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Temp. Street Closing - OCA Field DayCITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 Tele: 863-763-3372 X9821 Fax: 863-763-1686 e-mail: aneu@citvofokeechobee.com STREET CLOSING PERMIT Permit Numb r 2-001 Date(s) of Event: February 14, 2020 8:00 a.m. — 2:30 p.m. Permit Expiration: February 14, 2020 Purpose of Request: Field Day Property Owner: City of Okeechobee Address: 55 SE Third Avenue City: Okeechobee State: Florida Zip Code: 34974 Applicant: Okeechobee Christian Academy Applicant's Address:701 S Parrott Avenue . Okeechobee, FL 34974 Phone Number: 863-763-3072 Address of Project: SE 2nd Avenue — (SE 61" Street thru SE 7t" Street Current Zoning: P FLU Designation: Public Subdivision: City of Okeechobee Restrictions/Remarks: All debris must be removed within 24 hours of expiration date. C�a iP Now f y 21, 2020 Administrative Secretary Date General Services Department .Jf r ACk - Di Page 1 of 3 Revised 3/5/19 1-10-Zogo CITY OF OKEECHOBEE • A. ,y "'' 55 SE THIRD AVENUE OkFFCyL ��•'�� ZLL (\cy.OF °m ` �. aA, 4401°''' � r•; OKEECHOBEE, FL 34974 Tele: 863-763-9821 Fax: 863-763-1686 PARK USE AND/OR TEMPORARY STREET/ SIDEWALK CLOSING PERMIT APPLICATIONS / 1 Date Received: 1 -1 -,Z2.20 --� Date Issued: (2O �" 01 Application No: 4o )/ Date(s) & Times of Event: Friday, February 14, 2020 8am-2:30pm Information: Organization: Okeechobee Christian Academy Mailing Address: 701 S. Parrott Ave, Okeechobee, FL 34974 Contact Name: Melissa King E -Mail Address: Melissa.King@OkeechobeeChristianAcademy.org Telephone: Work: 863-763-3072 Home: Cell: Summary of activities: Students will participate in Field Day and will need to cross back and forth all day. Proceeds usage: Please check requested Parks: Flagler Parks: ❑ City Hall Park ❑ #1 Memorial Park ❑ #2 o #3 o #4 ❑ #5 ❑ #6 [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: 70 � S Parrott Ave Street(s) to be closed: SE 2nd Ave from SE 6th Street to SE 7th Street Date(s) to be closed: Friday, February 14, 2020 Time(s) to be closed: 8:00am-2:30pm Purpose of Closing: Safety of children crossing the street 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 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. //Ph - - - _ -- -- . - - -- -- - - - yU/ - -- / Page 3 of 3 Revised 3/5/19 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. 1/7/2020 Applicant Signature Date ••••OFFICE USE ONLY•••• Staff Review 1 J i_ Fire Department: // Of / Date: / `/®Ot Building Official: i// .... L„A., j t Date: / q''' go Public Works: / Date: 1-�'_ z� Police Department: Date: / `/ 7 Zoz° BTR De 1 artment: a `L I I iA ! Date: / - /641 City Administrator: d Date: / 3 / )0City Clerk: /4 dnut � 61/1 ( u Date: - /3 -40 NOTE: APPLICATION AND INSURANCE 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 1 - /4-9—.20 3-0 Date �� Temporary Street and Sidewalk Closing reviewed by City Council and approved / -( -- a?-1nn Date ARU`- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 01/06/2020 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 JDA Insurance Group 120 N Federal Hwy /1301 Lake Worth , FL 33460 NOME CT AChristine Dewey (AHic°Nt�o EA. (561) 296-0373 I FAX No): 5612960392 AIL ADDRESS: Christine@thejdagroup.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Indemnity Insurance -Company 18058 ENSURER Okeechobee Christian Academy 701 South Parrott Ave Okeechobee, FL 34974 INSURER B: Philadelphia Indemnity Insurance Company 18058 INSURER c: Philadelphia Indemnity Insurance Company 18058 INSURER a: Insurance Co Of Tho West 27847 INSURER E: Philadelphia Indemnity Insurance Company 18058 INSURER F : COVERAGES TIFICATE NUMB • 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 TI -IE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE ADDL INSR SUBR W]VD POLICY NUMBER POLICY EFF jMMIDDIYYYY) POLICY EXP (MMIDDIYYYYI LIMITS A GENERAL XDAMAGE LIABILITY COMMERCIAL GENERAL LIABILITY PHPK2000717 07/01/2019 07/01/2020 EACH OCCURRENCE $ 1000000 TO RENTED PREMISES (Ea occurrence) $ 500000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5000 PERSONAL&AOVINJURY $ 1000000 GENERAL AGGREGATE $ 3000000 GENI- AGOREGATE LIMIT APPLIES PER: POLICY PRC•h l JFCT I I LOC PRODUCTS - COMP/OP AGG $ 3000000 $ B AUTOMOBILE X LIABILITY ANY AUTO AUTOS OWNED HIRED AUTOS X UTOS SCHEDULED NON -OWNED AUTOS PHPK2000717 07/01/2019 07/01/2020 COMBIINdE° SINGLE LIMIT $ 1,000,000.00 BODILY INJURY (Per person)ALL $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PHUB681884 07/01/2019 07/01/2020 EACH OCCURRENCE $ 1,000,000.00 AGGREGATE $ 1,000,000.00 DED X RETENTION$ 10,000.00 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ¥I N ANY PROPRIETOPARTNER/EXECUTIVE OFFICER/MEMBERREXCLUDED? I N I (Mandatory In NH) 0 yes, describe under DESCRIPTION OF OPERATIONS below NIA WFL 5042021 01 07/02/2019 07/02/2020 WC STATU-0111- TORY LIMITS X ER E.L. EACH ACCIDENT $ 1,000,000.00 EL. DISEASE • EA EMPLOYEE $ 1,000,000.00 E.L. DISEASE- POLICY LIMIT $ 1,000,000.00 E Professional Liability PHPK2000724 07/01/2019 07/01/2020 Directors & Officers $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule tr more spaco Is required) The City of Okeechobee & R.E. Hamrick Testamentary Trust is named as Additional Insured in regards to the General Liability portion of policy. CANCELLATION City of Okeechobee R.E. Hamrick Testamentary Trust 55 SE 3rd Ave Okeechobee, FL 34974 FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED P4 ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SW 6th SI @AV 41.0iied S SF 6th St SE 6th St OVeechotfee Chvistian A-oxivirn Christ Fellowship Okeechobee 8_ rr CL )-> o csr th LAnsirt9 here. Fled cf.?\ ?›- o C11n SE 711i St hcre, 0) rn SE 6th St (n) Good Care Boarding Hon — Gail Neu From: Sent: To: Cc: Subject: Attachments: Thank you, Melissa. Robin Brock Tuesday, January 7, 2020 9:23 AM Melissa King Gail Neu; Patty Burnette FW: Street closing Field Day closing 02142020.pdf Merry Christmas and Happy New Year to you as well. 60LLI - rlievie. e CttIachecL `it rm.(te ,5uxee Is provi Eed- `i�en -Callow proessil pizadites le+ -nye leAnQ 1,014 -Au- y hcive anti qui S-haiS, Please allow me to introduce our new General Services Administrative Secretary, Gail Neu, who will be processing your temporary street closing application. Should you have any questions or need anything further regarding your application, please do not hesitate to contact Gail. See contact information below: 9ad. 1 Administrative Secretary CITY OF OKEECHOBEE 55 SE 3RD Avenue Okeechobee, FL 34974 386-763-3372 Ext 9821 Fax # 863-763-1686 gneu@cityofokeechobee.com After the application is processed and submitted back to me, I will place it on the January 21st City Council meeting for approval. As always, if you have any questions, please let me know. Have a wonderful day. Robin Robin Brock Executive Assistant 55 SE 3rd Avenue Okeechobee, FL 34974 Phone: (863) 763-3372 Direct: (863) 763-9812 FAX: (863) 763-1686 Email: rbrock@cityofokeechobee.com Website: www.cityofokeechobee.com .OFttDA • 1915 1 •, • NOTICE: Florida has a very broad public records law. As a result, any written communication created or received by the City of Okeechobee officials and employees will be available to the public and media, upon request, unless otherwise exempt. Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this office. Instead, contact our office by phone or in writing. From: Melissa King <melissa.king@okeechobeechristianacademy.org> Sent: Tuesday, January 7, 2020 8:03 AM To: Robin Brock <rbrock@cityofokeechobee.com> Subject: Re: Street closing Robin, Good morning again. I am sending the application again, but have included a diagram of where to close the street, an actually map that we have always included in the past. Thanks for understanding. Mrs. Melissa King Principal 863.763.3072 Office OKEECHOBEE CHRISTIAN ACADEMY 7)1 S Parrott Ave • Okeechobee, FL 34974 • www.Okeechobeechristianacademy.org Please be advised: The content of this email is confidential and intended for the recipient specified in message only. It is strictly forbidden to share any part of this message with any third party, without a written consent of the sender. If you received this message by mistake, please reply to this message and follow with its deletion, so that we can ensure such a mistake does not occur in the future. On Tue, Jan 7, 2020 at 6:57 AM Melissa King <melissa.kingPokeechobeechristianacademv.org> wrote: Good morning, Hope you had a very Merry Christmas and Happy New Year. Please find the attached application for a street closure on Friday, February 14, 2020. Please let me know if you need anything further. Thank you so much. Happy Tuesday! Mrs. Melissa King Principal 863.763.3072 Office OKEECHOBEE CHRISTIAN ACADEMY 7oi S Parrott Ave • Okeechobee, FL 34974 •v.OkeechobeeC,bnstianAcadany.org Please be advised: The content of this email is confidential and intended for the recipient specified in message only. It is strictly forbidden to share any part of this message with any third party, without a written consent of the sender. If you received this message by mistake, please reply to this message and follow with its deletion, so that we can ensure such a mistake does not occur in the future. 2