, including sidewalks and other outside areas which are contiguous to the premises, walls, doors, counters, sales areas, storage areas, restrooms, bar locations and any other specific areas which are part of the premises sought to be licensed. A multi -story building where the entire building is to be licensed must show each floor plan. ti)"A"eidk ev. \ \ Auth: 61A- 5.0013, FAC 3 SECTION 7 - AFFIDAVIT ;OF APPLICANT FOR'SPECIALSALES= LICENSE NOTARIZATION REQUIRED Full Name of Applicant Organization "I, the undersigned individual, or if a corporation for itself, its officers and directors, hereby swear or affirm that I am duly authorized to make the above and foregoing application for a special sales license which authorizes the sale of alcoholic beverages for period of up to three (3) days. I understand this license does not permit the sale of alcoholic beverages for consumption on the premises and only allows package sales in sealed containers and agree that the location may be inspected and searched during the hours that the special sale is being conducted without a search warrant by authorized agents or employees of the Division of Alcoholic Beverages and Tobacco, the Sheriff, his Deputies, and Police Officers for purposes of determining compliance with the beverages laws. I swear under oath or affirmation under penalty of perjury as provided for in Sections 559.791, 562.45, and 837.06, that the foregoing information is true to the best of my knowledge and that no other person or entity except as indicated herein has an interest in the special sales license and that all of the above listed persons or entities meet the qualifications necessary to hold this special sales license." STATE OF COUNTY OF APPLICANT SIGNATURE APPLICANT SIGNATURE The foregoing was ( ) Sworn to and Subscribed OR ( ) Acknowledged Before me this Day of , 20 , By who is ( ) personally known to me (print name(s) of person making statement) OR (. ) who produced as identification. Commission Expires: Notary Public Auth: 61A- 5.0013, FAC 5 ATTESTATION This form is to be completed by the alcoholic beverage license holder ONLY when the event of the non profit organization is being held at a location that is licensed by the Division of Alcoholic Beverages & Tobacco for the sale of alcoholic beverages. Note: This attestation must have the original signature of the alcoholic beverage license holder (only persons on file with the division may sign) and must be submitted by the non - profit group along with the application for the One/Two/Three Day Permit. Licensee: Business Name (DBA): License #: Series of Permanent License: Type: Name of Non - Profit Group: Date(s) of Event IMPORTANT A One/Two/Three Day permit is being requested for an event to be held on your licensed premises. During the event, no sales or service of alcoholic beverages may be made under your alcoholic beverage license in the area identified for use by the non - profit organization. Failure to comply will result in administrative charges being filed against your license. Signature of Licensee: Date: Auth: 61A- 5.0013, FAC 6 Okeechobee County Property Appraiser - W.C. Bill Sherman, CFA - Okee... Page 1 of 1 Okeechobee County Property Appraiser W.C. Bill Sherman, CFA - 0 - - - • • see, Florida - 863 - 763 -4422 Parcel List Generator Current Offset Dist Land Use Filter: ❑ Land Use type ce: 1100 ow only V Run Again NT COM (001000) Target Parcel: 3- 15- 37 -35- 0010- 01670 -0060 Owner's Name WILLIAMS HAYNES E REVOC TRUST Site Address SW PARK ST, OKEECHOBEE Mailing Address 206 N PARROTT AVE OKEECHOBEE, FL 349722931 Use Desc. (code) VACANT COM (001000) Tax District 50 () Neighborhood 518644.00 Land Area 0.162 ACRES Market Area 40 Description NOTE: This description is not to be used as the Legal Description for this parcel in any legal transaction. CITY OF OKEECHOBEE LOT 6 BLOCK 167 Sales 7/13/2015 762/1667WD V U 11 $100.00 10/21/2014 752/616 WD V U 16 $15,000.00 6/11/2004 534/1360QC I U 03 $0.00 7/14/2000 441/975 WD I U 03 $250,000.00 Parcel List Output 1 31537350010016600010 LRLACULERSON & RAULERSON 2 31537350010016600110 MYERS A LEON & CAROLYN 3 31537350010016700030 GRIFFIN ANGELA R 4 31537350010016700040 WEIR DONALD W & LINDA L 5 31537350010016700060 WILLIAMS HAYNES E REVOC TRUST 6 31537350010016700070 DANIELS LEONARD E JR & 7 31537350010016700090 O C OKEECHOBEE AIR HOLDINGS 8 31537350010016900130 CITY OF OKEECHOBEE 2164 SW 22ND CIR N BOX 1 313 SW PARK ST 3464 NW 10TH AVE 206 N PARROTT AVE DANIELS RICHARD W 312SW 2ND ST 55 SE 3RD AVENUE Download Results Print this page c,6) \' 0 314 SW 2ND STREET http: / /www.okeechobeepa.com /GIS /GISbuffer.asp 83 166 249 OKEECHOBEE, FL 349740000 OKEECHOBEE, FL 349730001 332 OKEECHOBEE, FL 34974 OKEECHOBEE, FL 349720000 OKEECHOBEE, FL 349722931 OKEECHOBEE, FL 349740725 OKEECHOBEE, FL 34974 OKEECHOBEE, FL 349742903 415 498 ft 6/20/2005 I $300,000 IIIQ 5/1/1981 I $80,000 I I 10 7/28/2014 I $200,000 IIIQ 4/29/1996 I $40,000 VIQ 7/13/20151$100 I V U 10/1/2007 I $0 I V I U 2/6/2014 I $400,000 I I I U 1/14/2015 I $0 III U 1/7/2016 Jackie Dunham From: Jackie Dunham < jdunham @cityofokeechobee.com> Sent: Tuesday, December 01, 2015 11:08 AM To: jayce @okeechobeemainstreet.org Subject: Re: Top of Lake Art Festival Jayce, I sent the Park Use Permit /Street Closing application to the weekly Staff Meeting today for signatures. Well, there's a little issue. If you wouldn't mind re- submitting just the first page of the application and under Summary of Activities I need you to type the following statement from Main Street. It is understood that the entire beer tent area, including entrance /exit must be fenced and trash receptacles conveniently placed inside fenced area. All alcoholic beverages will be consumed within the fenced area and debris placed in receptacles. If necessary, Main Street will provide an individual at the entrance /exit to ensure alcoholic beverages are not taken out of fenced area. This information was typed on the permit last year. If you have any questions please advise. Otherwise I will be looking for a revised first page. Thank you. &dwar y 100 limitil Ja ckfe/ Dwtiha viv Ge ne ra.LService.' Secretary Cray of Okeecholye& 55 SE Th.i.rd.Avevurei Okeechobee, FL 34974 Tele: 863-763-3372 eict. 217 Fa/w: 863 -763 -1686 jdunham @cityofokeechobee.com Website: http: / /www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. i Jackie Dunham From: Jackie Dunham < jdunham @cityofokeechobee.com> Sent: Monday, December 21, 2015 9:33 AM To: jayce @okeechobeemainstreet.org Subject: Top of Lake Add'I Info Attachments: Top of Lake Add'I Info.pdf When I came to work today my supervisor advised me we were supposed to get additional information for the upcoming Top of the Lake Festival. I had not done this before so I was unaware and none of the Department Heads requested it either. If you can please get me the information similar to what is attached I would appreciate it. It does state on the Permit Application that original signatures of all residents, property owners and business owners need obtained for all business owners affected by the street closing. If you have any questions please call. eeeei r y /0011/eand! Jackie Du;vthami eviera.L Sorvi-ce.e Secrets ry City ofOlce.echab-ee. 55 SE Th rd'Avevute Off, FL 34974 role,: 863-763-3372 pct. 217 Fay' 863-763-1686 jdunham@cityofokeechobee.com Website: http: / /www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. 1 0000024 08/06/15 DEPARTMENT OF REVENUE Consumer's Certificate of Exemption Issued Pursuant to Chapter 212, Florida Statutes DR -14 R. 04/11 85- 8013468005C -2 11/30/2015 11/30/2020 •801 (C)(3T b 11a`ANIZATION Certificate Number This certifies that OKEECHOBEE MAIN STREET INC 55 S PARROTT AVE OKEECHOBEE FL 34972 -2968 Effective Date Expiration Date is exempt from the payment of Florida sales and use tax on real property rented, transient rental property-rented, tangible personal property purchased or rented, or services purchased. FLORIDA DEPARTMENT OF REVENUE Important Information for Exempt Organizations DR -14 R. 04/11 1. You must provide all vendors and suppliers with an exemption certificate before making tax- exempt purchases. See Rule 12A- 1.038, Florida Administrative Code (F.A.C.). 2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's customary nonprofit activities. 3. Purchases made by an individual on behalf of the organization are taxable, even if the individual will be reimbursed by the organization. 4. This exemption applies only to purchases your organization makes. The sale or lease to others of tangible personal property, sleeping accommodations, or other real property is taxable. Your organization must register, and collect and remit sales and use tax on such taxable transactions. Note: Churches are exempt from this requirement except when they are the lessor of real property (Rule 12A- 1.070, F.A.C.). 5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for payment of the sales tax plus a penalty of 200% of the tax, and may be subject to conviction of a third - degree felony. Any violation will require the revocation of this certificate. 6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Account Management at 800 - 352 -3671. From the available options, select "Registration of Taxes," then "Registration Information," and finally "Exemption Certificates and Nonprofit Entities." The mailing address is PO Box 6480, Tallahassee, FL 32314 -6480. uxeecnonee county rroperty Appraiser - iviap rrmtea on i/ i/zuio 11:ui:v1 foul rage 1 01 1 3=1537 -35 -00.10 -01670 -0060 WILLIAMS HAYNES EREVOC TRUST '� 0162AC� 1021014 '$,15 000 -V /U tai Okeechobee County Property Appraiser W.C. "Bill" Sherman, CFA - Okeechobee, Florida - 863 - 763 -4422 1. -.;1 100' :200 300 fit ARCEL: 3- 15- 37 -35- 0010 -01670 -0060 - VACANT COM (001000) CITY OF OKEECHOBEE LOT 6 BLOCK 167 Name: WILLIAMS HAYNES E REVOC TRUST LandVal $36,975.00 Site: SW PARK ST, OKEECHOBEE BldgVal $0.00 Mail: 206 N PARROTT AVE ApprVal $36,975.00 OKEECHOBEE, FL 349722931 JustVal $36,975.00 Sales Assd $36,975.00 Info Exmpt $0.00 Taxable $36,975.00 This information, updated: 12/17 /2015, was derived from data which was compiled by the Okeechobee County Property Appraiser's Office solely for the governmental purpose of property assessment. This information should not be relied upon by anyone as a determination of the ownership of property or market value. No warranties, expressed or implied, are provided for the accuracy of the data herein, it's use, or it's interpretation. Although it is periodically updated, this Information may not reflect the data currently on file in the Property Appraiser's office. The assessed values are NOT certified values and therefore are subject to change before being finalized for ad valorem assessment purposes. http: / /www.okeechobeepa.com/GIS/Print Map. asp? pjboiibchhjbnligcafcefocnflcfdfefdbblej ... 1/7/2016 SECTIONS i- AFFIDAVIT OF APPLICANT FOR NON - PROFIT CIVIC ORGANIZATION ALCOHOLIC BEVERAGE PERMIT NOTARIZATION REQUIRED Full Name of Applicant Organization "This is to certify that the applicant requesting the permit in the above and foregoing application is a non- profit civic organization and that the permit, if used, will be used only by the organization making application, on the date(s) requested and at the location stated. This is to further certify that the applicant organization has not received more than three (3) permits within the calendar year, unless otherwise authorized by law, and agree that the location may be inspected and searched during the time that the permit is issued and business is being conducted without a search warrant by authorized agents or employees of the Division of Alcoholic Beverages and Tobacco, the Sheriff, his Deputies, and Police Officers for purposes of determining compliance with the alcoholic beverage laws. I, the undersigned individual, hereby swear or affirm that I am an officer and duly authorized to make the above and foregoing statements on behalf of the applicant organization. Furthermore, I swear under oath or affirmation under penalty of perjury as provided for in Sections 559.791, 562.45, and 837.06, Florida Statutes, that the foregoing information is true to the best of my knowledge." STATE OF ' 1-Evz-1 r, i COUNTY OF G 1r' APPLICANT SIGNATURE APPLICANT SIGNATURE The foregoing was ( ) Sworn to and Subscribed OR ( •) Acknowledged Before me this Day of 4-10 , 20 17-01/c. , By in v, c/k( B .6ie6 (16716- who is, personally known to me (print name(s) of person making statement) OR ( ) who produced as identification. VACLUAO 44 yam. 7 Commission Expires: 10 ^ t 5 r i g Notary Public MARCUS A. HANIMAN Commission # FF 168281 Expires October 15, 2018 Banda! Ihm oy Fab ha wnee 900385.7019 Auth: 61A- 5.0013, FAC 4 SECTION 3— SALES TAX TO BE COMPLETED BY THE DEPARTMENT OF REVENUE Full Name of Applicant Organization The named applicant for a license /permit has complied with the Florida Statutes concerning registration for Sales and Use Tax and has agreed to pay any applicable taxes due. Signed Date Title Department of Revenue Stamp: SECTION 4= :ZONING _ ,. TO BE COMPLETED. BY THE. ZONING AUTHORITY: GOVERNING THE EVENT LOCATION: Location of Event (Street and Number) i1µ -C A,;;.; i-V -i - n SW Pa m& 5—rxe C 1 ° ■ PA m ed. i 4Te-Lt W e 6T o f 314 60.) /'A 2 IC, ST City DILE C-IA 01E: El County Og-c=. e c_1-Lo 6cE The location complies with zoning requirements for the temporary sale of alcoholic beverages pursuant to this application for a One/Two/Three Day Permit. Signed Pi II 111 • Date 1 11 Title 0e1/1P A.VI N KWIC R Note: College fraternities and sororities must meet certain additional conditions which can be found in the application instructions and requirements. Auth: 61A- 5.0013, FAC 2 Jackie Dunham From: Jackie Dunham < jdunham @cityofokeechobee.com> Sent: Thursday, December 17, 2015 3:12 PM To: jayce @okeechobeemainstreet.org Subject: FW: Top of Lake Permit Attachments: 001Top of the Lake Art & Chalk Walk Fest.pdf Correction of CC meeting date! From: Jackie Dunham [mailto :jdunham @cityofokeechobee.com] Sent: Thursday, December 17, 2015 3:11 PM To: jayce @okeechobeemainstreet.org Subject: Top of Lake Permit Your Park Use Permit and Street Closings were approved at the Regular City Council Meeting held December 15th, 2015at 6pm. Attached is your permit. Should you have any questions or corrections please let me know. ede6tat`ur, 100'?eandf Ja.ck,:e 'D nha rni General Services, Secretary City of Okeechobee. 55 SE Th -d/Avenike. Okeechab-ee., FL 34974 Ted' 863-763-3372 e4ct. 217 Fouw: 863-763-1686 jdunham@cityofokeechobee.com Website: http: / /www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. 1