HomeMy WebLinkAboutSpecial Event - Angle of Hope Memorial Ride - August 19APPLICATION FOR USE OF
PUBLIC RIGHT-OF-WAY FOR EVENT
The following special event has been approved by the Special Events Committee.
Submitted by: Denise Miller
Event name: Angel of Hope Memorial Ride
Event Date: August 19 2023
Street Closure: Pinhook Park on Riverside to Cleveland -Brief interruption
Closure Times: 9:00 am-12:00
Sidewalk Closure: ❑ Yes ❑■ No
Comments: 22nd annual memorial benefit with all proceeds going to the
Angel of Hope Memorial Garden located in Pinhook Park.
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
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Elizabeth A. Maradik, President
Gary A. Gilot, Member
Murray L. Miller, Member
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Joseph R. Molnar, Vice President
Jordan V. Gathers, Member
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Attest: Theresa M. Heffner, Clerk
Date: March 28, 2023
1
02/20/2023
City of South Bend Special Event Application
Motorcycle Ride
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`=- $50 application fee if filed 60 days or greater (up to 360 days) in advance of event
Review the Instructions on the Special Events page before completing the application. City and Regional
Motorcycle Event applications must be submitted more than 60 days In advance of the event date or the
application will not be accepted.
Section A - Applicant Information
Date of Application:__%�% -- Organization Name: ri7E�AG�QiDiaNa
Applicant (Contact) Name: C.J2lkne l —
Applicant (Contact) Phone: _.J 7r/_2oR-,,2 Y 99—_— Contact Email: w_X)tlyCLAu�e�S °r' 7 7
Address:— 1._yy.-8µ l --_ City/State/ZIP:—/;/"a
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 evert.
Organization Name:
Contact Phone:
Address:
Contact Name:
Contact Email:
City/State/ZIP:
Section B - Event Information
Event Name: �e.] Cx N � ��2, - Event Type: Motorcycle
Event Classification: T 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.)
Date of Event Setup [mm/dd/ri]: _�� Time:-_-_�i✓1---__-_-_
Begin Date of Event [mm/dd/yy]: ��Vz 20,23 -Time:
End Date of Event [mm/dd/ri]: Q� /%/ 7 C�.23 Time: __- f Z__---_------
Event Cleanup Completion [mm/dd/yy]: Oz3-Time:___----
Total anticipated attendance: --_y,,
The proposed event will require the closing of: ❑ Streets ❑ Sidewalks
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Is the event ticketed or include fees? OrYes ❑ No If yes. list fees and fee groups below.
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Does the event have any partnered sponsorships? ❑ Yes P( 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? g Yes ❑ No
If yes, provide the date, location, and attendance of past special events and/or future planned events in the
seres SAME Loca� a.t AS ?AST ;a2Y,97AK�S
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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 Citys 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.
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Proposed Cleanup Plan - This plan should include, but is not limited to:
o Measures in place to collect and remove trash, litter and recydables.
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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 waming, tornado watch,
thunderstorm, and extreme temperatures.
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Section H - Site Plan / Route Map
Site Plan / Route Map • For N Events;
Provide an a'tached map Mid, the geographic locations of all event items listed below.
• Ou-Jne of entire event venue including the names of all affected streets and areas
• Clear mart ngs for street dosures and a schedule for each
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Section I - Mitigation of Impact
If you are using and for closing public sidewalks or streets. you are required to notify area business owners and
residerts. You must
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) - 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
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Section K Indemnity & Hold Harmless Agreement
City of South Bend Special Events Committee
Indemnity & Hold Harmless Agreement
Date: —Fe-,6 D�.ZOZ3 Event Date:
Event Name:
Organization:___
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Applicant (Contact) Name: —_------------
Applicant (Contact) Phone: _5--7`i:Z08 ,1H99—_ — Aft. Phone: _
Email:
Address:
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Event Location (Please describe):
Length of Event (Dates/Times):
City/State/ZIP:S%+iv�i3�lta�l,v�_y6SY�/
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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: , •/ - - ND rAa ____ 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 terns.
Signed on this Date: t
Authorized Organizer Signature
Printed Name and Title
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Section L - Permit & Agreement
I. Pursuant to Local Ordinance No. 10628-18, there is a $50.00 non-refundable fee for motorcycle rides
applications filed 60 or greater 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.
B. Barricades will be delivered and picked up at the event location. The APPLICANT is responsible forseeing
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 o.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
audlbie 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 appfication
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:—� ------
Applicant Signature:
Printed Name: �a%/ e�aPelscr+___---__
SPECIAL EVENTS COMMITTEE APPROVAL
�{ PresidentyJ Member Me
A'1���[9f' b-41_ 6ty-4s'c c (l5 6 i t io l)--
Member Member Date
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SPECIAL EVENT SIGNATURE FORM
Prior to the Commissioners approval of die (cvent) on
(day & ate) your request needs to be approved by the appropriate
departments affected by the designated route.
Emergency Management— 125 S. Lafayette Blvd.. South Bend, IN 4661)I
Ph. t9t4) 235-9378 Email. a kirsitogsicindiana_com
I have !mcn contacted regarding this event and give my approval of the event as stated.
N1 Joseph Count- � '•e-+1; - I i f! L4:h-np 'Cl , South Bend, IN 46628
(574)7.44-6140 (,- ; t'
I have been contacted tr i :"^v A of the event as stated.
Bill Redman, County finer.
Date
. St. Joseph Count)- Engtn. Lyg —1_' if! Jeferson Blvd Run. 732, South Bend, IN 46601
Ph. (574) 235-7800 Email. o, o, t.., in
I have been contacted regarding this event and give m) approval of Jtc event as stated.
Skv IC Medors P.L. County Engineer
Date
* South Bend Dept. of Public Works — 227 W. Jefferson Blvd., South Bend, IN 46601
Ph. (574) 235-9251 Fax. (574) 235.9171
I have been contacted regarding this event and give my approval of the event as stated.
Kara M. Boyles, Ph.D., P.E., City Engineer
Date
* Indiana Dept. of Transportation —12209 N. 1200 W., Montice!(o, IN 47960
Ph. (219) 851-1426 Fax. (219) 325-7516 3I5EcfT doyO 3o I a 4 r„d6T'tAf EfdJ
1 have been contacted regarding this event and give my approval of the event as staled.
Mike Hurt, Plymouth District
Date
* Mishawaka Engineering Dept. — 600 E. 31 St., Mishawaka, IN 46544
Ph. (574) 258-1619 Fax. (574) 258-1776
1 have been contacted regarding this event and give my approval of the event as stated.
Chris Jamrose, P.E., Mishawaka Engineer Date
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0�& C �'V'1ZPG O,
MEMORIAL GARDEN
Winter/Spring 2023
On Saturday, August 19, 2023, The Pack of Indiana will be hosting the 22Mt Annual
Angcl of Hope Memorial Bcnelit and Ride. All proceeds from this benefit go directly to
the Angel of I lope Menuxial Gardcn located at Pinhook Parkin South Bend, Indiana.
The Angelo I'I lope Garden serves as a peaceful site for local families to remember and
help heal after the loss of a child. It is a non-profit organisation that relics entirely on
donations from the community.
The motorcycle ride begins at Pinhook Park after a brief ceremony at the Angel of
Hope Garden and is police escorted. The ride is followed by a benefit with live
music and food and is held at Chain-O-Lakes Conservation Club.
We would be grateful to have your support for this benefit and ride in 2023. We arc
offering a variety of sponsorships including T-shirt sponsorships. Please review the
enclosed Donation Sheet to choose your level of commitment. A self-addressed
envelope is also enclosed for your convenience.
Thank you for partnering with us for the 2023 Angel of Hope Benefit and
Ride!
Compassionately,
Debbie Kamm
Angcl of Hope Board President
(574) 229-2688 anaclofhoncmichianaCdvahoo.com
Bill Kopriva, President
The Pack of Indiana (574)
993-2733
theackofindiananu yahoo
.com
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"THE PACK OF INDIANA", South Bend Chapter, is a family -oriented,
Cruiser Motorcycle Enthusiast Club. All brands of cruisers are welcome. All
Pack members wear patches as shown above. Charity events, poker runs, and
dinner rides are organized to get the most out of our riding experiences.
Our biggest goal is to promote (within our club and fellow riders) volunteer
opportunities to make a strong, positive and beneficial impact within the
local community while doing what we love to do best — RIDE!!
We, "THE PACK", are reaching out into this community as well as
surrounding areas, to help a cause that is so dear to our hearts. The Angel of
Hope Memorial Garden brings comfort to those who have lost someone so
precious to them. With help from the community, we would like to keep this
gathering place of peaceful refuge and reflection available for all families
who may need it.
This year marks the 22°d Anniversary for the Ride and Benefit, and we thank
everyone who has been a part of making this event so successful!
For more information, please contact Bill Kopriva at (574) 993-2733 or
email theoackofindianana,vahoo.com
22nd Annual Angel of Hope Memorial Garden
Benefit & Ride Saturday, August 19, 2023
Pinhook Park — Angel of Hope Memorial Garden
2801 Riverside Dr - South Bend, IN
Ride Registration from 9:00 AM-11:30 AM
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Ceremony at 11:00 AM
60mile ride leaves at 12:00 NOON
$15.00 DRIVER
$15.00 RIDER
T-shirt &pin while supplies last
Benefit with food, entertainment, door prizes, & more!
1:00 P.M. —??
Chain-O-Lakes Conservation Club
26230 Southport Drive
South Bend, IN
Open to the public, all ages welcome. All groups and organizations are encouraged
to participate in this remembrance ride in support of all who have lost children.
(12 & under free)
Sponsored by
I 40or-
All proceeds go to The Angel of Hope Memorial Garden
The Angel of Hope Memorial Garden is a peaceful place of reflection and remembrance for all who have lost a
child of any age. Engraved memorial bricks make up the Path of Lost Dreams leading up to the 4 ft bronze
winged angel statue.
www.an¢elofhooemichiana.or¢ theoackofmdiana(a).vahoo.com
For more information call:
1�1 Bill Kopriva (574) 993-2733 Y
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DONATION SHEET
On Saturday, August 19, 2023, The Pack will be hosting the 22nd Annual Angel of
Hope
Memorial Benefit and Ride. All proceeds from the benefit go directly to the Memorial Garden.
We would be honored to have your support for this year's benefit. Please complete the
information listed below regarding your desired level of commitment. This completed
donation sheet with payment can be mailed in the enclosed envelope OR you may contact
The Pack member listed below.
Thank you for partnering with us for the 2023 Angel of Hope Benefit and Ride.
Respectfully, The Pack of Indiana
Bill Kopriva, Pack President (574) 993-2733
Please make all checks payable to The Pack of Indiana.
T-Shirt Sponsor (Business Card ad) — $150.00 Size for Sponsor
Monetary Donations $
(item)
Door Prize Donation
Door Prize Donations (item donated)
Other Donation
Please respond for T-Shirt sponsorships by July 1.2023. Each T-shirt sponsor will receive one shirt
Additional shirts for sponsors are $10 each
Company Name:
Company Contact & Phone:
Company Address:
Name of Pack Member Contact:
www anaelofhopemichiana oro
the packofindiana@yahoo tom
J
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ANGEL OF HOPE MEMORIAL EVENT AND RIDE
SATURDAY AUGUST 19th. 2023
THE PACK OF INDIANA. For several years have Organized this Event to raise funds in support of the
Angel Of Hope Garden Located in Pinhook Park SOUTHBEND INDIANA.
We as a group have worked in direct contact with all local Law Enforcement SouthBend, St.Joseph
County.
We also have a safety action in place during the course of the Ride. We have several Riders with in
the ride that have a Radio to communicate with each other in case of a emergency along with 3
members with in the ride carrying first aid bags located in the begin ning,middle, and End of the Ride In
order to keep all whom attend this event Safe.
Thank you
Wally Anderson
Name ......Wally Anderson
Cell #..... 574-208-2499
Email ..... wall yar)derson774@Gmail.com
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Departure from Pinhook Park at 12:00 PM EST.
Day/Date Of Event Saturday August 19th, 2023
Pinhook Park on Riverside Dr. to Cleveland Rd.
West on Cleveland Rd. To Bendix Ave. turn Left (South)
South on Bendix Ave to Nimitz PKWY. turn Right (West)
West on Nimitz PKWY. to Olive Rd. turn Left (South)
South on Olive Rd. To Lincolnway / US 20 turn Left (East)
East on Lincolinway /US 20 merging on to US.31 Southbound
US.31 to SR.23 exiting right (Southwest) to Crumstown Hwy
Turn Right (West) onto Crumstown Hwy
(West) on Crumstown Hwy to Pear Rd. Turn left on Pear Rd. (North) on
Pear Rd. To SR 2 turn left on to SR 2. (West) on SR 2 to Timothy Rd.
(North) on Timothy Rd. To US 20 turn right (East) on US 20
Following East on US 20 to Quince Rd turn Right (South)
(South) on Quince Rd. to Southport Dr. turn Left (East)
Eastbound on Southport Dr. to Chain-O-Lakes.
Any Ride Question contact:
Name: Wally Anderson OR Name: Bill Kopriva
Cell #:574-208-2499 Cell #: 574-993-2733
Email:wallyanderson774@gmail.com
We also understand that if Weather or Traffic conditions accrue that Police Departments escorting this
event may change The Route for Safety Reasons the day of Event.
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