Temp. Street Closing - Homecoming ParadeBute •4 G50035(t)( cl. f A 0
Date: July 12, 2016
STATE 00 FIARlr1A DEPARTMENT OF TRANSPORTATION
TEMPORARY CLOSING OF STATE ROAD PERMIT
Permit No.
050.040.05
MA :NI ENAUCE
12/11
Governmental Entity
08/0 /aotC
Approving Local Government City Of Okeechobee Contact Person Patty- Burnette J,:. r,,:_ tJ .1,,rr
Address 55 SE 3rd Ave J r t
Telephone 863- 763 -3372 (ext. 2-1.8) Email _pbur-nette( cityofokeechobee.com
• 1.._(, �`,". i,, .-eer 1rL:.. I •.Ct ...
Organization Requesting Special Event
Name of Organization Okeechobee High School
Address 2800 Hwy 441 N Okeechobee, FL 34972
Contact Person Lauren Myers
Telephone 863 -462 -5025
Email myersL @okee.k12.fl.us
Description of Special Event
Event Title OHS Homecoming Parade Date of Event October 20, 2016
Start Time 6:00 PM End Time 6:45 PM
Event Route (attach map) Begin at SW 4th St to 441 N to 70 West to SW 7th Ave, ending at SW Park St.
Detour Route (attach map)
Law Enforcement Agency Responsible for Traffic Control
Name of Agency Okeechobee City Police
US Coast Guard Approval for Controlling Movable Bridge
Not Applicable 11
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 b the public.
Signatures of Authorizati
Event Coordinator Lauren Myers Signature
Law Enforcemen
Name/Title
Government Official
Name/Title 2
,5)) •.V2
� 6z ,' =% i 2 Iz. i?5:•,t) Signature
Cl Signature . ` Date ?�kr
r
FDOT Special Conttdfions
FDOT Authorization
Namertte
Signature. Date
1) : r
APROVED
Prior to any work requiring lane closures, mobile operations or traffic pacing operations the contractor or
perrnittee shall submit a request to the Department that includes the time, location, and description of work being
performed. The lane closure request shall be submitted to the Department a minimum of 2 weeks prior to the
proposed closure date and must be approved by the Department before work requiring the closure may begin
within the FDOT Right of Way. https: / /Iris. dot.state.fl. us/
Traffic Control shall comply with the Federal
Manual on Uniform Traffic Control Devices
(MUTCD) and FDOT Design Standards 600 Serves
_
'—"'
FDOT Authorization
Namertte
Signature. Date
1) : r
APROVED
INDEMNIFICATION AGREEMENT
This AGREEMENT, by and between the CITY OF OKEECHOBEE, FLORIDA,
(hereinafter "CITY”) and Okeechobee High School
(hereinafter "APPLICANT"), dated this 20th day of October_, 2016.
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:
I. 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 20th day of
October , 2016 . Applicant shall further reimburse the CITY for any
and all attoi neys 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 foi ins to make application to the State of Florida,
Department of Transportation, for temporary road closure.
APPLICANT CITY OF OKEECHOBEE, FLORIDA
BY: Lauren Myers
TITLE: Assistant Principal OHS
BY:
TITLE: ,
FOR CITY USE ONLY
ZrProof of liability insurance
Col porate resolution completed
DOther requirements (specify) 11-?- 1 `') 41, t:_■-.21- L
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BY: V
TITLE:
DATE: 7 1,4
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ACORO
FLORSCH -04 WILSONLR
DATE (MM /DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 7/26/2016
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
EPRESENTATIVE OR PRnrn IRFR AND THE CERTIFICATE HOLDER.
R
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
Willis Administrative Services Corporation DBA Willis Pooling
c/o 26 Century Blvd
P.O. Box 305191
Nashville, TN 37230 -5191
CONTACT Willis Towers Watson Certificate Center
NAME:
HOO,Nr o, Ext): (877) 945 -7378
FAX No): (888) 467 -2378
E-MAIL
ADDRESS: certificates @willis.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Florida School Boards Insurance Trust
D2772
INSURED
Okeechobee County School District
Attn: Renee Geeting
700 SW Second Avenue
Okeechobee, FL 34974
INSURER B
INSURER C :
INSURER D :
INSURER E :
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
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
(MM /DD/YYYY)
POLICY EXP
(MM /DD/YYYY)
LIMITS
LTR
A
X
COMMERCIAL GENERAL LIABILITY
FSBIT16CAS7 -1
07/01/2016
EACH OCCURRENCE
$ 1,000,000
07/01/2017
DAMAGE TO RENT-ED
PREMISES (Ea occurrence)
$ Included
$ Excluded
CLAIMS-MADE
X � OCCUR
MED EXP (Any one person)
PERSONAL & ADV INJURY
$ Included
$
GEN'L
GENERAL AGGREGATE
AGGREGATE LIMIT APPLIES
1 PRO-
PER:
LOC
PRODUCTS - COMP/OP AGG
$ Included
POLICY I I JECT I
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident)
$
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
SCHEDULED
AUTOS
NON -OWNED
AUTOS
BODILY INJURY (Per accident)
$
— PROPERTY DAMAGE
kPer accident)
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS-MADE
. EACH OCCURRENCE
$
, AGGREGATE
$
$
DED
I
RETENTION $
i
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 1 A
1 PER OTH-
STATUTE I 1 ER
E.L. EACH ACCIDENT
$
1 E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
1�
$
DESCRIPTION
Evidence
441 /70
one
OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
of Coverage, Okeechobee High School Home Coming Parade October 20, 2016. Parade route will begin at 441 and SW 4th Street and proceed to the
intersection, turn west on 70. End at SW 7th Avenue. Department of Transportation named the certificate holder for liability insurance in the amount of
million dollars. For the General Liability policy, General Aggregate is Unlimited.
CERTIFICATE HOLDER CANCELLATION
801 North Broadway of Transportation
way Aver i Avenue
801 North Broadway Avenue
iBartow, FL 33831
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
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_ Annnn nnoono ft 1"1/11.1 All rnh +c rn rvari
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ACORD 25 (2014/01)
The ACORD name and Joao are reaistered marks of ACORD
Jackie Dunham
From: Jackie Dunham
Sent: Tuesday, August 02, 2016 9:09 AM
To: kevin.morrisey @dot.state.fl.us
Subject: Annual Homecoming Parade and Annual Christmas Parade
Attachments: Annual Homecoming Parade.pdf; Annual Christmas Parade.pdf
Good morning Kevin. I am attaching two parade permits for your review and approval. The Homecoming
Parade will be in October. The Christmas Parade obviously will be in December but I thought perhaps you
could handle it now too. Thank you for your assistance.
Jc kie2 ('7u rthcwti
AdmiA iii trat'we/Sec etowy
C►y ofOkeeth o-b-e.e/
55 SE 7h6rd. 4 ve v e'
Off, FL 34974
7"ele': 863 -763 -3372 ext. 217
Fax,: 863-763-1686
j.dunhamrXcityofokeechobee.com
Website: http: / /www.cityofokeechobee.com
NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure.
Jackie Dunham
From:
Sent:
To:
Cc:
Subject:
Attachments:
Jackie Dunham
Thursday, August 11, 2016 8:09 AM
' myersl @okee.k12.fl.us'
Lt. Hagan (opddonaldhagan @yahoo.com)
Homecoming Parade 2016
Homecoming Parade 2016.pdf
Attached is the approved Homecoming Parade permit from FDOT.
c .ckie, Dwnhouvvv
Air ectvve, Secreta-ry
city ofOiceetholyee,
55 SE I Y.1yd Ave4tu e,
Okeecholyee., FL 34974
Tele: 863-763-3372 e t. 217
Fc(44/.: 863-763-1686
_jdunham!ik tvofokeechobee com
Website: http: / /www.cityofokeechobee.com
NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure.