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Park Use Permit - Food TruckCITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 Tele: 863 - 763 -3372 ext. 217 Fax: 863 - 763 -1686 e-mail: jdtifiI it (a)cit - fol wE.Ca Laces `,' Park Use Permit Permit Number: 005 Date(s) of Event: January 12, 2017 3:30pm- 9:30pm Permit Expiration: January 12, 2017 11:59PM Purpose of Request: Food Truck Event 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. Main street volunteers will assist with trash clean City water sources will not be utilized L General Services Secretary December 28, 2016 Date Page 1 of 3 Re), ked 11 4,16 CITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 Tele: 863-763-3372 ext. 217 Fax: 863-763-1686 PARK USE AND/OR TEMPORARY STREET/ SIDEWALK CLOSING PERMIT APPLICATION Date Received: 1) / i k Date Issued: A »lication No: i 7 - e.°04: Date(s) & Times of Event: .411 r 1 IntOrmation: Organization: Mailing Address: Contact Name: E-Mail Address: -Felephone: LWork: 1 Home: F(Tel Summary of activities: Proceeds uisae: Please check requested Parks: Hagler Parks: ri City Hall Park Li I Memorial Park i -42 n #3 Li 44 0 40 [Park 3 is location olGazebo. Park 4 is location of Bandstand1 (If other private property used in conjunction with this Park Use Permit please provide the address and parcel number below along with notarized letter of authorization from property owner) Additional Addresses, if applicable Parcel ID: TEMPORARY STREET AND SIDEWALK (Street Closings require City Council approvaL Mectit Address of Event: Streets) to be closed: Date(s) to be closed: Time(s) to be closed: Purpose of Closing: Page 2 013 Revised .4.16 OSING INFORMIATION & 3'`r 'Tuesdays but subject to change) Attachments Required for Use of Parks ► Site Plan ►Copy of liability insurance in the amount of $1,000,000.00 with the City of Okeechobee as additional insured. ► Proof of non- protit status (IRS Determination Letter) Attachments Required for Street /Sidewalk Closings Site Plan Copy of liability insurance in the amount of $17000,OO11.00 with the City of Okeeehobee and K.E:. Ilan-trick .Cestamentary Trust as Additional Insured. ► Original signatures of all residents. property owners and business owners affected by the closing. ► State Food Service License if = 3 days. ► Notarized letter of authorization from property owner, if applicable.* Required if private property used in conjunction with a Park 1 lse application. Alcoholic beverages can be served only on private property. Alcoholic beverages Parks. City streets or City sidewalks. See additional note below. ❑ Please check if items will be solo on City streets /sidewalLs. Each business wall rreecl to alaply fora 1-,einrporat tise Permit 667 along with the Street Closing application. Note: ► Cleanup 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 Iicense(s). Irk 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. ► State Food Service License it > 3 days. ► State Alcoholic Beverage License, if applicable.' ALLOWED in 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 arises out of applicants use of location for such event, and shall indemnify and defend] the City for such incident, including attorney teats The applicant shall be subject to demand for, and payment of, all of the actual costs 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 cashiers check or 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 of this Park Use /Street Closing Permit. Page 3 of 3 Roy ised hereby acknowledge that I have read and completed this ipplication, the attached Resolutions i\lo.(5) 03-8 and 04-03, concerning the use and the ruks of using City propem, that the information is correct, and that I am the duly authorized agent or the organization. 1 agree to conform with. abide bv and obey all the rules and regulations. \khich may be la■\ ffll y prescribed b\,' the City Council of the City of Okeechobee_ or its oflicers. for the issuance C'ertilicate of Insurance must name City of Okeechobee as Addilionul nsured as Well as R.E. Hamrick Testamentary Trust iL closing streets or sidevvalks, Applicant Signature Staff Review Fire Department: Building Official: Public. Works: Police Department: BTR Department: City Administrator: (.'ity Clerk: Date ""OFFICE USE ONLY•••• Date: "Tee—G2o14 Date: (?• iq • f 6 P Date: — Date: I9 Date: 24, Date: •ac-/_ _ 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 Date Temporary Street and Sidewalk Closing reviewed by City Council and approved Date ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 9/28/2016 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 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 Robins Insurance Agency, Inc 30 Burton Hills Blvd. Suite 300 Nashville TN 37215 INSURED What's Cooking Inc DBA: Gourmet Truck Expo 200 SW 32nd Avenue Deerfield FL 33442 CONTACT NAME: Small Business Unit PHONE (615) 665 9200 _A/C, No Ext): E -MAIL ADDRESS: bbache @robinsins .com INSURER(S) AFFORDING COVERAGE INSURERA:Southern Owners Ins INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : FAX (615) 665 -9207 NAIC # 10190 COVERAGES CERTIFICATE NUMBER:2016 -17 MASTER COI 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 SUER WVD T POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP LIMITS (MM /DD /YYYY) X COMMERCIAL GENERAL LIABILITY 03928331 Blanket Waiver Subrogation 7/18/2016 EACH OCCURRENCE $ 1,000,000 300 , 000 $ 10,000 CLAIMS -MADE [ X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) 7/18/2017 MED EXP (Any one person) GE X X PERSONAL & ADV INJURY $ 1,000,000 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 $ 3,000,000 $ 1,000,000 POLICY OTHER: JECT r PRODUCTS - COMP /OP AGG Hired & Non -Owned Aut AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED • AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS 03928331 7/18/2016 7/18/2017 COMBINED SINGLE LIMIT (Ea accidenk BODILY INJURY (Per person) BODILY INJURY (Per accident) $ 1,000,000 _ $ $ PROPERTY DAMAGE (Per accide $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ $ $ AGGREGATE DED I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE r - / N -1 OFFICER /MEMBER EXCLUDED? (Mandatory in NH) - If yes, describe under DESCRIPTION OF OPERATIONS below N / A I PER I 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) The Certificate Holder is included as an additional insured as required by written contract. CANCELLATION City 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. AUTHORIZED REPRESENTATIVE Bruce Robins /BACH ACORD 25 (2014/01) INS025 mum) © 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORO OKEEMAI -01 SOHARE CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 11/14/2016 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 Maury, Donnelly & Parr 24 Commerce St. Baltimore, MD 21202 INSURED Okeechobee Main Street 55 S. Parrott Avenue Okeechobee, FL 34972 CONTACT NAME: (A/CC,, Ni , Ext): (410) 685 -4625 (AA/c, No): (410) 685 -3071 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Transportation Insurance Services, Inc 20494 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : ERTIFICATE 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM /DD/YYYY) (MM /DD /YYYY) A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO T LOC JEC OTHER: X 4025933977 EACH OCCURRENCE 07/01/2016 07/01/2017 DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP /OP AGG $ _ $ $ $ $ $ $ 1,000,000 1 000 000 10,000 1,000,000 2,000,000 2,000,000 AUTOMOBILE UTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS • • AUNON-OWNED AUTOS ONLY AUUO ONLY COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ $ $ $ UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DED RETENTION $ EACH OCCURRENCE AGGREGATE $ $ $ 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) City of Okeechobee is named as Additional Insured. CANCELLATION City of Okeechobee Y 55 SE 3rd Avenue Okeechobee, FL 34874 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 ACG'RD® `.,►^ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIODIYYYY) 9/282016 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 poficy(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 Robins Insurance Agency, Inc 30 Burton Hills Blvd. Suite 300 Nashville TN 37215 CONTACT Small Business Unit NAME: Nu E :O (615)665 -9200 INC, Nat (615)665- 9207 E -MAIL bbache @robinsins.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURERA:Southern Owners Ins 10190 INSURED What's Cooking Inc DBA: Gourmet Truck Expo 200 SW 32nd Avenue Deerfield FL 33442 INSURER B: 7/18/2016 INSURERC: EACH OCCURRENCE INSURERD: DAMAGE 70 RENTED PREMISES PREMISES (Ea occurrence) INSURER E : INSURERF: X CERTIFICATE NUMBER-2016 -17 MASTER COI 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 TYp ADOL INSD SUBR WVD POLICY NUMBER POLICY EFF IMMIDD(YYYYI POLICY EXP (MMIDDIYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY 03928331 Blanket waiver Subrogation 7/18/2016 7/18/2017 EACH OCCURRENCE 5 1, 000, 000 DAMAGE 70 RENTED PREMISES PREMISES (Ea occurrence) 300, 000 CLAIMS -MADE X OCCUR MED EXP (Any one person) S 10,000 PERSONAL 8 ADV INJURY 5 1,000,000 GENERAL AGGREGATE 5 3 , 000 , 000 GE X X ML AGGREGATE LIMIT APPLIES PER. POLICY ( I E 0 1 (LOC OTHER: PRODUCTS - COMP /OP AGG $ 3,000, 000 Hired &Non.Owned Aut 0 1,000,000 A AUTOMOBILE X LIABILITY ANY AUTO ALLO'ANED AUTOS HIRED AUTOS - X SCHEDULED AUTOS NON - OWNED AUTOS 03928331 7/18/2016 7/18/2017 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 BODILY INJURY (Per person) 5 BODILY INJURY (Per accident 'ROPERTY DAMAGE (Per accident) 5 5 UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE 5 5 OED RESENT ON S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE r I N OFFICERIMEMBER EXCLUDED? f (Mandatory In NH) 8 yes, describe under DESCRIPTION OF OPERATIONS below NIA I PER OTH- STATUTE ER E.L. EACH ACCIDENT 5 E.L. DISEASE - EA EMPLOYEE 9 E . DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) The Certificate Holder is included as an additional insured as required by written contract. Okeechobee Main Street 55 South Parrott Ave Okeechobee, FL 34972 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 Bruce Robins /BACH rr^'�� = -,— ACORD 25 (2014/01) INS025 r2n14O11 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Detail by Entity Name http: / /search.sunbiz. org /Inquiry/CorporationSearch /Search Resu ItDetai... Detail by Entity Name Florida Not For Profit Corporation OKEECHOBEE MAIN STREET, INC. Filing Information Document Number N99000000045 FEI /EIN Number 65- 0887929 Date Filed 01/05/1999 State FL Status ACTIVE Last Event REINSTATEMENT Event Date Filed 10/18/2000 Principal Address 55 S. Parrott Ave OKEECHOBEE, FL 34972 Changed: 01/30/2013 Mailing Address 55 S. Parrott Ave OKEECHOBEE, FL 34972 Changed: 01/30/2013 Registered Agent Name & Address Fitzwater, Jayce L 55 S. Parrott Ave OKEECHOBEE, FL 34972 Name Changed: 03/16/2016 Address Changed: 01/30/2013 Officer /Director Detail Name & Address Title P Burroughs, Maureen 2661 SE 24th Blvd OKEECHOBEE, FL 34974 Title VP Griffin, Angie 313 SW Park St OKEECHOBEE, FL 34974 Title S Bragel, Paulette 55 SOUTH PARROTT AVENUE OKEECHOBEE, FL 34972 2 of 3 12/14/2016 1:00 PM d4WRO OKEEMAI -01 CERTIFICATE OF LIABILITY INSURANCE SOHARE DATE (MM /DD/YYYY) 11/14/2016 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 Maury, Donnelly & Parr 24 Commerce St. Baltimore, MD 21202 INSURED Okeechobee Main Street 55 S. Parrott Avenue Okeechobee, FL 34972 CONTACT NAME: PHONE FAX (A/C, No, Ext): (410) 685 -4625 (ac, No):(410) 685 -3071 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Transportation Insurance Services, Inc 20494 INSURER B INSURER C INSURER D INSURER E INSURER F : • 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', SUBR' POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD I WVD (MM /DD/YYYY) (MM /DD/YYYY) A : X COMMERCIAL GENERAL LIABILITY AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X 4025933977 AMAGE T 07/01/2017 PREM SESO(Ea occur ence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE $ 2,000,000 X POLICY JECT PRO LOC PRODUCTS - COMP /OP AGG $ 2,000,000 OTHER: $ IN SINGLE LIMIT • AUTOMOBILE LIABILITY (Ea ac8 ) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB ; CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER ANY PROPRIETOR /PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? N / A • (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The R.E. Hamrick Trust is listed as an additional insured. The R.E. Hamrick Trust owns the property that Okeechobee Main Street occupies. ANCELLATION R.E. Hamrick Trust 55 SE 3rd Avenue 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 Additional Named Insureds Other Named Insureds Gourmet Truck Expo Gourir.el Truck Expo. Doing Business As C Corporation, Doing Business As OFAPPINF (02/2007) COPYRIGHT 2007, AMS SERVICES INC APL oF Foot) S .E9■\); kk.v C-()..1) p__)(40,,t-cPic_-_ rosob -ro_c_xs PAA-K;,u& Jackie Dunham From: Jackie Dunham Sent: Wednesday, December 28, 2016 10:00 AM To: Brittany Carner Cc: Herb Smith; David Allen; Lane Gamiotea; Chief Peterson Subject: Food Truck Invasion Permit Attachments: 005 -Food Truck Invasion Downtown.pdf Please see the attached, approved permit for the upcoming Food Truck Invasion on January 12th, 2017. Be sure to contact the Fire Department at 863 - 467 -1586 to schedule inspections of the trucks as noted on the permit. Thank you. Ja ckie' Du,vha m' Ad:vturarwe. Se creta ry City of OiceechtYbse. 55 SE TYJrd'Avevw+.e' OkeechalYee,, FL 34.974 rote,: 863 -763 -3372 e4ct. 217 Fay' 863-763-1686 j dunham(c� cityofokeechobee. com Website: http: / /www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. 1