HomeMy WebLinkAboutSpecial Event - South Bend Housing Authority Job Fair Community Party - July 154yOt 116E
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APPLICATION FOR USE OF
PUBLIC RIGHT-OF-WAY FOR EVENT v . P►,F
The following special events have been approved by the Special Events Committee. 1665
Submitted by: Denise Miller
Event name: South Bend Housing Authority Job Fair/Community Party
Event Date: 7/15/21
Street Closure: Fremont from Marquette to Hamilton
Closure Times: 12:00 om to 6:00
Sidewalk CIosure: ❑ Yes ❑ X No
Comments: Job Fair combined with Bouncy Houses, music, food and social activities
for the community.
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
Elizabeth A. Maradik, President
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Gary A. Gilot, Member
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Jordan V. Gathers, Member
Murray L. Miller, Member
Joseph R. Molnar, Member Attest: Anne Fuchs, Clerk
City of South Bend Special Event Application
lwk
I 6-/ Neighborhood Event ar
$25 application fee if filed 30 days or greater (up to 180 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 30 days in advance of the event date or the application will not
be accepted.
Section A - Applicant Information
Date of Application:
June 23,2021 Organization Name: Housing Authority South Bend
______—__— ------------- —_
Applicant (Contact) Name:Michael - Williams
574-387-1152 mwilliams@sbhaonline.com
Applicant (Contact) Phone: 574-387-11152 Contact Contact Email:
1831 NFremont St. South -Bend -IN 46628
Address:----------- ---------------------City/State/ZIP:------- --
Secondary Contact Name:
Jaqueline Williams
-----------------------------------------------------------------------
Contact Phone: 574-387-0194 Contact Email: jwilliams@sbhaonline.com
---------------- ---- ----- -----
501 -Alonzo
Address: ---------- Watson Dr.
Watson
City/State/ZIP:South---------Bend--------IN----46601 --
Section B - Event Information
Job Fair/Community Party 150-500
Event Name: ___________— Expected Attendance:
Requested Street Closure: Fremont St_ — — —
From (Cross Street):Marquette --------------------------------------------------------------------
Hamilton
To (Cross Street):
-----------------------------------------------
Provide a brief description of the event:
It will be bouncy houses, music, food and social activities
Date of Event setup [mm/dd/yy]: July 15, 2021 1000 am.
- --------- Time: -------------
Begin Date of Event [mm/dd/yy]: July 15, 2021 - 12:00 -- am --------- Time: --------
------------------------
End Date of Event [mm/dd/yy]: July15, 2021 Time: 6:00 -pm. -- -
- - ------------------
Event Cleanup Completion [mm/dd/yy]: July 15, 2021
Time: 9:00 --�----------------------------------- —
Have all residents on the affected block have been notified and invited? 0 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: 4____________________________________________
Number of households represented by signatures on attached sheet:4
Will this event have music (live or other)? M 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: N/A
Contact Phone:
Contact Name:
Email:
Address:-------------------------------------------------- City/State/ZIP:
(b) Independent Security Information
Name: N/A
Qualifications:
Name:
Qualifications:
Name:
Qualifications:
Contact Phone:
Contact Phone:
Contact Phone:
Section D - Food
Will your event have food sales (food vendors, caterers, food trucks, etc.)? ❑ Yes M No
o If yes, the event coordinator must apply for and receive a St Joseph County Health Department
Temporary Event Permit.
o Vendors) 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 sjchd.org/food-service.
Participants of the Event
Please select food types: ElFood Vendor ElCaterer ❑ Food Truck M Other:
If a Food Truck, please list company name(s):
N/A
Please describe how food will be cooked and served:
Food will be cooked on a grill till done then served on paper plates.
Section E - Indemnity & Hold Harmless Agreement
City of South Bend Special Events Committee
Indemnity & Hold Harmless Agreement
Date: 6/23/2021 Event Date: July 15, 2021
-------------------
Event Name: Job Fair/ Community Party
Organization: South Bend Housing Authority__
Applicant (Contact) Name:
Michael Williams
Applicant (Contact) Phone: 574-387=1152
Email: mwilliams@sbhaonline.com
Address: 1831 N. Fremont St.
Event Location (Please describe):
Fremont Park
Alt. Phone:
574-235-9346 ext. 258
City/State/ZIP:
South Bend IN 46628
Length of Event (Dates/Times): JUly 15,2021 12.00 - 6.00 pm_
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:
6/23/2021
Authorized Organizer Signature
Michael Williams Resident Initiative Specialist
Printed Name and Title
Section F - Permit & Aareement
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. Applications filed less than 30 days in advance of the event
date will not be accepted.
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: June 23, 2021
Applicant Signature:
Printed Name: Michael Williams
President
-- I V V _-
Member
SPECIAL EVENTS COMMITTEE APPROVAL
Member
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Member
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Date
6/24/2021 Marquette Blvd & Fremont St - Google Maps
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ATTN: All Residents Living on Fremont St.
Between Marquette and Hamilton street.
There will be a Job Fair/ Community Party at
the Lasalle Landing and Fremont St. Park on
July 15th, 2021 from 12:00 — 6:00 pm. Set up
will begin at 10:00 am. And the Street will be
Blocked off on Fremont St. between Marquette
and Hamilton St. during this event. All
Residents are welcome to come and participate
in this event. If you have any questions please
contact Michael Williams the Resident Service
Coordinator, 574-387-1152.
Neighbor Signature Sheet - Neighborhood Special Event
We have been informed, agree to, and request that the Special Events Committee of the City of South Bend authorize a
block party in the area described as:
from Malde �� to A `
Street Name r�•� Cross Street Cross Street
Date of Event: SSI I �- 2 O r-2-
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CITY OF 58 SPECIAL EVE
731 S LAFAYETTE BLVD
SOUTH BEND, IN +6601
06;2412021 0945:23
MID: NXYWCYXXW401 TID: X9,YJl%800
DEBIT CARD
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Netwok MASTERCARD
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AID! AOCCOCCON2203
ATC: 0025
ARQC: E2C6E66E8DF0EA8E
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Bath 8. is
INVOICE I
Approval Code: 790797
Eno Medad: Chip Read
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SALE AMOUNT $? m
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MICHAEL 3'MLLIAMS
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