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Home My WebLink AboutNon Res Block Party - South Bend Farmers Market - Cars and Craft Brews1316 COUNTY -CITY BUILa INO 227 W, hzI`FERSON BouL LEAD D Sol 1"rigBF-.ND, INDIANA46601-1930 CITY of Sot.Tui BEND PrTE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS August 28, 2018 Jill DeLoddere South Bend Farmers Market 1105 Northside Blvd, South Bend, IN 46615 RE: Event Name: Cars & Craft Brews Street Closure: South Eddy St. from East Sample St, to Dead End Dear Ms. DeLoddere: N rONP, 574/ 235-9251 FAX 574/ 235-9171 The Board of Public Works, at its meeting held on August 28, 2018, approved your, request to close the above referenced street for your event scheduled for September 22, 2018 from 10:00 a.m, to 3:00 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 large 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 cane 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 Enclosure GARY A. G11.,o,r SUZANNA M. FRI'1'ZBEAw ELI%ABI iii A. MARADIK .IAWs A. 'v9111:I.LLs1t I'IililiC:�L J. T�(7EtAll APPLICATION FOR USE OF, AND BLOCKING OF ACCESS TO, THE PUBLIC RIGHT-OF-WAY FOR NON-RESIDENTIAL BLOCK PARTIES 1865 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. E�/Fcc Paid ol'o Applicant Name: -361A'� Ou"Id Address: /Id,& City: 6Etc 4 e, State: IV zip: Pq Phone: Email: 5�f/j ly2q e, ol Mgt chin 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 cifi'-5 A C-(qj"f AW'q-� Location S10 11L, tL Aw� eiiJ iey-f �AA e- �4,� �11 e-y (Describe Area/Rootc) Street Closure Name of Street Frown NO Date of Event 20, t9 1&4,IVV E] pm. Start ❑ p.m. End 13,T11. Time: Registration/Setup Approximate Number of Attendees Answer the following appropriately: 1. This event will have music (live or oth9r). ❑Yes ❑ No a. I understand the Noise Ordinance described in the Agreement/Permit EP' 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 Form 990 of Form 990-EZ are included with this application, and F-1 Yes 0/ 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 ❑ No c, A copy of a flyer or door hanger that has been distributed to all Yes No affected property owners. 3. a. This event involves City streets 1Z Yes No b. This event involves County roads F] Yes No c. This event involves State highways El Yes ❑No Updated 8/2017 d. This event involves the use of the sidewalk Yes ❑ No c. This event is 4Loca9regional/national event (Please circle the R/ Yes F❑ No appropriate event type) f. Affected property/business owners have been notified of this event. IV Yes F-1 No g. There is/arc resident(s) affected by the event that may need ADA El 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 El/ Yes E] No Qualls, Customer Service Manager, 235-593,9 to organize meeting). IF ALCOHOL IS TO BE SERVED OR SOLD Alcoholic beverages will be servedE] Alcoholic beverages will be sold[Z 0 n Yf 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 inonitor 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 inforination. • Application cannot be processed without a copy of this license. &L C7 �� , µ:� � � � ._ i'�'' .� ` :� �� Via.. J/ application only. Event end tunes are pursuant to the recommendations of the South Bend 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 maybe 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 day of 20 APPLICANT Signature Printed Name BOA D OF PUBLIC WORKS APPROVAL President Meller Member 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 0 i3 �Emerson Roberts L I i E&C�ii—e- L---J L.- . . ....... . .. ...... 6 Antiory K[Icheri N hopikeypousp Ycry QNHAND Me Bar MbfeUng DeMgn PreWntd CoMMon Rpp Soutfi Bend FannW WOO Aug.14_2015 03:20 PM FARMERS MARKET 5742821250 i4P 2/ 2 �y vv i-r rr vvrvo-LMp IVEf M e g 1/ 1 CERTIFICATE OF LIABILITY INSURANCE �Aza(HGNI1AFYvvY, THIS 09RTIFICATE 18 ISSUED AS A •MATTER OF INFORMATION ONLY AND CONFERS NO R113HTS UPON THE CERTIFICATE Ha DIR. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NrIGATIVULY AMEND, exreND OR ALT9R THE COVERA02 AFFORDED BY T14N POLICIES BELOW- TNIS CERTIFICAT9 OF INSURANCE 00E$ NOT CONSTITUTE A CONTRACT BETMEN THE ISSUING INSURER(S), AUTHORIZ90 REPRE9VNTATIV9 OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: It the terttficato hauler Is an ADDITIONAL INSURED, tha pollay(ias) must be endareed. It SUIBROQATION 10 WAIVED, $Ubjftt to the terms and corlditiona of the policy, certaln polialoo may requlre rin OrldoreeMent. A statement on this certificate daft not aonlbr rights to the uwtifioste holder In IInU of IaUeh nnrinraAmen,le% Insurance Notwark Member I.Incoln Ave. 1, IN 48426 Mrluruzo Farm era Marketlna Jason 1108 Northsida Slvd South Fend, IN 46615 THIS Is TO CERTIFY THAT THP POLICIE D OF INDICATED, NO7WITMSrANuiNe ANY RCQU 04RTII=1CATE MAY 86 16SUED OR MAY PBF EXCLUSIONS AND CONDETIONS OF SUCH PoL . TY➢RUPINAURANCE Ho A 3C aommuFtCfALONNEIR44UAf$IL►TY oLAIA 04MDE I ^ .l nCCUR I D( LA00raGATE UMrrAPP41e0 PER: AOLtoy 11 Pffei' F— Lou AUTQMD0ILE UACIUtV A`N`YaALITO AUTOS NN0 HIR2DAUT08 AUC•iN•48ULfrA A"A'rWa UMOReuALIA2 4t10UR AXQESG UAB ..� ..� .. 1A a (ANCE G18TED BELOW HAVE! BEEN 186up-A To THE INSUF NT, TERM OR CONDITION OF ANY 06NTRAGr OR OTHER THE INSURANGE AFFORDED BY THE POLICIES DESCRIBI LIMIT'S SHOWN MAY HAVE VrZEN REOUCi A By PAID CLAIMS 12J2912417IW111201( Dr.30RIPTION of oPERjk7jdNB I LppATi0U5I VLTWM40 (ACOAD 10f. Ad0cm) RNRirki schodul►, tnMy At lk�ahed Irnwra e}upe H r�gr,l 3ity of ,South Send Is art eddltlonal inaurgd. SOUTHBI City of South Bend 227 Westlefterdon Blvd South Bond, IN 45601-1031i NUMBER: ED NAMED ABOVE FOR TH9 POLICY PERIOD 000UMENT WITH AROPECT TO WHICH THIS IO HERRIN IS SUBJECT TO ALL THE TERMS, Liwa ea lL000U"eNCE t,eDp,00 El 0NWD gig I;Es o Mpp L�{P orto Dn F 100r40 s 5,60 PFRBONAL4AOVINJURY $ 1000100 0Et1ERALAIGROG1A7E 8 2,020,0G PR DUO tlMP!QPAGG 1 21000100 OMB g s 1200ILYtNJURY(Porparian) E BODILY INJUAY(ftrptddmq 4 erg RIs EACH GCCURRENCR' a E1 A REGATI 6 s s 8-L. tdACH ACCt6j4N7 91- DIOP-lAma - EA rmpLnvrd a IB B O I Y L rr.! THEU4�IIRATION HDAM THEREOF. Nb CI; POLICI eLLr WILL ES CBE CDELIWRE13 IN ACCORDANCE WIYN THS VOIJOY PROVI510NIy, AUTWORMED REPA6SENrAT1VE (ID 18BIt.Z014 AGORD CORPORAfiON. All rtght+erights ACORD 26 (2014101) The ACORD name and logo are roglatered marks of ACORD