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Temp. Street Closing-2017 Homecoming ParadeRule 14-65.0035(1)(c), F.A.C. Date: 8/15/2017 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION TEMPORARY CLOSING OF STATE ROAD PERMIT Governmental Entity Permit No. 2017-F-191-008 850-040-65 MAINTENANCE 12/11 Approving Local Government CITY OF OKEECHOBEE Address 55 SE Third Avenue Contact Person JACKIE DUNHAM Telephone (863) 763-9821 ext. Email jdunham@cityofokeechobee.com Organization Requesting Special Event Name of Organization Okeechobee High School Address 2800 Highway 441 North Contact Person Lauren Myers Telephone (863) 462-5025 ext. Email myersl@okee.k12.fl.us Description of Special Event Event Title OHs Homecoming Parade Start Time 6:00 PM (EDT) End Time 6:45 PM (EDT) Event Route (attach map) Detour Route (attach map) Date of Event 10/12/2017 Law Enforcement Agency Responsible for Traffic Control Name of Agency City of Okeechobee US Coast Guard Approval for Controlling Movable Bridge Not Applicable El 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 to the public. Signatures of Authorization Event Coordinator Lauren Myers Law Enforcement Name/Title Robert Peterson / Chief of Police Signature Lauren Myers Date 8/15/2017 Signature Robert Peterson Date 8/15/2017 Government Official Name/Title Marcos Montes de Oca / City Administrate Signature Marcos Montes de Oca Date 8/15/2017 FDOT Special Conditions FDOT Authorization Name/Title Lori Benton / DISTRICT PERMIT COORD Signature Lori Benton Date 8/15/201' --- Rule "4-65.0035(1)(4 F.A.C. Date: July 18, 2017 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION TEMPORARY CLOSING OF STATE ROAD PERMIT Governmental Entity Permit No. 850-040-65 MAIN fE NANCE 12/11 Approving Local Government City of Okeechobee Address 55 SE 3rd Ave Contact Person Patty Burnette Telephone 863-763-3372 (ext. 218) Email pburnette@cityofokeechobee.com 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 12, 2017 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 Qkeechobee City Police US Coast Guard Approval for Controlling Movable Bridge Not Applicable ✓ 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 to the public. Event Coordinator Lauren Myers Law Enforcement Name/Title 6/.///e-T;:,et26't,:E7 ,.0./-7eXAc&J Signature Government Official Name/Title Signatures of Authorization Signature -Sianature FDOT Special onditions Date 447_ Date %/ZT Date 2 Y/,� FDOT Authorization Name/Title Signature Date Page 1 of 1 ® AC CPRO `.►" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 07/21/2017 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 Willis Administrative Services Corporation DBA Willis Pooling c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA CONTACT NAME: PHONE 1-877-945-7378 FAX 1-888-467-2378 (AIC. No. Ext). (A/C, No): E-MAIL certificates@willis.com ADDRESS: INSURER(S)AFFORDINGCOVERAGE NAIC# INSURER A: Florida School Boards Insurance Trust D2772 INSURED Okeechobee County School District Attn: Chris Lawrence 700 SW Second Avenue Okeechobee, FL 34974 USA INSURER B: FSBIT1 7CAS7 -1 INSURER C : 07/01/2018 INSURER D : $ 2,000,000 INSURER E : INSURER F : X COVERAGES CERTIFICATE NUMBER: W3064457 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. ITR TYPE OF INSURANCE ADDL NSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MM/DDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY N N FSBIT1 7CAS7 -1 07/01/2017 07/01/2018 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTE PREMISES (Ear occuence) $ Included MED EXP (Any one person) $ Excluded PERSONAL &ADV INJURY $ Included GE 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ Included $ A AUTOMOBILE X X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY X SCHEDULED AUTOS NON -OWNED AUTOS ONLY N N FSBIT17CAS7-1 07/01/2017 07/01/2018 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILYINJURY(Peraccident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N No NIA N FSBIT17CAS7-1 07/01/2017 07/01/2018 X PER STATUTE OTH- ER El. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT 2,000,000 $ • DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) For the General Liability policy, General Aggregate is Unlimited. Parade route will begin at 441 and SW 4th Street and proceed to the 441/70 intersection, turn west on 70, end at SW 7th Avenue. The certificate holder is an additional insured in regards to this event only. CERTIFICATE HOLDER CANCELLATION Florida Department of Transportion 801 North Broadway Avenue Bartow, 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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Bernst • INDEMNIFICATION AGREEMENT This AGREEMENT, by and between the CITY OF OKEECHOBEE, FLORIDA, (hereinafter "CITY") and Okeechobee High School (hereinafter "APPLICANT"), dated this 12th day of October , 2017. 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: 1. 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 12th day of October , 2017 . Applicant shall further reimburse the CITY for any and all attorneys 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 forms to make application to the State of Florida, Department of Transportation, for temporary road closure. APPLICANT CITY OF OKEECHOBEE, FLORIDA.... BY: Lauren Myers BY: a1cA ,ba -n h A M TITLE: Assistant Principal _OHS __ • TLTLE: ; s T riiT; c %J55 C.&nler/„4l 6E-ity ':5 FOR CITY USE ONLY Proof of liability insurance � �Corporate resolution completed I l,�f Other requirements (specify) - b cit -c M ; FT CA i ;0 A4 /,�,e%,d cc a nI i BY: e, DuAA-P.4I' TITLE: DATE: 7 `I 7 Fi oMe &Um t) Jackie Dunham From: Jackie Dunham Sent: Friday, July 21, 2017 3:34 PM To: myersl@okee.k12.fl.us Subject: Re: OHS Homecoming Parade Yesterday a representative dropped off the application for the upcoming Homecoming Parade. The only other item I need will be the General Liability Insurance in the amount of $1 million, indicating the name and date of the event in the "description of operations" area and showing the Certificate Holder as Florida Department of Transportation, 801 N Broadway Ave., Bartow, FL 33831. If you have any questions just contact me. Have a nice weekend. Jackie Dunham. Ac NnVitrat'we- Secretcury City of Okeechobee. 55 SE ThirddAvetiuie Okeechobee., FL 34974 863 -763 -33 72 (Ma.:4n.) 863 -763 -9821 (Direct) 863-763-/686 (Fc4.40 j dunham(acityofokeechobee. 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: Subject: Attachments: Jackie Dunham Wednesday, August 16, 2017 12:02 PM myersl@okee.k12.fl.us Approved Homecoming Parade Permit OHS Homecoming Parade.pdf Please see the attached, approved Homecoming Parade for October, 2017. I'm sending the attachments too. Jack t e. Dw' ha.wv AclAirawiiistrax'vve. Secretary Cray of Okeechol 55 SE Third,Aveviue Okeec,ho-b-ee., FL 34974 863 -763 -3372 (Ma4;v0 863-763-9821 (Direct) 863-763-1686 (Fax) jdunham@cityofokeechobee.com Website: http://www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. i