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HomeMy WebLinkAboutNon Res Block Party - KRG Eddy St Commons - Santa Breakfast Holiday Happenings1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS November 8, 2016 Marquette Jamison KRG Eddy St. Commons 30 S Meridian St. Suite I100 Indianapolis, IN 46204 RE: Event Name: Santa Breakfast/Holiday Happenings Event Street Closure: Eddy St. from Napoleon to Angela Date: December 3, 2016 Dear Ms. Jamison: PHONE 574/235-9251 FAX 574/235-9171 The Board of Public Works, at its meeting held on November 8, 2016, approved your request to close the above referenced street for your event scheduled for December 3, 2016 from 6:00 a.m. until 2:00 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 SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DORAU INTER -OFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE SENT 10/24/2016 TO: Ed Gleckler, Traffic & Lighting , Gene Eyster, Police Department Matt Longfellow, Engineering Chris Dressel, Community Investment is�ederico Rodriguez, Fire Department v Marcia Qualls, Engineering Paula Garis, Park Department Adam Burck, Downtown South Bend (aburck@downtownsouth bend.com) FROM: Linda M. Martin, SUBJECT: Non- Residential Block Party LOCATION: Eddy St. from Angela to Napoleon DATE AND TIME: December 3, 2016 KRG Eddy St. Commons — Santa Breakfast Holiday SPONSOR: Happenings DATE DUE: November 1, 2016 FAX OR E-MAIL TO: 235-9171 / lmartin(&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. Applicant Name: D�6 30 S Meridian Street, Address: Suite 1100 City: Indianapolis State: IN Zip: 46204 Phone: 317-713-7713 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 Santa Breakfast / Holiday Happenings Event Location Eddy Street Commons (Describe Area/Route) Street Closure Name of Street Eddy Street From Napoleon To Angela Date of Event December, 3 20 16 ❑ a.m. ❑ a.m. ❑ a.m. Time: Registration/Setup 6 ❑ p.m. Start 8 ❑ p.m. End 2 ❑ P.M. Approximate Number of Attendees Answer the following appropriately: 1. This event will have music (live or other). ❑ 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, 4th 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 Updated 4/2015 1 d. This event involves the use of the sidewalk ❑ Yes ❑ No e. This event is a local/regional/national event (Please circle the El yes [I No appropriate event type) f. Affected property/business owners have been notified of this event. ❑ Yes ❑ No g. I understand that I must arrange a meeting with all affected governmental agencies to organize the above event (Call Marcia ❑ yes ❑ No Qualls, Customer Service Manager, 235-5939 to organize meeting). IF ALCOHOL IS TO BE SERVED OR SOLD 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. o4SOUTH 11�_4 d City of South Bend, Indiana • Board of Public Works w -ACE PERMIT AND AGREEMENT FOR THE USE OF 1865 N THE RIGHT-OF-WAY FOR NON-RESIDENTIAL BLOCK PARTIES The Non-residential Block Party will be permitted to take place under the following terms and conditions: 1. Pursuant to Local Ordinance No. 10224-13, there is a $125.00 non-refundable fee for non- residential Block Parties. Non-profit organizations meeting Section 501(c)(3) of the Internal Revenue Code are exempt from the fee provided copies of the 501(c)(3) Internal Revenue Exemption Status Document and a current copy of Form 990 of Form 990-EZ are filed with this application and with the Office of the City Clerk, 4th Floor, County -City Building, 227 W. Jefferson Blvd., South Bend, Indiana. 2. The APPLICANT must comply with all terms and conditions of this Permit and Agreement. 3. The APPLICANT shall reimburse the Board for the actual cost to the City for the event, if deemed necessary. 4. APPLICANT shall include a flyer or letter describing the details of the event. 5. Notification of approval/denial of this request will be issued by return of this form, upon signed authorization by the Board of Public Works. 6. The APPLICANT shall provide to the Board a Certificate of Insurance showing a liability policy in full force and effect with limits of $300,000.00 per occurrence and $5,000,000.00 aggregate and the City of South Bend listed as an additional named insured for this event. 7. The APPLICANT assumes Rill responsibility for providing ample disposal containers for refuse/recycling and assures the area will be cleaned up upon the conclusion of the event. 8. Barricades will be delivered and picked up at the event location. The APPLICANT is responsible for seeing that all cones are maintained and returned undamaged. 9. The APPLICANT will follow the City of South Bend Noise Ordinance, which is in effect at all hours. Between the hours of 11:00 p.m. and 7:00 a.m. certain noises are particularly prohibited. These include operating radio receiving sets, musical instruments, phonographs and other sound reproduction devices if audible fifty (50) feet away, as well as shouting, yelling, hooting, whistling, or singing in the streets in a manner to disturb the peace (Municipal Code 13-57). 10. The APPLICANT assures the City that the area will be closed during the times indicated on the application only. Event end times are pursuant to the recommendations of the South Bend Police Department. 11. IF ALCOHOL IS TO BE SERVED OR SOLD a Certified Check or Money Order for $400.00 must be submitted with application. The application cannot be processed without a deposit. The deposit will be returned by the Board of Public Works upon inspection of the event area after the event, and provided there is no damage to the area. Names, phone numbers, and qualifications (e.g. Off -duty police officer, professional security guard, or event APPLICANT) of THREE security guards to monitor underage drinking, must be submitted with the application. A drawing must be submitted showing fencing around serving area, and trash receptacles. For a temporary liquor license call the Alcohol and 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 day of cj(-o /i ,QZ 20 APPLICANT Signature - l a. - Printed Name ag BOARD OF PUBLIC WORKS APPROVAL President` Member l Member Member a 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 310178 A� R� CERTIFICATE OF LIABILITY INSURANCE oA6/15/2016YY) 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 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 endomement(s). PRODUCER Commercial Lines - (404) 923-3700 Wells Fargo Insurance Services USA, Inc. 3475 Piedmont Road NE, Suite 800 CONTACT Kimberlee Kolli NAME:PHONE 404-923-3532 FAX 877-362-9069 I4&C Ho EMI' AlAIC� _ _ E-MAIL kimberlee.m.kolli@welisfargo.com ADDRESS: o.com @ g Atlanta, GA 30305-2886 INSURER(S)AFFORDING COVERAGE NAIC W INSURER A: LM Insurance Corporation 33600 INSURED Kite Realty Group Trust INSURER B: Allied World Assurance Go (US) 19489 30 S. Meridian St., Ste, 1100 NBURER C INSURER 0: INSURER E : Indianapolis IN 46204 1INSURER F: COVERAGES CERTIFICATE NUMBER: 10580924 REVISION NUMBER' S b I ee eow 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, INPOLICY TRR TYPE OF INSURANCE DL SUB POLICY NUMBER EFF MMIDOIYYYY POLICY EXIP MMIDDYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY TB5Z91453740076 3/01/2016 3/01/2017 EACH OCCURRENCE Is 1,00g000 CLAIMS -MADE 1XI OCCUR DAMAGETO PREMISES Ea occurrence 8 300.000 No Deductible/Retention MED EXP (Any one person) g Excluded — Applies t0 GL PERSONAL &ADV INJURY _ $ 1,000,000 G ENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT I ^ I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY AS5Z91453740066 03/01/2016 3/01/2017 COMBINED SINGLE LIMIT a ccident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO No deductible ALL OWNED SCHEDULED AUTOS AUTOS on Auto Liability BODILY INJURY (Per accident) $ HIRED AUTOS X NON MED AUTOS X PROPERTY DAMAGE Peraccident $ $ B X UMBRELLA Lb1B X OCCUR 0308-8008 3/01/2016 3/01/2017 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 EXCESS LIAB CLAIMS -MADE DED X I RETENTION$ 5,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC5Z91453740086 3/01/2016 3/01/2017 H _ X STATUTE aTR YIN ANY PROPRIETORIPARTNERIEXECUTIVE E.LEACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N� N/A E. L. DISEASE-EAEMPLOVE $ 1,000,wo (Mandatory in NH) If yes describe under E.L. DISEASE -POLICY LIMIT s 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Board of Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1316 County -City Building THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 227 West Jefferson Boulevard South Bend, IN 46601 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD © 1988-2014 ACORD CORPORATION_ All rinhts rPsarv,n, ACORD 25 (2014/01) Pre ceN ona 1c11—x repiIcaNx 102031. 1—.d.1 WO16) rn