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Park Use Permit_OKMS_Farmer's Market 4060°�F'7K4c, CITY OF OKEECHOBEE • 55 SE THIRD AVENUE o o; OKEECHOBEE, FL 34974 - = o�� Tele: 863-763-9821 Fax 863-763-1686 e-mail: permit@cityofokeechobee.com ;zoo's Park Use Permit Permit Number: 24-014 Date(s) of Event: First and Third Wednesday of Every Month- See Attached Permit Expiration: April 16, 2025 @ 11:59 P.M. Purpose of Request: Farmer's Market Property Owner: City of Okeechobee Address: 55 SE Third Avenue City: Okeechobee State: Florida Zip Code: 34974 Applicant: Okeechobee Main Street Applicant's Address: 111 NE 2nd Street Phone Number: 863-357-6246 Address of Project: Seminole Square Current Zoning: PUB FLU Designation: PF Subdivision: City of Okeechobee Restrictions/Remarks: • Ail 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. 7c e' eaa Sande August 7, 2024 General Services Administrative Secretary Date Page 1 of 3 Revised 5/13/24 CITY OF OKEECHOBEE 55 SE THIRD AVENUE �� OKEECHOBEE, FL 34974 �o �;• Tele: 863-763-9821 Fax: 863-763-1686 - :• PARK USE AND/OR TEMPORARY STREET/ vAtsza SIDEWALK CLOSING PERMIT APPLICATION Date Received: -1•-j-ZC2 y Date Issued: <3.=1- Z Application No: 2-i -L i'1 Date(s)&Times of Event: 5 e i - p d Information: Organization: O/ Q_,e cd)©bee 1 f AtN Mailing Address: C l I e E. of r)-4 ekeee ho be p) 0(07 D Contact Name: /7)4P4OcJ 4cJeShel rnP2 E-Mail Address:1/V-1,3 COicee0m0Dep rr i N 5Te2Q FT.Op9 Telephone: Work: d(p3-_.�7-(c.t r, Home: Cell: 863- -1 SummA.ry of activities: -- rn,d-week TA2_me ' hAT- 4{1 Lbe1411 owri ieb eel e n) s nt fr9firs . Viso hi d a )c&�d -eflnds , , c Je) 1E S , -Takes AID19 i r)Vt e Pi+U214)) m e 00- 5 . Proce ds usage: rho ds sopp ± ThA/f\J -3t2eet (4n3a l-Ps tN ,e_ Q./ y ac ho bee Please check requested Parks: Flagler Parks: o City Hall Plaza o#1 Veterans Memorial Square ❑ #2-Speckled Perch Square 1 #3-Seminole Square o#4-Settlers Square o#5-Cattlemen's Square o #6-Butterfly Square [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: Okeechobee Main Street Farmers Market Location: Park #3 Event dates & time: Wednesday evenings, twice monthly October 2024 thru April 2025, from 3:00 pm to 7:30 pm October 2, 2024 October 16, 2024 November 6, 2024 November 20, 2024 December 4, 2024 December 18, 2024 January 1, 2025 January 15, 2025 February 5, 2025 February 19, 2025 March 5, 2025 March 19, 2025 April 2, 2025 April 16, 2025 Page 2 of 3 Revised 5/13/24 TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (Street Closings require City Council approval.Meetings 1st&3rd Tuesdays but subject to change) Address of Event: Street(s)to be closed: 1� 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 ON. 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. 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. Page 3 of 3 Revised 5/13/24 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 c osing streets or sidewalks. it —1j °°'-1- — d- )-CLUYIT Appli ant Signature Date ••••OFFICE USE ONLY•••• Staff Review r i �1 I Fire Department: Date: ( t 1(7 1 it-1Building Official: p,4110 it,/ Date: - 7-I3 ' Public Works: v• . Date: 1(IL!) Police Department: /( 4/ _ Date: 7A, 1# BTR Department: /` -" Date:, t City Administrator: C � /'" Date: 1 / City Clerk: had 11(411-f',� Date: ri il(p I,Q614 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 A 14 bit 202L/ Date) Temporary Street and Sidewalk Closing reviewed by City Council and approved AU.6111-S F 6/a°a4 Da[d Highway 70 U 1— a 4 '343 342 � \__/ � 339 338; � 345 335 ag� ;.� 0 1� •E :_, racier 333 Legend 330' al 346 LE 336 329 i a Bench ' I 1 0:11 1 ■ Trash Can ■ W = Picnic Bench M 351 E '-'•E 327 327 ® o Light Pole < : " ilk . p1 iiim •E Electric Outlets :� Water Spigot ■ 315 320 322 325 Shrubs o 350 QA 314 0 316 319 0 /21 3241 1) ® o .�I Tree —= 349 318. > 317 _ < '1-111%0,_...._. 'E —' Nl/eV_ " 0 4 22 Exhibitor Space �� ■ 1312 3111 �310 309.308,307 306 31 `- irll � 1 ,\ Utilities t= �— - 3023011 a Q Pole 'liII Drawn by Joe Papasso 3/1/2020 Park Street � iiiimi li..4 1 Park 3 Crept.ictlSeder =p OKEEMAI-01 MBUCHANAN ORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11/1/2023 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 CONTACT NAME: Lawrence Insurance Agency,Inc. PHONE 863 467-0600 FAX (863)467�142 P.0 BOX 648 (A/c,No,Exq. ( ) (A/c,No): Okeechobee,FL 34973 marlene@lawrenceins.com INSURER(S)AFFORDING COVERAGE NAIC• INSURER A:Mt.Vernon Fire Insurance CO INSURED INSURER B: Okeechobee Main Street INSURER C: 111 NE 2nd Street INSURER D: Okeechobee,FL 34972 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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. !NOR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDDIYYYY) IMMIDDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE 1 X I OCCUR NBP2652460F 10/26/2023 10/26/2024 DAMAGETORENTED 100,000 X PREMISES(Ea occunencel $ X Directors&Officers MED EXP(Any one person) S 5,000 re PERSONAL It ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 1,000,000 POLICY PECT RO- [ LOC PRODUCTS COMP/OP AGG $ OTHER: S „AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) S _ ANY AUTO BODILY INJURY(Per person) S OWNED — SCHEDULED AUTOS ONLY AUTNOSSyyNEp BODILY INJURY(Per accident) $ AUTOS ONLY _AUTOS ONLY IPerOacodeMPAMAGE S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I j RETENTION S S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y!N STATUTE ER ANY NYIPRRPRIIEggOER PARTNER/EDED?ECUTIVE I N/A E.L.EACH ACCIDENT S (mandatory In NH) E.L.DISEASE-EA EMPLOYEE S It yes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached If more space is required) City of Okeechobee and RE Hamrick is included as additional insureds with request to General Liability Coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Okeechobee THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 65 S.E.3rd Avenue Okeechobee,FL 34974 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY P. 0. BOX 2508 CINCINNATI , OH 45201 Employer Identification Number: Date: APR 2 9 2005 65-0887929 DLN: 17053329002014 OKEECHOBEE MAIN STREET INC Contact Person: 111 NE 2ND ST DEBRA JOHNSON ID# 75126 OKEECHOBEE, FL 34974 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: September 30 Public Charity Status: 509(a) ( 1) Form 990 Required: Yes Effective Date of Exemption: November 22, 2004 Contribution Deductibility: Yes Advance Ruling Ending Date: September 30 , 2009 Dear Applicant : We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c) (3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code. You are also qualified to receive tax deductible bequests , devises , transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status , you should keep it in your permanent records . Organizations exempt under section 501(c) (3) of the Code are further classified as either public charities or private foundations . During your advance ruling period, you will be treated as a public charity. Your advance ruling period begins with the effective date of your exemption and ends with advance ruling ending date shown in the heading of the letter. Shortly before the end of your advance ruling period, we will send you Form 8734 , Support Schedule for Advance Ruling Period. You will have 90 days after the end of your advance ruling period to return the completed form. We will then notify you, in writing, about your public charity status . Please see enclosed Information for Exempt Organizations Under Section 501(c) (3) for some helpful information about your responsibilities as an exempt organization. Letter 1045 (DO/CG)