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Park Use Permit - M2L BBQ Student CampPermit Number: 20-003 CITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 Tele: 863-763-9821 Fax: 863-763-1686 e-mail: gneu@cityofokeechobee.com Park Use Permit Date(s) of Event: March 20, 2020, 3:OOAM — 4:OOPM Permit Expiration: March 20, 2020 @ 11:59PM Purpose of Request: BBQ FUNDRAISER FOR STUDENT CAMP Property Owner: City of Okeechobee Address: 55 SE Third Avenue City: Okeechobee State: Florida Applicant: More 2 Life Ministries, Inc. Phone Number: 863-801-1971 Current Zoning:12 Subdivision: City of Okeechobee Restrictions/Remarks: All debris must be removed within 24 hours of expiration date. Zip Code: 34974 Applicant's Address: 605 SW Park St Ste 214 Address of Project: Park #3 FLU Designation: Public Clean-up of all garbage from the event including emptying the trash cans in the park(s) used and placing clean trash can liners in cans after the event. Ensure emergency vehicles have access to site and fire extinguishers are on site or available nearby. GaGL p. New Administrative Secretary/General Services February 4, 2020 Date :: Page 1 of 3 Revised 3/5/19 CITY OF OKEECHOBEE t.oF.oxy--_ 55 SE THIRD AVENUE m, OKEECHOBEE, FL 34974 �• : Page 2 of 3 Revised 3/5/19 TEMPORARY STREET AND SIDEWALK CLOSING ► ORMATION (Street Closings require City Council approval. Meetings 1st & 3rd - uesdays but subject to change) Address of Event: Street(s) to be closed: Date(s) to be closed: Time(s) to be closed: Purpose of Closing: 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. 10 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. filot z �� a&LL (1,,m_,64._. 020 c:... '` Page 3 of 3 j 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 TI/t. amentary T st if closing streets or sidewalks. �u. �'� \ \ /\ 3 I°1 Applicant Signature ' Date ••••OFFICE USE ONLY•••• Staff Review Fire Department: .� Date: / -j(19Q Building Official: Date: )'22• ZGN Public Works•_ �. Date: — Zd � Z 7Police Department:e7.:7,.-r,„..........°"44.14--' Date: 1 -Z-ZoeBTR Department:Date: / az ta' City Administrator: Date: 173 7,--c) City Clerk: % k L GGl IO Date: /.-fO' 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 Date Temporary Street and Sidewalk Closing reviewed by City Council and approved Date Application #: APPLICATION FOR SPECIAL EVENT 103 Name Of Event: Date Submitted: l Permit #: _brafarn`v Address Of Event: 1' c'‘( ` A43 Description Of Ert: , vc1 toz,S4) Name Of Sponsor/Organization: M4 )4\` T- L : �\ N e i d) Contact Number before/during event OF RESPONSIBLE PERSON: Date(S) And Time(S) Of Event: Date: 3 PIA /'1L.Q Starting Time: '4,M Closing Time: 1 D r'''\ Date: Starting Time: Closing Time: Date: Starting Time: Closing Time: ARE ANY ROADWAYS TO BE BLOCKED/CLOSED? 0 % LOCATION IF Will Emergency Apparatus (Fire and Ambulance) have access to area? NO, THEN EXPLAIN (provide alternatives): WILL ELECTRICITY BEUSED? 3 YESIVTIO ❑ Locations: mil el oc\* Provided By: WILL HEATING/OPEN FLAMES FOk J OD BE PROVIDED? YES KENO 0 Type of Heating Equipment Used: '1315 \,c�. l> WILL A TENT BE ERECTED? YES NO ❑ Tent Manufacturer: Si e ` p ) %1 Tent have sides and how many? fire rating posted: f �1 - ✓� >4) Department's checklist below to assist with expectations regarding safety] ***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 required) 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: 0 Firefighter/Inspector Amount: 0 Other: FIRE DEPARTMENT OFFICIAL (PRINT): SIGNATURE: Please call the FD at 863-467-1586 for any questions. 0000183 12/24/16 FLORIDA Consumer's Certificate of Exemption Issued Pursuant to Chapter 212, Florida Statutes DR -14 R. 10/15 85-8013755016C-7 02/28/2017 02/28/2022 501(C)(3) ORGANIZATION Certificate Number This certifies that MORE 2 LIFE MINISTRIES INC 605 SW PARK ST STE 213 OKEECHOBEE FL 34972-4173 Effective Date Expiration Date Exemption Category is exempt from the payment of Florida sales and use tax on real property rented, transient rental property rented, tangible personal property purchased or rented, or services purchased. Important Information for Exempt Organizations FLORIDA DR -14 R. 10/15 1. You must provide all vendors and suppliers with an exemption certificate before making tax-exempt purchases. See Rule 12A-1.038. Florida Administrative Code (F.A.C.). 2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's customary nonprofit activities. 3. Purchases made by an individual on behalf of the organization are taxable, even if the individual will be reimbursed by the organization. 4. This exemption applies only to purchases your organization makes. The sale or lease to others of tangible personal property, sleeping accommodations, or other real property is taxable. Your organization must register, and collect and remit sales and use tax on such taxable transactions. Note: Churches are exempt from this requirement except when they are the lessor of real property (Rule 12A-1.070, F.A.C.). 5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for payment of the sales tax plus a penalty of 200% of the tax, and may be subject to conviction of a third-degree felony. Any violation will require the revocation of this certificate. 6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Account Management at 800-352-3671. From the available options, select "Registration of Taxes," then "Registration Information," and finally "Exemption Certificates and Nonprofit Entities." The mailing address is PO Box 6480, Tallahassee, FL 32314-6480. ACORa 4.---- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1/22/2020 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 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 Pritchards & Associates, Inc 1802 S Parrott Ave Okeechobee - FL 34974 CON I NAME: r Sandy nines A/CNNo, Ext): 8637637711 FAX No): EMAIL ADDRESS: shines@pritchardsinc.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: OHIO SECURITY INS CO 24082 INSURED More 2 Life Ministries Inc 605 Sw Park St SUITE 214 OKEECHOBEE FL 34972-4173 INSURER B : AUTO OWNERS INS CO 18988 INSURER C : 11/11/2020 INSURER D : $ 1,000,000 INSURER E : INSURER F: X COVERAGES CERTIFICATE NUMBER: 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 NSURANCE 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. ILTR TYPE OF INSURANCE NSD WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) E -F POLICY EXP ( POLICY B YY) LIMITS A K COMMERCIAL GENERAL LIABILITY BKS58184017 11/11/2019 11/11/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PREMISES (Ea occurrence) _ $ 1,000,000 MED EXP (Any one person) $ 15,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE K LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY - SCHEDULED AUTOS NON -OWNED AUTOS ONLY 5049898900 10/06/2019 10/06/2020 COMBINED SINGLE LIMI r (Ea accident) $ 300,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PHOPEH I Y DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE S $ DED RETENTION $ C WORKERS COMPENSATION AND AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 106-44532 04/01/2019 04/01/2020 1H - PER 01H- STATUTE ER STATUTE ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Okeechobee is Additional Insured in regards to the General Liability per written contract. CANCELLATION City of Okeechobee 55 SE 3rd. 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 Lawwf-U' N. f r kh4r4 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Gail Neu From: Bill Crow <Bill.Crow@vnaflorida.org> Sent: Monday, January 20, 2020 8:29 AM To: Gail Neu Subject: Suite numbers at 208 SE Park Street Jackie, I was wrong when I said this might take weeks, it actually took months. We will be progressing with build -out within the next two weeks, so I will need to start to move with adding suites to our address. Please let me know what the next steps are. Feel free to give me a call. Thanks, Bill 772-419-5501 From: Bill Crow Sent: Wednesday, October 30, 2019 4:22 PM To: Jackie Dunham Subject: Re: Suite numbers at 208 SE Park Street I understand completely. I will notify you as soon as I get confirmation. It may be days, maybe weeks. I appreciate your working to get me the information. Bill Sent from my Verizon, Samsung Galaxy smartphone Original message From: Jackie Dunham <jdunham@cityofokeechobee.com> Date: 10/30/19 4:12 PM (GMT -05:00) To: Bill Crow <Bill.Crow@vnaflorida.org> Subject: RE: Suite numbers at 208 SE Park Street i re Please let me know for certain because I don't want to change our maps to add Suite A and Suite B unless it is really needed. This is why the County Addressing advised me they don't like to give out suite numbers until the offices are there. From: Bill Crow <Bill.Crow@vnaflorida.org> Sent: Wednesday, October 30, 2019 3:51 PM To: Jackie Dunham <jdunham@cityofokeechobee.com> Subject: RE: Suite numbers at 208 SE Park Street Yes, that is correct. From: Jackie Dunham [mailto:jdunham@cityofokeechobee.com] Sent: Wednesday, October 30, 2019 3:50 PM To: Bill Crow Subject: RE: Suite numbers at 208 SE Park Street So....if you don't negotiate a contract then you won't need the suite numbers?? Is that correct. From: Bill Crow <Bill.Crow@vnaflorida.org> Sent: Wednesday, October 30, 2019 3:44 PM To: Jackie Dunham <jdunham@cityofokeechobee.com> Subject: RE: Suite numbers at 208 SE Park Street Great! Thanks for the info. We are still negotiating with the prospective tenant, it is not a certainty that this will occur. Have a great day. Bill From: Jackie Dunham [mailto:jdunham@cityofokeechobee.com] Sent: Wednesday, October 30, 2019 3:36 PM To: Bill Crow Subject: RE: Suite numbers at 208 SE Park Street In that case you will definitely need a permit for that construction and it will have to also be reviewed by our Fire Chief in case fire walls are needed etc. From: Bill Crow <Bill.Crow@vnaflorida.org> Sent: Wednesday, October 30, 2019 2:41 PM To: Jackie Dunham <jdunham@cityofokeechobee.com> Subject: RE: Suite numbers at 208 SE Park Street We will likely be putting up a wall/door. Bill From: Jackie Dunham fmailto:idunham@cityofokeechobee.com] Sent: Wednesday, October 30, 2019 2:37 PM 2 Fr To: Bill Crow Subject: Re: Suite numbers at 208 SE Park Street I heard back from the County regarding the addressing. They are giving you Suite A and Suite B instead of 1 and 2. Is there an existing office where your new tenant will be located or are you intending to build a new suite? Jackie Dunham Administrative Secretary City of Okeechobee 55 SE Third Avenue Okeechobee, FL 34974 863-763-3372 (Main) 863-763-9821 (Direct) 863-763-1686 (Fax) jdunhamDcityofokeechobee.com WEBSITE: http://www.cityofokeechobee.com NOTICE: Due to Florida's broad public laws, this e-mail may be subject to public disclosure. William J. Crow Executive VP, IT & Plant Operations o. 772-419-5501 c. 772-485-2494 Confidential and privileged privacy notice: This email message and any attachments may contain Protected Health Information (PHI) that is privileged and confidential under Florida Statute 455.241 and 395.3025(i)(i); HIPAA 45 CFR Parts 160 & 164. The entire email message and any attachments are intended solely for the use of the intended recipient. You are hereby notified that any dissemination, distribution, copying or disclosure of the contents of this email, including attachments, is prohibited. If you have received this email in error, please reply back to the sender immediately and permanently delete the original of this email, including attachments. 3 Gail Neu From: Kay Matchett Sent: Wednesday, January 22, 2020 9:26 AM To: Jose Cisneros Cc: David Allen; Patty Burnette; Gail Neu Subject: City Hall Park - April Schedule Good morning Manny, Just wanted to give you a heads up — The second week of April is the Annual Castle Memory Field Dedication Ceremony event. They will be erecting the flags on April 10th to fly for approximately one week. The ceremony will be held on April 14th, 2020. Public Works needs to mark the sprinklers prior to the flags going up to keep them from being damaged. If you could please Schedule the landscaping service for the City Hall Park before April 9th, we will be able to mark the sprinklers and the lawn will Look fresh for the Ceremony on the 14tH Thank you Kay UVtatchett AchirYstrative Secretary R.hlic VAbrks aty of Ckeed,Dbee Mailing Address: 55 SE 3rd Avenue, Okeechobee FL 34974 Physical Address: 500 NW 11th Avenue, Okeechobee FL 34972 Phone: (863) 763-3926 ext. 9791 Direct: (863) 763-9791 kmatchett@cityofokeechobee.com www.citvofokeechobee.com N()f'1('1F:: Due to Florida's broad public Imes. this email may. be subject to public disclosure. PUBLIC RECORDS NOTICE: Under Florida law, email addresses are public records. If you do not want your email address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing. Florida Statute 668.6076 CITY OF OKEECHOBEE E-MAIL DISCLAIMER: Florida has a very broad public records law. Most written communications to or from local officials regarding city business are public records available to the public and media upon request. Your e-mail communications may therefore be subject to public disclosure. 1