HomeMy WebLinkAboutProcession - Pentecostal Church1316 COUNTY -CH Y BUILDING
2,27 W. JETHA60N BOULI-VARD
SNP I I I REND. I NDIANA 46601-1830
0TYCIF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
September 20, 2018
Mary Alford
Pentecostal Church
1025 Western Drive
South Bend, IN 46601
RE: Event: Pentecostal Fine Arts Walk -A -Than
Date: September 22, 2018
Dear Mr. Alford:
NIONF� 5741/235-9251
FAX 574/ 235-9171
The Board of Public Works, at its meeting held on September 20, 2018, approved your request
to conduct the above referenced event on September 22, 2018, from 9:3 0 a.m. to 12: 00 p.m. on
the designated route as submitted. Enclosed please find copy of your approved permit.
Please note that participants must stay on the sidewalks and obey all traffic laws.
If I can be of any further assistance to you in this matter, please call me at (574) 23 5-925 1.
Sincerely,
Linda M. Martin, Clerk
Enclosure
DARN, A. Gii,o'r SUZANNA M, NuTZBERG EUZAK"'ni A. MARADIK JAMES A. NMJULLFR J. DORAU
APPLICATIOP,FOR7;$1SE OF
The Board of Public Works must have FOUR (4) weeks prior notice of the
Sponsor: Submitted _&
Address:
City:
State: Zip: Phone:
Email:
Sponsor may use the public right-of-way described as (describe route and attach map)
A
PLEASE NOTE: THE SOUTH BEND POLICE DEPARTMENT RESERVES THE RIGHT TO
CHANGE YOUR ROUTE FOR SAFETY PURPOSES
Event name: LICR-K w5taj 41 N'PL) , ( )eal, K �y IAO/j
Fj The Board of Public Works must have FOUR (4) weeks, prior notice before event occurs
F-1 All certificates of insurance, pre -paid costs, maps, and any other applicable information requested
or required by the Board of Public Works have been provided with this application
F-1 The event shall be held on 67 _L5o7 3, 1- 20_ and no other date
i
Registration time for the event starts at PA&./P.M.O
❑ Starting time of the procession is
Estimated completion time is _Z_�_ ain? C-19.
This event involves the use of the following roadways
0This event involves closure of City residential streets
El This event involves County roads
❑ This event involves State highways
This event involves use of a park (Must obtain permission from Park Board)
❑ 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) � 1"hl 1` '
This event involves the use of the sidewalk I
Fj�Particip ants must stay on the sidewalk and obey all traffic laws.
MR This event is 00_00egional/national event (Please circle the appropriate event type)
[2This event will be coordinated with the property owner/business where staging will take place
Updated 08/2017 2
PERMIT/AGREEMENT
FOR A PROCESSION
1. Sponsor shall reimburse the Board for the actual cost to the City for the event, if deemed
necessary.
2. Sponsor 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.
3. Sponsor shall provide to the Board all additional licenses, permits and documentation
required for the event.
4. If this event results in closure of a residential street, all residents within the affected area
must be notified of this event. The APPLICANT must make a reasonable attempt to
notify all residents that reside on the block. A copy of a brochure or letter describing
the event purpose, date, and time must be distributed to all affected neighbors and
included with the application.
5. If this event results in closure of a residential street, the applicant is responsible, prior to
the event, for determining if there are any residents affected that could potentially need
assistance in accessing their residence. The applicant is responsible for providing said
resident access or transportation to their property.
6. Sponsor agrees to abide by all terms and conditions of the Board's policy governing
walks, runs, parades or other similar event adopted by the Board on March 3, 1985.
7. In order to ensure public safety during the event, the Board agrees to furnish traffic
planning, materials, equipment and personnel as deemed necessary by the Police
Department Traffic Bureau, the Bureau of Traffic and Lighting, and, where applicable,
the Board of Park Commissioners.
8. Sponsor acknowledges that the Police Department reserves the right to change this route
for safety purposes.
9. In consideration for approval by the Board and the use of the sidewalks for the purposes
set out above, the undersigned agrees and undertakes to hold the Civil City of South
Bend, Indiana, free and harmless from any liability loss, costs, 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 said activity, arising out of the approval of the request to use the sidewalks
indicated in the City of South Bend. The undersigned certifies that he/she is authorized to
bind the above mentioned sponsor to the terms hereof.
10. Notification of approval/denial of this request will be issued by return of this form, upon
signed authorization by the Board of Public Works
I understand the above rules and regulations and that this application may be denied based on
any false or incomplete information.
Sponsor Signature //Z d6e�l
RE T FO To: 3
Boar o Public Works
1316 my -City Building
227 West Jefferson Boulevard
South Bend, IN 46601
Prone: (574) 235-9251 • Fax: (574) 235-9171
Printed Name
Title
B Alm +aF PU LIB VJ' S APP"VAL
President Member e r
t s
Metyber Member Date
RETURN FORM TO: "k
Board of Public Works
131.6 County -City Building
227 West Jefferson Boulevard
South Bend, IN 46601
Phone: (574) 235-9251 e Pax; (574) 235-9171
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