2024-08-06 Exhibit 4, Item IV. E. • • MINUTE FILE
Exhibit 4
08/06/2024 C.0
iV• lc.
Page 1 of 3
Revised 5/13/24
CITY OF OKEECHOBEE
'��`\y.uF•oK __� 55 SE THIRD AVENUE
OKEECHOBEE, FL 34974
�o Tele: 863-763-9821 Fax: 863-763-1686
_ : 4,.�'� PARK USE AND/OR TEMPORARY STREET/
��=;,,,,g''4 SIDEWALK CLOSING
PERMIT APPLICATION
Date Received: 7 Date Issued:
Application No: .2 y - t Date(s)&Times of Event: '- j .�' - cc-� T-up /a-2� p y r
_ ,tip Fesr/U A 1 16- _pm
Information:
Organization: OKee h bee 11 q/,\' S L1 =NC'_
Mailing Address: / 1 I �.E• • .)T-. .e€c ry b e E3 FL ,34497
Contact Name: f A/Z.l or.J NE d 's !l e 12_
E-Mail Address: /nI-c cke e(`hp b e t 11 1►\!S i e I.
Telephone:
Work: ,%3 3 7 -7 y- o Home: Cell: ;Rb3-5 . 133 7
Summary of act�vitiies:
L be .flyy Fe /V A) Ik t1b. 1 t. 0,6a 1..
F'cc-1 Ve'Ado ieS , mu )iL ''Q An,d -� e <�Rme.5 -{cR `� l s.
Fie e_ Acll'Y�15ir ni * A f 1 •
Procee s usage:
1 N) 7k fir► h .
Please check requested Parks:
Flagler Parks: ❑ City Hall Plaza ❑#1 Veterans Memorial Square o #2-Speckled Perch Square
#3-Seminole Square X#4-Settlers Square a#5-Cattlemen's Square ❑ #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:
• •
Page 2 of 3
Revised 5/13/24
TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION
(Street Closings require City Council approval.Meetings 1"&3rd Tuesdays but subject to change)
Address of Event: FiA )e 9: ._L
Street(s)to be closed: /x) 3PJ A\x3 ANC SLJ -h f\JL° h t-Luep
Date(s)to be closed: 5L,NTj,c\ Cf- f-l-/ A�� f)')Ji—\f q-�-,� .
Time(s)to be closed: �' _1=a t 25".'()hp n- ( q- -,D4 ! 5..60 r n
Purpose of Closing: 1 I, :(Z Rya/ UC —c, R Lhr E ,<;i,V A
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).
O. 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 closing streets or sidewalks.
--)jhrl-U6U
Applicant Signature Date
••••OFFICE USE ONLY••••
Staff Review
Fire Department: Date: ( l 11 1 2
Building Official: Date: 7-ZZ 2�
Public Works: Date: 716.11,1,
Police Department: — Date:
BTR De artment: , • Date: e
Ci Administrator: Date:
City Clerk: (l ff1!j Date: j18621:0.4
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
• •
t �,
; City of Okeechobee Okeechobee County Fire Rescue •
55 SE 3rd Avenue 707 NW 6ih Street
Okeechobee,FL 34974 Okeechobee,FL 34972
% •t��• •0 Phone(863)763-3372 Phone(863)763-5544 < r
till.
Tent Permit Application Permit #
•Pennit is not required for tents less than 900 square feet*
In addition to this permit application,three copies of the following must be submitted for approval:
❑ Certificate of Flame Resistance for tent/canopy meeting the flame propagation performance criteria per NFPA 701 Standard Methods
of Fire Test for Flame Propagation of Textiles and Films
o Floor Plan of tent depicting layout, entrances/exits,and extinguisher locations(hand drawn plans'will not be accepted).
❑Copy of License to sell fireworks(if applicable)
Owner o Owner
oAddress Address
t° City City
g State Zip °
` State / Zip
Phone( 1 $ Phone I/ )
d E-mail u E-mail
•
O Signature o Signature
Proposed Tent Location Proposed Tent Description
Address Tent Size
Parcel Identification Number - o Open o Enclosed
The following requirements arc in compliance with National Fire Protection Association(NFPA)101 Life Safety Code,Chapter 11 Special Structures and High-
Rise Buildings,NFPA 1124,Chapter 7 Retail Sales of Consumer Fireworics.These are the minimum requirements approved by the Authority Having Jurisdiction
(AHJ),Okeechobee County Fire Rescue.The AHJ reserves the right to exceed the minimum requirements as conditions warrant.
Please initial next to each statement
PORTABLE FIRE EXTINGUISHERS:Fire extinguishers must be inspected by a licensed contractor,have a current tag,and be readily accessible.
MEANS OF EGRESS:The minimum number of exits provided from the retail sales areas shall be not less than three(3).Means of egress,including but not
limited to aisles,doors,and exit discharge,shall be clear at all times when the tent is occupied.Exit signs shall not be required to be illuminated in tents that are not open
for business after dark.Exit openings from tents shall have a clear opening width of not less than 44 inches.
EGRESS TRAVEL DISTANCE:Exits provided for ttie retail sales area of tents shall be located so that the maximum egress travel distance,measured from the
most remote point to an exit along the natural and unobstructed path of egress travel does not exceed 75 feet.
AISLE WIDTH:Aisles shall have a minimum clear width of 48 inches and shall be maintained and unobstructed at all times the tent is occupied by the public.
EMERGENCY LIGHTING:The means of egress,including exit discharge shall be illuminated whenever the tent is occupied.Emergency lighting shall not be
required in tents that arc not open for business after dusk.
ELECTRICAL:Electrical wiring must be rated for exterior use and not overloaded.Where temporary electrical conductors are placed on top of an outdoor surface
to connect the permanent power source to the tent's temporat electrical system,the conductors shall be provided with physical protection against damage caused by
pedestrian or vehicular traffic.Temporary electrical wiring installed in tents shall comply with NFPA 70,National Electric Code.
FIRE DEPARTMENT ACCESS:Any/portion of the sidewall of a tent shall be accessible within 150 feet of a public way or approved access by the fire
department.
COOKING OPERATIONS:Cooking requiring LPG must be outside of the tent pointing away fiom exposures.Cooking equipment of any type shall not be
permitted within 20 feet of tents used for storage or sale of consumer fireworks.Open flame cooking equipment of any type shall not be allowed within 50 feet of tents
used for storage or sale of consumer fireworks.
SIGNS:Signage stating"NO SMOKING"in 2-inch letters on a contrasting background shall be conspicuously posted at each entrance.
SECURITY:Signage stating NO FIREWORKS DISCHARGE WITHIN 300 FEET"in 4-inch letters on a contrasting background shall be conspicuously posted
(if applicable).
FLAME BREAKS:Tents used for storage or sale of consumer fireworks shall not exceed display dimensions of 4 feet wide,8 feet in length and 6 feet in height.
Flame breaks and solid display surfaces shall not be required for packaged fireworks merchandise displayed in bins,display racks,on pallets or tables located at the end of
a row of display fixtures.
CLEARANCE TO COMBUSTIBLES:The area located within 30 feet of a tent used for sales of consumer fireworks shall be kept free of accumulated dry grass,
dry brush,and combustible debris.
DISTANCE FROM FUEL DISPENSING:Tents for use of consumer fireworks sales shall not be located within 50 feet from the following:retail propane-
dispensing station dispensers;aboveground storage tanks for flammable or combustible liquid,flammable gas,or flammable liquified gas;compressed natural gas-
dispensing station dispensers;motor vehicle fuel-dispensing station dispensers.
DISTANCE FROM BULK FUEL DISPENSING:Tents for use of consumer fireworks sales shall not be located within 300 feet of any aboveground bulk storage
or bulk dispensing area/for the following:flammable or combustible liquid,flammable gas,flammable liquified gas.
PARKING:No motor vehicle or trailer used for the storage of consumer fireworks shall be parked within 20 feet of a tent except when delivering,loading,or
unloading fireworks or other merchandise and materials used,stored,or displayed for sale.
SEPARATION DISTANCES:Tents for use of consumer fireworks sales shall have a minimum separation distance of 20 feet from building,stands,combustibles,
other tents and any motor vehicle or trailer used for the storage of consumer fireworks.Tents for use of consumer fireworks shall be 10 feet from vehicle parking.
SOURCES OF IGNITION:Temporary electrical equipment,battery-powered equipment,and electrical cords that are used in conjunction with a tent used for the
sales of consumer fireworks shall be listed and used in accordance with their listing.
PORTABLE GENERATORS:Portable generators supplying power to tents for the sale of consumer fireworks shall use only Class III combustible liquid fuels.
f'tacc II and elacs III combustible liquid generator fuel shall be limited to not more than 5 gallons.Portable generators shall be allowed to use Class I flammable liquids as
fuel,provided the quantity of such fuel is limited to 2 gallons.Portable generators shall be located not less than 20 feet from the tent.Where generator fuel storage is
located not less than 50 feet from a tent for the sale of consumer fireworks.
RECORDS:A copy of the approved permit shall be on the premises and made available to the AHJ upon request.
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OKEEMAI-01 MBUCHANAN
,41COIzO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YVYn
11/1/2023
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANDCONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER.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 _- NQACT -
Lawrence Insurance Agency,Inc. P NE Ax
P.O BOX 649 (a"�,No,EXq:(863)467-0600 I rat.Noy(863)467-5142
Okeechobee,FL 34973 mariene@lawrenceins.com
INSURER(SIAFFORDING COVERAGE NAIC X
INSURER A:Mt.Vernon Fire Insurance Co
INSURED INSURER B:
Okeechobee Main Street INSURER C:
111 NE 2nd Street INSURERD:
Okeechobee,FL 34972
INSURER E:
INSURER F•
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 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.
INBR ADDL'SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE ruen MA!!) POLICY NUMBER LIMITS
IMM/DD/YVYYl IMMd'�I`����t it
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
CLAIMS-MADE I X OCCUR X NBP2552460F 10/25/2023 10/25/2024 PREMIsts EaExcu ante) S 100,000
X Directors 8 Officers MEDEXP(Any ono poison) S 5,000
PERSONAL&ADV INJURY S 1,000,000
GEN'L AGGREGATE LIMIf APPLIES PER GENERAL AGGREGATE S 1.000,000
POLICY oq
JELo�'T J LOC PRODUCTS-COMP/OP AGG S
OTHER S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident)
ANY AUTO BODILY INJURY(Per person) S
OWNED SCHEDULED
AUTOSRE� ONLY AUTOS
SSWNEp BODILY INJURY(Per accident! S
AUTOS ONLY AU70S ONLY ((Perx ICenll MACE
UMBRELLA LIAB OCCUR EACH OCCURRENCE S
EXCESS LIAB CLAIMS-MADE AGGREGATE S
DED 1 RETENTIONS S
WORKERS COMPENSATION _ I&FATUTPs.l _LRH AND EMPLOYERS'LIABILITY Y/N •_. .
ANYApN� FROPRIIETgORrPARTNERIEXECUTIVE E.L.EACH ACCIDENT S
(ManCa(ory In NHR EXCLUDED? r N/A
E.L DISEASE-EA EMPLOYEE S
M yes,descnbe unCer
DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD tot.Additional Remarts Schedule,may be attached if more space Is required)
City of Okeechobeeand RE Hamrick is included as additional insureds with request to General Liability Coverage
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Okeechobee
S.E. Avenue ACCORDANCE WITH THE POLICY PROVISIONS.
66Okeechobee,FL 34974 - -
AUTHORREDREPRESENTATIVE
ACORD 25 (2016/03) 01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
411
INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
P. 0. BOX 2508
CINCINNATI , OH 45201
Employer Identification Number:
Date: APR 2 9 2O5 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)
Thth w1
Katie Rogers 6ch 11
From: Katie Rogers
Sent: Monday, August 5, 2024 5:03 PM
To: 'info@okeechobeemainstreet.org'
Cc: Lane Gamiotea; Caya Ortega
Subject: Temporary Street Closures (Labor Day) and Park Use Application (Farmer's Market), 8/6
Council Meeting Agenda
Attachments: 2024 08 06 Exhibit 5.pdf; 2024 08 06 Agenda.pdf; 2024 08 06 Exhibit 4.pdf
Good Evening.
On behalf of City Clerk Gamiotea, attached is a copy of the 8/6/2024, City Council Agenda and Exhibits.
You are not required to attend, but it is encouraged. If you choose to attend, please note the meeting's
time change to 5:00 P.M.
Best,
Katie Rogers I Deputy Clerk
CITY CLERK'S OFFICE
CITY OF OKEECHOBEE
55 SE 3RD AVENUE, OKEECHOBEE, FL 34974
PHONE: (863) 763-3372 EXT. 9814
FAX: (863) 763-1686
EMAIL: DEPUPTYCLERK@CITYOFOKEECHOBEE.COM
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 ELECTRONIC DEVICE 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 correspondence via e-mail, text
message, voice mail, etc., may therefore be subject to public disclosure.
i