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HomeMy WebLinkAboutLicense - Renewals for Public Parking Facilities - Episcopal Cathedral of St. JamesFor all municipal business license questions, contact: City of South Bend • Department of Community Investment 227 West Jefferson Blvd • Suite 14005 -South Bend, Indiana 46601 • 574.235.5912 •F�I4.23 .902 50 LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY MUNICIPAL CODE SECTION - 4-39 I. APPLICATION TYPE Check One: II. BUSINESS DATA New Renewal X A. Business Name: Episcopal Cathedral of St James B. Business Address: 117 N Lafayette Blvd City: South Bend State: IN C. Mailing Address (If different from above): same City: State: D. Business Telephone Number: 5742324837 E. Business Fax Number: F. E-Mail Address: office@stjamessouthbend.org W. 11 ,Zip: 46601 11 G. Maximum Number of Vehicles that can be parked at facility at onetime: 25 H. Total Number of Parking Spaces at facility: 25 I. Hours during which vehicles may be stored: open H. Premises are (check one): Leased by Applicant Owned by Applicant X If Leased: Owner's Name: Owner's Business Address; City: State: Zip: Owner's Residential Address: City: J. Insurance Carrier and Amount of Liability Insurance OR Bonding Agent and Amount of Bond: Church Insurance Company of Vermont WOM For Office Use Only Application Filed JAN 1 6 2020 Public Works Approval Application Fee PaidJAN I MLicense Fee Paid Sent to Dept, J License Number . Zonir��- Y11111111"WI, of Pown Wall / SE Not Approved N Reason cvm 9 fi , For all municipal business license questions, contact: City of South Bend - Department of Community Investment 227 West Jefferson Blvd - Suite 1400 S -South Bend, Indiana 46601 - 574.235.5912 - F: 574.235.9021 LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY MUNICIPAL CODE SECTION - 4-39 III. PERSONAL DATA A. Applicant's Legal Name: B. Residential Address: City: State: C. Residential Telephone Number: D. Residential Fax Number: E. Celephone Number: F. Position with Business: Zip: IV. OWNERSHIP A. Type of ownership (check one): Sole Proprietorship (If sole proprietorship, proceed to 1). Partnership (If partnership, proceed to 2). X Corporation (If corporation, proceed to 3). 1. Sole Proprietor Name: Residential Address: City: State: Zip: Telephone Number: 2. Partnership (List at least two (2) partners) Name #1: Residential Address: City: State: Zip: Telephone Number: Name #2: Residential Address: City: Telephone Number:, Zip: 3. Corporation Legal name of corporation: Episcopal Cathedral of St. James Date and state of incorporation: 1868 01 For all municipal business license questions, contact: City of South Bend - Department of Community Investment 227 West Jefferson Blvd - Suite 1400 S -South Bend, Indiana 46601 - 574.235.5912 - F: 574.235.9021 LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY MUNICIPAL CODE SECTION - 4-39 IV. OWNERSHIP (Continued) A. Type of ownership (continued): 3. Corporation (continued) Resident Agent: Name: Nancy Studebaker Title: Administrative Assistant to the Dean Business Address: 117 N Lafayette Blvd City: South Bend State: IN gyp: 46601 Officers: Name #1: Christopher Hillak Title: Sr. Warden Business Address: 117 N Lafayette Blvd City: South Bend State: IN Zip: 46601 Residential Address: City: State: Zip: Name #2: Jane Hunter Title: Jr. Warden Business Address: 117 N Lafayette Blvd City: South Bend State: IN Residential Address: City:, State: ip: 46601 ip: Name #3: Peg Swadener Title: Treasurer Business Address: 117 N Lafayette Blvd City: South Bend State: IN Zip: 46601 Residential Address: City", State: Zip: 3 For all municipal business license questions, contact: City of South Bend • Department of Community Investment 227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 46601 • 574.235.5912 • F:574,235.9021 LICENSE APPLICATION FOR - PUBLIC PARKING FACILITY MUNICIPAL CODE SECTION - 4-39 V. INCLUDE COMPLETE RATE AND HOUR SCHEDULE WITH APPLICATION VI. INCLUDE A CURRENT INSURANCE POLICY OR BOND VII. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION b� Vill. AFFIRMATION I, hereby, certify and affirm that all of the information I have given in this application is true and accurate to the best of my knowledge. I further certify that I have in no way attempted to mislead the City in this application by omitting facts known to me. I have read and understand the regulations of the Public Parking Facility license found in the City of South Bend Municipal Code, Section 4-39. .. Signature Date , n+cA —f scA" e- j 5 95 . IMPA ry)DA -(�- nQf)­Ci G1Q[tf1 emp ho je S JVU 1 HINUU1 IVI CERTIFICATE OF LIABILITY INSURANCE Fa r�r ^ 1DDIYYYY) DATE (MM r'a.. 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 6,01s to the certificate holder in lieu of such endorsementts). PRODUCER The Church Insurance Agency Corp 210 South St, Ste 2 Bennington, VT 05201-2894 Church Ins Co of Vermont INSURED Cathedral of St James 117 N Lafayette Blvd South Bend, IN 46601-1507 10669V COVERAGES CERTIFICATE NUMBER: E SION NUMBI�R: 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. IN3R TYPE OF INSURANCE ADD L SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH 1 � CLAiMS,MADE ^ 7 OCCUR N N VPP0006095 5/112019 5/1/2020 � 1'000,000 .. DAMAGEr 4r oa 000,000 E,X,P, fAnv,,,one erson g 30,000 PERySQNAt mAbDV INJURY 1,000,000 Gk,NPO -jo APPLIESLOC GENERAL s 000,000 dOvl PRo„AGGREGATE„ 1,000,000 DIaCTS • cOMPrOP acG s 1, OTHFf s AUTOMOBILE LIABILITY E _C�'h+{E�O�NFD.�VPkG1117w9fT.. ANY AUTO DILY TL URY F r pecsnn)w. OWNED SCHEDULED AUTOS ONLY AUTOS U Y Psr accident 5 H ReD N , MU' R d�tlEp "L N�pODIPLFYL�N�JUFFi,m "' `IMAGE w. A TOS ONLY A U a t Ik. I er auci dnl mm 5 ) ... . .. S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE u.. AGGREGATE_ ,, ........... ... .. __- .a DED RETENTION $ S WORKERS COMPENSATION EMLOYIA ATH 4aTTIE.. YIN _ ANY PROPRIEfgORIPARTNERIESCECUTIVE E 1. FACH 4GClDENT ericCl Cf1 IUFHRI EXCLUDED? NIA . .- ... F.L.. DISEASE EA EI1 PLOYFE S _ If yes, describe under ....' ................."".. ". ESCRIPTION OF OPERATIONS Wow I li' E,L, DISEASE # POLICY LIMIT S A Umbrella N N PP0006095 511/2016 5/1/2017 Excess Liability 4,000,000` DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES be attached if more space is required) VEHICLESACORD 101, Addkf anal Remarks Scheduler, n'k Church parking, lot used as public facility, city named as an .additional insureda� CANCELLATION: THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT FOR EACH POLICY PERIOD. SHOULD THE POLICY BE TERMINATED, THE COMPANY WILL ENDEAVOR TO GIVE THE ADDITIONAL INTEREST IDENTIFIED 30 DAYS WRITTEN NOTICE, AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD EFFECT THAT INTEREST, IN ACCORDANCE WITH THE POLICY 'PROVISIONS OR REQUIRED BY LAW. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 227 W Jefferson Blvd., Ste 1400 South South Bend, IN 46601- AUTHORIZED REPRESENTATIVE 10 ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THE CATHEDRAL OF SAIN- JAMES Date: Friday, January 3, 2020 Name: Address: City, ST Zip: _ Dear This letter serves as a contractual agreement between you and the Episcopal Cathedral of St. James for the purposes of parking space rental in the lot located on the north side of Washington Street at the intersection of Washington and St. James Court. An Episcopal Church The monthly fee is, $25 and due in the office by the first of the month for the following month. You will not be billed. After five days a $5 late fee will be charged . If payment is not received after thirty days, Your assigned your parking privileges will be revoked, Fees may be paid: by check space is number or money orcler,and may be submitted by mail or brought to the office, (Office hours are &30am-230pmTuesay and Wednesdays; 1♦ • •Please • -ct questions-M • your to the Dean,Nancy-b - You a► to hang from yourmirror. Cathedral'sbe displayed at al�l times, or your car will be towed away. In the event that you find an unauthorized vehicle in your space, please park your vehicle in the • parking lot located off of Boulevard; or in the handicapped spaces close to our back doors. Please notify the office, so we may call the towing service, This agireement becomes effective with your signature. Please sign, date, and fill in the information for your vehicle. If you wish to register more than • - vehicle , please include the informationon Additional hangtags are available, You will receive your parking tag upon completion of this agreement and payment, If you wish to terminate this agreement, you give (30) thirty Failure to R'r so will result in a $25 fee. Your parking privileges begin Thank you, Nancy Studebaker, Assistant to the Dean 117 North Lafayette Boulevard South Bend, Indiana Signature 46601-1507 Date 574.232.4837 office 574.232.6993 fax Vehicle Make office@stjamessouthbend.org email Model www.stjamessouthbend.org Color _Year _License Plate - INTER -OFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE SENT: 1/22/2020 TO:/_P�om Anderson, Code Enforcement odd Skwar an, Fire Department att Longfellow, Engineering Chris Dressel, Community Investment gl�� , Plan FROM: Linda M. Martin, Clerk SUBJECT: License Application f+ lr Public Parking Facility Episcopal Cathedral of St. James LOCATION: Church location is 117 N Lafayette Blvd, Rental lot is at 307-311 Washington St. DATE DUE: 02/04/2020 FAX OR E-MAIL TO: 235-9171 / Imartin@southbendin.gov RECOMMENDATIONS AND COMMENTS: By _. _ Date INTER -OFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE SENT: 1/22/2020 TO: Tom Anderson, Code Enforcement Todd Skwarcan, Fire Department Matt Longfellow, Engineering Chris Dressel, Community Investment Lary Magliozzi, Area Plan FROM: Linda M. Martin, Clerk SUBJECT: License Application f PrPublic Parking Facility Episcopal Cathedral of St. James LOCATION: Church location is 117 N Lafayette Blvd, Rental lot is at 307-311 Washington St. DATE DUE:02/04%Z020 FAX OR E-MAIL TO: 235-9171 / lmartin@southbondin.gov 1101MOILILIVI 63 a By ii Date Nateesha Jacobs From: Todd Skwarcan Sent: Wednesday, January 22, 2020 4:08 PM To: Nateesha Jacobs; Tom Anderson; Matt Longfellow; Chris Dressel; Imaglioz@sjcindiana.com Subject: RE: License Application for Public Parking Facility at 307-311 Washington St. Thank you Nateesha, no issues, From: Nateesha Jacobs <njacobs@southbendin.gov> Sent: Wednesday, January 22, 2020 12:04 PM To: Tom Anderson <tlanders@south bend in.gov>; Todd Skwarcan <tskwarca@south bend in.gov>; Matt Longfellow <mlongfel@southbendin.gov>; Chris Dressel <cdressel@south bendin.gov>; Imaglioz@sjcindiana.com Subject: License Application for Public Parking Facility at 307-311 Washington St. Hello all, Please provide your recommendations. Thank you, Natee6fm law& r Administrative Assistant 1 Department of Public Works, Engineering Division (574) 235-9197 r c rb r §outhberldmy City of South Bend 227 W. Jefferson Blvd., Suite 1316 South Bend, IN 46601 e dellli eii sei,° ces that eiin1poweii" eve�yo e to thi,iNe. I!Ixtdo cnr,'e I ftco ntabiiRy I linnova't'on I Oo'7dw,icn � Viinptiowrta°meini Nateesha Jacobs From: Tom Anderson Sent: Thursday, January 23, 2020 8:21 AM To: Nateesha Jacobs Cc: Matt Longfellow; Chris Dressel; Todd Skwarcan; Imaglioz@sjcindiana.com Subject: Re: License Application for Public Parking Facility at 307-311 Washington St. Nateesha Tom from Code. No issues. Nice BIG sign from Hamilton's Towing. Sidewalks cleared of snow. Thank you Sent from my iPad On Jan 22, 2020, at 4:07 PM, Todd Skwarcan <tskwarca@south bendin.gov> wrote: Thank you Nateesha, no issues, From: Nateesha Jacobs <njacobs@southbendin.gov> Sent: Wednesday, January 22, 2020 12:04 PM To: Tom Anderson <tlanders@southbend in.gov>; Todd Skwarcan <tskwarca@south bend in.gov>; Matt Longfellow <mlongfel@southbendin.gov>; Chris Dressel <cdressel@southbendin.gov>; Imaglioz@sjcindiana.com Subject: License Application for Public Parking Facility at 307-311 Washington St. Hello all, Please provide your recommendations. Thank you, <image001.jpg> ✓Vateejfm 1a1,& Administrative Assistant Department of Public Works, Engineering Division (574)235-9197 11jacq mpm-,t roaq6 , apm City of South Bend 227 W. Jefferson Blvd., Suite 1316 South Bend, IN 46601 We, ad6lihteiu eii,Vc s that einpower iWery ne to thrive, 1: xceNcnco I A„;x oui iV.abiility V li i'mv,r6on I Indua k, n I I.ruilvowrerw wilt, Nateesha Jacobs From: Matt Longfellow Sent: Thursday, January 23, 2020 10:34 AM To: Nateesha Jacobs Cc: Toy Villa; Kara Boyles Subject: FW: License Application for Public Parking Facility at 307-311 Washington St. Attachments: 1512_001.pdf Nateesha, Engineering has no objection to the continued licensing for public parking at this location. Regards, p f65 Matt Longfellow Permit Inspector Public Works Engineering Office: (574) 235-5929 Mobile: (574) 286-9589 rrtl i) f e.1.CW so ith en�iin 1 py City of South Bend 227 W. Jefferson Blvd., Ste. 1316 South Bend, IN 46601 I^ott ww.so��tllnderl,;�awe From: Nateesha Jacobs <njacobs@southbendin.gov> Sent: Wednesday, January 22, 2020 12:04 PM To: Tom Anderson <tlanders@southbendin.gov>; Todd Skwarcan <tskwarca@south bend in.gov>; Matt Longfellow <mlongfel@southbendin.gov>; Chris Dressel <cdressel@southbendin.gov>; Imaglioz@sjcindiana.com Subject: License Application for Public Parking Facility at 307-311 Washington St. Hello all, Please provide your recommendations. Thank you, NClEm illia jCY.G(1& '�- Administrative Assistant Department of Public Works, Engineering Division (574) 235 9197 4 7NPov U �% ' g �6bM9�'We�tl�t,n�.�N nr City of South Bend 227 W. Jefferson Blvd., Suite 1316 South Bend, IN 46601 We deliver services that empower everyone to thrive. Excellence I Accountability I Innovation I Inclusion I Empowerment Nateesha Jacobs From: Chris Dressel Sent: Saturday, February 1, 2020 9:13 AM To: Nateesha Jacobs Subject: RE: License Application for Public Parking Facility at 307-311 Washington St. Recommended for approval, Christopher D Dressel, AICP Senior Planner Bicycle Coordinator Brownfields Coordinator Census Coordinator .,� Department of Community Investment City of South Bend 227 W. Jefferson Blvd., Suite 1400S South Bend, IN 46601 r.° aln,pii n a w' iivlk:.o s �:Ilnn�°t nip owe eviai° one to tll°nNve, I tcuiaiNO,dbflMt I lmuov«r,.lon I Inudusion I Finlunwcrninu,rnl From: Nateesha Jacobs Sent: Wednesday, January 22, 2020 12:04 PM To: Tom Anderson <tlanders@southbendin.gov>; Todd Skwarcan <tskwarca@south bendin.gov>; Matt Longfellow <mlongfel@southbendin.gov>; Chris Dressel <cdressel@southbendin.gov>; Imaglioz@sjcindiana.com Subject: License Application for Public Parking Facility at 307-311 Washington St. Hello all, Please provide your recommendations. Thank you, �.. ✓Vateeaka jaco& W, Administrative Assistant u Department of Public Works, Engineering Division 74)235 d� I�. ��,ol� ��sulh8� ooaVirro apOy P , City of South Ben d 227 W. Jefferson Blvd., Suite 1316 South Bend, IN 46601 e defliiver sovices that unn11roweM everyone e to tlhidve 11 nc .Ilooce � 'A'ccou„ 1nMhflHty II IiiiuGGrwiUon I oia; izu m � I:mlnow:rnnwiit: