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Temp. Street Closing - FBC Fall FestivalJackie Dunham From: Sent: To: Subject: Jackie Dunham Wednesday, October 05, 2016 9:51 AM ' beverly @fbcokee.org' Street Closing Approval Please be advised the request from First Baptist Church to close SW 4th Street between SW 501 and Oh Avenues on October 31s` for your Fall Festival was approved at the City Council meeting last evening, October 401. Share this information with all interested parties. Thank you. Jackie' (Da Act41 v A d n tr t"weSe seta, -y CLty of Okeecho -b-ee. 55 SE Th,i,rd/ 4 vevu,te/ Off, FL 34974 7 ete 863-763-3372 ext. 217 Fax'' 863-763-/686 jdunham @cityofokeechobee.corn Website: http: / /www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. t 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: Application No: Information: Date Issued: Date(s) of Event: 9/31 /I Lt' ' `L Organization: r' ft 8a fs t C�Lu.�� Tax Exempt No: gS- f041‘ 7 /IOC - to Mailin Address: Contact Person: %A l4 t- 0k A E -Mail Address: /SFt' -FittQ EA e'5c / �i,; L -rib- / L 901 54/ Y LL t f. Okeec hot o e , FL 3 Y 97 Telephone: Work: g67 -77.7 -a17/ Summary of activities: Home: Cell: I 47 - yy7 - F:-,s1. fa f s -t a.,.� < .., ; It 1 e. Q IA V her -A: 1a L/p OP e ✓ / Fall F« A: -.1 - ,-. ?.. A. 2 . k/ / // A be 4-4.I ke ..'�y, co.,.....,-.-//,v' O N j T/ i✓ di IC_e_ /a� , N die.' rp ✓�. /D v .?_2_4_4___S-1:1'.4 e i e J c /05kee T °r P••t.,'/L T.7 e..CsA...e tie&4 4,A . roe. Z-+aJt C0-- ,J a— v.; :+.G L'- foo- /e� �O e.e..T y Proceeds usage: N -�o Please check requested Parks: Flagler Parks: ❑ City Hall Park ❑ #1 Memorial Park ❑ #2 ❑ #3 ❑ #4 ❑ 1/5 r: #6 OR Address of event: 3/D 51 / 5 - Ave / eech04 rem Parcel ID: 1 : 7- l G/ e, (1 S G L�l Page 2 of 3 TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (If not using Park(s), provide event address) 3/0 $1,-/ 6— 4‘ /cJ/A� vt atoc/iole_e EL 7Y9'Y Street Address City State Zip Code j Street(s) to be closed: Si✓ "/ 6 571 Ceeli-«, 326 a-d e -t. Ave Date(s) to be closed: /077///6 1 Time(s) to be closed: 3 UOO,..,. - i 00 Purpose of Closing: ie..., rev :d e _CA -re farta:"t - -.s,.. �pav�ely /of 4 / '( Fe .-A....-. / Attachments Required: / Charitable Function Temporary Street and Sidewalk Closing • Site Plan • Original signatures of all residents property Ali uw_nersand 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-C=ity streets or sidewalks, a Tem se Permit (TUP) must be attached forme c business. TUP can be obtained front thT General Services Department. td I ✓1 • State Food Service License, if applicable. • State_f.00d-- Serviee+ieen-sg; if"applicable. A4 L, • 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 INSU' D. 1, 9 is' /6 No.(s) 03- is correct, and and obey all the or Ap a licant Signature Date ••••OFFICE USE ONLY•••• Staff Review Fire Department: )i Date: Date: - See aoj‘. '24) • i (o Building Official: krzi i hi,...L.d.. , f` _�.• 1 • Public Works: / Date: q -AU `it, Police Department: 6;: (:th i -� )- Date: Date: ., ./ , ) / (,1 BTR Department City Administrator: - - Date: Z City Clerk: ATE AND INSURANCE CERTIFICATE MUST BE COMPLETED SERVICES DEPARTMENT THIRTY (30) DAYS Closing submitted for review by City Council on Closing reviewed by City Council and approved Date: PRIOR I C / g1a'20 //k AND TO Li / i t� NOTE: APPLICATION RETURNED TO THE GENERAL EVENT FOR PERMITTING. Temporary Street and Sidewalk Temporary Street and Sidewalk Date it Witt Date Okeechobee County Property Appraiser - Map Printed on 9/21/2016 10:56:39 AM Page 1 of 1 SR 70,W SR 70 E SW 3RD S eh* T SV.' 3RC! ST i- 4 SW 5TH ST y c� ' Okeechobee County Property Appraiser W.C. Bill" Sherman,,, F'ALOke each° bee,; PARCEL: 3- 15 -37 -35 -0010 -01800 -0010 02 - CHURCHES (007100) CITY OF OKEECHOBEE LOTS 1 12 & VACATED ALLEY IN ORB 449 PG 1113 BLOCK 180 Name ,FIRST BAPTIST CHURCH OKEE INC LandVal Site: 1310 SW 5TH AVE, OKEECHOBEE BldgVal Mail: 401 SW 4 ST prVal OKEECHOBEE, FL 349744240 ustVal Sales Info $218,940.00 $1,108,044.00 $1,403,244.00 $1,403,244.00 $1,403,244.00 $1,403,244.00 $0.00 sd xmpt axable 0 i 250 500 750 fit This information, updated: 9/8/2016, 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 its 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? pjboiibchhjbnligcafcefocnfkfdfefdbble ... 9/21/2016 I)EPARTMFNT OF RI:VENUE r jConsumer's Certificate of Exemption Issued Pursuant to Chapter 212, Florida Statutes 85- 80126741400 -6 Certificate Number This certifies that 04/30/2012 Effective Date FIRST BAPT;ST CHURCH OF OKEECHOBEE INC 401 SW 4TH ST OKEECHOBEE FL 34974-4240 DR -14 R. 04/11 04/30/2017 !RELIGIOUS-PHYSICAL PLACE] Expiration Date Exemption Category 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:orservices purchased. 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 trom this requirement except when they are the lessor of real property (Rule 12.4- 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. AC' ORCI CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 09/22/2016 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 have ADDITIONAL INSURED provisions or 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 TERRY L. BROWN INSURANCE AGENCY INC FO BOX 121246 CLERMONT, FL 347121246 INSURED FIRST BAPTIST CHURCH OF OKEECHOBEE 401 S.W. 4TH ST Okeechobee, FL 34974 CONTACT LISA MARTIN NAME: PHONE 352 - 243 -1100 IA/C, No, Ext): E-MAIL LISA CHURCHAGBVT.NET ADDRESS: INSURER(S) AFFORDING COVERAGE FAX (NC, No): NAIC # INSURERA: GUIDEONE MUTUAL INS CO INSURER B INSURER C : INSURER D : INSURER E : INSURER F : 15032 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 (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A / V COMMERCIAL GENERAL LIABILITY OCCUR 1423 -828 12/01/2015 12/01/2016 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1 000 000 _ GEN'L \/ MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER POLICY PRO JECT 1 LOC OTHER GENERAL AGGREGATE PRODUCTS COMP /OP AGG $ $ 3,000,000 3,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR I CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Form CG2026, Additional Insured - "Designated Person or Organization" is attached. CERTIFICATE HOLDER CANCELLATION CITY OF OKEECHOBEE 55 SE 3rd Street 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NAMED INSURED: First Baptist Church of Okeechobee POLICY NUMBER: 1423 -828 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) CITY OF OKEECHOBEE 55 SE 3rd Street Okeechobee, FL 34974 Re: Fall Fest Oct. 31, 2016 Event Loc: 509 SW 4th Street, Okeechobee, FL 34974 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑