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Parade Permit - OHS Homecoming Parade
Rule 14-65.0035(1Xc), FAC. Date: 7/27/2018 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION TEMPORARY CLOSING OF STATE ROAD PERMIT Permit No. 2018-F-191-017 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 High School Address 2800 Hwy 441 N Contact Person Lauren Myers Telephone (863) 462-5025 ext. Email myersl@okee.kl2.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 10/18/2018 Law Enforcement Agency Responsible for Traffic Control Name of Agency City of Okeechobee Police Department US Coast Guard Approval for Controlling Movable Bridge Not Applicable 0 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 Jackie Dunham Signature Jackie Dunham Date 7/27/2018 Law Enforcement Name/Title Robert Peterson / Chief of Police Signature Robert Peterson Date 7/27/2018 Government Official Name/Title Marcos Montes de Oca / City Administrate Signature Marcos Montes de Oca Date 7/27/2018 FDOT Special Conditions Traffic controll shall comply with the Manual of Traffic Control Devices (MUTCD) and the FDOT Design Manual FDOT Authorization '7flr p_ 1 c I _fl17 Name/Title Lori Benton / DISTRICT PERMIT COORD Signature Lori Benton i pale 7/27/2018- 7/27/20' /27/2018. 7/27/20' Rule 14-65.0035(1)(c), FAC, Date: July 12, 2018 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION TEMPORARY CLOSING OF STATE ROAD PERMIT Governmental Entity • 850-040-65 MAINTENANCE 12/11 Permit No. Approving Local Government City of Okeechobee. Address 55 SE 3rd Ave q ? Contact Person Jackie Dunham Telephone 863-763-3372 (ext. -21-8) Email JDunhamcityofokeechobee.com Organization Requesting Special Event Name of Organization Okeechobee High School Address 2800 Hwy 441 N Okeechobee, FL 34972 Telephone 863-462-5025 Contact Person Lauren Myers Email rnyersL@okee.k12.fl.us Description of Special Event Event Title OHS Homecoming Parade Date of Event October 18, 2018 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 Okeechobee City Police US Coast Guard Approval or Controllingovable Bridge Not Applicable 1/1 Copy of USCG Approval Letter Attached El 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 Signature Law EnforcemenA, Name/Title /14V124....-Nkihtb Government Official Name/Title/ Signature 0198.11y sagned by Laure ers DN cn.Lasoren M 018071'0604O Date Date / T. Signature Date WYA: 49Age.Z.....1.3 1(11 711 FDOT Special Co ions FDOT Authorization Name/Title Signature Date • INDEMNIFICATION AGREEMENT• This AGREEMENT, by and between the CITY OF OKEECHOBEE, FLORIDA, (hereinafter "CITY") and _Okeechobee High School__ ......... . (hereinafter "APPLICANT"), dated this 18th day of October , 201 R . .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 18th day of October , 2018 . 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- BY: PPLICANT BY: Lauren Myers TITLE: Assistant Principal fHS . . • CITY OF OKEECHOBEE, FLORIDA.... BY: . TITLE: FOR CITY USE ONLY Proof of liability insurance Corporate resolution completed Other requirements (specify) DATE: i) -1 a - { g Page 1 of 1 A�� D® CERTIFICATE OF LIABILITY INSURANCE 07/11/2018 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.1.9/C.EMAIL P.O. Box 305191 Nashville, TN 372305191 USA CONTACT NAME: PHONE 1-877-945-7378 FAX 1-888-467-2378 No. Ex0 (AIC, No): ADDRESS: certificates@willis.com INSURER(S) AFFORDING COVERAGE 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 : FSBIT18CAS7-1 INSURERC: 07/01/2019 INSURERD: $ 1,000,000 INSURER E : $ Included INSURER F : E CERTIFICATE NUMBER: W6888526 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 PO M/LICY EFF (MDD/YYYY) POLICY EXP (MM/DD/YYYY) LIMBS A X COMMERCIAL GENERAL LIABILITY Y FSBIT18CAS7-1 07/01/2018 07/01/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO PREMISES (EaENTEoccu ence) $ Included CLAIMS -MADE X OCCUR MED EXP (Any one person) $ Excluded PERSONAL&ADVINJURY $ Included GENERAL AGGREGATE $ Unlimited GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES 'SCOT- PER: LOC PRODUCTS -COMP/OP AGG $ Included $ A AUTOMOBILE X X LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY HIRED — X SCHEDULED AUTOS AUTOS ONLYD FSSIT18CAS7-1 07/01/2018 07/01/2019 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per a ci ent) $ $ UMBRELLA UAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED7 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER STATUTE ERH 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) For the General Liability policy, General Aggregate is Unlimited. Evidence of Coverage: Okeechobee High School Home Coming Parade, October 18, 2018. 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. Florida Department of Transportation is included as an Additional Insured as respects to General Liability. NCELLATION Florida Department of Transportation 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 /,71 v d ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserve. 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Begin at 441 and SW 4th Street proceed to the 441/70 intersection, turn west on 70. End at SW 7th Avenue and SR 70. t:Os, ji Parade Rout Ends 5th Adie` .�A� f iL (cetIa nns� Ave -- R 0 000 0 1 5 1 � Jt I SR 70 East 3 d v t i i Vcf isSae 2)00I Parade Float Stagin. Area lo KEY Cone Officer or Flagman Detour Sign --Parade Route —Detoured Traffic MOT Plan Provided by LT. Bernst