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: gneuC(Dcityofokeechobee.com
TEMPORARY STREET CLOSING PERMIT
Permit Number: 24-005
Permit Expiration: March 8, 2024
Purpose of Request: Field Day
Date(s) of Event: March 8, 2024, 8:00 A.M. — 2:30 P.M.
11:59 P.M.
Property Owner: Christ Fellowship Church Inc.
Address: 701 S Parrott Avenue
City: Okeechobee State: Florida Zip Code: 34974
Applicant: Okeechobee Christian Academy Applicant's Address:701 S Parrott Avenue
Phone Number: 863-763-3072
Current Zoning: RSF-1
Subdivision: First Addition to Okeechobee
Restrictions/Remarks:
Okeechobee, FL 34974
Address of Project: SE 2nd Avenue — (SE 611 Street
to SE 7th Street)
FLU Designation: SF
® All debris must be removed within 24 hours of expiration date.
® Contact the Okeechobee County Fire Department at 863-763-5544 to schedule a final field
inspection before the event.
i4ereja Jorde February 7, 2024
Administrative Secretary Date
General Services Department
f 1
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/
SIDEWALK CLOSING
PERMIT APPLICATION
Date Received:
I Date Issued: 1 -% _c;_>
Application No:
1 ;.4 -CC,6
I Date(s) & Times of vent: Friday, March 8, 2024 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 1 Home: I I Cell
Oul,i,11aty vi a%,LiviLicw.
Students will participate in Field Day and will need to cross back and forth all day.
rroceeas usage:
Please check requested Parks:
Flagler Parks: ❑ City Hall Park ❑ # 1 Memorial Park ❑ #2 ❑ #3 ❑ #4 ❑ 95 ❑ #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 1't & 3d Tuesdays but subject to change)
Address of Event: 701 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, March 8, 2024
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
► 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.
Applicant Signature
Staff Review
1 /10/2024
Date
•••'OFFICE USE ONLY•••`
Z
Fire Department:
Date:
Building Official:
Date:
Public Works:
Date:
Police Department:
Date:
BTR Department:
Date:
/' "—/C%
City Administrator:
Date:
City Clerk:
)
Date:
j
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
d_�-a4
Temporary Street and Sidewalk Closing reviewed by City Council and approved "J= 2—
Date
Application Number:
APPLICATION FOR SPECIAL EVENT
Date Received:
NAME OF EVENT: _Okeechobee Christian Academy Field Day
ADDRESS OF EVENT: 701 S Parrott Avenue Okeechobee, FL
DESCRIPTION OF EVENT: Annual Field Day event where students will participate in sports and games on both
side of the road.
NAME OF SPONSOR ORGANIZATION: Okeechobee Christian Academy
Contact llumbe;- before and during event OF RESPONSIBLE PERSON: (863) 610-1268 -
RESPONSIBLE PERSON'S NAME
..—Melissa King
DATE(S) AND TIME(S) OF EVENT:
Date: 3/8/2024 Starting Time: 8:00am Closing Time
Date:
Starting Time:
2:00pm
Closing Time:
ARE ANY ROADWAYS TO BE BLOCKED/CLOSED?des LOCATION SE 2nd Ave from SE 6th Str to SE 7th Str
Will Emergency Apparatus (Fire and Ambulance) have access to area? yes
IF NO, THEN (provide alternatives):
WILL ELECTRICITY BE USED? YES M ENO .d (circle)
Locations: --
Provided By:
WILL HEATING/OPEN FLAMES FOR FOOD BE PROVIDED? (circle) YES M ONO (7
Type of Heating Equipment Used:
WILL A TENT BE ERECTED? (circle) YES i] i NO
Tent Manufacturer: Size fire rafing posted:
Tent have sides and how many?
Are there Fire Extinguishers accessible and ready for use? (circle) Yes
No
"','ATTACH SITE MAP OF EVENT LAYOUT***
FIRE DEPARTMENT LIFE SAFETY & FIRE SERVICES REQUIREMENTS: (See above)
Tents/canopy fire rating certificate required.
fiA Tent Size require life safety inspection (900 square feet or less then no permit is required)
Floor plan / seating / setup drawing required showing exits, etc.
RK Emergency access must be maintained. (REFERS TO VEHICLES AND EQUIPMENT)
Fire extinguishers must have current tag, and be operational and readily accessible.
N Cooking requires LPG outside of tent pointing away from exposures.
Electrical wiring exterior rated, not overloaded.
Fire Services inspection required.
f N Fire watch or inspector(s) REQUIRED? FIRE WATCH Amount:
VJ�P<Firefighter/Inspector Amount: a Other:
FIRE DEPARTMENT OFFI AL (PRINT):
SIGNATURE:
f txjuH�
Please call the FD at 863-467-1586 for any questions.
Revised 11-6-19
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oCERTIFICATE OF LIABILITY INSURANCE
YY) DATE (MMrDOA-Y
01111/2024
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 pollcy(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
CONTACT Marc Crispino
NAME:
JDA Insurance Group
N. Federal Hwy., #301
PHONE
E (561) 296-0373 ac No : (561 } II2II-0997
WC,120
E-MAIL mart@thejdagroup.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIL #
INSURERA: Philadelphia Indemnity Insurance Company
18058
Lake Worth FL 33460
INSURED
INSURER B : Insurance CO Of the West
27847
INSURER C :
Okeechobee Christian Academy, Inc.
INSURER D :
701 South Parrott Ave
INSURER E :
INSURERF:
Okeechobee FL 34974
COVERAGES CERTIFICATE NUMBER: CL2381704086 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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 INSURANCEADDLISUBRI
SD
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYW
POLICY EXP
MWDDIYYYY
LIMITS
x
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
OCCUR
DAMAGE T'cLA1MS-MADE
PRESES Ea occur RENTEante
$ 500,000
MED FXP (Any one person)
$ 15,000
PERSONAL&ADV INJURY
$ 1,000,000
A
Y
PHPK2572515
07/01/2023
07/01/2024
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 3,000,000
PRODUCTS-COMP/OPAOG
$ 3,000,000
JECT X POLICY ❑ PRO ❑ LOG
$
riOTHER: Abuse & Molestation
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
BODILYINJURY (Per accident)
$
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED v NON -OWNED
AUTOS ONLY AUTOS ONLY
PHPK2572515
07/01/2023
07101/2024
PROPERTY DAMAGE
Per occident
$
$
LUIB
OCCUR
EACH OCCURRENCE
$
IUMBRELLA
HCLAIMS-MADE
AGGREGATE
$
A
EXCESS LIAR
PHUBB70809
07/01/2023
07101/2024
DED I I RETENTION S
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LY / N IABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICER/MEMBER. EXCLUDED?
(Mandatory In NH)
N r A
WFL 5042021 05
07f0212023
0710212024
X STATUTE X EORTH
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
It yes, describe under
DESCRIPTION OF OPERATIONS below
Each Claim
$1,000,000
A
Professional Liability
PHPK2672617
0710112023
07101/2024
Aggregate
$1,000,000
Retention
$1,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
When required by contract or agreement, the certlficate holder(s) shall be Included as additional Insured(s) as respects the General Liability.
Re: With respect to a field day event for the school,
GERTI
The City of Okeechobee
R.E. Hamrick Testamentary TrUS
55 SE 3rd Ave
Okeechobee
FL 34974-2903
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
@ 1988-2015 ACORD CORPORATION, All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD