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HomeMy WebLinkAboutTemporary Installation - No Parking Zone Request for SBFDLinda Martin From: Gerard Ellis Sent: Tuesday, April 10, 2,018 8:32 AM To: Linda Martin Cc: Steve Cox; Federico Rodriguez; Laura O'Sullivan Subject: No Parking Request for Alarm Canvass Attachments: Scott Calvert Interjpg To: Board of Public Works, Coming upon Sunday, April 29"' and May 6"' of this year, SBFD, the American Red Cross, students from Notre Dame and La Casa will be canvassing two areas within the City of South Bend. All of the teams will consist of a firefighter, a red cross volunteer and a member of La Casa, The City of South Bend is one of 100 cities selected to install up to 850 alarms between April 28h and May 13, 2018, We are hosting two canvasing events on Sunday, April 29th, and Sunday, May 6th. The time for both events will be 12 p.m. to 4 p.m. The first event will cover the residential area between Indiana, Ewing, Kemble and Franklin Streets. The second event will include the areas between Ewing, Main, Doninoyer, and Fellows. I'm requesting a "No Parking," Zone at the intersection of Scott and Calvert for our staging and command area. The owner on the SE corner has allowed us to stage vehicles on his lot for the day. I request a time of I I a.m. to 4 p.m. for the signage. The attached maps have white lines to indicate the parking space needed for our support vehicles. Smoke alai -ins are the first line of defense once a fire occurs in the home and understanding what to do when the alarm "beeps" is just as critical as having a working smoke alarm on every level of the home. Education, installation and data collection will be key components to the completion of this event. Thanks for your consideration! Gerard Gerard Ellis Public Education Officer Captain, South Bend Fire Dept. 1222 S Michigan St. P- 574-235-5562 VIP, AV*V14,0vuT) 24Ni Gerard Ellis Public Education Qfficer Captain, South Bend Fire Dept. 1222 S Michigan St. P- 574-235-5562 KIN, (47pu; , � Client#: 26256 DL,ZCORPO ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (M,MIDDNYYY) 1 312212018 THIS CERTIFICATE IS ISSUED AS 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 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 any rights to the certificate holder In lieu of such endorsoment(s). PRODUCER COAT NA E.CT Katie Kresner Greyling Ins. Brokerage/EPIC PHONE 770.552,422.5FAx (AIC No, Ext): N.): $66.550.4082 3780 Mansell Road, Suite 370 E-MAIL ADDRESS, Katle.Kresnor@groyling.com Alpharetta, GA 30022 .................... INSURED DLZ Indiana LLC 2211 East Jefferson Blvd. South Bond, IN 46616 I INSURER A: N.U.ral Uri -Firm In, Ca PA Ttt�__ I I!NSURER 1: OBE Insurn— Coipamtlan 39217 -INSURERC LI.Yda0fl-0od.. COVERAGES CERTIFICATE NUMBER::, 18-19 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. i_WdR ADDLSUBR POLICY EXP LTR TYPE OF INSURANCE INSR WVD 1,1 IC MMIDRPr LIMITS _. __ (005 L —jon • X COMMERCIALOENERAL LIABILITY GL5268221 04101/2018 041ID11/2019 --71EACHOCCURRENNCE $1,000,000 CLAIMS -MADE OCCUR �.ETE,1ce) $500000 MED EXP (Any one person) $25.000 PERSONAL & ADV INJURY $1,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,0010,000 E" F_V� PRO - POLICY 1 -1 JECT 171 LOC �RD.YCTR _G.MP'OP AG. $2,000,000 OTHER: $ • AUTOMOBILE LIABILITY CA"89714 0410112018 04/0112019 COMBINED SINGLE. LIMIT 1110001000 A ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED NON -OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident)— $ B ­ X UMBRELLA LAB X OCCUR CCU3977348 0410112018 04/0112019 EACH OCCURRENCE $15,000,000 EXCESS LIAS CLAIMS -MADE AGGREGATE $15,000,000 -..T-x7 RETENTION $10,000 0410112018 041011 1801T, H- A WORKERS COMPENSATION 2019 7EA&TE AND EMPLOYERS' LIABILITY YIN WC015893,7'83 ANY PROPRIETOR/PARTNEPJEXECUTIVE[.--] E.L. EACH ACCIDENT $1,000, Doo OFFICERIMEMBER UXCUJ N N/A (Mandatory In NH) EMPLOYEE $1,000,000 Ugs, describe under E.L.fLDISEASE - E DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 C Professional Llab B0146LDUS,A1804157 01/0112018 04101/2011 Per Claim $5,000,000 Incl Pollution Aggregate $6,000,000 Liability DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: Colfax Avenue Two -Way Conversion - City Project 115-053; Indiana. City of South Bend is named as an Additional Insured with respects to General & Automobile Liability where required by written contract. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, we will endeavor to provide 30 days" written notice (except 'l 0 days for nonpayment of prem!"r the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 227 W. Jefferson Blvd. ACCORDANCE WITH THE POLICY PROVISIONS. South Bend, IN 46615-0000 AUTHORIZED REPRESENTATIVE 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of The ACORD name and logo are registered marks of ACORD 010090171IM11004019 KKRE1 Form ST-105 Indiana Department of Revenue Stat8(RS1 -17)orm 085 General Sales Tax Exemption Certificate (R518-17) l� Indiana registered retail merchants and businesses located outside Indiana may use this certificate. The claimed exemption must be allowed by Indiana code, Exemption statutes of other states are not valid for purchases from Indiana vendors. This exemption certificate cannot be Issued for the purchase of U_(t [e, Uelucles, tNarercraft. or f c aft. Purchaser must he registered with the Department of Revenue or the appropriate taxing authority of the purchaser's state of residence. Sales tax must be charged unless AU Information In each section is fully completed by the purchaser. Purchasers not able to provide all required Information must pay the tax and may file a claim for refund (Form GA-110L) directly with the Department of Revenue. A valid certificate also serves as an exemption certificate for (1) county innkeeper's tax and (2) local food and beverage tax. Name of Purchaser; City of South Bend Business Address: 227 W Jefferson Blvd City; South Bend State: IN ZIP Code: 46601 c w. purchaser must provide minimum of one ID number below.* V IS Provide your Indiana Registered Retail Merchant's Certificate TID and LOC Number as shown on your Certificate. r-. o TID Number (10 digits): 0003122131 LAC Number (3 digits): 001 If not registered with the Indiana DOR, provide your State Tax ID Number from another State *See instructions on the reverse side If you do not have either number. State ID Number: State of Issue: :cv o Is this a CAI blanket purchase exemption request or a © single purchase exemption request? (check one) $ Description of Items to be purchased: Purchaser must indicate the type of exemption being claimed for this purchase. (check one or explain) 0 Sales to a retailer, wholesaler, or manufacturer for resale only. „ n Sale of manufacturing machinery, tools, and equipment to be used directly In direct production. ® Sales to nonprofit organizations claiming exemption pursuant to Sales Tax Information Bulletin #10. (May not be used for personal hotel rooms and meals.) Q Sales of tangible personal property predominately used (greater then 50 percent) in providing public transportation - provide USDOT Number, A person or corporation who is hauling under someone else's motor carrier authority, or has a contract as a school bus operator, must provide their SSN or FID Number in lieu of a Stale ID Number In Section 1. USDOT Number: Saes to persons, occupationally engaged as farmers, to be used directly in production of agricultural products for sale, Note: Afarmer not possessing a State Business License Number may enter a FID Number or a SSN in lieu of a State ID Number In Section 1. El Sales to a contractor for exempt projects (such as public schools, government, or nonprofits). d Sales to Indiana Governmental Units (agencies, cities, towns, munloipalitles, public schools, and state universities). 0 Sales to the United States federal Government - show agency name. Note: A U.S. Government agency should enter Its Federal Identification Number (FID) in Section 1 In lieu of a State ID Number. Other -explain. I hereby certify under the penalties of perjury that the property purchased by the use of this exemption certificate is to be used for :`. an exempt purpose pursuant to the State Gross Retail Sales Tax Act, Indiana Code 6-2.5, and the item purchased is not a utility, vehicle, watercraft, or aircraft. a 1 confirm my understanding that misuse, (either negligent or Infenffonaf), and/or fraudulent use of this certificate may subject both me personally and/or the business entity I ropresprit t the ImposJtion of tax, interest, and civil and/or criminal penalties. Signature of Purchaser; XA41A 02 Date; 01/11/2018 Printed Name: Shannon L Fredline Title: AP Supervisor The Indiana Department of Revenue may request verification of reglstratlon in another state If you are an out-of-state purchaser. Seller must keep this certificate on file to support exempt sales.