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Temp Street Closing - First Baptist Fall Family FestivalCITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE, FL 34974 Tele: 863-763-9821 Fax: 863-763-1686 *7 991 s * e-mail. ldunham @cityofokeechobee. com Street Closing Permit Permit Number: #21-022 Date(s) of Event: October 31, 2019 1:OOP.M. — 8:00 P.M. Permit Expiration: October 31, 2019 11:59PM Purpose of Request: Fall Family Festival Property Owner: First Baptist Church of Okeechobee Address: 310 SW 5t" Ave (Ball field south of the ROC) City: Okeechobee State: Florida Zip Code: 34974 Applicant: FIRST BAPTIST CHURCH OF OKEECHOBEE Applicant's Address: 401 SW 4t" St., Okeechobee, FL 34974 Phone Number: 863-467-7625 Address of Project: 310 SW 5t" 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 01 Street between 5t" & 6t" Avenues to enable safety for children crossing between the two areas. If needed by PD's discretion also the 400 Block of SW 5t'1 Ave. Streets to be closed between 3:OOPM and 9:OOPM. (� CUU/P• New 0ctrab-or 27, 202.1 Gail P. Neu Administrative Secretary Date 0 ILI ` ( ,� Pagel 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/ SIDEWALK CLOSING PERMIT APPLICATION Date Received: Date Issued: / A lication No: Date(s) & Times of Event: 4; or I I Tn fnrm ati nn Organization: First Baptist Church of Okeechobee Mailing Address: 401 SW 4th Street Contact Name: Melanie Rooks E-Mail Address: Melanie@fbcokee.org Work: 1 (863)467-7625 1 Home: I I Cell: 1 (772)633-977 OU.111111dfy U1 UUL1V1LIUb. Booths, trunk or treat vehicles, food trucks rroceeas usage: Free event - No charge except for food trucks Please check requested Parks: Flagler Parks: ❑ City Hall Park ❑ #1 Memorial Park ❑ #2 ❑ #3 ❑ #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: 509 SW 4th Street Street(s) to be closed:500 block of SW 4th Street Date(s) to be closed: October 31, 2021 Time(s) to be closed: 1 pm - 8pm Purpose of Closing: Use street for walkway between parking at 310 SW 5th Ave. and parking of other vehicles Attachments Required for Use of Parks Attachments Required for Street/Sidewalk Closings ► Site Plan ► Site Plan ► Copy of liability insurance in the amount of ► Copy of liability insurance in the amount of $1,000,000.00 $1,000,000.00 with the City of Okeechobee as with the City of Okeechobee and R.E. Hamrick Testamentary additional insured. 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 ► State Alcoholic Beverage License, if applicable.** property owner, 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. ❑ 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 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. 10/5/21 Applicant Signature Date ••••OFFI USE ONLY**** Staff Review /l1 Fire Department: Date: Building Official: Date: Z -2! Public Works: Date: /1-1 Police Department: Date: BTR Department: --,a l Date: /y City Administrator: -! �- Date: City Clerk: ���5��(�-- Date: 6 . 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 o210 ZQW Temporary Street and Sidewalk Closing reviewed by City Council and approved Date Application #: CI - .:OL "E.L - APPLICATION FOR SPECIAL EVENT ;/La24 Date Submitted: so by Permit #: 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. Inflatable's will be set up by the rental company & operated with multiple adult supervisors. Tents will not be laraer 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 772-633-9777 Date(S) And Time(S) Of Event: Date: 10/311 Za-.l VYXIS—tarting Time: 5:00 PM Date: Starting Time: Date: Starting Time: Closing Time: 7:00 PM Closing Time: Closing Time: ARE ANY ROADWAYS TO BE BLOCKED/CLOSED? YES LOCATION SW 4th ST between 5th & 6th Avenue's Will Emergency Apparatus (Fire and Ambulance) have access to area? YES IF NO, THEN EXPLAIN (provide WILL ELECTRICITY BE USED? YES CIO ❑ Locations: In the center of the ball field Provided Bv: Joel Bass Electric WILL HEATING/OPEN FLAMES FOR FOOD BE PROVIDED? YES ❑NO Type of Heating Equipment Used: WILL A TENT BE ERECTED? YES ® NO ❑ NO LARGER THAN 10-FT X 10-FT Tent Manufacturer: N/A Size 10'X10' or smaller fire rating posted: Tent have sides and how many? N/A ... st regarding safg�, ***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 Tcnts/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 overlo O Fire Services inspection required. O Fire watch or inspector(s) REQU ? FIRE WATCH Amount: O Firefighter/Inspector Amo t: _ O Other: FIRE DEP (PRINT): alternatives): SIGNATURE: �- � Please call the FD at 863-467-1586 for any questions. Page 2 of 3 Revised 3/5/19 TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (Street Closings require City Council approval. Meetings 1" & 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 Dates to be closed: October 31, 20;4 Time(s) to be closed: 3:00 to 9:00 PM (Event time is approximately 5-7 PM) Purpose of Closing: Pedestrian crossing into the Fall Festival Attachments Required for Use of Parks Attachments Required for Street/Sidewalk Closings , ► Site Plan ► Site Plan Attached ► Copy of liability insurance in the amount of ► Copy of liability insurance in the amount of $1,000, 00.00 $1,000,000.00 with the City of Okeechobee as with the City of Okeechobee and R.E. Hamrick Testamenrry additional insured. Trust as Additional Insured. r/ ► Proof of non-profit status ► Original signatures of all residents, property owners and business owners affected by the closing. N/A AV_ ► -State Food Service License if > 3 days. I ► State Food Service License if > 3 days. N/A ► Notarized letter of authorization from ► State Alcoholic Beverage License, if applicable.** property owner, if applicable.* N/A * 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. ❑ 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 gover mrental re ul�atory, 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. Ir M ,a n a 1111M.I� 4r.: fAw 00' . it ` SW PARK ST r `�rn t"w; V `• t i * N aa._' O Ali x. F ° %V 7N[) S [ R� SW 214D S I C s , 1o• 1 J Y SIN ]RD Si SW 3RD SWT :E SW 311D ST _ n J� FBC _a S M The `""� Mission p 0 u rn House m rl t Temp �? ROC n I ,,.-..r_1 p 4 y ' Parking '. It . s� - y Closingrr m N A r SW 4ch ST SW 4TH ST Between �► c 5ch & 61h Ave Ball Field I ` AV _ FBC Main , . ., ` • ""�- ► k - Campus 1! ;" - - ParkingOL Q s c .,� .a�. i cs •, r i rs- r ±vSW 5TH ST 'rz rn 5W STH.ST CU IL m (O (6 r,. _ i n SW 6TH ST-74 "' I •' Mill FBC Okeechobee Fall Festival, Temporary Street Closing Saturday, October 31, 202� Event Time (approximately): 5:00 to 7:00 PM Street Closing (approximately): 3:00 to 9:00 PM The portion of the street to be temporarily closed is SW 4t1 Street between SW 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 due to amount of pedestrian traffic. ► Barricades are requested to close off both ends of 4th Street from Public Works. ► The Fire and Police Departments are 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 SW 4th Street and SW 511 Avenue during the event times. CERTIFICATE REQUEST FORM Name of your church: First Baptist Church of Okeechobee Guideone Policy# 1 001423828 Phone: 863-763-2171 Contact person from your organization: Melanie Rooks Type of event: Community Fall Festival Activities involved: Games - Event address: 310 SW 5t' Avenue Ball Field Date s) of event: 10/31 /2021 Approximate number of people attending : 200+ Organization requiring the certificate: (not your church) Name: City of Okeechobee .Address:55 SE 3d_Avenue City:Okeechobee FL 34974 Email or Fax#:gneu@cityofokeechobee.com Is the requesting organization asking to be listed as "an additional insured"? Yes No City & R.E. Hamrick Testamentary Trust as additional insured • �� FIRSB-1077 MHYDE ,4coRO"' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/5/2021 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 endorsements). PRODUCER NAMEACT Mary Hyde Church Asset Management, Inc. PHONE FAX 1500 Wall St. (A/C, No, Et): (800) 200-7257 4259 A/C, No): Saint Charles, MO 63303 E-M RIE . mhyde@ltcam.cOm INSURED First Baptist Church of Okeechobee 401 SW 4th St Okeechobee, FL 34974 INSURER F : GuldeOne Mutual rtnVFaer_I=c C1=aTIM1'ATP IJIIMRFD- ocvlclnW MnnnQCD- 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICDLTR Y EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [K OCCUR 1423-828 12/1/2020 12/1/2021 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED 1,000,000 MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ JECOT LOC OTHER: GENERAL AGGREGATE 3,000,000 PRODUCTS - COMP/OP AGG $ 3,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY AUTO ONLDY COMBINED SINGLE LIMIT id 't BODILY INJURY Perperson) BODILY INJURY Per accldent PPerOaent AMAGE $ UMBRELLA LIAB EXCESS LIAR OCCUR EACH OCCURRENCE HCLAIMS-MADE AGGREGATE DIED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE F7 Mandatory In NH) EXCLUDED? If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- T E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is listed as Additional Insured re: Community Fall Festival on 10/31/2021, 509 SW 4th Ave & 310 SW 5th Ave Activities: Carnival type games, music & food rrwr�r� n City of Okeechobee & R.E. Hamrick Testamentary Trust 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 AI:UKU L:) (LU'IbIU3) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD