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HomeMy WebLinkAboutNon Res Block Party - Kite Realty - Family Fun Day1316 COUNTY -CI Y BuILDING 227 W. JEFFERSON BOULEVARD Soui-i-i BEND, INDIANA 46601-1830 CITY OF SOUTH BEND PETE BU'I-I'IGIEG, MAYC BOARD OF PUBLIC WORK I May 22, 2018 Taryn Ford Kite Realty Group 30 S. Meridian Street Indianapolis, IN 46204 RE: Event Name: Family Fun Day Street Closure: Eddy St. from, Angela Blvd. to Napoleon St. Dear Ms, Ford: 8 HOM-1, 574/235-9251 FAX 574/ 235-9171 The Board of Public Works, at its meeting held on May 22, 2018, approved your request to close the above referenced street for your event scheduled for June 9, 2018 from 8:00 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) 235-925 1. Sincerely, Linda M. Martin, Clerk Enclosure c: Gene Eyster, Police Department Ed Gleckler, Traffic & Lighting GARY A. Git,o'j, SUZANNA M. FRITZBERG ELIZABEIE A. MARADIK JAMEs A. Mur,,,i,i,r�R THERESF J. DORAU INTER -OFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE SENT 5/10/2018 TO: Ed Gleckler, Traffic & Lighting G"e-Eyster, Police Department ?0 '-ScJ� b Matt Longfellow, Engineering Chris Dressel, Community Investment -dFederico driguez, Fire Department . a , Engineering O?dackie Appleman, Park Department Jill Sciccitano, Downtown South Bend FROM: Linda M. Martin, Clerk`f SUBJECT: Non- Residential Block Party -Family Fun Day Street Closure:Eddy St from Angela Blvd to Na oleon LOCATION: DATE AND TIME: June 9, 2018 8:00 a.m. to 2:00 p.m. SPONSOR: r -Cao � m vuwon� DATE DUE: May 15, _2018 FAX OR E-MAIL TO: 235-9171 1 Imartin southbendin. ov 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. Fee Paid d Applicant Nairte: Fib � /� r/ Address: City: ijsStajte�: p� Zip:" Phone: �•� �� Email:'' 1 G�QvG4 W 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 I 1 r l Location Street Closure Udw "(41- OWMA6 w S i (Describe Area/Route) Name orstreet -�•f From n G a f'lf To Date of Event1...G;_ 20 da.m. Time: Registration/Setup ❑ p,m Approximate Number of Attendees Start El p.m. End �i ❑f C".i p .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 [Vl 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 Forth 990 of Form 990-EZ are included with this application, and ❑V 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 and setup plan of the area d Yes ❑ No e. A copy of a flyer or door hanger that has been distributed to all affected property owners. ❑� 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 8/2017 1 d. This event involves the use of the sidewalk Yes ❑ No e. This event is a oca /regional/national event (Please circle the 9 appropriate even pe) Yes ❑ No f Affected property/business owners have been notified of this event. [� Yes ❑ No g. There is/are resident(s) affected by the event that may need ADA transportation assistance to their residence, Yes ❑ No h. 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). Yes ❑ No 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 (c.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. El® Call the Alcohol & Tobacco Commission at (317) 234-4315 for more information. • Application cannot be processed without a copy of this [icense. City of South ]Bend, Indiana a Board of Public Works PERMIT AND AGREEMENT FOR THE USE OF THE RIGHT-OF-WAY FOR NON-RESIDENTIAL BLOCS: PARTIES The Non-residential Block Parry 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 must 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 Danger 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 fonn, upon signed authorization by the Board of Public Works. S. 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 atthe 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.rn. 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 application only. Event end times are pursuant to the recommendations of the South Bond 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 afterthe event, and provided there is no damage to the area. blames, phone numbers, and qualifications (0.9- Off -duty police officer, professional security guard, or event APPLICANT) of THREE security guards to monitor underage drinking, rnust 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 I City it Indiana, from any liability, Civil Ci Of South Bend, 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 Eovents" 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 10- day of Mllt4 20 APPLICANT Signature Printed Name 100 V1 I h' 77- 0, RTC OF PU LIC WORKS APPROVAL resident Member Member ber 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 SIV Ifa A�COR�® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDfYYYY) 212712018 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 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 Commercial Lines - (404) 923-3700 US] Insurance Services National, Inc. 3475 Piedmont Road NE, Suite 800 Atlanta, GA 30305-2886 CONTACT NAME: Tim Baumann PHONE AtCo Ext : 470 875 0517 FAX 610 537-1929 AIC ... ADORE S: tim.baumann@usi.com INSURER(S) AFFORDING COVERAGE NAIC# INSURERA: Endurance Assurance Corporation 11551 INSURED Kite Realty Group Trust 30 S. Meridian St., Suite 1100 Indianapolis, IN 46204 INSURER B : Allied World National Assurance Co, 10690 INSURER C : Sompo America Insurance Company ��— 11126 - INSURER D 7 INSURER E ; _ INSURERF; COVERAGES CERTIFICATE NUMBER: 12774275 REVISION NUMBER: See below 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD - POLICY NUMBER POLICY EFF MMIDDNYYY POLICY EXP MMfDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Pfl OCCUR GGR10012604100 03/01/2018 03/01/2019 EACH OCCURRENCE S 1,000,000 DAMAG PREMISES' U(EHaeccurrence S _ 1,000,000 MED EXP (Any one person) $ Excluded PERSONAL &ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: JECTPRO- POLICY PRO- X LOG OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2,000,000 _. 5 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY ACVS100810 03/01/2018 03/01/2019 EeaccdenntSINGLELIMIT S 1,000,000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) 5 PROPERTY DAMAGE Per accident 5 s B X UMBRELLALIAB EXCESS LIAB X I OCCUR CLAIMS -MADE 3088008 03/01/2018 03/01/2019 EACH OCCURRENCE 5 25,000.000 AGGREGATE $ 25,000,000 DEfa X RETENTION 5,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTWRIEXFCUTIVE OFFICERIMEMBEREXCLUDED? C (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N1A WCN31015PO 03/01/2018 03/01/2019 X STATUTE ET'- E.L. EACH ACCIDENT 1.000,000 $ E.L. DISEASE - FA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: KRG Eddy Street Commons, LLC , Eddy Street Commons 1044-1234 Eddy Street, South Bend, IN 46601 CERTIFICATE HOLDER CANCELLATION City of South Bend Department of Public Works, Engineering Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 227 W Jefferson Blvd., Suite 1316 AUTHORIZED REPRESENTATIVE South Bend, IN 46601 The ACORD name and logo are registered marks of ACORD @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) IL 67, �f C19 NBOOKSTORE, 3s. 4Ui�Itc u[+sc ��� a;' I !cCArE. 20,15.1 SF X,034 SF TIAA-CREF', 2d in t1'. 4 j7 p tr, :CO7 ME DA Blaze Pizza ' 06 016 C04 1,506 SF w 2ASp . ao' no, G� PO4Iep,. ,t,41p7tSF 30 THE MARK MI C43-T.,fi80 SF.� N - 41NE & TAp tU 6U'.o 23' 7a' rr�ll A09 Z. 3,134 sF FIVE GUYS'. ��, F - r ■ iSVRG€RG erti fk1E6 n Sil alff rtk�'ixd�r -a . B27 .. ELEV." _ 8,627 SF F3• fltthtt A 03 2,728 SF:;' <i • �QiiOUPFITTE, (J �✓ T N N #01k!a�' !� ,367 SF; a1' oat 2,703 sr 641. MYww ADI .027 'FBF `411 F1 NOW [iATiUNAI, DANK a {DJ �AIR do GRILL MV 'v 42, B3E i�� a•!' 29' 7,786 517 113, n E. Angela Blvd RE Starbucks Samples YMCA Home Depot Craft Balloon Twisters Jimmy John's Kilwin's Chocolates Blaze Pizza Face Painting 1 Pigeon &Hen Pottery Magician Bounce House 13' Soccer Shots 14 7-Eleven BarBici Fire Engine Fire Safety Trailer Napoleon Blvd.