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Home My WebLink AboutNon Res Block Party - Make South Bend LLC1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS September 13, 2016 Ms. Michelle FitzGerald Make South Bend, LLC 2228 Mishawaka Ave South Bend, IN 46615 PHONE 574/235-9251 FAx 5741235-9171 RE: Event Name: Rebel Art Fest Street Closure: 23`s Street from Mishawaka Avenue to Alley at River Park United Methodist Church and Parking Lot Dear Ms. FitzGerald: The Board of Public Works, at its meeting held on September 13, 2016, approved your request to close the above referenced street for your event scheduled for September 17, 2016 from 8:00 a.m. until 4:00 p.m. For your information, the South Bend Police Department will monitor this event. Enclosed please find a copy of your approved permit. The Bureau of Traffic and Lighting will deliver barricades necessary to close the street to the applicant's address. You will be responsible for their placement and removal at the conclusion of the closing of various streets. Please note that a ten foot (10) clear and unobstructed lane must be maintained at either curb or down the center of the street for emergency purposes and that no fires are allowed in the street. The Applicant will be liable for the replacement cost of $50.00 per cone as a result of any missing or damaged cones. If you have any further questions regarding this matter, please call this office at (574) 235-9251. Sincerely, Linda M. Martin, Clerk Enclosure c: Gene Eyster, Police Department Federico Rodriguez, Fire Department Marcia Qualls, Streets Ed Gleckler, Traffic & Lighting Adam Burck, Downtown South Bend GARY A. GILOT DAVID P. RELOS ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DORAU INTER -OFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE SENT 8/10/2016 TO: Ed Gleckler, Traffic & Lighting Gene Eyster, Police Department Aorbitt Kerr, Engineering hris Dressel, Community Investment Federico Rodriguez, Fire Department a� Marcia Qualls, Engineering Paula Garis, Park Department Adam Burck, Downtown South Bend (aburck@downtownsout bend.com) FROM: Linda M. Martin, Clerk- �``— SUBJECT: Non- Residential Bloc Party LOCATION: Park United Methodist Church and their DATE AND TIME: September 17, 2016 SPONSOR: Make South Bend LLC DATE DUE: September 6, 2016 FAX OR E-MAIL TO: 235-9171 / Imartin(&southbendin.gov RECOMMENDATIONS AND COMMENTS: By Date APPLICATION FOR USE OF, AND BLOCKING OF ACCESS TO THE PUBLIC RIGHT-OF-WAY FOR NON-RESIDENTIAL BLOCK PARTIES The Board of Public Works must have FOUR (4) weeks prior notice of the event. A NON-REFUNDABLE APPLICATION FEE OF $125.00, IN THE FORM OF A CERTIFIED CHECK OR MONEY ORDER, PAYABLE TO THE CITY OF SOUTH BEND, MUST BE INCLUDED WITH APPLICATION. ` ['fee Paid Applicant Name: �- Sat.�Tff R�Nij LLL. Address: Y22 Mis ff,gwh City: State: Zip $ AVC So- n+ 13E-N 9 IN `%6 % (5 Phone: 5-7 y - 3 01- 7 17 ? This application is made to the City of South Bend, Indiana, Board of Public Works, for the use of the specified public right-of-way by Applicant for the holding of the hereinafter described event: Event Name Location Ar-4 -Fes* Z 3 -A Sfi,.r 19, ft.." /-,u 5 kAkivkkA Arve d- V,^,. Sr . (Describe Street Closure Name of Street Z 3 rA 5+. From MIS 44W4LA AV€ To ALLF—Y 6ezwra.t IUV" Piylc !Mi%d heAAAJ4 a'f/w.i/z.vkj [o't. Date of Event ` } 20 u. ---,� Time: Registration/Setup M. Start tya.m. End Ela.m. g ❑ P.m. to ❑ P.M. E p.m. Approximate Number of Attendees 3 00 Answer the following appropriately: 1. This event will have music (live or other). ER' Yes ❑ No a. I understand the Noise Ordinance described in the Agreement/Permit Yes ❑ No 2. Required Information to Accompany Application a. Certified Check or Money Order in the Amount of $125.00, or: [� ❑ b. For Certified Nonprofit Organizations: Copies of the 501(c)(3) Internal Revenue Exemption Status Document and a current copy of Form 990 of Form 990-EZ are included with this application, and Yes No additionally filed with the Office of the City Clerk, 41 Floor, County - City Building, 227 W. Jefferson Blvd., South Bend, Indiana. c. Certificate of Insurance d. Maps, drawings of the area and setup plan ❑ Yes ❑ No 3. a. This event involves City streets Yes ❑ No b. This event involves County roads ❑ Yes ❑ No c. This event involves State highways ❑ Yes ❑ No d. This event involves the use of the sidewalk ❑ ❑ Yes No Updated 4/2015 e. This event is a ca regional/national event (Please circle the appropriate event type) f. Affected property/business owners have been notified of this event. g. I understand that I must arrange a meeting with all affected governmental agencies to organize the above event (Call Marcia Qualls, Customer Service Manager, 235-5939 to organize meeting). IF ALCOHOL IS TO BE SERVED OR SOLD — / Yes No L� Yes ❑ No El Yes No Alcoholic beverages will be served ❑ Alcoholic beverages will be sold ❑ Certified Check or Money Order for $400.00 must be submitted with application. ❑ • Application cannot be processed without deposit. • Deposit will be returned upon inspection of event area by the Board of Public Works. Names and phone numbers of THREE security guards ❑ • To monitor underage drinking. • Qualifications must be listed (e.g. Off -duty police officer, professional security guard, or event APPLICANT). A drawing must be submitted showing: ❑ • Fencing around serving area • Trash receptacles. o Ample trash receptacles must be provided to ensure proper disposal of refuse. Temporary liquor license. ❑ • Call the Alcohol & Tobacco Commission at (317) 234-4315 for more information. • Application cannot be processed without a copy of this license. Tobacco Commission at (317) 234-4315 for more information. Application cannot be processed without a copy of this license. 12. APPLICANT agrees to indemnify, defend and hold harmless the Civil City of South Bend, Indiana, from any liability, loss, costs, damages or expenses, including attorney fees, which the Civil City of South Bend, may suffer or incur as a result of any claims or actions which may be made by any person, including a participant in the activity, arising out of the approval of this request by the Board of Public Works to close a portion of the public right-of-way for the event described above. I have read the Application and Permit and the Agreement for the "Use of Right -of -Way for Special Events" and I understand and agree to the above rules and regulations. I also understand that this application may be denied based on any false or incomplete information. Dated this qtk day of APPLICANT Signature 20 4 io Printed Name M )Ck4- it Z CZerQ d � wno-- o e-cAF- woad. f F;, Ra-6e.r. r4 Fef,� BOARD OF PUBLIC WORKS APPROVAL Presicjpnt ,�I I�1 I ember Member Member Member Date RETURN FORM TO: Board of Public Works 1316 County -City Building 227 West Jefferson Boulevard South Bend, IN 46601 Phone: (574) 235-9251 • Fax: (574) 235-9171 9 E-Mail: publicwks@southbendin.gov ni thf��tREBE �T. Michelle FitzGerald MAKE SOUTH BEND 2228 Mishawaka Ave. South Bend, IN 46615 Board of Public Works 1316 County -City Building 227 West Jefferson Boulevard South Bend, IN 46601 August 8, 2016 Dear Board, Thank you for your time to review this application. I spoke with Marcia already, and she advised me to turn this in now, even as we wait for the insurance certificate to come through. Our insurance is with Healy Group, and John Kersey is the agent over the account. The certificate should be available by the end of this week. We are expecting this first event to be small with around 300 people, so the certificate has a $2,000,000 aggregate. Please let me know if anything further is needed before this can be approved. Sincerely, Michelle FitzGerald Michelle FitzGerald, Event coordinator 2228 Mishawaka Ave. SOUTH BEND, IN 46615 Or contact Michelle for more information: michelle@makesouthbend.com c- 574.303.7177 EVENT MAP Mishawaka Ave. FOOD TRUCKS ❑ INFO CHINA GLAMOUR MAKE Uniquely SOUTH BEND UNIFORM HOUSE WEAR SOUTH Yours BEND 8z m MAIN Z 0 v STAGE O N BAND El MERCH 8 DIV FIRST AID TENT &INFO El El FOOD TRUCKS N W Q W r+ THE OTHER STORE alley RIVER PARK UNITED METHODIST TOILETS 1-11-1 PARKING alley Vine St. CERTIFICATE OF LIABILITY INSURANCE DATE MMNCIWYY) 8�11/2016 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(les) must 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 Surplus Insurance Brokers P. O. Box 749 South Bend IN 46624-0749 INSURED 46615 COVERAGES ..vwluly NUMULM 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 REIXJCED BY PAID CLAIMS. Ias I LTR TYPEOF INSURANCE OLe POLICY NUMBER MIN CY EF NoLIC LIMITS LIMITS A X OCMMERCIALOENERALUABIL" X CP02716060-01/17/2016 9/18/201 EACH OCCURRENCE 3 1,000,000 CLAIMSMADE OCCUR PREMISES ao:unanpa $ 100,000 MEDENP(Ally OnepammU 4 5,000 PERSONAL& ADVINARY $ 1, 000, 000 OENLMGREGATEUMITAPPUEBPER GENERAL AGGREGATE 3 2, D00, 000 X POLICY a P„ECy LOC PRODUCTS-COMPAlPA00 3 2, 000, 000 OTHER S AUTOMOBILELM01ITY COMBINEDS1 LE LIMT ocUMl S ANYAUTO BODILY INJURY(Peroomon) 3 ALL OUNED SCHEDULED SODILYINJURY&raapeeU 3 AUT09 AUTOS HIRSDAUTOS NON.OWNED AUTOS H PROPERTY DA .. 3 - UNBItEUA OCCUN EACH OCCURRENCE 3 EXCESB LIAS GLNMGMADE AGGREGATE S CEO RETENTIONS S SYORKERSCOAPBISATION ANDEMPLOYEAV U M ITY YIN STATUTE ER ANYPRCPRIETg ARTNERIE%ECITPIE FCERIMFl,1BER EKCLUOEDF NIA E.L.EACH ACCIDENT 3 (Mandatory Ie NH) IN B Yyaaa d,acrtau der DEBCPoPTION OF OPERATIONS We, El. DISEASE-EAEMPLOYE S E.L. DISEASE- POUCY LIMIT S DESCRIPTIONOPOPERATIONSILOCATION&/V6aCLEa (ACORO 101,AdJK1arml Ramm*m Schoub, may be aeeceed a mare Spec, IS m,u1m) GROUP 1-SPECIAL EVENT CERTIFICATE HOLDER IS AN ADDITIONAL INSURED PER FORM CG2026(04-13). CITY OF SOUTH BEND BOARD OF PUBLIC WORKS 1316 COUNTY CITY BLDG 227 W JEFFERSON BLVD SOUTH BEND IN 46601 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. reserved ^�� •� (...•.,+•+v I ne AUUKU name and logo are registered marks of ACORD (OMNI7 CERT004-130729/1608111039)