Park Use Permit - Tornado BBQCITY OF OKEECHOBEE
55 SE THIRD A VENUE
OKEECHOBEE, FL 34974
Tele: 863 - 763 -9820 Fax: 863 - 763 -1686
e -mail:
Park Use Permit
Permit Number: 012 Date(s) of Event: April 14, 2017 11AM -5PM
Permit Expiration: April 14, 2017 11:59AM
Purpose of Request: BBQ Fundraiser for Tornado Victims in Ft. Drum
Property Owner: City of Okeechobee
Address: 55 SE Third Avenue
City: Okeechobee
Applicant: His Church
Phone Number: 863 - 357 -6500
State: Florida Zip Code: 34974
Applicant's Address: 1167 Linda Rd,
Okeechobee, FL 34974
Address of Project: Park #4
Current Zoning: P FLU Designation: Public
Subdivision: City of Okeechobee
Restrictions /Remarks: All debris must be removed within 24 hours of expiration date.
The Public Works Director requests 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.
Pa -f j M. 13 wrv,e,H
April 12, 2017
General Services Coordinator Date
Apr 10 2017 04:10PM His Church 8633576500
page 1
Page 1 of 3
Revised 3 -21 -17
CITY OF OKEECHOBEE
55 SE THIRD AVENUE
OKEECHOBEE, FL 34974
Tele: 863- 763 -9821 Fax: 863 - 763 -1686
PARK USE AND /OR TEMPORARY STREET/
SIDEWALK CLOSING
PERMIT APPLICATION
Date Received:
Application No:
7 Ql'9t,
Date Issued: #1 - i , -
Date(s) & Times of Event: t y _ i ar 1\ NA- _1_PM
Information:
Organization: t-kts ek\uizc\t
Mailing Address: 1\ Ls,""/ _ �, O -�� L -61'kc17IA
Contact Name: 1 -A WvCt i'gi,k3 Mho .u1 S
E -Mail Address: pi7c.km 1nt s 11 -tA° Ne.E 56(xiMI)) -0rti
Telephone:
Work: (at53) 357 - L,5c10
home:
Summar of activities:
Cell:
(834czto -3485 i71-1
(Bib3 4%4 - L cf 2 Per
Futk 'MAW) S T 'b kuM Ani •
-yr
Proceeds usage:
►UO j• 'jo TM Vi 1114∎5
Please check requested Parks:
Flagler Parks: u City Hall Park ❑ #1 Memorial Park ❑ #2 ❑ #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:
Apr 10 2017 04:10PM His Church 8633576500
page 2
Page 2 of 3
Revised 11/4/16
TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION
(Street Closings require City Council approval. Meetings 1" & 3rd Tuesdays but subject la change)
Address of Event:
Street(s) to be closed:
Date(s) to be closed:
Time(s) to he closed: ✓
Purpose of Closing:
Attachments Re uired for Use of Parks Attachments Required for Street /Sidewalk Closin . s
• 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.
• Original signatures of all residents, property owners and
business owners affected by the closing.
• Proof of non - profit status (IRS Determination
Letter)
• State Food Service License if> 3 days.
• State Food Service License if> 3 days.
• Notarized letter of authorization from
property owner, if applicable.*
• State AIcoholic 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.
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 pennit, 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.
Apr 10 2017 04 :10PM His Church 8633576500 page 3
Page 3 of 3
Revised 1 1/4/16
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.
i
Applicant Signature
'Viol 17
Date
""0 CE USE ONLY••••
Staff Review
Fire Department:
Date:
/ /Apr� L �/;
51' l`2 • ( 7
Building Official:
' �,,,, _ C k 1 _ ,
Date:
Public Works:
Date:
11-, D —17
Iii
Police Department:
l
Date:
.110 7
.
I
,r: f`,
BTR Department:
t;1» 1.'aq I1c)
Date:
Date:
City Administrator:
City Clerk:
f
J
Date:
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
Temporary Street and Sidewalk Closing reviewed by City Council and approved
Date
Date
Apr 10 2017 04:10PM His Church 8633576500
•
•
page 4
RESOLUTION NO. 03 -8
A RESOLUTION OF THE CITY OF OKEECHOBEE, FLORIDA TO
ESTABLISH GUIDELINES FOR USE OF PUBLIC PARKS OR OTHER
LANDS OWNED BY THE CITY OF OKEECHOBEE FOR CERTAIN
CHARITABLE OR BENEVOLENT ORGANIZATIONS; OR THE GENERAL
PUBLIC; PROVIDING FOR AUTHORITY TO REVIEW SUCH
APPLICATIONS; PROVIDING FOR STANDARDS FOR REVIEW;
PROVIDING FOR GUIDELINES FOR SUCH ORGANIZATIONS TO
FOLLOW; PROVIDING FOR INSURANCE REQUIREMENT; PROVIDING
FOR AN EFFECTIVE DATE.
WHEREAS, there are located within the City of Okeechobee certain public parks and other
areas owned by the City of Okeechobee that are intended for, and open for use by,
the general public, with certain restrictions; and
WHEREAS, these functions range from large gatherings which attract many participants,
to very small groups, which may or may not cause traffic control problems, and vary
in intensity; and
WHEREAS, current regulations require the same liability insurance coverage for any such
group authorized to gather in the parks or on city lands, which creates a hardship
on the smaller gatherings;
NOW, THEREFORE, be it resolved and adopted by the City Council for the City of
Okeechobee, Florida the following resolution:
1. THAT permission for charitable or benevolent organizations, or non profit
groups, to engage in certain activities in City parks or on City lands, is
governed by Article IV, Sections 14 -141 to 14 -149 of the City Code of
Ordinances, which regulations and restrictions shall be considered by
General Services whenever an application or request for use of public areas
is made, and followed accordingly.
2. THAT for any permit or permission granted by the Department of General
Services for such activities on public lands, such permit shall be also
executed by the City Administrator, prior to such event taking place.
3. THAT most applicants for use of parks and public lands are charitable or
civic groups, who stage large events and attract many people. However,
smaller groups for prayer meetings; weddings; boy and girl scouting; and
similar type events are also authorized in parks and in public places, but are
also subject to the requirements of Article IV of the City Code.
THAT current regulations require the applicant for an event to procure
liability insurance In the sum of $ 1 million; the cost of which is or may be
prohibitive for smaller and more informal groups.
5. THEREFORE, for any application wherein it appears to the Department of
General Services that the participants thereof may be 100 or fewer persons,
the liability insurance requirement shall be waived. The City reserves the
right to require the participants to execute a hold harmless agreement,
depending upon the nature and impact of the event.
Page 1 of 2
Apr 10 2017 04:10PM His Church 8633576500
•
page 5
INTRODUCED AND ADOPTED this Sth day of Auctust„ 2003.
. ATTEST:
•,!
Lane Gamiotea, City Clerk
REVIEWED FOR LEGAL SUFFICIENCY:
.------
Cook, City Attorney
Page 2 of 2
James. E. Kirk, Mayor
Apr 10 2017 04:10PM His Church 8633576500 page 6
RESOLUTION NO. 04 -03
A RESOLUTION OF THE CITY OF OKEECHOBEE, FLORIDA
SUPPLEMENTING RESOLUTION NO. 03-08; GUIDEUNES FOR USE OF
PUBUC PARKS OR OTHER LANDS OWNED BY THE CITY OF
OKEECHOBEE FOR CERTAIN CHARITABLE OR BENEVOLENT
ORGANIZATIONS; PROVIDING FOR AUTHORITY TO REVIEW SUCH
APPLICATIONS; PROVIDING FOR STANDARDS FOR REVIEW;
PROVIDING FOR GUIDELINES FOR SUCH ORGANIZATIONS TO
FOLLOW; PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, there are located within the City of Okeechobee certain public parks and other
areas owned by the City of Okeechobee that are intended for, and open for use by,
the general public, with certain restrictions; and
WHEREAS, these uses change from time to time, and problems arise by certain uses that
are not anticipated, but should be the subject of regulation and control by the City
of Okeechobee for the safety and welfare of its citizens, and which requires
supplementing existing rules as necessary;
NOW THEREFORE, it is resolved before the City Council for the City of Okeechobee,
Florida; presented at a duly advertised public meeting; and passed by majority vote
of the City Council; and properly executed by the Mayor or designee, as Chief
presiding Officer for the City:
1.- THAT permission for charitable or benevolent organizations, or non- profit
groups, to engage in certain activities in City parks or on City lands, is
governed by Article IV, Sections 14 -141 to 14-149 of the City Code of
Ordinances, which regulations and restrictions shall be considered by
General Services whenever an application or request for use of public areas
is made, and followed accordingly.
2. THAT for any authorized use of the public parks or rights -of -way within the
City, the following regulations shall be followed, as applicable:
a. The organization or permit holder, or their designee, shall be
responsible to completely clean up the public area used by the permit,
within two days of completion of the event, unless otherwise
designated in the permit.
b. No trailers unattached to a motor vehicle shall be parked along any
street or avenue or public right -of -way, or in a marked parking spot,
unless the right -of -way is closed for the event, not otherwise blocked
off by the City. No other motor vehicles or trailers will be allowed to
park or remain on the Park grounds unless prior written approval is
obtained from the City Public Works Director or their designee, or
such vehicle or trailer is participating in an event such as a permitted
activity or car show. Any motor vehicle or trailer parked in violation of
this section may be towed by the City at the owners expense, who
shall be liable for all towing and storage fees.
c. Golf carts, 4- wheelers or other vehicles not licensed for use on public
rights -of -way, will not be permitted on the Park grounds without prior
written approval of the City Public Works Director or their designee.
• d. Certain events, such as but not limited to parades, or those which
draw a large number of people, require significant incurring of costs
Page 1 of 2
Apr 10 2017 04:11 PM His Church 8633576500
page 7
by the City, for traffic control, crowd control, fire safety, paramedic
service, or general policing, which often requires adding personnel,
and incurring overtime labor expense. For any such event, the City
may require the organization or permit holder to be responsible for
these additional costs, including property or personal injury damages
that may occur during the event. There will be a mandatory inspection
meeting between the Public Works Director or their designee and a
representative from the permit holder prior to and after each event_
Any additional expenses as stated above, will be billed to the
organization or permit holder, who shall pay such sum to the City.
e. For activities in Flagler Park, the use of generators for power is
encouraged, as electric outlets are limited and subject to the right of
the City to deny their use. When generators or extension cords are
used, the applicant shall cause a U.L. approved extension cord of
proper gauge to be safely attached, and routed so as to not interfere
with any pedestrian path, or in such area as may pose a risk of harm
to the public or other participants.
INTRODUCED AND ADOPTED this 16n0 day of March, 2004.
REVIEWED FOR LEGAL SUFFICIENCY:
John R. Cook, City Attorney
•
Page 2 of 2
James. El. kirk, Mayor
Apr 10 2017 04 :11 PM His Church 8633576500 page 8
100548
IRSDepummO of the Treasury
:eternal Revenue Service
P.O. BOX 2508
CINCINNATI OH 45201
HIS CHURCH - ITS JESUS CHURCH INC
1167 LINDA RD
OKEECHOBEE FL 34974
In reply refer to: 9999999999
Sep. 23, 2014 LTR 3367C SO
47- 0978467 OD0000 00
00024781
BODC: TE
Employer identification number: 47- 0978467
Tax form: 1023
Document locator number: 17053- 253 - 30901--4
For assistance, call: 1-877-829-5500
Dear Applicant,
We received your application for exemption from federal income tax
and your user fee payment.
During the initial review process, applications for exemption are
separated into two groups:
1. Those that can be processed based on information submitted
2. Those that require additional information to be processed
If your application falls in the first group you'll receive a
determination letter within approximately 90 days from the date of
this notice stating that you re exempt from federal income tax.
If your application falls in the second group, you'll be contacted
when your application has been assigned to an Exempt Organizations
specialist for review. You can expect to be contacted within
approximately 180 days from the date of this notice. After 180 days,
if you haven't been notified your application was assigned to a
specialist, you can contact Customer Account Services Monday through
Friday at the toll -free number shown above to check on its status.
The individual calling on your behalf will need the following
information:
* Your name
* Your employer identification number (EIN)
* The document locator number listed above and assigned to your
request
* A proper power of attorney submitted with your exemption
application, unless the individual calling is an officer or
director and legally authorized to represent you
The IRS doesn't issue "tax- exempt numbers" or "tax- exempt
certificates" for state or local sales or income taxes. If you need
exemption from these taxes, contact your state or local tax offices.
Most organizations are required to file an annual information return
Apr 10 2017 04 :12PM His Church 8633576500
HIS CHURCH - ITS JESUS CHURCH INC
1167 LINDA RD
OKEECHOBEE FL 34974
page 9
9999999999
Sep. 23, 2014 LTR 3367C SO
47- 0978467 000000 00
00024782
(Form 990, Form 990 -EZ, or Form 990 -PF) or electronic notice (Form
990 -N, the e- Postcard) while their applications for exemption or
miscellaneous determination requests are pending. If you don't file a
required return or notice for three consecutive years, your exempt
status will be automatically revoked. Visit www.irs.gov and type
"annual exempt organization return: who must file" in the search box
for information on the types of organizations that are required to
file annual returns or notices.
To receive the Exempt Organizations' EO Update, an electronic
newsletter with information for tax - exempt organizations and tax
practitioners, go to www.irs.gov /charities and click on "Free
e- Newsletter."
For tax forms, instructions, and publications, visit www.irs.gov or
call 1- 800 - TAX -FORM (1- 800 - 829 - 3676).
Sincerely yours,
G
Tamera Ripperda
Director, Exempt Organizations
Apr 10 2017 04:12PM His Church 8633576500 page 10
0009060 12/12/14
I OFIDA
i
Consumer's Certificate of Exemption
�l �= Issued Pursuant to Chapter 212, Florida Statutes
DEPARTMENT
OF REVENUE
85- 8016593338C -5
Certificate Plumber
This certifies that
12/05/2014
Effective Date
HIS CHURCH -ITS JESUS CHURCH INC
1167 LINDA RD
OKEECHOBEE FL 34974 -0430
DR -14
R. 04/11
12/31/2019 RELIGIOUS - PHYSICAL PLACE 1
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, or services purchased.
P1DR L'-
4
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 from this
requirement except when they are the lessor of real property (Rule 12A- 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.
Apr 10 2017 04:12PM His Church 8633576500 page 11
4/10/2017
Google Maps Flagler Park
Flag ler Park - Google Maps
Flagler Park
4.7 * * * * •10reviews
Park
9 55 SE 3rd Ave, Okeechobee, FL 34974
cityofokeechobee.corn
(863) 763 -3372
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Map data ®2017 Google 100 ft ► e
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Patty Burnette
From:
Sent:
To:
Cc:
Subject:
Attachments:
Patty Burnette
Wednesday, April 12, 2017 11:11 AM
'Matthew Jones'
'office@hischurch-itsjesuschurch.org'
RE: BBQ fundraiser
012-His Church BBQ Fundraiser.pdf
From: Matthew Jones [
Sent: Tuesday, April 11, 2017 12:07 PM
To: Patty Burnette
Subject: Re: BBQ fundraiser
1
$10 Rib J inner
includes: potato salad, baked
beans,
dessert, and sweet tea
100% of Donations
will go to the family who lost their home
and have a baby on the way.
This rriday
April l4
11:30am • Sold Out
Call Dawn
484 - 0196
To place your Orders