HomeMy WebLinkAboutSpecial Event - 3rd. Annual Suicide Awareness Ruck March 22 - June 26APPLICATION FOR USE OF
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PUBLIC RIGHT-OF-WAY FOR EVENT
The following special events have been approved by the Special Events Committee. isas
Submitted by: _Denise Miller
Event name: Yd Annual Suicide Awareness Ruck March "22"
Event Date: 6126121
Street Closure: Intermittent
Closure Times: 7:30 am to 1:00
Sidewalk Closure. ❑ Yes ❑ X No
Comments: Soldiers, Veterans and Civilians complete a 22K Ruck March starting at
the Maple Lane Reserve Center and continuing through the City and
winding back to the starting point.
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
Elizabeth A. Maradik, President
Gary A. Gilot, Member
Joseph R. Molnar, Member
Jordan V. Gathers, Member
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Murray L. Miller, Member
Attest: Anne Fuchs, Clerk
1
City of South Bend Special Event Application
City and Regional Event
$50 application fee if filed 60 days or greater (up to 360 days) in advance of event
$100 expedited application fee if filed 30-59 days in advance of event
Review the Instructions on the Special Events page before completing the application. City and Regional Special
Event applications must be submitted more than 30 days in advance of the event date or the application will not
be accepted.
Section A - Applicant Information
Date of Application:
04/27/2020 organization Name: 428th Military Police Company
Applicant (Contact) Name:SFC Joseph E. Kovatch
------------------------------------
Applicant (Contact) Phone: 719-366-0488 __ Contact Email: ]oseph_e.kovatch.civ@mail.mil
Address: 2402 E. Rose St. _ city/State/ZIP: South Bend, IN 46635
List any professional event organizer, event service provider or commercial fundraiser that is authorized to work
on your behalf to plan, produce and/or manage your event.
Organization Name:
Contact Phone:
Address:
Contact Name:
Contact Email:
City/State/ZIP:
Section B - Event Information
Event Name: Event Type: (Festival, Race, Parade, Other
3rd Annual Suicide Awareness Ruck March "22" Ruck March
------------------------ ):____________
Event Classification: ® Non -Profit' ❑ For -Profit
❑ City (Civic) Sponsored ❑ Other (If Other, please describe): ..................................... —__—__
"The Special Events Committee may request proof of non-profit status.
Provide a brief description and timeline of event (Note: A detailed map plan is required in Section H of this
application. The description should be a summary overview.)
The 428th MP CO and 415th CA BN have joined together to hold the 3rd Annual Suicide Awareness Ruck
March. Soldiers, Veterans, and civilians will completed a 22K Ruck March through town to help raise money for
the Wounded Warrior Project. We chose 22K because of the 22 suicides per day among service members and
veterans. This march will start at the Maple Lane Reserve Center around 0730 hours and end at the same
location around 1200-1300 hours. Our goal is to help bring awareness to our community. We are asking for
SBPD to help escort those participating until we reach Notre Dame. A detailed map will be attached.
Date of Event Setup (mm/dd/yy]: 06/26/2021 Time: 0700
Begin Date of Event [mm/dd/W]: 06/26/2021--- —_ Time: 0730
End Date of Event [mm/dd/yyl: _ 06/26/2021 _ Time: 1300
Event Cleanup Completion [mm/dd/yy]: 06/26/2021 _______ Time: _1330
Total anticipated attendance:25-50-people _______
The proposed event will require the closing of: ❑ Streets ❑ Sidewalks
Is the event ticketed or include fees? ❑ Yes ® No If yes, list fees and fee groups below:
Does the event have any partnered sponsorships? ❑ Yes ® No
If yes, list the number of sponsors at each level of partnered sponsorship:
Is this a returning special event or part of a series of special events? M Yes ❑ No
If yes, provide the date, location, and attendance of past special events and/or future planned events in the
series:
The 428th MP CO completed a 22 mile Suicide Awareness Ruck March in July of 2019 that
started at the Maple Lane Reserve Center and went into Niles, MI before coming back and
ending at the Reserve Center. That ruck march had 30 participants and was escorted by
Indiana and Michigan State Troopers. Last year, we completed our 2nd Annual Suicide
Awareness Ruck March that went through South Bend with the support of the SBPD. We
shortened the ruck march to a 22k and would like to keep this event going annually to keep
awareness up on the suicides among service members and raise money to help support
those in need.
If your event is a parade, race, or other processional -type event, please complete Section C. Otherwise,
continue to Section D.
Section C - Parades. Races, and other Processional Events
What is the estimated number of parade/race spectators on the proposed route? 0
Describe any sound equipment that will be used in the parade/race:
No sound eclipment will be utilized for this event.
Does the event have participant categories? For example, a run that has different race divisions or a parade with
separate walking/marching groups.
❑ Yes ® No
If yes, list categories and anticipated participants per category.
If your event is a parade, what is the approximate number and type(s) of animals, vehicles, and floats participating
in the parade? (Note: If using animals in a parade, event organizers are responsible for cleaning up animal waste
left on the parade route.) Describe parade participants below:
Section D - Eauioment. Set-up, and Logistics
Are you hiring a company to provide entertainment, games or inflatables? ❑ Yes ® No
o If yes, you must submit proof of insurance for all stage and entertainment companies three (3) weeks
before the event.
Describe any hired entertainment:
Will you be staking any tents, inflatables, portable restrooms or any other anchorings? ❑ Yes ® No
C If yes, you must provide proof of locates (locate number) two (2) weeks prior to your event. Locates can
be found by calling 811.
Does your event include the use of fireworks, rockets, lasers, or other pyrotechnics? ❑ Yes ■ No
o Depending on the potential fire risk, applicants may need to receive approval of the South Bend Fire
Department (process facilitated by event coordinator).
o Describe the event's proposed fire -related entertainment:
Will there be any musical entertainment features at the event? ❑ Yes ® No
o If yes, describe the type of music, schedule of sound check/performances, and the names of any artists
performing:
For stage inspections, contact the Department of Homeland Security at 317-232-2222.
If your route crosses over a state road or a bridge please contact the following for permission:
State, IN DOT: County bridges:
Michael Hurt Andy Hayes
219-235-7528, Mhurtl@indot.in.gov 574-235-9626, ahayes@co.st-joseph.in.us
Section E - Food
Are you having food at your event (food vendors, caterers, food trucks, etc.)? ❑ Yes 0 No
If yes, the event coordinator must apply for and receive a St Joseph County Health Department
Temporary Event Permit.
Vendor(s) must also apply for and receive a St. Joseph County Health permit. Health Permits must be
filed with the county 30 days prior to the proposed event. Each vendor must obtain necessary permits to
serve on-site and display these permits at the event.
All applications and guidelines can be found at the St. Joseph County Health Department Food Service
website: sichd.org/food-service.
Please select food sales types: ❑ Food Vendor ❑ Caterer ❑ Food Truck ❑ Other:
If a Food Truck, please list company name:
Describe how food will be cooked and served:
Section F - Alcohol
Will alcohol be served or sold? ❑ Yes R No
If no, please continue to Section G - Contingency and Strategic Planning
If yes:
The applicant must apply for and receive a temporary liquor license from the Alcohol & Tobacco
Commission. Indiana ATC forms are located at in.gov/atc/2409.htm. (Temporary Permits are near the
bottom of the form list.) Forms must be filed with the district ATC office five (5) days prior to the
requested event date.
o Application cannot be processed without a copy of this license.
A refundable $400.00 deposit paid by card or check (made to City of South Bend) must be submitted
with application.
c Application cannot be processed without deposit. Deposit will be returned upon inspection of
event area by the Board of Public Works.
o Events with have alcohol sales must provide security. If your event will be hiring a security company,
please provide its contact information in sub -section (a) below. Otherwise, please list the names, phone
numbers, and qualifications (e.g. off-duty police officer, professional security guard, or event applicant) of
three (3) security guards in the fields provided in sub -section (b).
(a)
Company Name: ----_—__ Contact Name: ________
Contact Phone: Email:
City/State/ZIP: --------
(b)
Name: Contact Phone:
Name: ----- ---_— -------------------------- ---- Contact Phone:
Qualifications: __----------------- --------- —
Name: _______— —--- ___---- ---------- Contact
Qualifications: ----------- ------------------------------
Section G - Contingency and Strategic Planning
For each of the following, please provide detailed descriptions. If you run out of space, attach a response to this
application submission.
Emergency Safety Plan - This plan should include, but is not limited to:
o The number of Indiana Law Enforcement Academy certified officers, fire, and emergency
medical personnel, and the need to use any of the City's public safety or emergency response
services.
o If hiring a security service, provide contact information and the number of hired event personnel.
o Proposed internal communications systems and public address systems.
The unit will provide a qualified combat lifesaver with a combat lifesaver bag on hand that will
ride in the centers GSA vehicle. This vehicle will also carry water to ensure participants are
hydrated thorughout the event.
• Proposed Cleanup Plan - This plan should include, but is not limited to:
o Measures in place to collect and remove trash, litter and recyclables.
No cleanup will be required as the only trash from this ruck march will be water bottles that will
be collected as needed by the trail vehicle of the 428th MP CO.
• Inclement Weather Plan - This plan should include, but is not limited to:
o Safety measures that will be taken in the event of a tornado warning, tornado watch,
thunderstorm, and extreme temperatures.
The 428th organizing members will monitor the weather prior to the event and will
cancel/postpone if the weather creates a threat to the safety of the participants.
• Proposed Lost and Found Plan - This plan should include, but is not limited to:
o A description of the use of signage, announcements on public address systems or pre -event
handouts.
V/1-1
Section H - Site Plan / Route Mao
For parades, races and other processional events:
Are you selecting one of South Bend Police Department's (SBPD) pre -approved race routes? ❑ Yes ® No
You must select from SBPD's pre -approved race routes (see links on application site) or provide sufficient
evidence of event participation if the applicant is proposing a different route through South Bend.
If your event will not be using a pre -approved race route, the proposed event map should include a route plan
clearly identifying the timing and locations of proposed street closures, and the direction of parade
movement.
If your event will not be using a pre -approved race route, please explain
The organizing members of the 428th MP CO and 415th CA BN mapped out a specific route
that starts at the 428th MP CO at the Maple Lane Reserve Center on Rose St. and ends at
the same location that equals 22k. We chose main roads and kept the route as clear and
direct as possible. Map of the desired route is attached.
Site Plan / Route Map - For All Events:
Provide an attached map with the geographic locations of all event items listed below.
• Outline of entire event venue including the names of all affected streets and areas.
• Clear markings for street closures and a schedule for each.
• Location of fencing, barriers, and/or barricades. Indicate any removable fencing and exit locations for
emergency purposes.
• Location of all stages, platforms, bleachers, grandstands, tents, booths, cooking areas, vehicles, trailers,
and other temporary structures. Applicants should also clearly mark locations of food and alcohol
serving or sales, if applicable.
• The location(s) and number of all portable toilets and wash stations.
• The location(s) and number of all trash and recycling containers, including dumpsters.
• The location of generators or any source of electricity.
• Traffic plan and map, including proposed loading/drop off areas, barricades, secured areas, vehicle and
bicycle parking areas, and considerations for TRANSPO bus route changes.
Section I - Mitigation of Imoad
If you are using and/or closing public sidewalks or streets, you are required to notify area business owners and
residents. You must:
o Present your event concept to the surrounding stakeholders (residents, businesses, and neighborhood
groups) that represent the venue area.
Attach a copy of the brochure or door hanger distributed to all affected residents/businesses/neighborhood
groups describing the event purpose, date and time.
Section J - Insurance
A Certificate of Insurance (copy) confirming the existence of a liability policy (General Liability and Automobile
Liability) of not less than $700,000 per occurrence and $1,000,000 aggregate, which specifically names the City
of South Bend, IN as an additionally insured for the event must be submitted. Copy of Certificate of Insurance
must be submitted two (2) weeks prior to the date of the event.
Section K - Indemnity & Hold Harmless Agreement
City of South Bend Special Events Committee
Indemnity & Hold Harmless Agreement
Date: 04/27/2021-- Event Date: 06/26/2001
Event Name: 3rd Annual Suicide Awareness Ruck March "22 --
--------------------------------------------------------- -
------------
Organization: 428th Military Police Company —
E. Kovatch
Applicant (Contact) Name: SFC Joseph
Applicant (Contact) Phone: 719-366-0488 Alt. Phone: 574-274-1197
Email: joseph.e.kovatch.civ@mail.mil
Address: 2402 E. Rose St.
City/State/ZIP: South Bend, IN 46635
Event Location (Please describe):
Starts at the Maple Lane Reserve Center on Rose St. and will end at the same location
(map of planned route included)
Length of Event (Dates/Times): 06/26/2021 from 0700_1300
Insurance Amount: This event is insured for no less than $700,000 per occurrence and $1,000,000 in aggregate,
and the certificate of insurance includes a rider naming City of South Bend, Special Events Committee, and Board
of Public Works as additionally insured for the event.
Organization Name: __--_----_ —_—_ _ _ 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, Indiana, may suffer or incur as a result of any claims
or actions which may be made against the City, its agents, employees, or subdivisions by any person, including a
participant in the activity, arising out of the approval of this request by the Civil City of South Bend, Indiana,
through the Board of Public Works, to close a portion of the public right-of-way for the event described above,
or for any harm or damage alleged to have occurred because of the holding of the special event The
undersigned certifies that he/she is authorized to bind the APPLICANT to these terms.
Signed on this Date: 04/27/2021
KOVATCH.JOSEPH.EDWARD.1085110027 Datea2029p427y1KO9�-04'0SEPH.EDWARD.1085110027
Authorized Organizer Signature
SFC Joseph E. Kovatch
Printed Name and Title
Section L - Permit & Aareement
1. Pursuant to Local Ordinance No. 10628-18, there is a $50.00 non-refundable fee for Tier II and III event
applications filed 60 or greater days in advance of the event, or a $100 non-refundable expedited fee for
applications filed between 30 and 59 days in advance of the event.
2. The APPLICANT must comply with all terms and conditions of this Permit and Agreement.
3. The APPLICANT must obtain signatures from and/or make 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, time and contact information must be included with the
attachments to this application. The applicant is responsible for providing affected residents and
business owners with transportation to their property.
4. The APPLICANT shall reimburse the Board for the actual cost to the City for the event, if deemed
necessary.
5. Notification of approval/denial of this request will be issued by return of this form, upon signed
authorization by the Special Events Committee.
6. The APPLICANT shall provide to the Board a Certificate of Insurance showing a liability policy in full
force and effect with limits of $700,000.00 per occurrence and $1,000,000.00 aggregate and the City of
South Bend, Special Events Committee, and Board of Public Works listed as an additional named insured
for this event.
7. 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.
8. 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.
9. 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).
10. 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 Bend Police
Department.
I have read the Application and the Permit and Agreement for this Special Event and I affirm the truth of
the information provided by me to the best of my knowledge. I understand and agree to the above rules
and regulations, and any applicable state and federal laws. I also understand that this application may be
denied based on any false or incomplete information.
Date: 04/27/2021
KOVATCH.JOSEPH.EDWARD.1085110027 oalita1202gmdbyKOV0AQT8CHH..JOOSEPH.EDWARD.1085110027
Applicant Signature: ------------ -------------------------1 04.27=------------------------
Printed Name: SFC Joseph E. KovatCh
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START: 2402 E. Rose St. (Maple Lane Reserve Center) - Go North on Maple Lane to Roosevelt St. 2000 n'
- Go West on Roosevelt St. to Ironwood Dr.
- Go South on Ironwood Dr. to Jefferson Blvd.
- Go West on Jefferson Blvd to N. Eddy St.
- Go South on Eddy St. and continue around the curve over the bridge, continue to S. Michigan St.
- Go North on S. Michigan St. to Western Ave.
- Go West on Western Ave to Chapin St.
- Go North on Chapin St. to Lincoln Way W.
- Go East on Lincoln Way W., merge onto W LaSalle Ave to Michigan St.
- Go North on Michigan St. to Angela Blvd
- Go East on Angela Blvd to S.R. 23
- Go NorthEast on S.R. 23 to Ironwood and then South to Roosevelt and finish back at Maple
Lane Reserve Center