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2019-10-15 Ex 02Exhibit 2 Oct 15, 2019 to ""•f- 0�1/4%`� • _"' `T• • Page 1 of 3 Revised 3/5/19 CITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 Tele: 863-763-9821 Fax: 863-763-1686 PARK USE AND/OR TEMPORARY STREET/ '�-:-.00��' SIDEWALK CLOSING PERMIT APPLICATION Date Received: ilio / i 4 Date Issued: Application No: /y . fli y, Date(s) & Times of Event: ;;1ib U a -,/o,.-: Tar..- =1',': :.: 2 ;! i ! p,,; -5-1- Information: Organization: 0 K{e.e.t cb-ec r o�.i vt u-e-e4- MailingAddress: 5 s'pi1/4.4-61_'} rD-}-4.� Contact Name: j , /Acio LPowyy E -Mail Address: L ivris ,Q. 0yeechbti._e.wtcu y 4 -red-- 0rej Telephone: J Work: "Ari-) LeIAO Home: 1 Cell: SII I-Iy'1teL-jbh Summary of activities: -4- .2 do e vv& A-- W tAA.ct' f nd i • ru34 c-) a varre-3y o P cu.,s� e,� d v. ors . L 4'... �, • F. .i . - 'h', .L __... ay N 10 , 1 r1 CLICK 2, x3-150 Ct- f i e 0 w curio) to s Kte h D u). l F Pass a Wt-. W i A ' U, -h ,- . -t /. 0 w i 4- 1-1,-, cw K. 2 - .Proceeds Proceeds usage: qv() CQ..ed s —1 -}-41,t:5-et/Rya 0 �`rA© �."e VAS Qyid l'-1- tovii-Viv itivA.G Wo.(45 01-' 6%P'QC,hcb-ee alt e._ e_nhaince. Ou r0.01on' ey: CL o-5 4v heari'bc-:- 611 vt r" euro r►1, . Please check requested Parks: Flagler Parks: o City Hall Park o #1 Memorial Park #2 _ • 3 #={- o #5 0 #6 [Park 3 is location of Gazebo. Park 4 is location of : andst (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 Revised 3/5/19 TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (Street Closings require City Council approval. Meetings lst & 3rd Tuesdays but subject to change) Address of Event: `Flft31e r % (RW) -1 ei _- Li JJ Street(s) to be closed: V.54W of -�-e_ eui SW � D'- I ` ` peiu e .. ",; . ,,`t,J,: i AQ`� Date(s)E. �(U�} to be closed: Y �`' C) i) Of``,4r- I�nA 5 iTime(s) to be closed: 5 yr, sem, Nw.. g/'' -n t 51941 7JOf- 1 ft,..:— Purpose Purpose of Closing: - &flow Shl— j9 9;2 vardniS &no( last o,2 - (Wen we s . Attachments Required for Use of Parks Attachments Required for Street/Sidewalk Closings ► Site Plan ► Site Plan ► 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. ► State Food Service License if> 3 days. ► State Food Service License if> 3 days. ► Notarized letter of authorization from property owner, if applicable.* ► State Alcoholic Beverage License, if applicable.** * 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 depaituiental 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 sure 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 04-03, concerning the use and duly authorized agent of the regulations, which may be lawfully the issuance Certificate of Insurance must have read and completed this application, the attached Resolutions the rules of using City property, that the information is correct, and organization. I agree to conform with, abide by and obey all the rules prescribed by the City Council of the City of Okeechobee, or name City of Okeechobee as Additional Insured as well as R.E. Hamrick streets or sidewalks. )ki to t,2D/q No.(s) 03-8 and that I am the and its officers, for Testin ar -ru, : if closing • pplican/Signature Date' ""OFFICE USE ONLY"" Staff Review Fire Department: 50, Date: ./ASE/° Building Official:, 41/6 Date: q' (7' (c, Public Works: . (----- �� , Date: g-- �- �`� Police Department: ,`/G`" Date: 7 76 yr BTR Department: rJ /� i 0, rulta. Date: �- / '� f „/, l r City Administrator: < Date: Date: r 21,x/' q- j 0 oiq City Clerk: t% a fri t..t,•6`--' NOTE: APPLICATION AND INSURANCE CERTIFICATE MUST BE COMPLETED RETURNED TO THE GENERAL SERVICES DEPARTMENT THIRTY (30) DAYS EVENT FOR PERIYIITTING. 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 Id ---1 ..i i" Date Date CITY OF OKEECHOBEE FIRE DEPARTMENT APPLICATION FOR SPECIAL EVENT Application #: Date Submitted: 1 -10 i i Permit #r Name Of Event: OKefahnioee Math fro, Tat( l Address Of Event: lex vx , d*,) *LI Description Of Event: !Ave rn u. c Cat.Y f 7', k e 5 LI rn . Nance Of Sponsor/Organization: OKV.eChCJ P YnLi'l S1Y. - J Contact Number before/during event OF RESPONSIBLE PERSON: 'in n fit_ Ptivae.vS Date(S) And Time(S) Of Event: Date:. OVe V e' Starting Time: 1-0Opp Date: N61'-e--"IINCfotarting Time: 1O[xrn Date:N0V-tw Meir 1 t Starting Tirne: 1 0 r" ARE ANY ROADWAYS TO BE BLOCKED/CLOSED? _ Will Emergency Apparatus (Fire and Ambulance) IF NO, THEN Closing Time: ¶T- t tJ..- Closing Time: 3 ',DOpm-lie Closing Time: ' to tJ r ., , 3 clow € LOCATION:: l)r t Ne. 4-- �iVejILCQ ave access to area? C S EXPLAIN(provide alternatives): WILL ELECTRICITY BE USED? YES QINO i' i GX T i J . ct;Sh er> w Locations: be AOA; IAbre Provided By: �[ WILL HEATING/OPEN FLAMES FOR FOOD BE PROVIDED? YES (-1 h O,(U Type of Heating Equipment Used: WILL A TENT BE ERECTED? NO ❑ Tent Manufacturer: Size 1 fire rating posted: Tent have sides and how many? DC o (See Fire Department's 'checklist below to assist With expectations regaignirriT ***ATTACH SITE MAP OF EVENT LAYOUT*** The following items to be completed by Fire Department oniv 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 required) 0 Floor plan / seating / setup drawing required showing exits, etc. 0 Emergency access must be maintained. (REFERS TO VEHICLES AND EQUIPMENT) 0 Fire extinguishers must have current tag, and be operational and readily accessible. O Cooking requires LPG outside of tent pointing away from exposures. 0 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: 0 Other: (PRINT): Please call the FD at 863-467-1586 for any questions. t -; Hernia /Wt.. ii00/86n-5061 fix f.ki 3/740-Rilffi t.' 7; 144.0' fi.;• St datiokEa fretryt areaiittirkirtyv.inlienithaide NAME. eechobee o sne u ice AT CITYOkeech�beTATE- FL, .34972' Geribicqicirli.isefeby mode 111,-.m-tit:1es described un this Ge4 tittGatr: haye been treated with a lianie-ieianiant appioved ,heinic.41 anet tballhf; sopfieAtiQn r.4f ttheinical iitiIonforinanc,e. wilh1--;.16cral s NEPA 701 pe,ii Ica Melitod of doptiGat ion: Inherently Flame resistant Tt Ades ii:;uree. of tiatilf:.-Si.F.tarit teltri(7. •".r 41! i,id Reg. F-419-01 • ft August 2011 #29261 I ) The klame Retardant Proce.-; Used wilinotLie Remover:I Esy Washing (win or will no!) and is good for the life ol the fabric. Renewal Certification unnecessary, Sunblock White 15-16 oz. psy Color and weight of fabric: Description of item certified: _(1) 20'..x.40.11..r4me_ThitToF:s Thomas Sciortino by Production Supervisor Name of ApottrA /Or PindtICLOr;-5140C1,ntenth ni tine We hereby certify this to be a true copy of the original "CERTIFICATE OF FLAME RESISTANCE" Issued to us, "original copy" of which has boistrt Mott with the California State Firs Marthal. Lori Walker Signed by Y lagier YarK - uoogie iviaps Google Maps Flagler Park '1 C. • ws , , of O. d! ' '.'-- "tet 7 - Afn,' 1 'a-`i@R 04._ *, :, :y' ' N i LeA.0&{ \J QS, 11V• o,3, i�d.sfl f s.,as_ .e. • (•• .04f aSl-Ili rr�;l�ili }y- ' l _ • •I..l2.lr ll (7t41T� • ) ft' • __fir. A .. � ;48i'''.'11',Ir-qm1Y411:iggifite,-.;...x.,.:.,.. 'ii, . . • • ! M 1, • - - gi.l. rl'ts:�f�:tc G1S7FdeJri 1 1Lr( o1 1:4,/,10@:,..., �Y !•� u��t 6`rrrtrr ..?„ p c 31_. �Gi � 3 Ia,.....,..1.-7.7F.1:1.7 ,.. .- iv lijyl ry'. t -E6J :I at� _ 11 � h • : 1 tar • r , , i. `. 4� .. I ' 1 Il�j� ••.�'c 'A t••'t,r n - II : t ' 111'.. ( l.=)9fii1 /llrS+ 7 I,l '1 L")iG27r ��1 i ifs � r71f�i�• l'31(1y, !iiifr. ��q j71Gt1�3i] �'•11F9P��) elC_ri2E9 ,'V.;,�.•1.'� ill , ! ' .nt, ..7,, ori, Iiii t 1. �i &-1 •,1 . , ��ar Jfal .ol Imagery ©2017 Good e, Map data ©20 L 17 Google United States vk 3 rAtvka .Ne 200 ft ,r COVERAGES • • 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 ADOL NSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDOPyyYY) LIMITS A X COMMERCIAL GENERAL LIABILITY INSURED Okeechobee Main Street 55 S Parrott Ave Okeechobee, FL 34974 INSURER 8: INSURER C: EACH OCCURRENCE 1,000 000 r INSURER E : CLAIMS -MADE )( OCCUR Y NBP2552460 10/25/2018 10/25/2019 DAMAGE TO RENTED PREMISES (Ea }S $ 100,000 occurrence) MED EXP,(Any one person) _ $ 5,000 PERSONAL & ADV INJURY GENU AGGREGATE LIMIT APPLIES PER:1,000,000 GENERAL AGGREGATE $ X POLICY 1 T8T LOC PRODUCTS - COMP/OPAGG 5 Incl OTHER: 5 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1E0 accident) 5 1,000,000 ANY.AUTo NBP2552460 10/25/2018 10/25/2019 80DILY INJURY (Per person) 5 OWNED AUTOS ONLY _ SCHEDULED AUTOS BODILY INJURY (Per accident) $ X AUTODS ONLY X AVOOVJNLD S OONN PRO eccidenl)AMAGE Po 5 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LtAB CLAIMS -MADE ._5 AGGREGATE $ CED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PER 0114 STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTNE YIN N IA E.L. EACH ACCIDENT $ OFFICER1MEMEEREXCLUDED? (Mandatory In ) 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) City of Okeechobee & RE Hamrick Testamentary Trust are included as additional insureds with respect to General Liability OKEEC29 OP ID AC V lW:=70 " CERTIFICATE OF LIABILITY INSURANCE DATE (MMI DDIYWI) 10/30/2018 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 863-467-0600 ISU Lawrence Insurance Agency PO Box 549 Okeechobee, FL 34973 Heath Lawrence F,(FACT Heath Lawrence PHONE 863-467-0600 I FAx 863467-5142 (A1C, No, Ext): (AIC, No): E-MAIL ADDRESS: INSURER(S) AFFORD/NG COVERAGE NAIC in INSURER A: Mt. Vernon Fire Insurance Co INSURED Okeechobee Main Street 55 S Parrott Ave Okeechobee, FL 34974 INSURER 8: INSURER C: INSURER D : INSURER E : INSURER F : CERTIFICATE HOLDER CANCELLATION City of Okeechobee & RE Hamrick Testamentary Trust 55 S.E. 3rd Avenue Okeechobee, FL 34974 CTYOKEE 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 (2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 2019 FLORIDA NOT FOR PROFIT CORPORATION ANNUAL REPORT DOCUMENT# N99000000045 Entity Name: OKEECHOBEE MAIN STREET, INC. Current Principal Place of Business: 55 S. PARROTT AVE OKEECHOBEE, FL 34972 Current Mailing Address: 55 S. PARROTT AVE OKEECHOBEE, FL 34972 US FEI Number: 65-0887929 Name and Address of Current Registered Agent: POWERS, LYNDA M 55 S. PARROTT AVE OKEECHOBEE, FL 34972 US FILED Apr 22, 2019 Secretary of State 0710899077CC Certificate of Status Desired: No The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, In the State of Florida. SIGNATURE: LYNDA M. POWERS 04/22/2019 Electronic Signature of Registered Agent Officer/Director Detail : Title Name Address City -State -Zip: Title Name Address City -State -Zip: PRESIDENT GRIFFIN, ANGIE 313 SW PARK STREET OKEECHOBEE FL 34974 SECRETARY BRAGEL, PAULETTE 55 S PARROTT AVE OKEECHOBEE FL 34972 Title Name Address City -State -Zip: Title Name Address City -State -Zip: VP HEDDESHEIMER, MARION P.O. BOX 2338 OKEECHOBEE FL 34973 TREASURER AUSTIN, ASHLEY 55 S. PARROTT AVE. OKEECHOBEE FL 34972 Date I hereby certify that the information indicated on this sport or supplemental report is true and accurate and that my electronic signature shell have the same legal effect as if made under oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: ANGIE GRIFFIN PRESIDENT 04/22/2019 Electronic Signature of Signing Officer/Director Detail Date