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2019-10-15 Ex 01Exhibit 1 Oct 15, 2019 00"°'- 42, Er Page 1 of 3 Revised 3/5/19 CITY OF OKEECHOBEE 55 SE THIRD AVENUE c OKEECHOBEE, FL 34974 Tele: 863-763-9821 Fax: 863-7634686 , PARK USE AND/OR TEMPORARY STREET/ SIDEWALK CLOSING PERMIT APPLICATION Date Received: ' ' Date Issued: Application No: Date(s) & Times of Event: 10/31/2019, 5:30 to 7;30 PM Information: Organization: First Baptist Church of Okeechobee, Childrens tvlinistry Mailing Address: 401 SW 4th St, Okeechobee, FL 34974 Contact Name: Melanie Rooks, Director of Recreation & Children's Ministry E -Mail Address: melanie@fbcokee.org Telephone: Work: 1467-7625 (ROCK) 1 Home: Cell: 1772-633-9777 Summary of activities: Fall Family Festival outside activities such as booths with garnes, music bounce house/inflatable's. Candy, and other types of refreshments such as cold water, soft drinks, hotdogs, chips, popcorn, snow cones, and/or cotton candy. Parking will be at the ROC -located North ot the bat Held), the main church campus & Mission House (located to the East ot the bat field). I he Festival and afi froc, ' 5th octivitica ore or ravides-o aafc altc++ etive-te-geing-dear to door tri . , .sing on-ehildren-'rrt-gradc3 -and younger. The electrical power at the field for the inflatable's & temporary lights will be provided and overseen by Joel Bass of Bass Electric. Rest rooms are located inside the ROC, Barricades are requested for use at both ends of 4th Street, as well as an invitation to the Police and Fire Uepartment's to have a booth on site within the ball fields, and a request tor assistance to assist with pedestrian SW 5th Avenue. traffic ocro33 Proceeds usage: NIA - Please check requested Parks: ( /IV Flagler Parks: o City Hall Park o #1 Memorial Park o #2 o #3 ❑ 44 ❑ 45 o 46 [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: Page 2 of 3 Revised 3/5/19 TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (Street Closings require City Council approval. Meetings 1st & 3rd Tuesdays but subject to change) Address of Event: Ball Field south of the ROC 310 SW 5th Ave Street(s) to be closed: SW 4th St, between SW 5th & 6th Avenue's; if needed & at the Police Dept's discretion: the 400 block of SW 5th Ave Date(s) to be closed: October31, 2019 Time(s) to be closed: 3:00 to 9:00 PM Purpose of Closing: Pedestrian crossing into the Fall Festival Attachments Required for Use of Parks Attachments Re uired for Street/Sidewalk Closings ► Site Plan' ► Site Plan t/' ► 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. ► Proof of non-profit status ► Original signatures of all residents, property owners and business owners affected by the closing. MX ► State Food Service License if > 3 days. ► State Food Service License if > 3 days. /J / A- ► Notarized letter of authorization from' 10 -State Alcoholic Beverage License, if applicable.** property owner, if applicable.* 14 IA— * 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. o 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 3/5/19 I hereby acknowledge that I have read and completed this application, the attached Resolutions 04-03, concerning the use and the rules of using City property, that the information is correct, and duly authorized agent of the organization. I agree to conform with, abide by and obey all the rules regulations, which may be lawfully prescribed by the City Council of the City of Okeechobee, or 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. nitiziAui eorgri)Iii Rd on •, 9/20/2019 No.(s) 03-8 and that I am the and its officers, for Applicant Signature Date ••••OFFICE USE ONLY•••• Staff Review ‘'..... Fire Department:9 : ..1. Q ea) r y Date: d9-&p..,20/- Building Official: ra -� -iii�; Date: 4.75.11 Public Works: ,��" Date: ti f Police Department: /� fF� • L j ft, 1, /, Date: Date: ! �j ''l (�,�7 " 7 L9PLI 19 ;t'�// BTR Department: City Administrator: Date: City Clerk: 0Q �` ;,ti/ Uitgaita1tu2 //!` ,(�j4. ( b t.0 Date: COOAxic v , NOTE: APPLICATION AND INSURANCE CERTIFICATE MUST BE COMPLETED RETURNED TO THE GENERAL SERVICES DEPARTMENT THIRTY (30) DAYS 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 AND PRIOR TO rG f f f /9' Date Date CITY OF OKEECHOBEE FIRE DEPARTMENT APPLICATION FOR SPECIAL EVENT Application #: 1 'Oil Date Submitted: 9/20/2019 Pert i : Name Of Event: Fall Festival (1st Baptist Okeechobee Children's Ministry) Address Of Event: Ball Field located south of the ROC 310 SW 5th Ave Description Of Event: Fall Festival in our ball field with game booths, free candy & refreshments. Intlatable's will be set up by the rental company & operated with multiple adult supervisors. Tents will not be larger than a 10 x 10. Name Of Sponsor/Organization: First Baptist Church of Okeechobee Contact Number before/during event OF RESPONSIBLE PERSON: Melanie Rooks 467-7625 or 772633-9777 Date(S) And Time(S) Of Event: Date: 10/31/2019 Starting Time: 5:30 PM Closing Time: 7:30 PM Date: Starting Time: Closing Time: Date: Starting Time: Closing Time: ARE ANY ROADWAYS TO BE BLOCKED/CLOSED? YES LOCATION SW 4th ST between 5th & 6th Avenue's IF Will Emergency Apparatus (Fire and Ambulance) have access to area? YES NO, THEN EXPLAIN (provide alternatives): WILL ELECTRICITY BE USED? Locations: in the center of the ball field YESfl1O❑ Provided By: Joel Bass Electric WILL HEATING/OPEN FLAMES FOR FOOD BE PROVIDED? YES I 1 Nag Type of Heating Equipment Used: WILL A TENT BE ERECTED? YES 2 NO 0 No I ati IDS, .- • Tent Manufacturer: /•1 f i�- Size `fi!Jt /D re rating posted: Tent have sides and how many? Ai /11 - ***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) T Floor uire life safety inspection (900 square feet or less then no permit is required) Ian / seating / setup drawing required showin• exits, etc. mergency access must • - maintame. '10 ERS TO VEHICLES AND EQUIPMENT) 'Fire extinguishers must have current tag, and be operational and readily accessible. ectrical wiring exterior rated, not overloaded., — 0/ee- t k i_- (.s �r P Pf-se t6 Fire Services inspection required. G-_ Fire_w O -F i; IN* FIRE DEPARTM SIGNATURE: (PRINT): r1L-0Z-2N,o, Please call the FD at 863-467-1586 for any questions. $W 3rd ST 1 Temp Closing SW ST between 5th &6th II Av FBC Mission House Parking x W Q 2. w S S'i Ball Field FBC Main Campus Parking a�r�r .rrrtl�r. w11111111ir,rl. SW 6. ST Google FBC Okeechobee Fall Festival, Temporary Street Closing Oct. 31, 2019 Event time: 5:30 to 7:30 PM, Street Closing from approximately 3:00 to 9:00 PM. The portion of the street to be temporarily closed is SW 4th ST between 5th and 6th Avenues for pedestrian safety. Should the Police Dept find it necessary, the portion of SW 5th Avenue between the ball field and FBC main campus may need to be temporarily closed. 0 -Barricades are being requested to close off 4th Street from Public Works. 0 -The Fire and Police Departments are encouraged and invited to participate by having a booth/tent within the ball field during the event. ► Requesting the Police Department to assist with traffic at the intersection of 4th Street and 5th Avenue during the event. 9/20/2019 rg Detail by Entity Name E',g31l1i i Oj rI (7 r rj A .•r• `,.fit ' l rtl(i' ird fttle pf i ttN't:Itf :: i,': (.r.• Department of Stale / Division of Corporations / Search Records / Detail By Document Number / DwisIOe GF CORPORATIONS 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 search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder-FIRSTBAPTIST... 1/3 9/20/2019 Title SD Detail by Entity Name 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 2017 2018 2019 Filed Date 04/19/2017 03/12/2018 04/22/2019 Document Images 04/22/2019 -- ANNUAL REPORT 03/12/2018 -- ANNUAL REPORT 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 05/01/2008 -- ANNUAL REPORT 05/23/2007 -- ANNUAL REPORT 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 format View image in PDF format View image in PDF format__ View image in PDF format View image in PDF format 05/17/2006 -- ANNUAL REPORT View image in PDF format 04/26/2005 -- ANNUAL REPORT 10/25/2004 -- ANNUAL REPORT View image in PDF format View image in PDF formal 04/16/2004 -- ANNUAL REPORT View image in PDF format sea rch. sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=FIRSTBAPTIST... 2/3 FIRSB-1077 JHECKMAN , ACC: PR CERTIFICATE OF LIABILITY INSURANCE 16....---9/26//201201YYY) DATE (M 9 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 Church Asset Management, Inc. 1500 Wall St. Saint Charles, MO 63303 CONTACT NAME: PHONE FAX (A/c, No, Ext): (BOO) 200-7257 (AIC, No(866) 608-0600 ADDRIESS* INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : GuideOne Mutual Insurance Company INSURER B : 15032 INSURED First Baptist Church of Okeechobee 401 SW 4th St Okeechobee, FL 34974 INSURER C : 1423-828 INSURER D : 12/1/2018 INSURER E : $ 1,000,000 INSURER F : COVERAGES CERTIFICATE 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 POLIC ES 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 W VD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A COMMERCIAL GENERAL LIABILITY 1423-828 12/1/2017 12/1/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE1OCCUR DAMAGETOEa RENTEDoccurrence) PREMISES ( $ 1,000,000 .__ MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE POLICYP OTHER: LIMIT APPLIES JECT PER: LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 3'000'000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY _ __ SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ $ $ BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITYY PROPRIETOR/PARTNER/EXECUTIVE CER/M (Mandatory in ER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / N 1OFFIANY N / A PER STATUTE OTH- ER 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) Please see the attached CG 2026 stating The City of Okeechobee and R.E. Hamrick Testamentary Trust is named additional inssured for the event on 10/31/2019 CERTIFICATE HOLDER 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 44 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NAMED INSURED: First Baptist Church of Okeechobee POLICY NUMBER: 1423-828 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) R.E. Hamrick Testamentary Trust and City of Okeechobee 55 SE 3d Avenue Okeechobee, FL 34974 Email or Fax#: jdunham@cityofokeechobee.com Fall Festival on October 31, 2019 © 310 SW 5th Avenue 5:30PM - 7:30PM 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