Park Use Permit - Food Truck EventCITY OF OKEECHOBEE
55 SE THIRD A VENUE
OKEECHOBEE, FL 34974
Tele: 863 - 763 -3372 ext. 217 Fax: 863 - 763 -1686
e- mail.' jdunham r(7_cityofokeechobee.com
Park Use Permit
Permit Number: 016 Date(s) of Event: August 26, 2016 3:30PM- 9:O0PM
Permit Expiration: August 26, 2016 11:59PM
Purpose of Request: Food Truck Event in Downtown Okeechobee
Property Owner: City of Okeechobee
Address: 55 SE Third Avenue
City: Okeechobee State: Florida Zip Code: 34974
Applicant: Okeechobee Main Street
Phone Number: 863 - 357 -6246
Current Zoning: P
Subdivision: City of Okeechobee
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.
Ja ck ,e'
General Services Administrative Secretary
August 23, 2016
Date
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Page 1 of 3
CITY OF OKEECHOBEE
55 SE THIRD AVENUE
OKEECHOBEE, FL 34974
Tele: 863 - 763 -3372 ext. 218 Fax: 863 - 763 -1686
PARK USE AND /OR TEMPORARY STREET/
SIDEWALK CLOSING
PERMIT APPLICATION
Date Received:
o8/1 1/2016
Date Issued:
/ 3 /, .
Application No:
1(0 - Q j L,
Date(s) of Event:
r
08/26/2016 :3c pu _. f . cc PIA'
Information:
Organization:
Okeechobee Main Street
Tax Exempt No:
Mailing Address:
55 South Parrott Avenue Okeechobee, FL 34972
Contact Person:
Brittany Carner
E -Mail Address:
brittany @okeechobeemainstreet.org
Telephone:
Work:
863- 357 -6246
Home:
Cell:
Summary of activities:
good mac . eiJ -eq+ In di .to QeC c^be,e`-5 N_)i.Q_-■ ton . fly evex\tro ic)
en cx- ceG- ,c\ t,-)t \e lcAs ti(\ci oLi1)(‘ _ . -This nIG�Flt II
iv) e, uk / �� . C,ro, :/Qfc\e)cs, poi rl-1CaQ f atM
kt 1') and and coc Y)
a Z Lz cc cis .
Met •ee .- Go b ye. ca\uin i5 Vc�( +f Ikea n Lo and VA p( e
*ee
c 1/\ e i c - �a�k cr)c no_c- Peat `-,_ - �� eot1\ b uup to
-i-kQ E\4-cr tAn ckr 4-kz ga�b.o .
Proceeds usage:
Proceeds for this event 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 (I#3 ❑ #4 ❑ #5 ❑ #6
OR
Address of event:
Parcel ID:
1 oi 3
CITY OF OKEECHOBHE
55 SE THIRD AVENUE
OKEECHOBEE, FL 34974
Tele: 863-763 3372 ext. 218 Fax: 863-763-1686
PARK USE AND/OR TEMPORARY STREET/
SIDEWALK CLOSINC
PERMIT APPLICATION
Date Received:
Application No:
Information:
Organization: j
Mailing Address:
Contact Person:
E-Mail Address:
Tele hone:
Work:
Summa,
Date Issued:
/4- Ono Date(s) of Event:
S:3of • Coop )
1 lax Exempt No: 1
of activities:
Proceeds usage:
Home:
Please check requested Parks:
Flagler Parks: n City Hall Park Ei Memorial Park Li g, 44 Fri /45 46
OR
Address of event:
Parcel ID:
Maw\ s fe.e- t\Dciol d t tj Aro irk Vim\ - trut64 s can --tiAs. Cash-, u3ee: \-,
curd .s-\-r Si (4525 os 1cu /'.)0 r00ItcAbturps )us�r Page 2 of 3
u-1+1 icx t CPA o pc3.t G, i n es a_ccu nd p (t,
'-TEMPORARY STREET ANDS EWALK CLOSTM INFORMATION
(If not using Park(s), provide event address)
Street Address
City State Zip Code
Street(s) to be closed:
Date(s) to be closed:
Time(s) to be closed:
Purpose of Closing:
Attachments Required:
Charitable Function
Temporary Street and Sidewalk Closing
• Original signatures of all residents, property
owners and business owners affected by the closing.
• Site Plan
• 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
sum not incurred shall be refunded to the applicant.
1 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 inforumition is correct, and
that I ant the duly authorized agent of the organization. 1 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 MI ST NAME CITY OF OKEECIR WE AS ADDITIONAL
INSURED.
Applicant Signature
Staff Review
Fire Department:
no Officia 1:
Public Works:
Police Department:
BTR Department:
City Administrator:
City Clerk:
Date
••••OFFIC'E USE ONLY••• •
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
Temporary Street and Sidewalk Closing reviewed by Oty Council and approved
Date
Jackie Dunham
From:
Sent:
To:
Subject:
Brittany Carner <brittany @okeechobeemainstreet.org>
Tuesday, August 16, 2016 9:36 AM
Jackie Dunham
Food Truck
Goodmorning,
Okeechobee Main Street has spoke with all buisnesses along Park Street about Friday Night Fun in the Park, August 26th,
2016. They are aware of what our plans are with this event and all buiness owers are supportive.
Thank you
P.riirtany (barber
Executive r! re •?tor
CJkeec O tte %11Gtir.. StO e"
S Parrott :Ave
Okeechobee, Ft 549 -72
843-357-6245
Follow us on Facebook and Twitter.
Visit us at www.okeechobeemainstreet.org
i
Okeechobee Main Street, INC.
SSS Parrott Ave, Okeechobee, FL. 3407Z
863'357-MA|N
To City Council,
Okeechobee Main Street has spoken with the businesses on the 300 block of Park Street. They
are aware of our plans for the food truck event and do not have any reservations.
Please do not hesitate to contact Okeechobee Main Street with any questions or concerns.
Thank you.
Sincerely,
Brittany Carner
Executive Director.
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The ACORD name and logo are registered marks of ACORL)
Form W519
(Rev. August 2013)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. [)o not
send to the IRS.
Print or type
See Specific Instructions on page 2.
t'.ame (as shown on yote income tee return)
Okeechobee Main Street, Inc.
Business name/disregarded entity name, ii different from above
Check appropriate box for federal tax claseifiestion:
❑ Individual/sole proprietor 1 C Corporation . S Corporation ■ Partnership 0 Trust:estate
El Limited liability company, Enter the tax classification (C --C corporation, S =S corpora ion, P= partnership) to
Exemptions (see instructions):
Exempt payee code (if any)
Exemption from FATCA reporting
cede (it any
11 Other (see instructions) le
Address (number, street, and apt or suite no)
55 S. Parrott Ave
P,equester's name and address (optional)
City. state, arid ZIP code
Okeechobee, Florida 34972
list account numbers) 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 t instructions on page 3. For other
entities. it is your employer identification number (EIN). If you do not have a number, see How to pet a
Social securely number
-
1
TIN 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
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number for 1 am waiting for a number to be issued to me), and
2. t am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that i 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 withhofdalg, 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 alp interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgaae
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 3.
Sign Signature of
Here U.S. person '
Date ►
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. The IRS has created a page on IRS.gcw for information
about Far W.9, at www.irs.gcwfw9. Information about any future dvelopments
affecting Form 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 fie an inferrnation rotten with the IRS must obtain your
correct taxpayer identification number (TIN) to report, for example, income paid to
you payments made to you in seliierrent of payment card and third party network
transactions, real estate trarmaclions, mortgage interest you paid. acquisition or
abandonment of secured property, cencetlation of debt, or contributions you made
to an IRA.
Use Form W -9 only if you are s U.S. person (Including e resident alien). to
provide your correct TIN to the person requesting, It (the requester) and, when
applicable, to:
1. Certify that the TIN you are giving is correct for you are waiting tors number
to be issued),
2. Certify that you are not sidoject to backup withholding, or
3. Claim exemption from backup withholding if ycu are a U.S. exempt payer,. If
applicable, you nee 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 tex on forelen partners' share of effectively connected income, and
4. Certify that FATCA. codes) entered on this form (if any) tndlcatind that you are
exempt from the FATCA reporting, is correct.
Note. If you are a U.S. ,person and a requester gives you a forrn other than Form
W -9 to request your TIN. you must use the requester's form nit is substantially
similar to this Forte W -9.
Definition of a U.S. person. For federal tax purposes. you are considered a U.S.
person if you are:
• An individual who is a U.S. taken or U.S. resident alien,
• A partnership, corporation. company. or association created or organized in the
United States or uncle: the laws of the United States.
• An estate (other than a foreign estate), or
• A domestic trust as defined in Regulations section 301.7701 -7).
Special 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 partner is 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. e -2013)
INTERNAL REVENUE SERVICE
P. 0. BOX 2508
CINCINNATI, OH 45201
Date:
APR 2 9 20115
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)
Jackie Dunham
From:
Sent:
To:
Subject:
Jackie Dunham
Thursday, August 11, 2016 9:44 AM
Jayce Fitzwater (J ayce @okeechobeemainstreet.org); Brittany Carner
Food Truck Event
Good morning to you both. I'm just curious if Marcos ever spoke with either of you regarding the upcoming
Food Truck event and what was decided. No one has signed it yet because they wanted MORE INFO! It was
indicated to Patty in their Staff Meeting they wanted a letter that ALL owners on SW Park were ok with this
event. Also wanted location of porta lets and asked about trash. You did tell me the trucks won't be using our
water. Lastly, I think they only want to show this for one date only! If acceptable for additional dates THEN
we need to do a separate application for each date.
Marcos hasn't shared anything with me so I'm in the dark.
Jack 4 e/ D u.vt ha/vw
Arc t'weiSecvetc ry
City of Okeechobee/
55 SE thi rd/ Avevu e/
Okeecho-b-ex/, FL 34974
ret& 863-763-3372 e-%t: 217
To 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
Jackie Dunham
From:
Sent:
To:
Subject:
Jackie Dunham
Friday, July 29, 2016 4:36 PM
'Jayce Fitzwater'
RE: Food Truck request correction
Jayce, Marcos left you a voice mail regarding Food Truck Invasion. He wants the trucks to be parked in the spaces so
they are serving food into the park. I couldn't determine from your site plan if that's how they would be positioned.
They would have to be parked parallel to the curb. Hopefully this will work for however many trucks will be there. Also,
he wants a letter from Main Street assuring that the business owners along that section of SW Park Street are ok with
the event and with them utilizing the parking spaces. You are welcome to call him on his cell, I believe he left you that
number, or you may call me. Hopefully well get this thing wrapped up next week. Have a good weekend.
Jackie Dunham
Administrative Secretary
City of Okeechobee
55 SE Third Avenue
Okeechobee, FL 34974
Tele: 863 - 763 -3372 ext. 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.
Original Message
From: Jayce Fitzwater [ mailto: Jayce@okeechobeemainstreet.org]
Sent: Friday, July 29, 2016 2:58 PM
To: Jackie Dunham
Subject: Food Truck request correction
Good afternoon,
Here is the revised form for the food truck event. I hope this helps.
Jayce Fitzwater
Executive Director
Okeechobee Main Street
55 S Parrott Ave
Okeechobee, FL. 34972
863 - 357 -6246
Follow us on Facebook and Twitter.
Visit us at www.okeechobeemainstreet.org
1
Jackie Dunham
From: Jackie Dunham
Sent: Thursday, August 04, 2016 9:27 AM
To: Marcos Montes De Oca; Herb Smith; Chief Denny Davis
(ddavis @cityofokeechobee.com); Robert Peterson (Major Peterson); David Allen; Kim
Barnes; Jeff Newell; Lane Gamiotea
Cc: Robin Brock
Subject: Main Street Monthly Food Truck Event
Attachments: Food Truck Event.pdf
I'm hoping the attached Park Use Permit can be discussed at the regular staff meeting on Tuesday, August
Wanted each of you to be able to review it beforehand. Main Street is not asking for street closings. They
don't want to minimize parking on the south side of Park Street for patrons. I believe the attached paperwork
will explain. Thank you.
Jc ckie/Du.vtha vw
A d traxwe'Secretcu y
City of Okeecho
55 SE Thixd'Avevuce
Okeecho1yee, FL 34974
Tele: 863-763-3372 ext. 217
Faiw' 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.
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