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Temp. Street Closing - Okee. Christian Acad.Page 1 of 3 CITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 Tele: 863 -763 -3372 ext : PARK USE AND /O TEMPORARY STREET SIDEWAL ' i PERMIT APPLICATION Date Received: �� 1' / �` � Date (s) Event: ��� � � / Application No: ! r: E� �) i'� r> i`L . ���� Organization: _�, Tax Exempt No: Mailing Address: Ti. Contact Person: E -Mail Address: Telephone: Work: F. Home: Cell: 1 Summary of activities: Proceeds usage: Please check requested Parks: Flagler Parks: ❑ City Hall Park ❑ #1 Memorial Park ❑ #2 ❑ #3 ❑ 84 ❑ #5 ❑ #6 OR Address of event: Parcel ID: Date Date Received: �� 1' / �` � Date (s) Event: ��� � � / Application No: ! r: E� �) i'� r> i`L . ���� Organization: _�, Tax Exempt No: Mailing Address: Ti. Contact Person: E -Mail Address: Telephone: Work: F. Home: Cell: 1 Summary of activities: Proceeds usage: Please check requested Parks: Flagler Parks: ❑ City Hall Park ❑ #1 Memorial Park ❑ #2 ❑ #3 ❑ 84 ❑ #5 ❑ #6 OR Address of event: Parcel ID: TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (If not using Park(s), provide event address) Street Address City Page 2of3 State Zip Code Street(s) to be closed:: j -mil_. I _ > Original signatures of all residents, property owners and business owners affected by the closing. �,. ...iP� > Copy of liability insurance in the amount of $1,000,000.00 with the City of Okeechobee as additional insured. i SY {'( 4. > State Food Service License, if applicable. Date(s) to be closed: (r ;, �" _ °_ t � )r _,1 r,: r �� E � ; Time(s) to be closed: Purpose of Closing: � ,-(r P r i; . 5 , 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. TUP 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 suns 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 No.(s) 03- 08 and 04 -03, concerning the use and the rules of using City property, that the information is correct, and that I am the duly authorized agent of the organization. I agree to conform with, abide by and obey all the rules and regulation, which may be lawfully prescribed by the City Council of the City of Okeechobee, or its officers, for the issuance of this Charitable Function Permit. CERTIFICATE OF INSURANCE MUST NAME CITY OF OKEECHOBEE AS ADDITIONAL INSURED. Appli ant Signature Date 'OFFICE USE ONLY "" Staff Review iii, Fire Department: Date: //-/b -,20/4 Building Official: �� '.. Date: 2. • /(f;7 Public Works: '�.■ Date: / 44-- � F .k/ Police Department: -:- Date: /./477f BTR Department: / Date: - /1 7lli' - % 1 '8.n/ City Administrator: Date: 7 l City Clerk: 1/2Z t Date: /�� , i ,'7 j NOTE: APPLICATION AND INSURANCE CERTIFICATE MUST BE COMPLETED AND RETURNED TO THE GENERAL SERVICES DEPARTMENT THIRTY (30) DAYS PRIOR TO EVENT FOR PERMITTING. Temporary Street and Sidewalk Closing submitted for review by City Council on a -ic / cr Date Temporary Street and Sidewalk Closing reviewed by City Counci and approved a 1t 14' Date RESOLUTION NO. 04 -03 A RESOLUTION OF THE CITY OF OKEECHOBEE, FLORIDA SUPPLEMENTING RESOLUTION NO. 03 -08; GUIDELINES FOR USE OF PUBLIC PARKS OR OTI[ER LANDS OWNED BY THE CI'T'Y OH OKE ECETOlili 1, FOR CERTAIN CEIAR[TAI3[ E OR :BENEVOLENT ORGANIZATIONS; PROVIDING FOR AU'1. LIORC['Y TO RIi V1E W SUCH APPLICATIONS; PROVIDING FOR STANDARDS FOR REVIEW; PROVIDING FOR GUIDELINES FOR SUCH ORGANIZATIONS TO FOLLOW; PROVIDING FOR AN E FECTIVE DATE. WHEREAS, there are located within the City of Okeechobee certain public parks and other areas owned by the City of Okeechobee that are intended for, and open for use by, the general public, with certain restrictions; and WAE,RE,AS, these uses change from time to time, and problems arise by certain uses that are not anticipated, but should be the subject of regulation and control by the City of Okeechobee for the safety and welfare of its citizens, and which requires supplementing existing rules as necessary; NOW THEREFORE, it is resolved before the City Council for the City of Okeechobee, Florida; presented at a duly advertised public meeting; and passed by majority vote of the City Council; and properly executed by the Mayor or designee, as Chief presiding Officer for the City: 1. Tf CAT permission for charitable or benevolent organizations, or non profit groups, to engage in certain activities in City parks or on City lands, is governed by Article IV, Sections 14 -141 to 14 -149 of the City Code of Ordinances, which regulations and restrictions shall be considered by General Services whenever an application or request for use of public areas is made, and followed accordingly. 2. THAT for any authorized use of the public parks or rights -of -way within the City, the following regulations shall be followed, as applicable: a. The organization or permit holder, or their designee, shall be responsible to completely clean up the public area used by the permit, within two clays of completion of the event, unless otherwise designated in the permit. b. No trailers unattached to a motor vehicle shall be parked along any street or avenue or public right -of -way, or in a marked parking spot, unless the right -of -way is closed for the event, not otherwise blocked off by the City. No other motor vehicles or traders will be allowed to park or remain on the'Park grounds unless prior written approval is obtained from the City Public Works Director or their designee, or such vehicle or trailer is participating in an event such as a permitted activity or car show. Any motor vehicle or trailer parked in violation of this section may be towed by the City at the owner's expense, who shall be liable for all towing and storage fees. c. Golf carts, 4- wheelers or other vehicles not licensed for use on public rights -of -way, will not be permitted on the Park grounds without prior written approval of the City Public Works Director or their designee. d. Certain events, such as but not limited to parades, or those which draw a large number of people, require significant incurring of costs Page 1 of 2 d. Certain events, such as but not limited to parades, or those which draw a large number of people, require significant incurring of costs by the City, for traffic control, crowd control, Eire safety, paramedic service, or general policing, which often requires adding personnel, and incurring overtime labor expense. For any such event, the City may require the organization or permit holder to be responsible for these additional costs, including property or personal injury damages that may occur during the event. There will be a mandatory inspection meeting between the Public Works Director or their designee and a representative from the permit holder prior to and after each event. Any additional expenses as stated above, will be billed to the organization or permit holder, who shall pay such sum to the City. e: For activities in :Hagler Park, the use of generators for power is encouraged, as electric outlets are limited and subject to the right of the City to deny their use. When generators or extension cords are used, the applicant shall cause a U.L. approved extension cord of proper gauge to be safely attached, and routed so as to not interfere with any pedestrian path, or m such area as may pose a risk of harm to the public or other participants. INTRODUCED AND ADOPTED this 166 day of March, 2004. Lane Garuiotea, City Clerk R}VII?WED FOR LEGAL SUI FICIENCY: John It. Cook, City Attorney Page 2 o f 2 James. E Kirk Mayor RESOLUTION NO. 03 -8 A RESOLUTION OF TUE CITY OF OKEECHOBlE, FLORIDA TO ESTABLISH GUIDELINES FOR USE OF PUBLIC PARKS OR OTHER LANDS OWNED RV 'WE CITY OF OKEECHOBEE FOR CERTAIN CHARITABLE OR BENEVOLENT ORGANIZATIONS; OR THE GENERAL PUBLIC; PROVIDING FOR AUTHORITY TO REVIEW SUCI[ APPLICATIONS; PROVIDING FOR STANDARDS FOR REVIEW; PROVIDING FOR GUIDELINES FOR SUCH ORGANIZATIONS TO FOLLOW; PROVIDING FOR INSURANCE REQUIRENIENT;'PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, there are located within the City of Okeechobee certain public parks and other areas owned by the City of Okeechobee that are intended for, and open for use by, the general public, with certain restrictions; and WHEREAS, these functions range from large gatherings which attract many participants, to very small groups, which may or may not cause traffic control problems, and vary in intensity; and WHEREAS, current regulations require the same liability insurance coverage for any such group authorized to gather in the parks or on city lands, which creates a hardship on the smaller gatherings; NOW, THEREFORE, be it resolved and adopted by the City Council for the City of Okeechobee, Florida the following resolution: 1. THAT permission for charitable or benevolent organizations, or non profit groups, to engage in certain activities in City parks or on City lands, is governed by Article [V, Sections 14 -141 to 14 -149 of the City Code of Ordinances, which regulations and restrictions shall be considered by General Services whenever an application or request for use of public areas is trade, and followed accordingly. 2. TI[AT for any permit or permission granted by the Department of General Services for such activities on public lands, such permit shall be also executed by the City Administrator, prior to such event taking place. 3. THAT most applicants for use of parks and public lands are charitable or civic groups, who stage large events and attract many people. However, smaller groups for prayer meetings; weddings; boy and girl scouting; and similar type events are also authorized in parks and in public places, but are also subject to the requirements of Article IV of the City Code. 4. THAT current regulations require the applicant for an event to procure liability insurance in the sum of 1 million; the cost of which is or may be prohibitive for smaller and more informal groups. 5. TI[ERFFORT, for any application wherein it appears to the Department of General Services that the participants thereof may he 100 or fewer persons, the liability insurance requirement shall be waived. The City reserves the right to require the participants to execute a hold harmless agreement, depending upon the nature and impact of the event. Page 1 of 2 INTRODUCED AND ADOPTED this 5 th day of August„ 2003. ATTEST: Lane Gantiotea, City Clerk REVIEWED FOR LEGAL SUFFICIENCY: .1ohn Cook, City_ Attorney Page 2 of 2 hums. E. Kirk,Mayor Feb. 16. 2016 8:56AM No. 1876 '.0 CERTIFICATE OF LIABILITY INSURANCE DATE(MMJDDNYYY) 02/12/16 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 DETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is ah ADDITIONAL INSURED, the pollcy(les) Must be endorsed. IF SUBROGATION IS WAIVED, subject to the terms and condltlone of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Jda Insurance Group LIc 120 N. Federal Hwy #301 Lake Worth, FL 33460 Phone (561) 296 -0373 Fax (561) 828-0997 coNTACT Danielle MarcJnek NAME: p pA No FkO, (561) 296 -0373 (�G.NoL• (561) 296 -0392 DRESS • Danlclle ®theidagroup.com INSURER(S) AFFORDING COVERAGE NAIL# INSURER A ; Philadelphia lndemnity Insurance Company 18058 INSURED Okeechobee ChriStlan Academy 701 South Parrott Ave Okeechobee, FL 34974 _ INSURER B : Philadelphia Indemnity Insurance Company 18058 INSURER c : Philadelphia Indemnity Insurance Company 18058 INsURER D : Bddgefleld Employers Insurance Company 10701 INSURER E ; Philadelphia Indemnity Insurance Company 18058 INSURERF: PERSONAL & ADV INJURY 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 CLAMS. INBR LTR TYPE OF INSURANCE ADDLGUBR , , : ,i , POLICY NUMBER PoLI Y FF MM/0� PaQdI� I Y -XP MMID� LIMITS A GENERAL LIAeIU1Y v COMMERCIAL GENERAL LIABILITY . . CLAIMS -MADE © OCCUR = NI Y N PHPK1335321 07101/2015 07101/2016 EACH OCCURRENCE ;, 1 000 000.00 DAMAGE TO RENTED •E, E r, . $ 100,000.00 MED EXP An one . -fson $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GENT_ AGGREGATE LIMIT APPLIES PER O POLICY • PRO- ❑ LoC PRODUCTS - COMP/OPAGG $ 2,000,000.00 , $ B AUTOMOBILE LIABILITY . ANY AUTO ALLOWNED SCHEDULED ❑AUTOS AUTOS HIREDAUT09 NON -OWNED AUTOS N N PHPK1335321 07/01/2016 07/01/2016 OMMINED ' INGLE LIMIT Ea secMenl 1,000.000.00 BODILY INJURY (Perpersmr) $ BODILY INJURY (PereaddenU $ PROPER aAMAGE Pera enl $ C • UMBRELLA LIAR ® OCCUR EXCE69 Lin ❑ CLAIMS -MADE N N PHUB499366 • 07/01/2015 07/01/2016 EACH OCCURRENCE $ 1 000 000.00 AGGREGATE $ 1,000,000.00 • DEO V RETENTION 10,000.00 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERJMEMBER EXCLUDED? (Mandaloty In NH) ( rtyse d8OC,1be under oESCRhPTION OF OPERATIONS below N / A 830 -39477 07/02/2015 07/02/2016 • WC STATEN 7 OTH F. L. EACH ACCIDENT $ 1,000,000.00 E.L. DISEASE - EA EMPLOYE $ 1,000,000.00 E.L. DISEASE - POLICY LIMIT $ 1,000,000 -00 E Professional Liability PHSD1058204 07/01/2015 07/01/2016 Directors & Officers $1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHIGLES (Allach ACORD 101, Additional Romance Schedule- I1 more space le required) The City of Okeechobee Is named as Additional Insured In regards to the General Liability portion of policy. CERTIFICATE HOLDER CANCELLATION . Oily of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORRED REPRESENTATIVE Aut-kk &41.\,-4 ACORD 26 (2010/05) QF O 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 0 Ct d w FEBRUARY 16, 2016 - RE COUNCIL ACTION - DISCUSSION - VOTE coE E 0 . 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O a) E a) 0 E () .o _ En- v) v=) 0 C) Y co OQ CO a o .c E L o 0 -o O X a3 co c 0 • o m U o` Q 0 N W V) L _ (6 > 0 c 0- C f z, E o a) ca -a O E 0 2 i_ Q U F� 0 a) C..) (0 Z` N 0 o 0, o U W °T p (T Q 1 Z E ) N U > w o w (n N O a) -0 a) C (0 0_ C CD mUQinii <.n W Z CO U 0 0 0 U O 4) E a) 0 O U 0) c T 0_ 0 0 E 0) c 0 0) 0) c �.o w U w w H p >Jan'!C 'CWo `ealo!weO auei m % JoAeW `)pyi .3 sowed / cr co / cn co CO CD ) 0 % co ) \g3 =� CD 3 Q 3' D 9 / =tee/ ez =c gco— < 1) cro \\m \�\ C 2 3' o / k COUNCIL ACTION - DISCUSSION - VOTE FEBRUARY 16, 2016 - REGULAR MEETING - PAGE 5 OF 5 Jackie Dunham From: Sent: To: Subject: Jackie Dunham Wednesday, February 17, 2016 8:49 AM mking.oca @gmail.com Street Closing for Schoolwide Field Day Your request for closing SE 2°d Avenue from SE 7th Street to SE 6th Street on Friday, February 19th from 8:30AM to 2:OOPM was approved by our City Council at the Regular Meeting held Tuesday, February 16th at 6:OOPM. Jack e/ D u-vi he +w Acimii444tra"we/ Secr'eta.vy C ty of O keecha1Tee& 55 SE Ti. rddAvevntte/ Okeechab&, EL 34974 Tee: 863-763-3372 ext. 217 Jaw.' 863-763-/686 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