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Home My WebLink AboutNon Res Block Party - Historic Landmark Foundation of Indiana1316 COUNTY -CITY BUILDING 227 W. JEFFE'RSON Bomi,,VARD Sourn BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS February 27, 2018 Todd Zeiger Historic Landmark Foundation of Indiana 801 W Washington Street South Bend, IN 46601 RE: Event Marne: Treasure Hunt —North Street Closure: LaPorte Ave. from W. Washington St. to Colfax Ave. Date: July 21, 2018 Dear Mr. Zeiger: IlijoNj574/235-9251 FAX 574/ 235 -9 t 71 The Board of Public Works, at its meeting held on February 27, 2018, approved your request to close the above referenced street for your event scheduled for July 21, 2018 from 6:00 a.m. to 2:00 p.m. subject to following Engineering's request to alter the location slightly south due to construction at the intersection of LaPorte Avenue and Colfax Avenue. Please contact Matt Longfellow in the Engineering Department to discuss at 574-235-9251. 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) 235-925 1. Sincerely, Linda M. Martin, Clclk Enclosure c: Gene Eyster, Police Department Marcia Qualls, Streets Ed Gleckler, Traffic & Lighting GAizy A. Gii.o,r SUZANNA M. FiuTZBERG B]ZABETH A. MARADIK JAM1.1s A. MUELLER THERESE J. DORAU TO: FROM: SUBJECT: LOCATION: INTER -OFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE SENT 2/1/2018 ,d Gleckler, Traffic & Lighting ene Eyster, Police Department "yVatt Longfellow, Engineering Chris Dressel, Community Investment Federico Rodriguez, Fire Department .0 larcia Qualls, Engineering .Kara Wood, Park Department �1ill Sciccitano, Downtown South Bend Linda M. Martin, Clerk- Non- Residential Block Party -Treasure Hunt -North Street Closure: La Porte Ave at W. Washington to Colfax Ave. Street Closure: W. Washin ton St at Charles Martin/Chapin to Elm St DATE AND TIME: July 21, 2018 6:00 a.m. to 2:00 p.m. SPONSOR: Historic Landmarks Foundation of Indiana c/o Todd Zei er DATE DUE: February 6 2018 FAX OR E-MAIL TO: 235-9171 1 lmartin(a)-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 FOW OF A CERTIFIED CHECK OR MONEY ORDER, PAYABLE TO THE CITY OF SOUTH BEND, MUST BE INCLUDED WITH APPLICATION. F-1 Fee Paid Applicant Name: Historic Landmarks Foundation of Indiana c/o Todd Zeiger Address: 801 West Washington City: South Bend State: IN Zip: 46601 Phone: 574-232-4534 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: Treasure Hunt -North Historic West Washington Neighborhood: West Washington Street (from Chapin/MLK Drive to Elm Street); La Porte Avenue from West Washington Street Location to Colfax Avenue (St. Paul's UMC) (Describe Area/Route) Street Closure Name of Street 1. La Porte Avenue at West Washington Street to Colfax From 1. West Washington Street at Charles Martin/Chapin to Elm Street To Date of Event July 21 20 18 E a. m. a.m. ❑ a, M, Time: Registration/Setup 6:00 Ej p.m. Start 8:00 E]p,m. End 2:00 E P,M. Approximate Number of Attendees 750 Answer the following appropriately: 1. This event will have music (live or other). Yes E] No a. I understand the Noise Ordinance described in the Agreement/Permit Z Yes ❑ No 2. Required Information to Accompany Application a. Certi:fied 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, 4"' Floor, County - City Building, 227 W. Jefferson Blvd., South Bend, Indiana. c. Certificate of Insurance d. Maps, drawings of the area and setup plan M Yes El! No 3. a. This event involves City streets M Yes E] No b. This event involves County roads E] Yes E No c. This event involves State highways ❑ Yes No d. This event involves the use of the sidewalk Yes No Updated 4/2015 1 City of South Bend, Indiana • Board of Public Works PERMIT AND AGREEMENT FOR THE USE OF 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. All residents and businesses within the affected area trust be notified of this event. The APPLICANT must obtain signatures from and/or has made an attempt to notify all residents that reside on the block. A copy of a brochure or door hanger distributed to all affected residents/businesses describing the event purpose, date, and time must be included with the application. 4. The applicant is responsible, prior to the event, for determining if there are any residents or business owners affected that could potentially need assistance in accessing their property. The applicant is responsible for providing said resident/business owner transportation to their property. 5. The APPLICANT shall reimburse the Board for the actual cost to the City for the event, if deemed necessary. 6. APPLICANT shall include a flyer or letter describing the details of the event. 7. Notification of approval/denial of this request will be issued by return of this form, upon signed authorization by the Board of Public Works. 8. 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. 9. The APPLICANT assumes full responsibility for providing ample disposal containers for refuse/recycling and assures the area will be cleaned up upon the conclusion of the event. 10. 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. 11. 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). 12. The APPLICANT assures the City that the area will be closed during the times indicated on the d. This event involves the use of the sidewalk Yes ❑ No e. This event is local/regiona ational event (Please circle the yes ❑ No appropriate event f Affected property/business owners have been notified of this event. Yes [j No g. There is/are resident(s) affected by the event that may need ADA ❑ yes No transportation assistance to their residence. h. 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. application only. Event end times are pursuant to the recommendations of the South Bead Police Department. 13. 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. 14. 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 �T day of f v Agc�j 20 APPLICANT Signature Printed Name -T,4ek A Z6 6'ti? BOARD OF PUBLIC WORKS APPROVAL _;OLL � I I'L. - - 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 Internal Revenue Service Department of the Treasury District Director .. ^L''u " ^d� J Person to Contact �.":�: v �� Date: I _'4 Date A. Pepper Contact Telephone Number. i3h.'4641 513 - 684 - 38 66 P Historic Landmarks Foundation of Indiana, Inc. 3402 Boulevard Place Indianapolis, IN 46208 CI N: E0: '81 0 5 8 0 Dear Sir or Madam: 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) ofIthe 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: Jack R. Shaw Ernst & 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(DO) (6--77) P.O. Box 2508, Cincinnati, Ohio 45201 lj 52 X!n Y�i Y �RR. (Y Cd3 �."tia tTn Jr�r spa quµ. �W 1gqQ�IP, IX f XI9C�k� e Ifi u'ldYYod ,...yw.. I f�f A9 dd" Cd G a YTl gym,. P 41, �UtiA �Sti 144J "duJ C�y,A ;4'f`� � t^u, GFi ,va� rn P w I ti Y �'li wT� W Cr 'Yy a CC7 co dR'Y .. " rL xA 4 V oA G: r^ U) _X M1MV ll4 rr wnN T Ynb ";pQ. d-«h^ �r.Nl G9I n40CD I$ Lll d "q Ll0 ia) millm'J"A }.� L.IKJP[JJ - �wuuwwu � CD CG COi GY IID �w�l IN ��•• r�+m �' Y�X L pAp yyI(I i J CD trabl4ltir � a:4 IN'r r41A � � INrIII AN.n1 SF ROWN T ACORO" ��. CERTIFICATE OF LIABILITY INSURANCE DATE (MM1ODlY1'YY)ov1s12o1s 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 pollcy(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 Gregory &Appel insurance 140 N Cap€to Suite Insurance Indianapolis, IN 46202 CANT A E:CT PHONE 31 634-7491 FAx (ArC,Na, Ext): ( 7) {Arc, Nol:(317) 634-6629 Ap AIL . corp@gregoryappet.com INSURERS AFFORDING COVERAGE NAIC N INSURER A: Zurich American Insurance Co 16535 INSURED INSURER 13: Accident Fund Insurance Company of America 10166 INSURERC: Indiana Landmarks INSURER D : 1201 Central Avenue Indianapolis, IN 46202 INSURER E INSURER F : r'n%/F:PAr3PC r'FRTIFIC:ATP NI IMRPR• 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 Llkn Ty PE OF INSURANCE AnDL SUBR D POLICY NUMBER POLICY EFF IDD POLICY EXP M DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAWSWADE ❑X OCCUR CP00219870 08/31/2017 08/3112018AMAGETOREMISESEaENTEDo OCCURRENCE $ 1,000,000 [EACH ce $ 100,000 ED EXP (Any oneperson) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO LOG OTHER: GENERAL AGGREGATE S 2,000,000 PRODUCTS-COMPIOPAGG 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X 000SONL� CP00219870 08/31/2017 08/31/2018 COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY fPerperson) $ BODILY INJURY Peraeddeni $ PorraccitlenDAMAGE $ $ A X UMBRELLA LIAD EXCESS LIAS X OCCUR CLAIMS -MADE AUC1072172 08/31/2017 08/3112018 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X I RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN E ANY PROPRIETORIPARTNERIEXECUTNN FFICERIMIEMBER EXCLUDED? Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N 1A WCV5007125 08/31/2017 08/31/2018 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT 500,000 $ E.L. DISEASE - EA EMPLOYEE 500,000 $ E.L. DISEASE - POLICY LIMIT 500,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The City of South Bend is included as Additional Insured per Policy Forn U-GL-1345-B CW (04/13) with respects General Liability according to the terms, conditions, and exclusions within the policy regarding Indiana Landmarks use of North Street in South Bend for a flea market event on July 21, 2018. C:FRTIFIr'ATP Ian) nPR CANCF_LEATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of South Bend y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: Marcia Qualls 4th Floor, County City Bldg 227 W Jefferson Blvd AUTHORIZED REPRESENTATIVE South Bend, IN 46601 ACORD 25 (2016103) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Return of Organization Exempt From Income Tax OMB No, 1545-0( Form 9 9 0 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 2016 Department or the Treasury IN -Do not enter social security numbers on this form as it may be made public, • Internal Revenue Service ► Information about Form 990 and its instructions is at wwwJrs.gov/form990. A For the 2016 calendar year, or tax year beginning 0 9 / 0 1 , 2016, and ending 08/31, 20 17 C Name of organization D Employer identification number B c ec napp5cable' HISTORIC LANDMARKS FOUNDATION OF INDIANA, INC 35-1162B73 Address choose Doin9 businesses INDIANA LANDMARKS Name change Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number Initlal relwn 1201 CENTRAL AVENUE (317) 639-4534 penal ratedlurnr City or town, state or province, country, and ZIP or foreign postal code termina Pd tUr,, ra+turn INDIANAPOLIS, IN 46202-2656 G Gross receipts $ 13,546,899. Appl€cation IFName and address of principal officer: J. MARSHALL DAVIS, PRESIDENT H(a) Is this a group return for Yes R No pending Subordinates91201 CENTRAL AVENUE INDIANAPOLIS, IN 46202-2656 H(b) Are all suberdinatesinluded7 YesNo I Tax-exempt status: I X 5ol(c)(3) 1 1 501(.)( ) a (insert no.) 4847(a)(1) or 527 If "No," attach a list. (see instructions) J Webslte: ► WWW. INDIANALANDMARKS .ORG H(c) Group exemption number ► K Form of organization: I X I Corporation I I Trust I Association Other ► L Year of formation: 19 6 01 M State of legal domicile: IN ounrtnar y 1 Briefly describe the organization's mission or most significant activities: INDIANA LANDMARKS ADVANCES THE o, PRESERVATION OF HISTORICAL AND ARCHITECTURALLY SIGNIFICANT SITES m THROUGHOUT INDIANA. E i 2 Check this box ► 0 if the organization discontinued its operations or disposed of more than 25% of its net assets. 8 0 3 Number of voting members of the governing body (Part VI, line 1a) , , , , , , , , , , , , , , , , , , , , 3 31. 4 30. 4 Number of independent voting members of the governing body (Part VI, line 1 b) , , , , , , , , , , , , S Total number of individuals employed in calendar year 2016 (Part V, line 2a). 5 48. 6 150. 6 Total number of volunteers (estimate if necessary) 7a 242, 663. 7a Total unrelated business revenue from Part Vill, column (C), line 12 , , , , , , , , , , , , , , , , , 7b —34, 032 . b Not unrelated business taxable income from Form 990-T, line 34 Prior Year Current Year 8 Contributions and grants (Part VIII, line 1h), 10,309,890, 2,599,820. 441,238. 410,454. 9 Progfam service revenue (Part VIII, line 2g) . , .. . .. .. . .. .. . .. . 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d), , , 358, 654. 1,527,141. 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 1le) . , , , , , , , , , , , 437,574. 571,244. 1.1, 547, 356. 5,10B,659. 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) , , , , , , , , , , , , , 289,450. 247,956. 0. 0, 14 Benefits paid to or for members (Part IX, column (A), line 4) , , , , , , , , , , , , , , , , 2,716,792. 2, 879,467. w 15 Salaries, other compensation, employee benefits (Past IX, column (A), lines 5-10). , , , , , 0. 0. c 16a Professional fundraising fees (Part IX, column (A), line 11e) , , , , , Xb Total fundraising expenses (Part IX, column (D), fine 25) ► 330, 652 . 2,756,460. 2, 900, 075. w 17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) , , , , , , , , , , , , , , 5,762,702. 6,027,498. 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) , , , , , , , , 5,784,654. —918, 839 . 19 Revenue less expenses. Subtract line 18 from line 12 , `o v Beginning of Current Year End of Year [) a20 Total assets (Part X, line 16) 79, 718, 688. 82, 628, 319. cc a , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 21 Total liabilities (Part X, line 26). , , , , , , , , 2, 467, 331. 3,102,128. 77, 251, 357 . 79, 526, 191 . Z2 22 Net assets or fund balances. Subtract line 21 from line 20. Signature Block Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the nest of my Knowledge ana Deuet, It Is true, correct, and complete, Declaration of preparer (other than officer) is based on a€I information of which preparer has any knowledge. Sign , Signature of officer Here J. MARSHALL DAVIS PRESIDENT 1 Type or print name and title Print/Type preparer's name Preparer's signature Date Paid NICOLE B FISHBACK �01/15/2018 Preparer Use Only Firm's name ►BKD, LLP I € Firm'saddress ►201 N. ILLINOIS STREET INDIANAPOLIS, IN 46204 11 May the IRS discuss this return with the preparer shown above? (see instructions) , , , , , , , , , , , , , , For Paperwork Reduction Act Notice, see the separate instructions 01/15/2018 Check U if PTIN self-employed P01279475 sFIN ►44-0160260 le no, 317.383.4000 . , . , , X I Yes No Form 990 (2016) JSA 6 rz1010 1.000 1133KR D310 PAGE 2