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HomeMy WebLinkAboutNon Res Block Party - South Bend Museum of Art1316 COUNTY-Crry Buiu)iNo 227 W. JF .17FERSON Boui,EVARD Sou'ru BEND, IND [ANA 46601-18 30 CiITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLICJYORk�� June 26, 2018 Cathy Dietz South Bend Museum of Art 120 S. Martin Luther King Jr. Blvd, South Bend, IN 46601 PHONE 574/235-925 FAX 574/ 235-9171 RE: Event Name: Fireworks for Meet Me on the Island Street Closure: Jefferson Blvd. from Niles Ave. to Martin Luther King Jr. Blvd. Date: July 6, 2018 Dear Ms, Dietz: The Board of Public Works, at its meeting held on June 26, 2018, approved your request to close the above referenced street for your event sebeduled for July 6, 2018 from 7:00 p.m. until 12:00 a.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- 9251. Sincerely, Linda M. Martin, Clerk APPLICATION FOR USE OF, AND BLOCKINGOF ACCESS TO, THE PUBLIC RIGHT-OF-WAY FOR NON -RE SIDENTIAL 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 fNCLUDED WITH APPLICATION. F] Fee Paid Applicant Name: ( ,CLIWIV WetLv DoLtrD-Ickld P/0G1eUyA Address: P05 J�,,,Ptljd State: '7,DO Zip. ♦ Phone: Email: enA f , () 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: A Event Name F-(r-P-kkxo&f, 4r Mlw+ffig Location (crs Uf-�' flkl pz� 4n'o- Lr- firptoorl (Describe Area/Route) Street Closure Name of Street Froin oi Lep A�, it"41 -, TA o Date of Event 20 [I a,ni. El a.m.. Time: Registration/Setup -7: ap"In' Start 54P'm E+a.rn. End Op.m. Approximate Number of Attendees Answer the following appropriately: 1. This event will have music (live or other). EQ Yes ❑ No a. I understand the Noise Ordinance described in the Agreement/Permit Yes F1 No 2. Required Information to Accompany Application a. Certified Check or Money Order in the Amount of $125.00, or: b, For Certified Nonprofit Organ izations: 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 F-1 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 and setup plan of the area Yes E] No e. A copy of a flyer or door hanger that has been distributed to all Yes E] No affected property owners. 3. --# a. This event involves City streets Yes F-1 No b. This event involves County roads F-1 Yes No c. This event involves, State highways E] Yes No Updated 8/2017 1 d. This event involves the use of the sidewalk yes ❑ No e. This event is a local Dionanational event (Please circle the ❑ yes ❑ No appropriate event type) 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 deed ADA ❑ Yes 'K 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 r ❑ 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 Iisted (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) 234-43.15 for more information. • Application cannot be processed without a copy of this license. City of South Bend, Indiana @ Board of Public Works The Non-residential Block Patty 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 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 0 application only. Event end times are pursuant to the recommendations ofthe South Bend Police Department. 13. IF ALCOHOL IS TO BE SERVE D OR SOLD a Certified Check or Money Order for $400.00 must be submitted with application. The application cannot be processed without a deposit. Tile 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 TI-IREE 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 Corrunission 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 / a .. .. ....... . ... . . ... . day of I " APPLICANT Signature /n Printed Name BOARDjOF PJULIC WORKS APPROVAL Ilk President Mem er Me ber Member Member RETURN FORM TO: Board of Public Works 1316 County -City Building 227 West Jefferson Boulevard South Bend, IN 46601 Phone: (574) 235-9251 L Date South Bend Museum of Art 120 S. Dr. Martin Luther King Jr. Blvd. South Bend IN, 46601 June 13, 2018 1316 County -City Building 227 West Jefferson Blvd. South Bend, IN 46601 I I ...... ...... SBM S/iuth Bend M,,��seuin fit, At I This letter Is a request for closure of the Jefferson Street Bridge for a fireworks show on First Friday, July 6, 2018. 1 apologize that this request has not been submitted 4 weeks prior. We have held this fireworks show on the First Friday in July for the past several years, not only to close out our Meet Me on the Island event, but enhance the downtown experience for downtown South Bend's Restaurant Week, which historically is held during the same week. For these shows the fireworks have been launched from the former Wart Restaurant site, the current site of the Cascade Residences. Because of construction at this site and at Seitz Park, we cannot continue to use this area. I over the past few weeks I have have been discussing other possible solutions for areas we could launch the show from with Scott Herczeg at Century Center, Jeff Jarnecke with Venues, Parks & Arts, Jill Scicchitano at Downtown South Bend, Inc., and Bryan Szajko owner -of RKM Fireworks. The first idea we explored was using the Jefferson Street bridge. At that time DTSB was told that the museum's budget of $1500 was not high enough for a show on the bridge. After exploring other options, and in further discussions with Bryan, he has graciously agreed to provide a fireworks show on the bridge within our budget. Other options discussed were: At the Century Center we discussed using the roof or part of the parking lot. The South Bend Fire Chief will not allow them on the roof. The parking lot poses a danger to guests and cars in the lot. Another proposed site is Howard Park, just south of the Jefferson Street bridge, I am still waiting to hear back from the Fire Chief about this, but Bryan at RKM fireworks feels because of the Increased distance from the spectators and the low elevation in that area of the park it would affect the quality of the show. He would prefer that we not launch them from there. I s oke with Marcia Qualls this morning to confirm that this request will not interfere with any scheduled events downtown on July 6th. I am happy to provide additional details if needed. Thank you for your c sideration, Ca'-fh r letz s Director of Marketing & 511V,verf s I South Bend Museum of Art dietzc@southbendart.org 1574.514,9032 CERTIFICATE OF LIABILITY INSURANCE DATE 108/2OIYYYY) 05/0812016 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 endorsements ; PRODUCER JMS Insurance Inc. 300 Michigan Street Walkerton, Indiana 46574 CONTACT Whard Bishop NAME: PHONE (674) 686-7259 Arc No ; EMAIL D INSURER 3 AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Insurance Corrpany PHI INSURED South Bend Museum of Art 120 Or Martin Luther King Jr Dr S South Bend, I1446601 INSURERB: Unknown Insurance Company 30104 INSURER C : INSURER D: INSURER E INSURER v: 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.B.E 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. ILTR TYPE OF INSURANCE A DLSUBR POLICYNUMBER POLICYBFF POLICY MWDD EXp. LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS-MADE P OCCUR Y PHPK1766339 01/0612018 0110612019 EACH OCCURRENCE $ 1,000,000 -DAMAGE TO RENTE15- PREMISES Ea occurrence $ 100,000 MED EXP (Any me Parson) $ 5,000 PERSONAL& ADV INJURY $ 1.000,000 GEN'LAGGREGATE LIMIT APPLIES PER J POLICY ❑ 2CT1:1 LOC OTHER GENERALAGGREGATE $ 2,000,000 PRODUCTS-COMPIOPAGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLYHAUTOS / HIRED NON -OWNED V AUTOS ONLY AUTOS ONLY PHPK1756339 01/06/2018 01/06/2019 COMBINED SINGLE LIMIT Ee seddall_ $ BODILY INJURY (Per person) $. BODILY INJURY.(Peracetdent) $ 1,000,600 PROPERTY DAMAGE Per acrid € $ UMBRELLALIAB EXCESS I" OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEO I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORF'ARTNERIEXECUTIVE — OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, desc4m under DESCRIPTION OF OPERATIONS belay N I A 36VVECPV8073 01/06/2018 01/06/2019 A $ERT TE FORR !r E.L EACH ACCIDENT $ 100,000 E,L DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 50(),000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace is required) The City of South Bend, Board of Park Cornnissioners, and South Bend Venues Parks & Arts are listed as Additional Insured on the General Liability Policy. City of South Bend, Indiana; 227 W Jefferson Blvd, South Bend, Indiana 46601 Board of Park Comrrssioners, 321 E Walter St, South Bend, Indiana 46614 South Bend Venues Arts & Parks, 321 EWalter St, South Bend, Indiana 46614 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of South Bend ACCORDANCE WITH THE POLICY PROVISIONS. 227 W Jefferson Blvd AUTHORIZED REPRESENTATIVE South Bend, IN 466011830 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD