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Park Use Permit -Speckled Perch FestivalCITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 Tele: 863 - 763 -3372 ext. 217 Fax: 863 - 763 -1686 e -mail: jdunham(cityofokeechobee. com Park Use Permit Permit Number: 003 Permit Expiration: March 12, 2017 11:59PM Purpose of Request: Speckled Perch Festival Property Owner: City of Okeechobee Address: 55 SE Third Avenue City: Okeechobee Applicant: Okeechobee Main Street Phone Number: 863 - 357 -6246 Current Zoning: P Subdivision: City of Okeechobee Date(s) of Event: March 11 & 12, 201710A -3PM State: Florida Zip Code: 34974 Applicant's Address: 55 S. Parrott Avenue Address of Project: Parks 2, 3, 4 & 5 FLU Designation: Public Restrictions /Remarks: All debris must be removed within 24 hours of expiration date. Per Fire Chief due to the extent of activities he will have members of his staff on site assisting with Fire, Life and Safety issues. Reminder: Main Street responsible for emptying trash receptacles and replacing with new liners per Public Works Director. ,jack4;e7Dccnlur444/ March 8, 2017 General Services Assistant Date �LL `��y.oF•OKFFCt+ s� °om∎ ,^ ` 41� s; "- 47 - •,,;,,;,��' 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: 08/09/2016 Date Issued: 3 .'.f' -, •1 Application No: 1 • • co 3 Date(s) of Event: 03/11/2017 & 03/12/2017 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: 52nd Annual Speckled Perch Festival will be the weekend of March 11, 2017 and March 12, 2017. This event is a celebration of the fishing industry that put Okeechobee on the map. This event will include artist, vendors of all kinds, food, DJ music and an outdoor family friendly event. There will be a parade accompanying the festival on Saturday morning as a tribute to our community. In addition there will be an antique car show located in Park 5. 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 X #3 X #4 Af #5 ❑ #6 OR Address of event: Parcel ID: 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 and 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 INSURED. 4dtahVI/(4/1/ W6/7/0 No.(s) 03- is correct, and obey all the or Applicant Signature Date! ••••OFF E USE ONLY•••• \) Staff Review ( T00 a- 1-° a S / Fire Department: Asx;S;NS ilfa. Date: / Cf•0,Z0l7 Building Official: Firs. r- Li I SAritry r / c.._ Date: Z .15. 17 Public Works: ,r /....--- Date: 2-/t/ ^ j 7 Police Department: ! ., ;/ Date: Z /_5' % 7 BTR Department: /j'y Oetit, Date: o - /y -/ 7 City Administrator: Date: Z; 4-,r /' City Clerk: f ' 'l� } 4 ,`�`� i as Date: r NOTE: APPLICATION AND INSURANCE CERTIFICATE MUST BE COMPLETED RETURNED TO THE GENERAL SERVICES DEPARTMENT THIRTY (30) DAYS EVENT FOR PERMITTING. Temporary Street and Sidewalk Closing submitted for review by City Council on Temporary Street and Sidewalk Closing reviewed by City Council and approved AND PRIOR TO _ 7 - f I Date b - ? -1-1 Date Page 2 of 3 TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (If not using Park(s), provide event address) Street Address City State Zip Code Street(s) to be closed: Sv42nd, 3rd and 4th Avenue 'KJ iita N id AKA su! PANt sr Date(s) to be closed: Friday March 10, 2017 - Sunday March 12, 2017 Time(s) to be closed: Close streets Friday at 5PM and reopen Sunday at 3PM Purpose of Closing: Speckled Perch Festival Attachments Required: Charitable Function Temporary Street and Sidewalk Closing • Site Plan • Original signatures of all residents, property owners and 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 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. Sk-C:UQj S-1.-\0eJ CjDsp. P03, 3rc\, LVVIt' �►�s OKEEMAI -01 SOHARE '4CORb' CERTIFICATE OF LIABILITY INSURANCE L..----- 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 CONTACT NAME: PHONE 410 685 -4625 FAX 410 685 -3071 (A/c, No, Ext >: ( ) (A/c, No):( ) ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Trans • OrtatiOn Insurance Services, Inc INSURER B : 20494 INSURED Okeechobee Main Street 55 S. Parrott Avenue Okeechobee, FL 34972 INSURER C : 4025933977 INSURER D : 07/01/2017 INSURER E : $ 1,000,000 INSURER F : $ 1,000,000 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 (MMIDDIWWI POLICY EXP (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X 4025933977 07/01/2016 07/01/2017 EACH OCCURRENCE $ 1,000,000 Rat SES1 ao(ccurrrence) $ 1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one •erson S 10,000 GEN'L PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 AGGREGATE POLICY 1 OTHER: LIMIT APPLIES PRO- JECT PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE UTOMOBILE ■ LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY SCHEDULED AUTOS NON-OWNED ONLY COMBINED SINGLE LIMIT [Ea accident) $ BODILY INJURY Per •erson S BODILY INJURY Per accident $ PROPERTY DAMAGE AMAGE Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE 5 $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY OFFICER/MEMBER EXCLUDED? PROPRIETOR/PARTNER/EXECUTIVE (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N 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) The R.E. Hamrick Trust is listed as an additional insured. The R.E. Hamrick Trust owns the property that Okeechobee Main Street occupies. CANCELLATION 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 OKEEMAI -01 SFISHER A C)Rlb CERTIFICATE OF LIABILITY INSURANCE DATE (MMI O76 DDIYYYY) 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 Maury, Donnelly & Parr 24 Commerce St. Baltimore, MD 21202 CONTACT NAME: PHONE 410 685 -4625 FAx 410 685 -3071 (A/C, No, Ext): ( ) (A/C, No): ( ) E-MAIL A DDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Transportation Insurance Services, Inc 20494 INSURED Okeechobee Main Street 55 S. Parrott Avenue Okeechobee, FL 34972 INSURER B : 4025933977 INSURER C : 07/01/2017 INSURER D : $ 1,000,000 INSURER E : $ 1,000,000 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X 4025933977 07/01/2016 07/01/2017 EACH OCCURRENCE $ 1,000,000 PREMISES� (Ea r occurrence) $ 1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE X 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALLOWNED AUTOS HIRED AUTOS SCHEDULED NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 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 ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y I N N / A STATUTE OTH- 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 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 (2014/01) © 1988-2014 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 I 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 1 am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617. Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: MAUREEN BURROUGHS PRESIDENT 03/16/2016 Electronic Signature of Signing Officer /Director Detail Date Jackie Dunham From: Sent: To: Cc: Subject: Tracking: Jackie Dunham Monday, February 13, 2017 10:48 AM Herb Smith; David Allen; Chief Peterson; Lane Gamiotea; Kim Barnes Robin Brock; Jessie; Major Hagan New Park Use /Street Closing Applications Recipient Herb Smith David Allen Chief Peterson Lane Gamiotea Kim Barnes Robin Brock Jessie Major Hagan Robert Peterson Read Read: 2/14/2017 6:48 AM Read: 2/13/2017 4:33 PM Read: 2/14/2017 8:14 AM Read: 2/13/2017 10:59 AM Read: 2/13/2017 11:56 AM Review and signatures are needed for two Park Use Applications, one includes a street closing which will go to the City Council Meeting scheduled for March 7`i'. Please stop by my desk for more information. Jackie/ D u.1.h cfmty A d wu.vurtv'atwe'Secv'eary City of0ice-echo-1)-ex/ 55 SE Thi.rd/Avevw e' Okeechobee, EL 34974 Tee' 863-763-3372 ext. 217 Fa-w' 863-763-/686 idunham(cb,cityofokeechobee.com Website: http: / /www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. 1 Jackie Dunham From: Jackie Dunham Sent: Wednesday, March 08, 2017 4:02 PM To: Herb Smith; David Allen; Chief Peterson; Major Hagan; Lane Gamiotea Cc: Patty Burnette; Jessie Subject: Upcoming Speckled Perch Festival Attachments: Speckled Perch Permit.pdf Attached is the approved permit and application for the Speckled Perch event this weekend. This event does include street closings and a parade on Saturday. Please coordinate with your staff accordingly. Thank you. Jc ck.ie' D um.ha.wv fl dM tvatOvei Secv eta vy City of Okeechobee/ 55 SE Th d'Avevutie Okeecha1 , FL 34974 Ted' 863 -763 -3372 ext. 217 F--': 863-763-7686 jdunham0),cityofokeechobee.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: Jackie Dunham Sent: Wednesday, March 08, 2017 3:57 PM To: Brittany Carner Subject: Speckled Perch Festival Attachments: 003 - Speckled Perch Festival.pdf Brittany, here is your permit. My apologies that this was cut so close to your event date. If anything looks incorrect please let me know asap. Jackie'Dw hanyv Aa m, vid/stv'a- vve'Secreta ry City of Okeechobee/ 55 SE 1hrd'Avevuke/ Okeecho1 ee', FL 34974 Yet' 863-763-3372 ext. 217 Fay' 863 -763 -1686 j dunham(cityo fokeechobee. com Website: http: / /www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. 1