HomeMy WebLinkAboutSpecial Event - Concours d'Elegance at Copshaholm -July 10ti J�
APPLICATION FOR USE OF
yl react: y
PUBLIC RIGHT-OF-WAY FOR EVENT
The following special events have been approved by the Special Events Committee. 1865 '
Submitted by: Denise Miller
Event name: Concours d' Elegance at Copshaholm
Event Date: 7/10/21
Street Closure: W Washington from Laurel St to Chapin St
Closure Times: 5:00 am to 6:00 pm
Sidewalk Closure: ❑ Yes ❑ X No
Comments: Vintage car show exhibited in the historic garden around the Oliver
Mansion. The Pass -in -Review will showcase each car as it drives past
bleachers on W Washington St.
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
Murray L. Miller, Member
Attest: Anne Fuchs, Clerk
1
S L,T City of South Bend Special Event Application
Neighborhood Event
$25 application fee if filed 45 days or greater (up to 180 days) in advance of event
$50 expedited application fee if filed 14-44 days in advance of event
Review the Instructions on the Special Events page before completing the application. Neighborhood Special
Event applications must be submitted more than 14 days in advance of the event date or the application will not
be accepted.
Section A - AnDlicant Information
June 9 2021 Studebaker National -Museum
Date of Application: �___ Organization Name: —_
Applicant (Contact) Name:Jo McCo Y
Applicant (Contact) Phone: 235-9714 _ Contact Email: j.mccoy@studebakermuseum.org
Address: 201 Chapin St_ — — city/state/ZIP: South Bend, IN 46601— —
Secondary Contact Name: Patrick Slebonlck, Executive Dir_
- ---------------------------------
Contact Phone:
235-9714 — -----Contact Email: pslebonick@studebakermuseum.org
Address: 201 Chapin St_ -- — _ City/State/ZIP: South Bend, IN 46601 --_
Section B - Event Information
Event Name: Concours d'Elegance at Copshaholm Expected Attendance: 2,000
Requested Street Closure:W. Washington St. _____________
From (Cross Street): Laurel St.
To (Cross Street): Chapin St_-- -- _ _--_
Provide a brief description of the event:
An invitation -only vintage car show, exhibited in the historic gardens around the Oliver Mansion.
The Pass -In -Review will showcase each car, as it drives past the bleachers on W. Washington
between Laurel and Chapin Streets. Tickets will be sold at 3 entry -points, proceeds to benefit the
Studebaker National Museum. This will be the third year we have hosted this event.
Date of Event Setup [mm/dd/yy]: 07/10/2021__________ Time: 5:00am -
Begin Date of Event [mm/dd/yyl: 7/10/2021 _—_ Time: 10_00arn
End Date of Event [mm/dd/yy]: 07/10/2021 ------ --Time: 5_00pm
Event Cleanup Completion [mm/dd/yy]: 07/10/2021 ---Time: 6_00pm—
Have all residents on the affected block have been notified and invited? ®Yes ❑ No
Please attach a copy of the door hanger or letter used to notify residents in addition to signature attachment.
Number of households fronting the proposed street closure: 3_—__—_____
Number of households represented by signatures on attached sheet:
Will this event have music (live or other)? 0 Yes ❑ No
Section C - Alcohol
Will alcohol be served or sold? ❑ Yes ® No
If Yes:
o The applicant must apply for and receive a temporary liquor license from the Alcohol & Tobacco
Commission.
o Application cannot be processed without a copy of this license.
o A refundable $400.00 deposit paid by card or check (made to City of South Bend) must be submitted
with application.
o Application cannot be processed without deposit.
o Deposit will be returned upon inspection of event area by the Board of Public Works.
o The applicant must submit a map or drawing of:
o Fencing around serving area
o Trash receptacles
o Events that will 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) Security Company Information
Company Name:_____________ _ Contact Name:
Contact Phone: Email:
City/State/ZIP:
(b) Independent Security Information
Name: Contact Phone:
Name: Contact Phone:
Qualifications:
Name: Contact Phone:
Qualifications:
Section D - Food
Will your event have food sales (food vendors, caterers, food trucks, etc.)? ® Yes ❑ No
o If yes, the event coordinator must apply for and receive a St Joseph County Health Department
Temporary Event Permit.
o 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.
o All applications and guidelines can be found on the St. Joseph County Health Department Food Service
website at sichd__org/food-service.
Please select food types: ® Food Vendor ❑ Caterer ❑ Food Truck ❑ Other:
If a Food Truck, please list company name(s):
n/a
Please describe how food will be cooked and served:
Woodstock & Grill. Frankie's Tacos. Bonnie Doon's DoonBuggy.
Section E - Indemnity & Hold Harmless Aitreement
City of South Bend Special Events Committee
Indemnity & Hold Harmless Agreement
Date: June 9, 2021 Event Date: July 10, 2021
Event Name: Concours d'Elegance at Copshaholm — ................
-------- -
Organization:
Studebaker -National Museum
---------------------------------------------------------------------------------
Jo McCoy
Applicant (Contact) Name: ------------------ ------------ --------------------------------------
Applicant (Contact) Phone: 235-9714
--- --------
Email: jmccoy@studebakermuseum.org
Address: 201 Chapin
Alt. Phone:
City/State/ZIP: South Bend, IN 46601
Event Location (Please describe):
An invitation -only vintage car show, exhibited in the historic gardens around the Oliver Mansion. The Pass -In -Review
will showcase each car, as it drives past the bleachers on W. Washington between Laurel and Chapin Streets.
Saturday, July from 5am to 5pm
Length of Event (Dates/Times):____10'—___--____—_____—
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 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: 05/19/2021
Jo Ellen McCoy
2021.05.19 13:38:23 -04'00'
Authorized Organizer Signature
Jo Ellen McCoy, Assistant Director of the Studebaker National Museum
Printed Name and Title
Section F - Permit & Agreement
1. Pursuant to Local Ordinance No. 10628-18, there is a $25.00 non-refundable fee for applications filed 30
days or greater in advance of the event date, or a $50 non-refundable expedited fee for applications filed
between 14 and 29 days in advance of the event date.
2. All residents within the affected area must be notified of this event. The APPLICANT must obtain
signatures from at least 10 residents that reside along the closed right-of-way and make an attempt to
notify all other affected residents. APPLICANTS must include a copy of a brochure or letter of invitation
distributed to all affected neighbors describing the event purpose, date, and time.
3. The APPLICANT is responsible, prior to the event, for determining if there are any affected residents that
need assistance accessing their residence. The APPLICANT is responsible for providing said resident(s)
access or transportation to their property.
4. The cones will be delivered to the APPLICANT's address. The APPLICANT assumes full responsibility for
clean-up and assures the City that all cones will be maintained and returned undamaged. The APPLICANT
will be liable for the replacement cost of $50.00 per cone as a result of any missing or damaged cones.
5. Block parties must end by 8:00 p.m.
6. A street will be blocked off from intersection to intersection only. No half -blocks or alleys can be blocked
off.
7. The Special Events Committee reserves the right to deny any block party application based on traffic and
speed limit records. No street may be closed with a speed limit over 30 MPH or considered to be a major
arterial.
8. The Special Events Committee reserves the right to deny any block party application based on information
gathered from the South Bend Police Department or other sources.
9. The APPLICANT agrees to allow residents that live on the above -referenced block access in and out of the
restricted area as needed.
10. The APPLICANT agrees to abide by all terms and conditions of the South Bend Municipal Code and Board
of Public Works' policy adopted in Resolution No. 10628-18 on December, 11, 2018.
11. Notification of approval/denial of this request will be issued by return of this form, upon signed
authorization by the Board of Public Works.
12. The City of South Bend Noise Ordinance 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 stereos, speakers, musical
instruments, 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).
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: 06/9/2021
Ellen McCoy
2021.05.19----
0
Applicant Signature: t�v 2021.05.-- 13--- -04'00'
Printed Name: JO Ellen McCoy
President
Memb r
SPECIAL EVENTS COMMITTEE APPROVAL
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COtCOURS WELEGANCF.
AT VOPSHAHOLM
NOTIFICATION OF SPECIAL EVENT IN YOUR NEIGHBORHOOD
WHAT: Concours d'Elegance at Copshaholm
WHERE: W. Washington Street from Laurel Street to Chapin Street [See attached location map]
DATE(s): Saturday, July 10, 2021
TIME(s): 6am to 4pm
WHO: Studebaker National Museum
CONTACT: The on-site contact during the event is: Patrick Slebonick, cell number (S74) 334-8087
On Saturday, July 10, 2021, the Studebaker National Museum will be hosting a special event at the Oliver
Mansion, called the Concours d'Elegance at Copshaholm. We are thrilled to be guests in your neighborhood
and it's important to us that we communicate clearly with you, the neighbors.
EVENT DESCRIPTION:
• We will leave your neighborhood as we found it: litter will be handled by the Studebaker National
Museum.
• During the event hours, we expect between 1,500 to 2,000 attendees.
• Street will be closed between 6am and 4pm on Saturday, July 10, 2021. Seethe attached map for
specifics.
We will have amplified sound from 8am to 4pm: there will be a public address system and
pre-recorded background music.
We are working closely with the City of South Bend to minimize the impacts of the event. Our goal is to create
an enjoyable and positive experience in your neighborhood.
If you or any of the surrounding residents and businesses have questions or comments about impacts of this
event, please email us at:
� f
Signature
Patrick Slebonick
Studebaker National Museum
201 Chapin St.
South Bend, IN 46601
pslebonick@studebakermuseum.org
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Street Address Date
Do you have any resident(s) who may need ADA transportation assistance? YES �NO
07/11/2012 15:19 FAX 574 235 5522
Internal Revenue Service
District Director
Date;
NOV 2 8 1983
Studebaker Museum, Inc.
227 W. Jefferson
South Bend, IN 46601
Dear Applicant:
STUDEBAKER MUSEUM
11001
Department of the Treasury
Employer Identification Number:
35-1555535
Accounting Period Ending:
December 31
Foundation States Classification-
509(a)(2)
lass cation -509(a)(2)
Advance Ruling Period Ends:
December 31, 1984
Person to Contact:
Donna Carlis:l.e
Contact Telephone Number.
513-684-3578
Case No, 313276024E0
Based on information supplied, and assuming your operations will be as stated
in your application for recognition of exemption, we have determined you are exempt
from Federal income tax under section 501(c)(3) of the Internal Rev,BPuo Code.
Because you are a newly created organization, we are not now malting a final
determination of your foundation status under section 509(a) of the Cade. However,
we have determined that you can reasonably be expected to be a publicly supported
organization described in section 509(a)(2).
Accordingly, you will be treated as a publicly supported organization, and not
as a private foundation, during an advance ruling period. This advance ruling period
begins on the date of your inception and ends on the date shown abo'+e.
Within 90 days after the end of your advance ruling period, you must submit to
us information needed to determine whether you have met the requirements of the
applicable support test during the advance ruling period. If you establish that you
have been a publicly supported organization, you will be classified as a section
509(a)(1) or 509(a)(2) organization as long as you continue to meet the requirements
of the applicable support test. It you do not meet the public support requirements
during the advance ruling period, you will be classified as a private .foundation for
future periods. Also, if you are classified as a private foundation, you will be
treated as a private foundation from the date of your inception for purposes of
sections 507(d) and 4940.
Grantors and donors may rely on the determination that you are not a private
foundation until 90 days after the end of your advance ruling period. :If you submit
the required information within the 90 days, grantors and donors may continue to
rely on the advance determination until the Service makes a final determination of
your foundation status. However, if notice that you will no longer be treated as a
section 509(a)(2) organization is published in the Internal Revenue Bulletin,
grantors and donors may not rely on this determination after the date of such
publication. Also, a grantor or donor may not rely on this determination if he or
she was in part responsible for, or was aware of, the act or failure -to act that
resulted in your loss of section 509(a)(2) status, or acquired knowledge that
the Internal Revenue Service had given notice that you would be removed from
classification as a section 509(a)(2) organization.
P.O. Boz 2508, Cincinnati, Ohio 45201 tov.rl
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Lotler 1045(00) (6-77)
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ACOROJ OF LIABILITY INSURANCE
DATE (MMIDD'YYYY)
11CERTIFICATE
06/09/2021
THIS CERTIFICATE IS ISSUED ASA 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 rights to the certificate holder in lieu of such endomement(s).
PRODUCER
CONTACT CO FeCher
NAME: Cory
Gibson InsuranceAgency, Inc.
PNONE (800) 814-2122 FAX (800) 836-2122
A/C No E xt: AIC No:
202 S Michigan St, Suite 1400
EMAIL cfecher@thegibsonedge.Cam
EACH OCCURRENCE $ 1,000,000
ADDRESS:
INSUMP481 AFFORDING COVERAGE NAICN
CLAIMS -MADE 19 OCCUR
South Bend IN 46601
INSURERA: Mount Vernon Fire Ins Co 26522
INSURED
INSURER B
Studebaker National Museum
INSURER C:
201 Chapin St
INSURER D:
INSURER E:
South Bend IN 46601
INSURERF:
COVERAGES CERTIFICATE NUMBER: 07/10/21-07/12/21 EVENT REVISION NIIMRFR
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
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CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
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TYPE OF INSURANCE
POLICY NUMBER
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The History Museum
808 W Washington St
South Bend
IN 46601
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Cal 1 QRR.9n15 ACr1Rn Cr1RPrIRATIr1N All .inhre ----A
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