HomeMy WebLinkAboutProcession - St Joseph County Right to Life1316 COUNTY —CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND. INDIANA 46601-1830
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CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
January 24, 2017
Antonio Marchi
St. Joseph County Right to Life
2004 Ironwood Circle, Suite 130
South Bend, IN 46635
RE: Event: March for Life and Rally
Date: January 27, 2017
Dear Mr. Marchi:
PHONE 574/235-9251
FAx 574/235-9171
The Board of Public Works, at its meeting held on January 24, 2017, approved your request to
conduct the above referenced event on January 27, 2017, from 11:30 a.m. to 12:15 p.m. on the
designated route as submitted. Enclosed please find copy of your approved permit.
Please note that participants must stay on the sidewalks and obey all traffic laws. Also,
applications must be turned in to the Board four (4) weeks prior to the event. The Police
Department will not assist with your event due to the late submission.
If I can be of any further assistance to you in this matter, please call me at (574) 235-9251.
Sincerely,
Linda M. Martin, Clerk
Enclosure
c: Gene Eyster, Police Department
Ed Gleckler, Traffic & Lighting
Federico Rodriguez, Fire Department
Marcia Qualls, Engineering
GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DORAU
TO:
FROM:
SUBJECT
SPONSOR:
DATE OF EVENT:
DATE DUE
FAX OR E-MAIL TO:
INTER -OFFICE MEMORANDUM
BOARD OF PUBLIC WORKS
DATE SENT: 1/13/2017
Ed Gleckler, Traffic & Lighting
JJFederico Rodriguez, Fire Department
Matt Longfellow, Engineering
Paula Garis, Park Department
Lt. Gene Eyster, Police Department
Jill Sciccitano, Downtown South Bend
Marcia Qualls, Engineering
Legal Department
Linda M. Martin, Clerk
PROCESSION RECOMMENDATION
St. Joseph County Right to Life
January 27, 2017
January 17, 2017
235-9171 / ImartinA-southbendin.gov
RECOMMENDATIONS AND COMMENTS:
By Date
APPLICATION FOR USE OF
PUBLIC RIGHT-OF-WAY FOR PROCESSIONS
The Board of Public Works must have FOUR (4) weeks prior notice of the
Antonio Marchi, Program
Sponsor: St. Joseph County Right to Life Submitted By: Manager
Address: 2004 Ironwood Circle, Suite 130
City:
State:
South Bend
IN
Zip: 46635 Phone: 574-232-5433
Sponsor may use the public right-of-way described as (describe route and attach map)
The event will begin indoors at 553 E. Washington St. at 11:30 am on January 27, 2017. As in
the past, from approximately 12:00pm-12:15pm, the group will March from this location down
the sidewalks on Hill St., turn on Jefferson, and follow the sidewalks to the Federal Courthouse.
The group will not block any public parking spaces while standing outside the Federal
Courthouse.
PLEASE NOTE: THE SOUTH BEND POLICE DEPARTMENT RESERVES THE RIGHT TO
CHANGE YOUR ROUTE FOR SAFETY PURPOSES
Event name: March for Life and Rally -- South Bend
❑ The Board of Public Works must have FOUR (4) weeks prior notice before event occurs
❑ All certificates of insurance, pre -paid costs, maps, and any other applicable information requested
or required by the Board of Public Works have been provided with this application
❑ The event shall be held on January 27, 2017 and no other date
❑ Registration time for the event starts at 11:30 Rally indoors a.m./p.m.
❑ Starting time of the procession is 12_00 a.m./p.m.
❑ Estimated completion time is 12_15 a m./p.m.
This event involves the use of the following roadways
❑ This event involves City streets
❑ This event involves County roads
❑ This event involves State highways
❑ This event involves use of a park (Must obtain permission from Park Board)
❑ 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)
X This event involves the use of the sidewalk
X Participants must stay on the sidewalk and obey all traffic laws.
Updated 4/06/16
X This event is a local/regional/national event (Please circle the appropriate event type)
X This event will be coordinated with the property owner/business where staging will take place
Updated 4/06/16
PERMIT/AGREEMENT
FOR A PROCESSION
I. Sponsor shall reimburse the Board for the actual cost to the City for the event, if deemed
necessary.
2. Sponsor 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.
3. Sponsor shall provide to the Board all additional licenses, permits and documentation
required for the event.
4. Sponsor agrees to abide by all terms and conditions of the Board's policy governing
walks, runs, parades or other similar event adopted by the Board on March 3, 1985.
5. In order to ensure public safety during the event, the Board agrees to furnish traffic
planning, materials, equipment and personnel as deemed necessary by the Police
Department Traffic Bureau, the Bureau of Traffic and Lighting, and, where applicable,
the Board of Park Commissioners.
6. Sponsor acknowledges that the Police Department reserves the right to change this route
for safety purposes.
7. In consideration for approval by the Board and the use of the sidewalks for the purposes
set out above, the undersigned agrees and undertakes to hold the Civil City of South
Bend, Indiana, free and harmless from any liability loss, costs, 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 said activity, arising out of the approval of the request to use the sidewalks
indicated in the City of South Bend. The undersigned certifies that he/she is authorized to
bind the above mentioned sponsor to the terms hereof.
8. Notification of approvatIdenial of this request will be issued by return of this form, upon
signed authorization by the Board of Public Works
I understand the above rules and regulations and that this application may be denied based on
any false or incomplete information.
Sponsor Signature
Printed Name
Title Aft-D.v 14-40 t r %c 644/1 .4 L
WARD OF PV LI W S —APPROVAL
G
President Member Member
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Member M mber Dates
RETURN FORM TO:
Board of Public Works
1316 County -City Building
227 West Jefferson Boulevard
South Bend, W 46601
Phone: (574) 235-9251 0 Fax: (574) 235-9171 9 E-Mail: publicwks(al,,southbendin.gov
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'9tC- "-"" CERTIFICATE OF LIABILITY INSURANCE
DATEIM01/17//01720117
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 endorsements .
PRODUCER
Syynergy Insurance Group
13800 Jackson Road
Mishawaka, IN 46544- , Ch
Bryan K. Nafrady, CLU, ChFC
CONTACT Bryan K Nafrad
NAME
NCNNo Eat:574-258-5555 ac rve: 574-258-9177
ADDRESS: bnafrady synergyinsurance roup.com
PRODUCER
CUSTOMER ID #: RIGHTDI
INSURERS) AFFORDING COVERAGE
NAIC#
INSURED St Joseph Co Right to
Life Inc St Joseph Co Right
to Life Educational Fund
2004Ironwood Circle Ste 130
South Bend, IN 46635
INSURERA:Auto-Owners Insurance Co.
18988
INSURER B:
INSURERC:
INSURERD:
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER oclmm�arwuaoce.
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.
TR
TYPE OF INSURANCE
A
U
R POLICY NUMBER
MM/DI POLICY
MMIDD/YYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
It 1,000,oOO
A
X COMMERCIAL GENERAL LIABILITY
X
96.762-842.00
09/28/2016
09/28/2017
AMA ETo-RELATE
PREMISES Ea occurrence
$ 50,00
CLAIMS 1XI OCCUR
-MADE
MED EXP (Any one person)
$ 6,000
PERSONAL &AOV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,Ono ,o00
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS-COMP/OP AGG
$ 1,000,00
X POLICY PRO -
$
AUTOMOBILE
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accitleni)
$
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED AUTOS
BODILY INJURY (Per accident)
$
SCHEDULED AUTOS
GE
PROHIRED
$
AUTOS
(PER ACCIDENT)
(PER ACCIDENT)
$
NON-OWNEOAUTCS
$
UMBRELLA LAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LAB
CLAIMS -MADE
DEDUCTIBLE
$
$
RETENTION $
WORKERS COMPENSATION
WC STATU- OTH-
AND EMPLOYERS' LIABILITY YIN
O VLIMIT ER
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
IN
E.L. DISEASE -EA EMPLOYEE
$
(Mandatory in NH)
sccbeunder
E. L. DISEASE -POLICY LIMIT
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TION OF OPERATIONS below
rCONTRACT
OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
OUTH BEND INCLUDED AS ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN
AS RESPECTS EVENT BEING HELD
March for Life Rally' to be held Friday Jan 27, 2017
SOBDPUB
City Of South Bend
Public Works
227 W.Jefferson
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.
AUTHORIZED REPRESENTATIVE
IV 188t1-ZUUs ACUKU CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD