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2024-08-06 Exhibit 5, Item IV. F.
MINUTE FILE • • Exhibit 5 08/06/2024 Otht1414 °I ge 1 of 3 y,�Rev�ised 5/13/24 �( CITY OF OKEECHOBEE ''��yy 55 SE THIRD AVENUE '. OKEECHOBEE, FL 34974 •o Tele: 863-763-9821 Fax: 863-763-1686 =G� - :•,�`' PARK USE AND/OR TEMPORARY STREET/ tirka.. SIDEWALK CLOSING PERMIT APPLICATION Date Received: 1-'`$- -t-_,:y Date Issued: Application No: ?.--I -L 11 Date(s)&Times of Event: SEe /4.4Act_he d Information: Organization: d) bee_ 1 I)A,N SSAt 1 _TNT _-1 Mailing Address: I// 1'1,E. S Qr-) -i- CO'NCI lC e r -Ft ,3(1/ 7 Contact Name: , )i-)��-- Or`! 1-0c cJe, S hel me(. E-Mail Address:/t./}C C Okee�1 T.bE,v II1-4,N 5 r r.045 Telephone: Work: S)(03-.3t)7-(ram I,, 1 Home: Cell: 4,3- )'i 9.54, Summary of activities: i--I- ,1),H-L C e€ k (FA1 1)F►? MA-A-r2 kF T ) ih AT e-4 k2. Le t-i-11 Jc 1Zr�c)N dLeF r -�'l-5 1 , /=end )-yri T S , 1sC .2)iz)kcll c c. -dt))0k._H rds j _irti11 ciJF�)lhl�• S , —To)(le A)nn;J I s;l h n�- ' / .)-L)$r4 /I 17V ck �>i C�CO-) 3 . - Proceeds usage: 'l�.c C.5 _��n c_� I)")A rJ S-ti eet �ti a 1+ . P t i /n,' c, �(i .; DKve(zh0 bee tic. Please check requested Parks: Flagler Parks: ❑ City Hall Plaza ❑ #1 Veterans Memorial Square o #2-Speckled Perch Square '11,#3-Seminole Square o#4-Settlers Square ❑ #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: • • 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 1"& 3rd Tuesdays but subject to change) Address of Event: Street(s)to be closed: ,//113 , 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 I ► 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. Caka- (2L; di L(L ilx_t_ )1YNI 7 - I L'--) --;,DL-1 A liCant � PP Signature r Date ••••OFFICE USE ONLY"" Staff Review II �-1 Fire Department: Date: l I.I I I ZLi Building Official: Date: 4 7-15 Public Works: �� Date: _ /(14 Police Department: Date: BTR Department: ` Date: 7 l�o,, City Administrator: C /' ' Date: �5 [ a LA City Clerk: . f1 itLE ' i_ (.L/l i_ Date: ' I litti, /./..,t_,Y 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- ,I[ili4 ii 202� DateJ Temporary Street and Sidewalk Closing reviewed by City Council and approved Date Highway 70 13431342 t 4r 1� 340 339 338? �1 335 �^ ' '� , .....,. �,. s +� � 3.31 Legend �� 1,14,4-1 345 v O �� p /�.� 330 ® Bench inch 0 333 ® Trash Can - 329 Lib en W ® Picnic Bench °� � �" 336 s 346a{ O Light Pole co a Electric Outlets i ? ��i�. 321 326; ® Water Spigot I I ® r�i I EE -.� LL___ R 3 5 arc Shrubs ® � r."�"' j __320 0 322 323 324 ? Tres 1 t t , \---31156 319 '�-� i321 / 4 o U�350 �� 314 0 318 o ,\91— , / Exhibitoro 349 ,�> E \\ __ 317 - j 1-1,. .\ ,e... rn 0 22 , ‘,\ � y �\ 303" 302 301 Pole �� _ � � �310'3091308 307 � � i i 1�� E ` .II . 31 1 0 1 _ asso stia020 " , Utilities _ Drawn by Joe Yap Park Street park 3 • • OKEEMAI-01 MBUCHANAN orl?O CERTIFICATE OF LIABILITY INSURANCE DATEIMMDD/YVYY) 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 gap CTLawrence ------- P.O BOX Insurance Agency,Inc. PHONE (A/C E rl (863)467-0600 AA ( ,rrol:(863)4675142 Okeechobee,FL 34973 lass mariene@iawrenceins.com INSURER(S)AFFORDING COVERAGE NAIL Y INSURER A:Mt.Vernon Fire Insurance Co INSURED ------ INSURER B Okeechobee Main Street INSURERC: 111 NE 2nd Street INSURERO: 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. 7R TYPE OF INSURANCE ADDS SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS INSD W VD IMMIDOIYYYY),(MMIDEVYYYY1 A X COMMERCIAL GENERAL LIABILITY 1,000,000 __ _ EACH OCCURRENCE E CLAIMS-MADE 5X 'OCCUR NBP2652460F 10/25/2023 10/25/2024 oAMAGETORENTED 100,000 X PREMISES(Ea occurrence) s X `Directors 8Officers MEDEXP(Anyoneperson) S 5,000 PERSONAL S ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPUES PER, GENERAL AGGREGATE S 1,000,000 POLICY[ J JeCT I J LOC PRODUCTS-COMPIOP AGG S OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT LEaCcoden0 S ANY AUTO __ BODILY INJURY(Per person) S OWNED SCHEDULED I AIURTEOS ONLY AUTOS BODILY BODILY INJURY(Per accident) S I AUTOS ONLY A�TOS ONLV (PeOP RTeY ntDAMAGE S - E UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTIONS S WORKERS COMPENSATION ___J PER T - II_LOTH AND EMPLOYERS'LIABILITY Y_I_N ANYAQNF PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT S QFFICatplyIn NH)EXCLUDED? I I N IA E L.DISEASE-EA EMPLOYEE S d Yes,descION under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS?LOCATIONS/VEHICLES.(ACORD 101,Addllional 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 THE EXPIRATION DATE THEREOF,City of Okeechobee ACCORDANCE WITH THE POLICY PROVISIONS.ICE WILL BE DELIVERED IN 66 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) VI-PAOZA1 CC. Rogers ��ern Katie /V, c' f ,6Ff S From: Katie Rogers klkbtkd(k,4 / ayeQ )` Sent: Monday, August 5, 2024 5:03 PM -r ! To: 'info@okeechobeemainstreet.org' Y' /9' 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.