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HomeMy WebLinkAboutSpecial Event - Clark Run 5 K - October 21t rti J {- APPLICATION FOR USE OF - y PUBLIC RIGHT-OF-WAY FOR EVENT The following special event has been approved by the Special Events Committee. 180 Submitted by: Denise Miller Event name: Clark Run 5K Event Date: October 212023 Street Closure: Donmoyer to Marine St, Marine to Altgeld, Altgeld to Woodmont Woodmont to Rid edale Rid edale to Miami finish at Stanley Clark. Closure Times: 10:00 am-11:00 am Sidewalk Closure: Comments: ❑ Yes ❑■ No IOth annual 5K run and 3.5K walk to benefit Stanley Clark School. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member Murray L. Miller, Member Fr m Joseph R. Molnar, Vice President Jordan V. Gathers, Member Attest: Theresa M. Heffner, Clerk Date: March 28, 2023 1 03/06/2023 4 THE; City of South Bend Special Event Application %d` t 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 Please Bring Completed Application and Payment to: Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN 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. Date of Application: 03/06/2023 Section A - Applicant Information Organization Name: Stanley Clark School Applicant (Contact) Name: Tom Carter Applicant (Contact) Phone: 574-286-5594 Contact Email: scarter829@gmail.com Address: 3123 Miami Street City/State/ZIP: South Bend, IN 46614x 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: Event Name: Clark Run 5K Contact Name: Contact Email: City/State/ZIP: Section B - Event Information Event Type: (Festival, Race, Parade, Other): Race 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.) This is the loth Annual Clark Run. It's a 5K Run and a 3.5K Walk. Both events start at 10:00 AM. We will be returning to the original course route. Date of Event Setup [mm/dd/yy]: 10/21/2023 Time: 8:30 AM (Registration) Begin Date of Event [mm/dd/yy]: 10/21/2023 Time: 10:00 AM (Run/Walk Starts) End Date of Event [mm/dd/yy]: 10/21/2023 Time: 11:00 AM (Race Completes) Event Cleanup Completion [mm/dd/yy]: 10/21/2023 Time: 12:00 PM (Event Closes) Total anticipated attendance: 200-300 The proposed event will require the closing of: ❑x Streets ❑ Sidewalks Is the event ticketed or include fees? © Yes ❑ No If yes, list fees and fee groups below: There is an online signup with a registration fee. Does the event have any partnered sponsorships? ❑X Yes ❑ No If yes, list the number of sponsors at each level of partnered sponsorship: Sponsor list will finalize closer to the date of event and can be provided. Is this a returning special event or part of a series of special events? ❑x Yes ❑ No If yes, provide the date, location, and attendance of past special events and/or future planned events in the series: This is our loth year putting on this event at the Stanley Clark School. If your event is a parade, race, or other processional -type event, please complete Section C. Ot herwise, 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? Describe any sound equipment that will be used in the parade/race: 0-100 We will have a DJ on campus with sound equipment. Nothing on the course. Does the event have participant categories? For example, a run that has different race divisions or a parade with separate walking/marching groups. 0 Yes ❑ No If yes, list categories and anticipated participants per category. 5K Run (125 Participants estimated) 3.5K Walk (75 Participants estimated) 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-uo. and Loeistics 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: We will have a DJ for music/announcements, a balloon artist and a timing company to time the race. They will all be located on campus. Will you be staking any tents, inflatables, portable restrooms or any other anchorings? ❑ Yes x❑ No o 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 ❑X 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? x❑ Yes ❑ No If yes, describe the type of music, schedule of sound check/performances, and the names of any artists performing: We will have a DJ located on campus. 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, INDOT: County bridges: Michael Hurt Andy Hayes 219-235-7528, Mhurtl@indot.in.gov 574-235-9626, ahayes@co.st-joseph.in.us Are you having food at your event (food vendors, caterers, food trucks, etc.)? ❑ Yes 0 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 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 ® No If no, please continue to Section G - Contingency and Strategic Planning If yes: o 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. 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. 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 Nam( Contact Phone: Address: (b) Contact Name: Email: City/State/ZIP: Name: Contact Phone: Name: Qualifications: Name: Qualifications: Contact Phone: Contact Phone: 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. We plan to utilize the same number of officers for this event as in previous years. We also require an officer to escort the lead runner. • Proposed Cleanup Plan - This plan should include, but is not limited to: o Measures in place to collect and remove trash, litter and recyclables. Volunteers will be available to clean up during and after the event. This will include a water stop on the course as well. • Inclement Weather Plan -This plan should include, but is not limited to: o Safety measures that will betaken in the event of a tornado warning, tornado watch, thunderstorm, and extreme temperatures. Event will be canceled should we experience inclement weather. 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. Lost and found will be located on Stanley Clark's campus. Section H - Site Plan / Route Map For parades, races and other processional events: Are you selecting one of South Bend Police Department's (SBPD) pre -approved race routes? ❑ Yes ❑x 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 We intend to use the same race route as previous years. Map is attached below. 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 schedulefor 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. 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 al I 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. Date: 03/06/2023 Event Name: Section K - Indemnity & Hold Harmless Agreement City of South Bend Special Events Committee Indemnity & Hold Harmless Agreement Event Date: 10/21/2023 Organization: Stanley Clark School Applicant (Contact) Name: Applicant (Contact) Phone: 574-286-5594 Email: scarter829@gmail.com Phone: Address: 3123 Miami Street City/State/ZIP: South Bend, IN, 46614 Event Location (Please describe): Stanley Clark School Length of Event (Dateslrimes): 8:30 AM (Registration), 10:00 AM (Procession), 12:00 PM (Closure) 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: Stanley Clark School 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: 03/06/2023 //LOifLllb C.�/� Authorized Organizer Signature Tom Carter - Race Director Printed Name and Title 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: 03/06/2023 Applicant Signature: I / Bht¢� (?44t it, Printed Name: Tom Carter - Race Director SPECIAL EVENTS COMMITTEE APPROVAL % I President Member M I Member Member Date St T V L C � c y 3 N W an y Js" J a Woodmont Dr �7 4sy east Dr Southeast Dr a° 0 cg° Hilltop Dr G�¢e of r Kpt J� yo Caro\\oe St C c h m U ey M i ode "' M O y = 'u . 'o H U 3 e5 eP v NI s St yo 0 Y eW r ne m > N > Q Q N N o A v o V > ` rn E Y Y O G W W W W W Miami St i i i i r N - a Q a > � O 9 m Dale Ave WoodmontI o� H1\\t°Q 4� York Rd W J 17 CO W c C -C O to L N Un N O Y � 7 O J K Q Z K Y Y to V1 M pobinhood Ln c � U 0*1 a 00 Miami A U m Saond R