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HomeMy WebLinkAboutNon Res Block Party - Historic Landmarks Foundation of IndianaINTER -OFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE SENT 3/6/2017 TO: 1Ed Gleckfer, Traffic & Lighting \/ ene Eyster, Police Department att Longfellow, Engineering Chris Dressel, Community Investment %\J,,ederico Rodriguez, Fire Department arcia Qualls, Engineering Kara Wood, Park Department Jill Sciccitano, Downtown South Bend FROM: Linda M. Martin, Clerk r-_ SUBJECT: Non- Residential Block Party LaPorte Ave from W Washington to LaSalle still open at intersection) W Washington from Elm to Charles Martin LOCATION: Drive restricted DATE AND TIME: July 22. 2017 (Rain Date: July 23. 2017 SPONSOR: Historic Landmarks Foundation of Indiana DATE DUE: March 7, 2017 FAX OR E-MAIL TO: 235-9171 1 Imartin(absouthbendin.gov RECOMMENDATIONS AND COMMENTS: By Date ill c. This event involves State highways ❑ Yes ® No d. This event involves the use of the sidewalk ® Yes ❑ No e. This event is a locdQre Iona ational event (Please circle the ® Yes El 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 Quails, Customer Service Manager, 235-5939 to organize meeting). IF ALCOHOL IS TO BE SERVED OR SOLD — NIA 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. -m �;.- m �,.. �E� I Y ` AI c- .. J ; 2µfa ail^ ' 04, iY Wt. ip r.Lf, C a }r 22 a'rrti a 1 i`a'-- ry r�+ lfi `r, 5 tiS trs,~ jI:]ifi `&' ✓ Id ti J r 7 r',,:. x Xis Ty r 4° INv# ."�!., 2SY Ti _��l`'•t#�-�I �eIrM lNV 5�tf iy`r.rnti~yY "r.+ yIS%F,3`Y,ti.;err --5'• ��A% I I �•X' � �yw e�',A. y r '+�I.j. -S �°o d- "I?l�'{�'1,,'� tt � 7{� :,ba siFSc 4� s�� �� � �,C o. v b i,rA• b�Fal r� Form ® Return of Organization Exempt From Income Tax IOMB No. 1545-0047 ®� Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Department of the Treasury Do -Do not enter social security numbers on this form as it may be made public. • + . r Internal Revenue Service ► Information about Form 990 and its Instructions is at www.lrs.gov1form990. Y • + A For the 2015 calendar year, or tax year beginning 09/01 , 2015, and ending O8/31, 20 16 C Name of organization D Employer Identification number 13 cna�kYapprane HISTORIC LANDMARKS FOUNDATION OF INDIANA, INC 35-1162873 cn Ille5 Doing business as INDIANA LANDMARKS rua�a cnanpe Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number Iaeiairat.rn 1201 CENTRAL AVENUE 1 (317) 639-4534 Final rat.rN City or town, state or province, country, and ZIP or foreign postal code Wrnlnaled Amended INDIANAPOLIS, IN 46202-2656 G Gross receipts $ 41,503,048. return Application F Name and address of principal officer: J. MARSHALL DAVIS, PRESIDENT H(a) Is this a group return for L] Yes X No pending subordinates? 1.201 CENTRAL AVENUE INDIANAPOLIS, IN 46202-2656 M(b) Areal1sub dinam+i.%deda Yes No Tax-exempt status: I X 1 501(c)(3) 1 1 501(c) ( ) -4 (insert no.) 4947(a)(1) or 527 If "No;' attach a list. (see instructions) ,f Website: ► WWW. INDIANALANDMARKS .ORG H(c) Group exemption number ► K Form of organization: I X I Corporation I I Trust I I Association Other ► L Year of formation: 19 6 01 M State of legal domicile: IN Summary 1 Briefly describe the organization's mission or most significant activities: INDIANA ------------------------------------------- LANDMARKS ADVANCES THE 4) PRESERVATION OF HISTORICAL AND ARCHITECTURALLY SIGNIFICANT SITES --------------------------------------------------------------------------------------- R THROUGHOUT INDIANA. 2 --------------------------------------------------------------------------------------- Check this box ► F-1 if the organization discontinued its operations or disposed of more than 25% of its net assets. c� 3 Number of voting members of the governing body (Part VI, line 11a) , , , , , , , , , , , , , , , , , , ,, , ,, 3 30. N 4 Number of independent voting members of the governing body (Part VI, line 1 b) , , , , , , , 4 29. 5 Total number of individuals employed in calendar year 2015 Part V, fine 2a 5 47. u 6 Total number of volunteers (estimate if necessary) 6 150. a 7a Total unrelated business revenue from Part Vill, column (C), line 12 , , , , , , , , , , , , , , , , , 7a 93,244. b Net unrelated business taxable income from Form 990-T, line 34 ....................... 7b --44, 690 . Prior Year Current Year m 8 Contributions and grants (Part Vill, line 1h), , , , , , , , , , , , , , , , , , , , , , , 3,869,323. 10,309,890. 361,121. 441,238. m 9 Program service revenue (Part VIII, line 2g) a, 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d). 3,128,064. 358,654. 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 1le) . , , , , , , , , , , , 335,459. 437,574. 7,693,967. 11,547,356. 12 Total revenue - add lines 8 through 11 must equal Part Vlll, column A , line 12 . 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) , , , , , , , , , , , 570, 402 . 289,450. 0. 0. 14 Benefits paid to or for members (Part IX, column (A), line 4) , , ,, , , , , , , , , ,, , , , 2, 54 6, 576 . 2,716,792. 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10). 16a , , Professional fundraising fees (Part IX, column (A), line Ile) , , , , , 0. 0. x b Total fundraising expenses (Part IX, column (D), line 25) ► 335, 654 ._ 2, 618,511. 2,756,460. W 17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) __ 5, 735, 489. 5,762,702. 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) , , , , , , 1, 958,478, 5,784,654. 19 Revenue less expenses. Subtract line 18 from line 12 . .................. as Beginning of Current Year End of Year 11 20 Total assets (Part X, line 16) , , , , , , , , , , , , , , , , , , , , , , , , , , , , 71, 804, 621. 79, 718, 688, 2, 517, 064. 2,467,331, as 21 Total liabilities (Part X, line 26), , , , , , , , , , , , , , , , , , , , , , , , , , , , , z",IL 22 Net assets or fund balances. Subtract line 21 from line 20. 69,28V,557. 77,251,357. MOM Signature Block Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge. Sign Signature of officer Date Here J. MARSHALL DAVIS PRESIDENT ' Type or print name and title Print/Type preparees name Preparers signature Date Check if PTIN Paid NICOLE B FISHBACK I self-employed P01279475 Proparer Use Only Flrm's name ► BKD LLP , Firm'sEIN ►44-0160260 Flrm'saddress ►201 N. ILLINOIS STREET INDIANAPOLIS, IN 46204 1 Phone no. 317.383. 4000 May the IRS discuss this return with the preparer shown above? (see instructions) U Yes I_I No For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2015) JSA 5E1010 1.000 1133KR D310 PAGE 3 Internal Revenue Service Director sfa:x District A V. _ =�R _. 1 " Date: ins : a! �--•- �..c liniAF�f Historic Landmarks Foundation of Indiana, Inc. 3402 Boulevard Mace Indianapolis, IN 46208 Dear Sir or Madam: Department of the Treasury Person to Contact: Date A. Pepper - Contact Telephone Number. 513-684-3866 CI N: Eo: '81 0 5 S 0 Based on the information you recently submitted, we have classified your organization as one that is not a private foundation within the meaning of section 509(a) of the Internal Revenue Code because you are an organization described in section 509(a)(1) and 170(b)(1)(A)(vi). Your exempt status under section 501(c)(3) of the Code is still in effect. This classification is based on the assumption that your operations will continue as you have stated. if your sources of support, or your purposes, character, or method of operation change, please let us know so we can consider the effect of the change on your exempt status and foundation status. Because this letter could help resolve any questions about your foundation status, you should keep it in your permanent records. If you have any questions, please contact the person whose name and telephone number are shown above. Sincerely yours, D. L. James, Jr. District Director cc: .lack Shaw Ernst S Whinney One Indiana Square, Suite 3400 Indianapolis, IN 46204 This determination is effective as of September 1, 1975, the beginning of your 60 month termination period under section 507 of the Code. This determina- tion supersedes our determination dated December 4, 1972 which held you to be a private foundation. Letter 1078(1)0) (6--77) P.Q. Box 2508, Cincinnati, Ohio 45201 lj For years beginning on and after September 1, 1980 you are now required to file an annual information return on Form 990 rather than Form 990-IF. I INDILAN-01 SBROWN ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE3131201 YYY) I3I2017 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 endorsement(s). PRODUCER Gregory & Appel Insurance 1402 N Cappitol Suite 400 Indlana olis, IN 46202 p CONTACT NAME: PHONE FAX Arc No Ext : (317) 634-7491 AIc No ; (317) 634-6629 EMAIL cor re o a el.com AODREss: p@J 9 rY pp INSURERS) AFFORDING COVERAGE NAIC # INSURER A:Fireman's Fund Insurance _ 29181 INSURED INSURER B : Accident Fund Insurance Company of America 10166 Indiana Landmarks INSURERC: INSURER D : 1201 Central Avenue Indianapolis, IN 46202 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 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. IIJSR LTR TYPE OF INSURANCE D❑ INSD 5 BR WVO POLICY NUMBER POLICY EFF MMfDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR MXG$0972762 OS13112016 08131l2017 _ DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: E...RA._.VL. 2,000,000 jPOLICY XLOG DUCTS - COMPIOPAG ..A.._G._G....R.._E.,_GA..T..,E,,....,_._.__$ rR 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Par person) $ A ANY AUTO MXG80972762 08/31/2016 08/31/2017 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ S X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE s 10,000,000 A EXCESS LIAR CLAIMS -MADE CGU24555021 08/31/2016 08/31/2017 DED I X I RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFtCEPJMEMBEREXCLUDED? (Mandatory In NHI NIA WCV5007125 08131 /2016 08/31/2017 X I PER OTH- STATUTE I IFR E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT s 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) The City of South Bend is included as Additional Insured as defined in policy form CG7158 1-14 with respects to General Liability according to the terms, conditions and exclusions within the policy regarding closure of streest for a public event. CERTIFICATE HOLDER CANCELLATION City of South Bend ATTN: Libby Horvath 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD