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Temp Street Closing - MLK Parade 2018Rule 14-65.0035(1)(c), F.A.C. Date: 12/7/2017 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION TEMPORARY CLOSING OF STATE ROAD PERMIT Permit No. 2017-F-191-022 Governmental Entity 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 Community Improvement Association Contact Person Shirlean Graham Address 585 SE 15th Avenue Telephone (863) 697-6107 ext. Email sgraham@marthashouse.org Description of Special Event Event Title Annual Martin Luther King Parade Start Time 10:00 AM (EST) End Time 11:00 AM (EST) Event Route (attach map) Detour Route (attach map) Date of Event 1/13/2018 Law Enforcement Agency Responsible for Traffic Control Name of Agency City of Okeechobee US Coast Guard Approval for Controlling Movable Bridge Not Applicable 0 Copy of USCG Approval Letter Attached 0 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 Jackie Dunham Signature Jackie Dunham Date 12/7/2017 Law Enforcement Name/Title Robert Peterson / Chief of Police Signature Robert Peterson Date 12/7/2017 Government Official Name/Title Marcos Montes de Oca / City Administrate Signature Marcos Montes de Oca Date 12/7/2017 FDOT Special Conditions Traffic Control Shall comply with the Manual of Traffic Control Devices (MUTCD) and FDOT Design Standards Please enter the parade information into the LCIS system. FDOT Authorization Name/Title Lori Benton / DISTRICT PERMIT COORD Signature Lori Benton r) to 12`7 J ,'! Rule 14-65.0035(1)(c), F.A.C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 850-040-65 TEMPORARY CLOSING OF STATE ROAD PERMIT MAINTENANCE 1zn1 Date: Governmental Entity Permit No. Approving Local Government 6 ry p F DVIU-[_ C HD h C Contact Person K; Address 5-5- 5 3 p At1C G�K� t� cf-4 6L / Fl 34,97Y Telephone 04, 3- 7(03-- Email .0--&4 t� p M C � T� O �=0�; L[rG NO [_ • co /L( Organization Requesting Special Event Name of Organization Q Keerho bec er,nhiAA lmet/IR.-4.cnt Ass. Contact Person `11i`r/(ari. 6fGLhc pv) Address 5q5 S E /,S Ale. ©'_ eeci) Are 97Y Telephone e 3- G 97 -6,07 Email Sy,-u//arrt antlayil' .,s%louse, ars Description of Special Event Event Title lyl LK PDate of Event / /3-19 Start Time /0'•P D A4 End Time f /; U A4 // / ,r Event Route (attach map) Mgr mai Paid(' %�u/rAlt - 5I-jOir A) (!O.'nff vi' Sit) y',$�eeiL v .c/.1)34�g�i Pam f urn 1(8 -North / h>'i( 5t. hArn tr. (, eSj 1) '2 s`ree. ; Detour Route (attach map) /✓o,)h Law Enforcement Agency Responsible for Traffic Control Name of Agency C i CFSGLC 6Lc= US Coast Guard Approval for Controlling Movable Bridge Not Applicable fa--" 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 Shy' -/Pail Cral)an) Law Enforcement Name/Title Z/1-7 /€1, - Government /J�7,t,E�st Government official Name/Title Signature Signature tee, Signature FDOT Spec' Conditions Date /.}-5 •-/'7 Date i z4/7 Date it/c1)-- FDOT Authorization Name/Title Signature Date INDEMNIFICATION AGREEMENT This AGREEMENT, by and between the CITY OF OKEECHOBEE, FLORIDA, (hereinafter "CITY") and S1)1 Jean Crc -?C W) l C 4 (hereinafter "APPLICANT"), dated this 5 day of 7t i?eynbev , 2al7 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 1314' day of Stan , , gag( . 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: SAfr/f44 BY: 0/>C_f5 c 1.1 4A{ TITLE: VP ez Pre 5i rJ-en- TITLE: General Services Assistant FOR CITY USE ONLY XX Proof of liability insurance Corporate resolution completed XX Other requirements (specify) Indemnification Agreement REVIEWED BY: TITLE: DATE: General Services Assistant 14--/7 Ctf�f��I'.L:I 7TH STS; GTH ST \ f{(•.L4. NW fiTHT '' ST 1 r. ,i NW 3TH : -{2: r. 7TH • -t•�.� i.�,r1 + { S 1 •�': ': .�� -44 •��r p 4-4 'r.e'S1141'','�TLt . �� ate._ 2t,a =,^ST • }ti4.4.........T***4**ToTa4.1fT414-....****44( ....4: .;STH • }1: ST 9TH BM ST ! V,' 7TH ST 6T} i T— ST < < = s {1 �. o)); -, „ 3RD �,- Ss: ++��r': S,. SV; < STS. lar... .....` > (SVI .jlD Sp;7•c: m C :SV: iii S7' r S •1ST S1 St. 8TH --{ M-- r; ST • S • lal;': Sri c! sV pir 1 ST ST i 3iL�`. �.ii�'1• 12TH . ST r;I:-•1iT}i ST Ii 10TH ST STH ST a.. T i l c;tfkk Co tts 1_Feder 1. Man' € «? on Umto "tf 1,:;f is Co?De k es ( U rCD) and FDOT Design Stan £° lrth 6 0 Series. r: : °Tri ST Begin at 44 e 441/70 intersection turn west tan 7G. End at SW 7}1' Avenue and SR 7th, > rte'' ;Ti n m V! S, HST ',9THIST ';0'11; •1 TH uk :;):__ -1 S1. 7TH RT Sf 6TH J NW 3rd St W 2nd 5th West SR 70 West / . ._ ecID cD Ave DEC 7,000 000'D Parade Float Stagtn Area —t' ..i KEY Cone 1 Officer or Flagman ® Detour Sign —Parade Route —Detoured Traffic 0 �! Not To Scale MOT Plan Provided by LT. Bernst ACORO CERTIFICATE OF LIABILITY INSURANCE OKEE-44 OP ID: S2 DATE (MM/DD/YYYY) 12/05/2017 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 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 Pritchards & Associates, Inc. 1802 S Parrott Ave Okeechobee, FL 34974-6179 Lowell H Pritchard INSURED Okeechobee Community Improvement Association 585 SE 15th Avenue Okeechobee, FL 34974 NAME: CONTACT Sandy Hines PHONE (A/c. No. Ext): 863-824-3175 FAX No): 863-763-5629 ADDARESS: shines@pritchardsinc.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A Philadelphia Indemnity Ins 18058 INSURER B : INSURER C : INSURER D : INSURER E : 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 LTRINSD TYPE OF INSURANCE ADDL SUBR POLICY EFF WVD POLICY NUMBER (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY i i EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE [-X I OCCUR EV25036 01/13/2018 01/15/2018 GE TO PREMSES (EaENTED occurence) $ 100,000 MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY PRO JECT LOC PRODUCTS - COMP/OP AGG $ 3,000,00Q OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ I— HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENT ON $ $ WORKERS COMPENSATION 1 PER I STATUTE OTH- ER AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE / N E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 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) Certificate Holder is listed as an Additional Insured in regards to the Martin Luther King Festival being held on 1/13/18 - 1/15/18 CITY -92 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 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD