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Temporary Street Closing Permit_Christ fellowship_ Field Day L `iotsce -.,m: CITY OF OKEECHOBEE `° 0.^� 55 SE THIRD AVENUE .•e OKEECHOBEE, FL 34974 —%�1 4`,/11 0 Tele: 863-763-3372 X9821 Fax: 863-763-1686 e-mail: gneu(a�citvofokeechobee.corn TEMPORARY STREET CLOSING PERMIT Permit Number: 24-025 Date(s) of Event: February 13, 2025, 8:00 A.M. - 2:30 P.M. Permit Expiration: February 13, 2025 @ 11:59 P.M. Purpose of Request: Field Day 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 Okeechobee, FL 34974 Phone Number: 863-763-3072 Address of Project: SE 2nd Avenue — (SE 6th Street to SE 7th Street) Current Zoning: RSF-1 FLU Designation: SF Subdivision: First Addition to 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 expiration date. 1,ereia iorcle January 8, 2025 Administrative Secretary Date General Services Department Page 1 of 3 Revised 3/5/19 CITY OF OKEECHOBEE y„st 55 SE THIRD AVENUE % °�,; OKEECHOBEE, FL 34974 1�LL Tele: 863-763-9821 Fax 863-763-1686 :;$ PARK USE AND/OR TEMPORARY STREET/ 41.414r.011 i01. SIDEWALK CLOSING PERMIT APPLICATION Date Received: 12-2-2024 Date Issued: I I3 2©2. Application No: Zy-025 Date(s) &Times of Event:Thursday,February 13,2025 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 Home: Cell: Summary of activities: Students will participate in Field Day and will need to cross back and forth all day. Proceeds usage: Please check requested Parks: Flagler Parks: o City Hall Park o #1 Memorial Park ❑ #2 o #3 o #4 ❑ #5 ❑ #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 ls`&3`d Tuesdays but subject to change) Address of Event: 70� S Parrott Ave Street(s)to be closed:SE 2nd Ave from SE 6th Street to SE 7th Street Date(s)to be closed:Thursday,February 13,2025 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. 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 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. 12/2/2024 Applicant Signature Date ••••OFFICE USE ONLY•••• Staff Review Fire Department: Date: VI- 12- 12 Building Official: Date: )? -2- 2 Public Works: CN\iDate: 1242-I�4 • Police Department: Date: Wdi/.24( BTR Department: `� Date: l2 s o? City Administrator: — / //a.- Date: /)1-11# City Clerk: \ ? Date: a 3 f,�,0, 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 1 ) 7 I20 Z Date Temporary Street and Sidewalk Closing reviewed by City Council and approved 1 '7"01-5 Date . , m ® + 1 h 0 c; = cz al o c.. o . :.:.:'. ....Li ... 4.) 4,...) ..... ..- ,,..i.- ...r. to-1 ...., -- c' 47-- •..-- - o S7,.' -,;...:1' 0 --- Cl. ..— ,,-,-,. fra 0 0 _Ca c.) 0 C..0 1 r .... ..... ......... ,,.. ......, .t,r 0 c....-.), S Parrott Ave --- ...._ L./a-A O CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/02/2024 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 Beth Shapiro NAME: JDA Insurance Group (PHHc NE ExI): (561)296-0373 FAX.No) (561)828-0997 120 N.Federal Hwy.,#301 E-MAIL beth@thejdagroup.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Lake Worth FL 33460 INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B: Insurance Co of the West 27847 Okeechobee Christian Academy,Inc. INSURER C: 701 South Parrott Ave INSURER D: INSURER E: Okeechobee FL 34974 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2481405251 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTRINSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,DAMAGE T000 RETE CLAIMS-MADE X OCCUR PREMISESO(Ea occur ence) $• 500,000 MED EXP(Any one person) $ 15,000 A Y PHPK2572515-016 07/01/2024 07/01/2025 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 PRO X POLICY 3,000,000 JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED PHPK2572515-016 07/01/2024 07/01/2025 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE PHUB870809-016 07/01/2024 07/01/2025 AGGREGATE $ 1,000,000 •DED RETENTION$ $ WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y I N B ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA WFL 5042021 06 07/02/2024 07/02/2025 E.L.EACH ACCIDENT $ 1'000'000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , Each Claim $1,000,000 Professional Liability A PHPK2572517-007 07/01/2024 07/01/2025 Aggregate $1,000,000 Retention $10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) When required by contract or agreement,the certificate 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. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN The City of Okeechobee ACCORDANCE WITH THE POLICY PROVISIONS. R.E.Hamrick Testamentary Trus AUTHORIZED REPRESENTATIVE 55 SE 3rd Ave Okeechobee FL 34974-2903 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1