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Temp. Street Closing - FBC VBSCITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 Tele: 863-763-9821 Fax: 863-763-1686 e-mail: jdunham(c�cityofokeechobee.com Street Closing Permit Permit Number: 007 Permit Expiration: June 14th 2019 11:59PM Purpose of Request: Vacation Bible School Property Owner: First Baptist Church of Okeechobee Address: 401 SW 4th Street City: Okeechobee Date(s) of Event: June 10-14,2019 8AM — 1PM daily State: Florida Zip Code: 34974 Applicant: FBC of Okeechobee Applicant's Address: 401 SW 4th St., Okeechobee, FL 34974 Phone Number: 863-467-7625 Address of Project: 310 SW 5th Ave./The Rock Current Zoning: RMF FLU Designation: Single Family Subdivision: City of Okeechobee Restrictions/Remarks: All debris must be removed within 24 hours of expiration date Temporarily closing SW 4th Street between 5th & 6th Avenues to enable safety for children crossing between the two areas. Tacl e' ,T mine/ 5, 2019 Administrative Secretary Date Page 1 of 3 Revised 3-24- 3- s-I 4 CITY OF OKEECHOBEE y oF.01(4.y_ 55 SE THIRD AVENUE •'4,,cgr. OKEECHOBEE, FL 34974 o , [ r; Tele: 863-763-9821 Fax: 863-763-1686 ='d= ` o °•'• PARK USE AND/OR TEMPORARY STREET/ -1,*9 -IK � SIDEWALK CLOSING PERMIT APPLICATION Date Received: 5. Ci c`1Ctol Date Issued: 6. - l q Application No: iy ..col Date(s) & Times of Event: j7- (0 (4, 2UI' p nry, ft 1 phi doci Information: Organization: 5}- j-r H* Cpl ttl1th of 044 echoto& Mailing Address: LAO W- ContactName: riVlQVien0 KS' ,C- tidrenlsr&tr eirlibEad v'LE, � OT Lice (�LMt'dealy5t4k000 E-Mail Address: rY,€.►arxceG4bcoK ...OrC Telephone: Work: y(p9 - `T (pa 5 Horne: Cell: Summary of activities: Vaco to n .BCtoft Soi)col1 h th y-11.R00-; trn oJ.i rim °Wad e 61,14/(1(60,A) irk-LQ.- f-c ha 11 .Pie ick (sook o C) h cunt 014 PAIL/1k 9n Q 41 i i •k -I-o 54- , i ihajGod) i Page 2 of 3 Revised 11/4/16 TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (Street Closings require City Council approval. Meetings lst & 3rd Tuesdays but subject to change) Address of Event: 310S4) _ii. kle, Poo(lhClll --PIPtck --10 '1. k &0.44l Street(s) to be closed: SW L4.4 -i. S-1-1 ko, beten 544, e; (p i-c� Ay-Ulu/A) & Date(s) to be closed: Sun P, j 0 (r'r.o ) — 1 4 ( Fit i 1 20 lci Time(s) to be closed: 8 Am 0.c 6 dC.-\I ko 1 P m e ac (kit) Purpose of Closing: .cp � _oir (`1NiurQtr\ ('.rps5k_rn 43(1_l we l_ki cS Clfe a3 rlukil V ( , Attachments Required for Use of Parks Attachments Required for Street/Sidewalk Closings ► Site Plan ► Site Plan cul aa&L ( ► 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 -Ftid' $1,000,000.00 with the City of Okeechobee and R.E: ' Hamrick Testamentary Trust as Additional Insured. ► Proof of non-profit status (IRS—Determination Letter) I. Original signatures of all residents, property owners and business by the 14 pc owners affected closing. only ► State Food Service License if > 3 days. ► State Food Service License if > 3 days. N 1 1\-- ► Notarized letter of authorization from property owner, if applicable.* ► State Alcoholic Beverage License, if applicable.** jJ I & * 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. n 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 permit, 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. Page 3 of 3 Revised 11/4/16 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. Llil,Lb a 5/q fao i Applicant Signature A via Nato Date ••••OFFICE USE ONLY•••• Staff Review Fire Department: Wt.,-. Date: S • 9 -1 q Building Official: Date: S l • Pr' Public Works: '- 11119, — Date:—q^/ 4J Police Department:/1", Date: S - 7.-/ 9 BTR Department:ti7' -,.. 1 .- Date: /9J0 19 City Administrator: f Date: s ��. City Clerk: 1A Q csj (- Date: 5t6 1901 NOTE: APPLICATION AN`Ir(NSURANCE 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 j - a 1 - i ci Date Temporary Street and Sidewalk Closing reviewed by City Council and approved 5-)-1-1 Date 111.1111111.11111LF OKEECHOB.EF FIRE' I).E.P,ANTJ.IJ. TT (1C)) Application APPLICATION FOR SPECIAL EVENT Date Submitted: 5 -q-.90161 Permit #: A, I l\ NAME OF EVENT: Temporary S{ cee.4 CtvsLA - 154 eapra CA woiri ADDRESS OF EVENT: 3(0 SW 64-ik f v2(u R06 -t-PL.C.¢o 1-,e1S I k 1.S6-18 DE CRIPTION OF EVENT: aCa on &plc 5CO1Ool - C�c.Q AL we e.� & �� / (i 1 Ii a &tweak.) Hoc st -%.Bois - --t-(6Q-1-TCA) NAME OF SPONSOR ORGANIZA7"ION: Contact Number before and during event OF RESPONSIBLE PERSON: NJ we ROO, 467 7&,9 `j DATE(S) AND TIME(S) OF EVENT: Date: nix II)- 111, 'IDA Starting Time: S Af \ Closing Time: 1 N(Y\ Q ue'4 1/ atftires- Date: Starting Time: Closing Time: 3'•3OWOO I7Pl Date: Starting Time: Closing Time: +_' ARE ANY ROADWAYS TO BE BLOCKED/CLOSED? 4 .19.,&, LOCATION Sud Li 4,05-(--- Nun. 54& to, Pw-2- Widl Emergency Atntnarat s (Fire and Ambaulaaee) have access to area? IF NO, THEN EXPLAIN (provide alternatives): H WILL ELECTRICITY BE USED? Locations: N 1 Provided By: ti' 1 (Y YES El ❑ NO! WILL HEATING/OPEN FLAMES FOR FOOD Type of Heating Equipment Used: 1Jf 11 - It E PROVIDED? YES ❑ ❑NO - WILL A TENT BE ERECTED? YES ❑ NMI Tent Manufacturer: 1,)1 Size t IP - Tent have sides and how many? fire rating posted: fit ***ATTACH SITE MAP OF EVENT LAYOUT*** The following items to be completed by Fire Department only FIRE DEPARTMENT LIFE SAFETY & FIRE SERVICES REQUIREMENTS: (See above) O Tents/canopy fire rating certificate required. O Tent Size require life safety inspection (900 square feet or less then no permit is rewired) O Floor plan / seating / setup drawing required showing exits, etc. O Emergency access must be maintained. (REFERS TO VEHICLES AND EQUIPMENT) O Fire extinguishers must have current tag, and be operational and readily accessible. O Cooking requires LPG outside of tent pointing away from exposures. O Electrical wiring exterior rated, not overloaded. O Fire Services inspection required. O Fire watch or inspector(s) REQUIRED? FIRE WATCH Amount: O Firefighter/Inspector Amount: FIRE DEPARTMENT j� /WL ow l /1 SIGNATURE: ICIAL RINT): Please call the ED at 863-467-1586 for any questions. h4 eiy‘p S4-00 0,foScqft c SA- Pion ;41 -1.4 • IrPlifillt 21.r.imoir L. • IVA Er -140 ;. 411.11r,' W., Temporarily close this part of SW 4th St between 5th & 61, Ave's on jun In -14,2019 Stilm - I Pni atkth do -14 ;i - .--ir • ..,...r.a.?rwr • -• --- ,...=, m2,-,, si . . , .- 7.1iPli --Iptr .774' 'Tfg v &--- ' ' 1 li.—• 1/ s'i, ,i•... i!; , . i 7,s...q :.. N = . _ ... . _ ..,... 4." . -......irdritildlrAlle II illitilkINE 1... +5C :i3,11. Field Area 1 .". –nd."-•••••••;•• - - -.' - - e• -.Ni - - — IC MIA "" 4-4 , • •••;;—, 1 • r" ,, 0 ki, . I— s-.-..-- • . -,-„..141_ —.75.•,•,- ,.., • e,•' • -11; FBC Mi parking Campus '4 FBC parking • tow dito. • ..20ir tr,41 i.31)Fsb .; • fie • • — "ag !..; it'j°,5 -s ' r•VI. "j0 7.: 411411^1r4 _ _ • ALA: em.SEJ.3_,:t..5T-4:-. Excerpt of City Map with First Baptist Church property identified, and the portion of the street requesting to temporarily close. Should any tents be used they will be small, portable ones, no larger than 10' x Requesting temporary barricades from Public Works. DIVISION OF CORPORATIONS /''.org r'rJ;) �rj AV" to) ',j/ir•re/ 7foi Ivetrate Department of State / Division of Corporations / Search Records / Detail By Document Number / Detail by Entity Name Florida Not For Profit Corporation FIRST BAPTIST CHURCH OF OKEECHOBEE, INC. Filing Information Document Number 718538 FEI/EIN Number 59-0948707 Date Filed 05/18/1970 State FL Status ACTIVE Principal Address 401 S.W. 4TH ST. ATTN: BEVERLY SHURLEY OKEECHOBEE, FL 34974-4240 Changed: 04/03/2001 Mailing Address 401 S.W. 4TH ST. ATTN: BEVERLY SHURLEY OKEECHOBEE, FL 34974-4240 Changed: 04/03/2001 Registered Agent Name & Address LEVINS, THOMAS C 8511 S.W. 2ND STREET OKEECHOBEE, FL 34974 Name Changed: 05/01/2008 Address Changed: 05/01/2008 Officer/Director Detail Name & Address Title TD TURBEVILLE, JOI C 2198 N.E. 54th Trail OKEECHOBEE, FL 34972 Title SD WHITE, ROBERT D 1888 N.W. 3RD LANE OKEECHOBEE, FL 34972 Title PD LEVINS, THOMAS C 8511 S.W. 2ND STREET OKEECHOBEE, FL 34974 Title VP GILLIS, TIM 1910 N.E. 54TH TRAIL OKEECHOBEE, FL 34972 Title Director Caves, Robert 815 SE 9th Court Okeechobee, FL 34974 Annual Reports Report Year 2016 2017 2018 Document Images Filed Date 03/09/2016 04/19/2017 03/12/2018 03/12/2018 — ANNUAL REPORT View image in PDF format 04/19/2017 — ANNUAL REPORT 03/09/2016 — ANNUAL REPORT 06/08/2015 — ANNUAL REPORT 04/21/2014 -- ANNUAL REPORT 03/20/2013 -- ANNUAL REPORT 03/22/2012 -- ANNUAL REPORT 04/27/2011 -- ANNUAL REPORT 05/03/2010 -- ANNUAL REPORT 10/16/2009 -- ANNUAL REPORT 03/19/2009 — ANNUAL REPORT 05/01/200$ -- ANNUAL REPORT 05/23/2007 -- ANNUAL REPORT 05/17/2006 — ANNUAL REPORT 04/26/2005 — ANNUAL REPORT 10/25/2004 —ANNUAL REPORT 04/16/2004 — ANNUAL REPORT 04/07/2003 — ANNUAL REPORT 05/13/2002 — ANNUAL REPORT View image in PDF format View image in PDF format View imiPrmat View imageage inn PDFDF foforma View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF formal View image in PDF format View image in PDF format View image in PDF format View image in PDF format FIRSB-1077 MNEMNICH CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 6/5/2019 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 License # 6268 Church Asset Management, Inc. 1500 Wall St. Saint Charles, MO 63303 INSURED First Baptist Church of Okeechobee 401 SW 4th St Okeechobee, FL 34974 CONTACT Michele Nemnich NAME: PHONE FAX 608-0600 (A/C, No, Ext): 4219 E-MAIL mnemnich@ltcam.com • INSURERS) AFFORDING COVERAGE NAIC # INSURER A : GuideOne Mutual Insurance Company 15032 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : EVISION 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 WVD POLICY NUMBER POLICY EFF IMM/DD/YYYY) POLICY EXP (MMIDD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR 1423-828 12/1/2018 12/1/2019 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY jEa LOC PRODUCTS - COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED Ea acciden SINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident) $ $ AUTOS ONLY AUTOS ONLDY PROPERTY DAMAGE (Per ccident) _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEO RETENTION $ $ WORKERS COMPENSATION PER STATUTE TH- ER R AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEN Y/N E.L. EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? (Mandatory In NH) / 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) Form CG2026, Additional Insured -Designated Person or Organization is attached regarding Vacation Bible School to take place June 10-14, 2019. City of Okeechobee and R.E. Hamrick Testamentary Trust 55 SE 3d 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 L_. ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NAMED INSURED: POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) City of Okeechobee and R.E. Hamrick Testamentary Trust 55SE 3D Avenue Okeechobee, FL 34974 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ Jackie Dunham From: Jackie Dunham Sent: Wednesday, June 05, 2019 2:34 PM To: Melanie Rooks (melanie@fbcokee.org) Cc: Gil Culbreth (gil@gilberthasit.com); Mike Hamrick (mhamrick@manateelegal.com) Subject: Approved Street Closing 6-10 thru 6-14, 2019 Attachments: 007-FBC VBS (Street Closing).pdf Attached is your approved Street Closing Permit for First Baptist Church's upcoming Vacation Bible School being held from June 10th thru June 14th from 8:OOam to 1:OOpm daily. The street requested to be closed was SW 4th Street between 5th & 6th Avenues for the safety of the children crossing streets. The City of Okeechobee wishes you much success with this year's VBS. Jackie. Du. rawu vv A divniAlLstrarove.Secr'eta.vy CL y of Okeechobee. 55 SE 71 rd'Avevwce. Ok.eecho ee., FL 34974 863 -763 -33 72 (Madvv) 863-763-9821 (Direct) 863-763-1686 (Fa ) jdunham@cityofokeechobee.com Website: http://www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this email may be subject to public disclosure. 1