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Park Use Permit-Food Truck EventCITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 Tele: 863-763-3372 ext. 217 Fax: 863-763-1686 e -mail: jdunham ci cityofokeechobee.com Park Use Permit Permit Number: 009 Permit Expiration: March 9, 2017 11:59PM Purpose of Request: Food Truck Event Property Owner: City of Okeechobee Address: 55 SE Third Avenue City: Okeechobee Date(s) of Event: March 9, 2017 3:30pm- 9:30pm State: Florida Zip Code: 34974 Applicant: Okeechobee Main Street Applicant's Address: 55 S. Parrott Avenue Phone Number: 863 - 357 -6246 Address of Project: Park #3 Current Zoning: P FLU Designation: Public Subdivision: City of Okeechobee Restrictions /Remarks: All debris must be removed within 24 hours of expiration date. City water sources will not be utilized IMPORTANT REMINDERS Fire Department Needs To Inspect All Food Trucks Please Call To Schedule At 863 -467 -1586 Main Street is responsible for removing all barricades, cones etc. from the street and placing them in the corner of the park to be collected after event. All street & sidewalks need to be open and clear of traffic control devices. Main Street is responsible for clean -up of all garbage from the event including emptying the trash cans in the park(s) used and placing clean trash can liners in cans after the event. Ja,d<.ei March 1, 2017 General Services Secretary Date Page 1 of 3 Revised 11/486 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: 2/22/2017 Date Issued: 5 -/ -/ "7 Application No: r-i - t ,ci Date(s) & Times of Event: 3/9/2017 3:30PM- 9:30PM Information: Organization: Okeechobee Main Street Mailing Address: 55 South Parrott Ave. Okeechobee, FL 34974 Contact Name: Brittany Carver E -Mail Address: brittany @okeechobeemainstreet.org Telephone: Work: 863/357/6246 Home: Cell: 863/273/1842 Summary of activities: A food truck event in Okeechobee's Downtown. An evening to enjoy great food with friends and family. This night will include a DJ, craft vendors,and foods of all kinds. Main Street will provide volunteers for trash clean up and Port A Lets in the North East corner of Park 3. The DJ will set up under the gazebo. Proceeds usage: Proceeds of 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 a #3 ❑ #4 ❑ #5 ❑ #6 [Park 3 is location of Gazebo. Park 4 is location of Bandstand] (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: Page 2 of 3 Revised 11/4/16 TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (Street Closings require City Council approval. Meetings 1st & 3" Tuesdays but subject to change) Address of Event: Street(s) to be closed: Date(s) to be closed: Time(s) to be closed: Purpose of Closing: equired for Use of Parks Attachments Required for Street /Sidewalk Closings ■ Site Plan ■ 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 and R.E. Hamrick Testamentary Trust as Additional Insured. ■ Proof of non - profit status (IRS Determination Letter) ■ Original signatures of all residents, property owners and business owners affected by the closing. ■ State Food Service License if > 3 days. lo- State Food Service License if > 3 days. • Notarized letter of authorization from property owner, if applicable.* It- State Alcoholic Beverage License, if applicable. ** * Required if private property used in conjunction with a Park Use application. ** Alcoholic beverages can be served only on private property. Alcoholic beverages NOT ALLOWED in City Parks, City streets or City sidewalks. See additional note below. ❑ Please check if items will be sold on City streets /sidewalks. Each business will need to apply for a Temporary Use Permit 667 along with the Street Closing application. 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. * * *NO CITY WATER SOURCE WILL BE UTILIZED * ** 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 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 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 cashier's 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 Revised 11/4/16 I hereby acknowledge that I have read and completed this application, the attached Resolutions No.(s) 03 -8 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 regulations, which may be lawfully prescribed by the City Council of the City of Okeechobee, or its officers, for the issuance Certificate of Insurance must name City of Okeechobee as Additional Insured as well as R.E. Hamrick Testamentary Trust if closing streets or sidewalks. Brittany Carner 2/22/2017 Applicant Signature Date ••••OFFICE USE ONLY**** Staff Review n� Fire Department: c (3 -‘:'----I �. 'fi,`' / Date: 0/ Max. D.c,tT Building Official: f ,l• Date: 2'27.11 Public Works: J Date: 2-.77—/ 7 Police Department: Date: Z1/4-3/ 7 BTR Department: r i Date: 41 /17 City Administrator: Date: 7-7/2� // City Clerk: ■�/ ` CI(\ G1-- Date: 3I i I I(`1 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 IMPORTANT REMINDERS Fire Department Needs To Inspect All Food Trucks Please Call To Schedule At 863 - 467 -1586 Main Street is responsible for removing all barricades, cones etc. from the street and placing them in the corner of the park to be collected after event. All street & sidewalks need to be open and clear of traffic control devices. Main Street is responsible for clean -up of all garbage from the event including emptying the trash cans in the park(s) used and placing clean trash can liners in cans after the event. ,E6) e fV1 • AA\ 13 c4 c) CZ Ck • 11 it 4111k'*k , t _ ' • ACORN►® 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. CERTIFICATE OF LIABILITY INSURANCE DATE (MM(DDIYYYY) 9/28/2016 '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 CONTACT NAME: Small Bus l.ness Unit PHONE (615) 665 -9200 (A/C. No Ext) E-MAIL ADDRESS: bbache @robinsins.corn INSURER(S) AFFORDING COVERAGE INSURER A :Southern Owners Ins FAX (AIC, No): (615)665 -9207 t NAIC 8 10190 INSURED What's Cooking Inc DBA: Gourmet Truck Expo 200 SW 32nd Avenue Deerfield INSURER B : INSURER C : INSURER D : INSURER E: FL 33442 INSURERF: 2016 -17 MASTER COI REVISION NUMBER: vvvcmmvcv - ..........._.._...__... 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 W VD POUCY NUMBER POLICY EFF DI (MMIDYYYY) POLICY EXP (MMIDDIYYYY) LIMITS A X GEN'L X X COMMERCIAL GENERAL LIABILITY 03928331 Blanket Waiver Subrogation 7/18/2016 7/18/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300, 000 -MADE LIMIT APPLIES PER. MED EXP (Any one person) $ 10,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 AGGREGATE PRO LOC PRODUCTS - COMP /OPAGG $ 3,000,000 POLICY OTHER: JECT Hired & Non -Owned Aut $ 1,000,000 A AUTOMOBILE LIABILITY 03928331 • ,, , 7/18/2016 7/18/2017 CO aBBINEDDtj INGLE LIMIT $ 1,000,000 AUTO BODILY INJURY (Per person) $ ANY ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS AUTOS ED BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB $ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N ANY PROPRIETOR/PARTNER /EXECUTIVE I OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA H 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. GtK I ie'IGA 1 t r7ULunrc 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 /BACI-i .ww es el,..1 s1-1 It TIA \I A11 ....1.4... s,/ ACORD 25 (2014/01) INS0251701e01t The ACORD name and logo are registered marks of ACORD OKEEMAI -01 SOHARE 4 2 JRO iii.....-••••"-- CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/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 CONTACT NAME: PHONE 410 685-4625 FAx (AIC, No, Ext): { ) 5-4625 (A/C, No):(410) 685 -3071 IL DDMARESS: INSURER(S) AFFORDING COVERAGE NAIC 4 INSURER A : Transportation Insurance Services Inc INSURER B • 20494 INSURED Okeechobee Main Street 55 S. Parrott Avenue Okeechobee, FL 34972 INSURER C 07/01/2017 INSURER D $ 1,000,000 INSURER E : $ 1,000,000 INSURER F : j CLAIMS -MADE X ji OCCUR • 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 ADDL TYPE OF INSURANCE )NSD SUBR WVD POLICY NUMBER POUCY EFF IMMIDDIYYYY) POLICY EXP IMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 4025933977 07/0112016 07/01/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED ESEMLSE (Ea_cum„el $ 1,000,000 j CLAIMS -MADE X ji OCCUR X MED EXP An • one •erson $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE X 'L AGGREGATE LIMIT APPLIES PER. POLICY ' PELT r. , LOC OTHER: PRODUCTS - COMP /OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY AUE TOS ONLY .— SCHEDULED AUTOS p OWN I0 AUTOS ONLY CO MaccnjeDISINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per acckfeni) $ $ UMBRELLA UAB EXCESS LIAB ^ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N AAFYIPRPROPRIETOR/PARTNER/EXECUTIVE E N (- � (Mandatory in NH) I — If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER I IORTH- STATUTE, L E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Okeechobee is named as Additional Insured. City of Okeechobee 55 SE 3rd Avenue Okeechobee, FL 34874 I 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 2016 FLORIDA NOT FOR PROFIT CORPORATION ANNUAL REPORT DOCUMENT# N99000000045 Entity Name: OKEECHOBEE MAIN STREET, INC. Current Principal Place of Business: 55 S. PARROTT AVE OKEECHOBEE, FL 34972 Current Mailing Address: 55 S. PARROTT AVE OKEECHOBEE, FL 34972 US FEI Number: 65- 0887929 Name and Address of Current Registered Agent: FITZWATER, JAYCE L 55 S. PARROTT AVE OKEECHOBEE, FL 34972 US FILED Mar 16, 2016 Secretary of State CC4932521914 Certificate of Status Desired: No The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: JAYCE FITZWATER 03/16/2016 Electronic Signature of Registered Agent Officer /Director Detail : Title Name Address City- State -Zip: Title Name Address City- State -Zip: P BURROUGHS, MAUREEN 2661 SE 24TH BLVD OKEECHOBEE FL 34974 S BRAGEL, PAULETTE 55 SOUTH PARROTT AVENUE OKEECHOBEE FL 34972 Title Name Address City- State -Zip: Title Name Address City- State -Zip VP GRIFFIN, ANGIE 313 SW PARK ST OKEECHOBEE FL 34974 T SCHERRER, GARY 55 S. PARROTT AVE OKEECHOBEE FL 34972 Date hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am an officer or director of the corporation or the receiver or trustee empowered lo execute this report as required by Chapter 617. Florida Statutes. and that my name appears above, or on an attachment with all other tike empowered. SIGNATURE: MAUREEN BURROUGHS PRESIDENT 03/16/2016 Electronic Signature of Signing Officer /Director Detail Date Jackie Dunham From: Brittany Carne/<brittary@okeechobeemainsteet.org/ Sent: Wednesday, February 22, 2017 3:55 PM To: Jackie Dunham Subject: RE: Food Truck Jackie, The rermft that 1 submitted states everything that will take place at this event, TherevviUbeno"speda|eveot"nneaning\hotvvewiUnothaveaK]demo'movieiothepa/k,ecL The site plan states where the food trucks will he, where the DJ will be, where the vendors will be, and also where the Port A Lets will he placed. This is going to he a very basic food truck event. This permit was written today and I did copy the site plan that you drew because it has not changed. 1 hope this helps. Bwttamy Carner ExecutweDirectnr O&eerchoLee Man Street 55S Parrott Ave Okeechmbee, FL. 34972 863'357-6246 Follow us on Facebook and Twitter. Visit us at www.okeechobeemainstreet.org From: Jackie Dunham [maikoidunham .com] Sent: Wednesday, February 22, 2017 3:26 PM To: Brittany Carner Subject: RE: Food Truck Brittany please call and talk with me about this event. Thank you. A S [i,ty/f Oke,e,c,holue/ 55SE7hi,ro,,4vexvzte. Oknahabma,FL 34974 7els863'763'3372o4ct217 Fm*z863-763-1686 uo�`-� �� nh �c�o�cc��o��cco ] u _ / �tyo � nu Website: http://www.cityofokeechobee.com NOTICE: Due to a's broad public laws, this email may be subject to public disclosure. l From: Brittany [erner[maUto:britta i Sent: Wed February 22, 2017 3:19 PM To: Jackie Dunham Cc: Marcos Montes De Oca Subject: Food Truck Jackie, Attached is the Food Iruck application. There will be no special event or activity. Thank you. &hittamy Carnes Executive thnector Oheachmbee rilal'in6tmeet 55 .S, Parrott Ave :Okeechobee' FL, 34972 �61.3'S57'6245 FoIIow us on Facebook and Twitter. Visit us at www.okeechobeemainstreet.org 2 Jackie Dunham From: Jackie Dunham Sent: Thursday, February 23, 2017 9:01 AM To: Chief Peterson; Herb Smith; David Allen; Lane Gamiotea; Kim Barnes; Jeff Newell Cc: Patty Burnette; Jessie Subject: Signatures Required I am in receipt of two new Park Use Permit applications which will require your review and signatures. One is for the Okeechobee Main Street's monthly Food Truck Event in Park 3. They will not be having any other special activities with this event other than a DJ and vendors which they have noted on their site plan. Their event is March 9`h. The other is for the annual March of Dimes Walk in Park 4. They will be having music, food, crafts and an awards presentation. Their event is April 1st. Neither of these events are requesting any streets to be closed. Please stop by my desk at your earliest convenience so I may complete these applications in a timely manner. Your cooperation is appreciated. Jackie/ DwvtihaN w A dAtt,i vr✓iistrat'we' Secretary City of Okeechab-e e' 55 SE Tyu;vd'Avevwse- Oicoechabe.e/, EL 34974 Teie: 863-763-3372 ext. 217 Fax: 863- 763 -1686 jdunham a 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: Jackie Dunham Sent: Wednesday, March 01, 2017 2:36 PM To: Herb Smith; David Allen; Chief Peterson; Lane Gamiotea Cc: Jessie; Major Hagan; Patty Burnette Subject: Reminder for Upcoming Food Truck Event Attachments: March 9th Food Truck Event.pdf Attached is a copy of the permit, application and site plan for the upcoming Food Truck Event being held March 9th in Park 3. Please schedule your staff as required or needed. Thank you. Ja cki e- D unh.a vw Ad tr t ve/Secr'etavy City of O koe chab-eeZ 55 SE 7 r& l vevut.e' Okeecholye,eJ, FL 34974 Tee,.. 863 -763 -3372 ext. 217 Fad' 863-763-1686 jdunham(ci)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: Jackie Dunham Sent: Wednesday, March 01, 2017 2:32 PM To: Brittany Carner Subject: Food Truck Permit Attachments: 009 -Food Truck Invasion Downtown.pdf Attached is the permit for the upcoming Food Truck event being held March 9th in Park 3. Please pay special attention to the reminders in red. Thank you. Jack ie/ D tkVaLCA4Nli Amara - Ove'Secv'eta.vy C(ty of OkeeclicUee/ 55 SE ThivctAvevwtez Okeechobe , EL 34974 TeL' 863-763-3372 ext. 217 863-763-/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. 1