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Park Use Permit_COC_Small Buisness Saturday ��off I'oKFFrti CITY OF OKEECHOBEE 0,* 55 SE THIRD A VENUE - OKEECHOBEE, FL 34974 ae, Tele: 863-763-9821 Fax 863-763-1686 • rt * �• e-mail: permit(@_citvofokeechobee.com ,411 Park Use Permit Permit Number: 24-024 Date(s) of Event: November 30, 2024, 8:00 A.M. — 2:00 P.M. Permit Expiration: November 30, 2024 c 11:59 P.M. Purpose of Request: Small Business Saturday Shopping Property Owner: City of Okeechobee Address: 55 SE Third Avenue City: Okeechobee State: Florida Zip Code: 34974 Applicant: Chamber of Commerce of Okeechobee County Applicant's Address: 55 S. Parrott Avenue Phone Number: 863-467-6246 Address of Project: Seminole Square Current Zoning: PUB FLU Designation: PF Subdivision: City of Okeechobee Restrictions/Remarks: • Contact the Okeechobee County Fire Department at 863-763-5544 to schedule a final field inspection before the event. • All debris must be removed within 24 hours of the expiration date. 7 e'zeQa 7a ide November 19, 2024 General Services Administrative Secretary Date Page 1 of 3 Revised 5/13/24 CITY OF OKEECHOBEE ��,`efro y�_ 55 SE THIRD AVENUE z`�tett.! 1110 A OKEECHOBEE, FL 34974 r; Tele: 863-763-9821 Fax: 863-763-1686 �;'' PARK USE AND/OR TEMPORARY STREET/ .„.-�'' SIDEWALK CLOSING PERMIT APPLICATION Date Received: It j Jy/2G24 Date Issued: Application No: '2i{.-c 2,4 Date(s) & Times of Event: :>aturd f.v, r•lovernbar 0th 18:00 AM 0 PM Information: Organization: Chamber of Commerce of Okeechobee County Mailing Address: 55 S Parrott Ave. Okeechobee, FL 34972 Contact Name: Mariah Arana Chamber Office Manager E-Mail Address: info@okeechobeebusiness.com Telephone: Work: 863.467.6246 Home: 363.%0 : 1,4 Cell: , Summary of activities: FREE holiday shopping promotion for local Okeechobee businesses. Shoppers Mere %end c passport of participating business. These get signed off on as shoppers visit and when purci;a as are ni,hcic: :-.i :es are drawn to encourage visiting as many stores as possible. #Srlopsmall Iloblo liirikb sho c Proceeds usage: No fees are exchanged or collected Please check requested Parks: Flagler Parks: o City Hall Plaza o #1 Veterans Memorial Square o #2-Speckled Perch Square m #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: Page 2 of 3 Revised 5/13/24 TEMPORARY STREET AND SIDEWALK CLOSING INFORMATION (Street Closings require City Council approval.Meetings is'&3rd Tuesdays but subject to change) Address of Event: Street(s)to be closed: ; 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 ► 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. [..i 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 maybe 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. Mariah Arana 11/14/2024 Applicant Signature Date ••••OFFICE USE ONLY•••• Staff Review Fire Department: Date: l t I l S' Z 1/41 Building Official: � Date: (( f v 24 Public Works: -�� / Date: �l Police Department: i Date: ( 1 1 aoa(1 BTR Department: Ii/P. �a&ai Date: // /11.r City Administrator: %  Date: J-14- City Clerk: YV./1110 Date: i i i i l7' 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 /U Date,, Temporary Street and Sidewalk Closing reviewed by City Council and approved 'v M Date INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY P. 0. BOX 2508 CINCINNATI, OH 45201 Employer Identification Number: DateMAY 1 2 2011 27-4426593 DLN: 17053102368021 BUSINESS DEVELOPMENT BOARD OF Contact Person: OKEECHOBEE COUNTY INC JEFFERY A CULLEN ID# 31215 C/O CHAMBER OF COMMERCE OF OKEECHOBEE Contact Telephone Number: 315 NW 4TH AVE (877) 829-5500 OKEECHOBEE, FL 34972 Accounting Period Ending: December 31 Form 990 Required: Yes Effective Date of Exemption: January 1, 2011 Contribution Deductibility: No 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) (6) of the Internal Revenue Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Please see enclosed Publication 4221-NC, Compliance Guide for Tax-Exempt Organizations (Other than 501(c) (3) Public Charities and Private Foundations) , for some helpful information about your responsibilities as an exempt organization. Sincerely, (tett, Loit G. Lerner Director, Exempt Organizations Enclosure: Publication 4221-NC Letter 948 (DO/CG) DATE(MM/DD/YYYY) ACORL® CERTIFICATE OF LIABILITY INSURANCE 11/8/2024 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 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 Pritchards And Associates NAME: Pritchards And Associates c (I(A/ No,Eel): (863)763-7711 AC,No): EMAIL ADDRESS: ClO@pritChardSinC.COm INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Philadelphia Indemnity Insurance Co. 18058 INSURED BUSIDEV-01 INSURER B:Zenith Insurance Company 13269 Business Development Board Of Okeechobee County, Inc 55 S PARROTT AVE INSURER C: OKEECHOBEE FL 34972-2968 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1604916607 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP INS() WVO POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY PHPK2567791 7/20/2024 7/20/2025 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $100,000 MED EXP(My one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident $ AUTOS ONLY AUTOS ) HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ B WORKERS COMPENSATION Z134078208 3/3/2024 3/3/2025 PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 A Directors&Officers PHSD1801565 7/20/2024 7/20/2025 Aggregate 1,000,000 Deductible 1,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Hammerick House Trust Additional Insured: City of Okeechobee R.E. Hamrick Testamentary Trust Okeechobee,FL 34974 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Okeechobee 55 SE 3rd Avenue AUTHORIZED REPRESENTATIVE Okeechobee FL 34974 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD , . . 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