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Temp. Street Closing - MLK Parade 2016
1485.0035(1)(e), F.A.C. Date: /:21/51//5 STATE OF FLOROA DEPARTMENT OF TRANSPORTATION TEMPORARY CLOSING OF STATE ROAD PERMIT Permit No. 2 o /S - -F- / 9/- / /Governmental Entity 7Fe C . //////C Approving Local Government di ly o'C 0Kee erode e. Contact Person f Address Telephone • Email es- 6s MAINTENANCE 14/11 Organization Requesting Special Event Name of Organization Okee(;(,vil4 e COmtku x,411 1.,k��1x+1r„k c) Contact Person Cit.? i C'S4 -er L&) k dkc Address 83?j NE (6 4 o. 1 Telephone 8'3 (o3 4 - 4460 Email O C I A kw t T y yd /100 • GraiH ( Description of Special Event ) Event Title iA LK Q. e " etr Acie Date of Event .., Sul .� (61 20 I a Start Time 04:100 End Time t ('.00 401kAt I PqR 4 n c Event Route (attach map) .A.Ctr•E C Defter o G 5u) y *h S re e V / 5 39-e t t 3 Yrr,41- ({-4.4e4) ieC+1 Rio wr 40 Park 5t (74.4."o ) Coo we.A- -70 S.4.) 113$fr e1- Detour Route (attach map) 7" is , s .c, &DLL / skia. PAiled/1F h, £' Do A/o 'r 1) C70 u,e _,14/99 I? 20 v ,4Q 77.11E C' 7'//, i'I/,27o.2 Pcw s J Po Enforcement Agency Responsible for Traffic Control IName of Agency e i' i y. Po 1, US Coast Guard Approval for Controlling Movable Bridge Not Applicable . �( Copy of USCG Approval Letter Attached ❑ Bridge Location The Permittee will assume all risk of and indemnify, defend and save harmless the State of Florida and the FDOT from and against any and all loss, damage, cost or expense arising in any manner on account of the exercise of this event. The Permittee shall be responsible to maintain the portion of the state road it occupies for the duration of this event, free of litter and providing a safe environment to the public. Signatures of Authori tI -. Event Coordinator 5. 1 UeS4e( c.Jks toe Signature / wk Date (2.1e1( 6 Law Enforcement s R P 0eio., IV r¢". A80.1Z 1 NameFTitle ,,r, 0-70.e, /r F. ,06, s , Signature / A'r�r Date , Z fi si/ S` Government c ial iXo rri sDEc'cw -- NamelTitie c. f tf 412,42.+'1 -s P'4.4-112L. Signature Date / FDOT Special TraTc control Era.!, corn with the Federal Aranu �1- UC1rrs= Traffic Gor. c.! Dov:ce t (�'�� D) S nrl -f4;01- t1a��rn ` ate .'cards 600 ditions FDOT Authorizati OKEE -44 OP ID: S2 AC-ORO" CERTIFICATE OF LIABILITY INSURANCE 1...----- DATE(MMIDDIY5 1212112015 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 Pritchards & Associates, Inc. 1802 S Parrott Ave Okeechobee, FL 34974 -6179 Lowell H Pritchard NAME: Sandy Hines PHONE FAX (AIC, No Ext): 863- 763 -7711 (arc, No): 863 - 763 -5629 ADDRESs: shines @pritchardsinc.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Indemnity Ins 18058 INSURED Okeechobee Community Improvement Association 275 SW 25th Street Okeechobee, FL 34974 INSURERB: PHPK1431610 INSURER C: 01/19/2016 INSURERD: $ 1,000,000 INSURER E : $ 100,000 INSURER F : COVERAGES 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MM/DDrYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY PHPK1431610 01/16/2016 01/19/2016 EACH OCCURRENCE $ 1,000,000 PTORENTED PRREMIEMI ESES (Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 0 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE POLICY OTHER LIMIT APPLIES PRO JECT PER. LOC PRODUCTS - COMP /OP AGG $ 3,000,000 $ 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 LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y! ANYPROPRiETORIPARTNERfEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N N!A PER STATUTE OTH- ER E. L. EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Special Event - M K Parade CANCELLATION 1 FLORI41 Florida Department of Transportation 801 N Broadway Avenue Bartow, FL 33830 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 Ce ��4 ACORD 25 (2014101) © 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INDEMNIFICATION AGREEMENT This AGREEMENT, by and between the CITY OF OKEECHOBEE, FLRIDA, (hereinafter "CITY ") and O C.kobee C'ornw��.nit‘. .1 M(lrvicev tC-"{ //t 55cC (hereinafter "APPLICANT "), dated this / / day of DC. CE-M6 , or . WHEREAS, APPLICANT desires to hold or sponsor a special event, parade, festival, or other activity requiring the temporary closure of a state - controlled roadway in the City of Okeechobee, Florida, and therefore requires the execution and submission of an application for such temporary closure to the State of Florida Department of Transportation by the CITY pursuant to regulations of said Department, and WHEREAS, pursuant to Resolution No. 88 -5 the CITY requires indemnification by any applicant for temporary road closure before the appropriate CITY officials may execute such application to the Department. NOW, THEREFORE, in consideration of the mutual obligations and covenants set forth hereafter, the parties agree as follows: 1. APPLICANT shall indemnify, protect, defend, and hold harmless the CITY from any and all losses, injuries, damages, or claims of any nature or type resulting directly or indirectly from the temporary road closure and the special event, festival, parade, or other activity to be held on t Lo day of JAntt.i , 100. Applicant shall further reimburse the CITY for any and all attorneys fees, court costs or other legal costs incurred by the CITY as a result of any such losses, injuries, damages or claims. 2. If the APPLICANT is a corporation, partnership or other legal entity (other than an individual), APPLICANT shall attach hereto a duly executed resolution, partnership agreement or other document in legal form evidencing the authority of the officers of such entity to enter into this indemnification agreement. 3. Upon the APPLICANT complying with paragraph 2 above, the requirements of Resolution No. 88 -5 of the CITY, and any other reasonable requirements of the CITY, the CITY shall cause the appropriate City officials to execute the necessary forms to make application to the State of Florida, Department of Transportation, for temporary road closure. APPLICANT CITY OF OKEECHOBEE, FLORIDA BY: tii LIL bt)14, -1-f1 Kt-6 TITLE: b. P c-co A BY: k ■ C.: 'Du/ALLA-4 /*AAA TITLE: C. , 7 A P\ FOR CITY USE ONLY i/ Proof of liability insurance Corporate resolution completed t../ Other requirements (specify) -1-n)i=iu.) F CAI BY: ,tiZA-c. TITLE: A-cc, • (Li.")...„.„...1._ DATE: /-1 -/ 11(c7 Li LI L._rd Manual on Uniform Traffic Control Devices (MUTCD) and FDOT Design Standards 600 Series. 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I- 5-i : • . ..L.-.1- m : "1:: ti),. c!....-; cAtt :1 I Ti: I !'‘. u.; • f:2-t --,i --7:-. ■ r--.. t' 'i- - - - ' - - .: - --t.' , ' ...:t o _ . •:!. ■ '''l .s ,.„ 1 2 I-: --, , ....,: in : c.,:: : f -..-i : ri";; tr,!".•,, .-- ' • '-- ... I- --- ' .::- i -:-.1,c,/ It 1.;.: 1 :AS v.: ■ :..,1-3,'„V I V 1, I II t _ • • -_-- t sYr1i ...WE SW if: • eV, c 41-# 4) 44, 0 4) N ct 4) -c 4-0 Jackie Dunham From: Sent: To: Subject: Attachments: Jackie Dunham <jdunham @cityofokeechobee.com> Tuesday, January 12, 2016 4:19 PM ociaunity @yahoo.com FW: Okeechobee MLK Parade Permit 2016 2016 -F- 191 -1.pdf Sylvester please see the attached and approved Parade Permit from DOT. Thank you. Jac-4e/ D14.4, a wv Gen ev'a.LSevvice.s,A ai.sta,nt City of okeecho-b-ee, 55 SE Thy d/Avevutie' Off, FL 34.974 Yee 863 - 763 -3372 e4xt: 217 Fow 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. From: Smith, David M [ mailto :David.Smith@adot.state.fl.us] Sent: Tuesday, January 12, 2016 4:16 PM To: Jackie Dunham Cc: Stewart, Douglas; Morrisey, Kevin; Stublen, Robin; Mancil, Sandra; Burch, Zachary; May, JoAnn A; Hill, Stacy Subject: RE: Okeechobee MLK Parade Permit 2016 I apologize for the wrong attachment..... This is the correct one Thank You David M. Smith District Permit Coordinator (863) 519-2319 david.smith @dot.state.f I.us 1 Jackie Dunham From: Sent: To: Subject: Jackie Dunham < jdunham @cityofokeechobee.com> Monday, December 21, 2015 9:20 AM david.smith @dot.state.fl.us MLK Parade Permit 2016 Attached is the request for the annual Martin Luther King Parade sponsored by OCIA. If you have any questions please let me know. Have a Merry Christmas David. e leguttur y /00'l1eani! Jack e'DIA.44.haml., Ge vwera. Sorv(ce y Secretary City of Okeechalrne. 55 SE Thi rd/Ave-viue Olceecho-bee/, FL 34974 Teie/ 863 - 763 -3372 etc . 217 Fax' 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