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HomeMy WebLinkAboutSpecial Event - Fallen Officer Scholarship Ride - August 26til1L FH BF APPLICATION FOR USE OF o PUBLIC RIGHT-OF-WAY FOR EVENT S_ The following special event has been approved by the Special Events Committee. 1865. " Submitted by: Denise Miller Event name: Fallen Officer Scholarship Ride Event Date: August 26 2023 Street Closure: Brief interruptions at intersections along pre -approved route. Closure Times: 12:00 pm to 11:00 pm Sidewalk Closure: ❑ Yes ❑■ No • Comments: scholarship fundraiser to provide graduating high school seniors a scholarship in honor of the Scott Lee Severns Memorial Scholarship Fund and fallen SBPD officers. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS vl�a z��_ 7Tt Elizabeth A. Maradik, President Gary A. Gilot, Member Joseph R. Molnar, Vice President Jordan V. Gathers, Member 1 ��vv_ Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk 0 Date: May 23, 2023 1 "E TH,iJ 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 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. mg •1_ .i r • u. •� Date of Application: 05/10/2023 Applicant (Contact) Name: Dominick Rodriquez Organization Name: FOP #36 Applicant (Contact) Phone: 574-310-0495 Contact Email: drodriquez@southbendin.gov Address: 701 W. Sample St City/State/ZIP: South Bend, IN, 46601 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: Fallen Officer Scholarship Ride Event Type: (Festival, Race, Parade, Other): Motorcycle Ride 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 a scholarship fund raiser to provide graduating high school seniors a scholarship in honor of the Scott Lee Severns Memorial Scholarship Fund and our fallen SBPD officers. Registration at SBPD from noon to 1345 hrs. ride starts at 1400 making two stops. The first stop is the City Cemetery to honor a fallen officer and the second stop is out at the Southlawn Cemetery prior to ending up at the FOP 36 lodge. 08/26I2023 1200 hours Date of Event Setup [mm/dd/yy): Time: Begin Date of Event [mm/dd/yy): 08/26/202 3 Time: 1200hours End Date of Event [mm/dd/yy): 08/26/2023 Time: 1700 hours Event Cleanup Completion [mm/dd/yy): 08/26/2023 Time: 2200 hours • Total anticipated attendance: 150 The proposed event will require the closing of: ® Streets 0 Sidewalks Is the event ticketed or include fees? ® Yes ❑ No If yes, list fees and fee groups below: • - $20 for a rider & $10 for a passenger Does the event have any partnered sponsorships? ® Yes ❑ No If yes, list the number of sponsors at each level of partnered sponsorship: No sponsors currently committed. Is this a returning special event or part of a series of special events? ® Yes ❑ No If yes, provide the date, location, and attendance of past special events and/or future planned events in the series: - The event starts at the SBPD and typically stops at a cemetery of the chosen Fallen Officer to honor their sacrifice. Ultimately the event ends at the FOP 36 grounds. The ride has taken place for approximately the last 9 years. • 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? None Describe any sound equipment that will be used in the parade/race: em1 Cl • 0 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. -N/A 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: -N/A Section D - Eauioment. Set -um and Lo¢istics Are you hiring a company to provide entertainment, games or inflatables? ❑ Yes ❑ No c 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 c Depending on the potential fire risk, applicants may need to receive approval of the South Bend Fire Department (process facilitated by event coordinator). c 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 thefollowingfor permission: State, IN DOT: County bridges: Michael Hurt Andy Hayes 219-235-7528, Mhurt1@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 m No If yes, the event coordinator must apply for and receive a St Joseph County Health Department Temporary Event Permit. 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. 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.jzov/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. 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 Contact P (b) Name: Name: Qualifications: Contact Name: Email: City/State/ZIP: Contact Phone: Contact Phone: Contact Phone: 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. Police motorcycle escort determined by the route and Sgt. Brad Rohrscheib • Proposed Cleanup Plan - This plan should include, but is not limited to: o Measures in place to collect and remove trash, litter and recyclables. -N/A • 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. -N/A • Proposed Lost and Found Plan - This plan should include, but is not limited to: o Adescription of the use of signage, announcements on public address systems or pre -event handouts. -N/A 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 - Currently working with Sgt. Brad Rohrscheib on the event route. Once the route is complete Sgt. Rohrscheib will provide the Special Event Committee with the route. 0 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. 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. r1 U Section K - Indemnity & Hold Harmless Agreement • City of South Bend Special Events Committee Indemnity & Hold Harmless Agreement Date: 05/10/2023 Event Date: 08/26/2023 Event Name: Fallen Officer Scholarship Ride Oreani7AHnn. Fraternal Order Of Police Lodge #36 Applicant (Contact) Name: Dominick Rodriquez Applicant (Contact) Phone: 574-310-0495 Finail• drodriquez@southbendin.gov Address: 701 W. Sample F11MVTM City/State/ZIP: South Bend, IN, 46601 Event Location (Please describe): - South Bend Police Department to the South Bend City Cemetery, Southlawn Cemetery, ending at FOP lodge 36. Length of Event (Dates/Times): One day event on 08/03/2019 from 1200-1700 hr • 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: Fraternal Order of Police Lodge #36 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, arisingout of the approval of this request bythe 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: 05/10/2023 ,7 Authorized Organizer Signature Dominick Rodriquez is Printed Name and Title Event Coordinator 1. Section L - Permit & Agreement Pursuant to Local Ordinance No. 10628-18, there is a $50.00 non-refundable fee for Tier I I 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 anyfalse or incomplete information. Date: 05/10/2023 Applicant Signz Printed Name: SPECIAL EVENTS COMMITTEE APPROVAL • resident Member U11 "I Ilk V'Y4k Member Member _W93,00 If Date FOP Scholarship Motorcycle Ride 2019 •A) South Bend Police Department West on Sample South on SR 23 (Prairie Ave.) North on Crumstown Hwy. (turns into Sample St.) East on Sample St. North on Olive St. East on Orange (turns into Colfax) B) City Cemetery East on Colfax South on Chapin South on SR 23 South on Locust Easton Kern &orth on Lilac East on Johnson North on Miami East on Jackson South on Elm West on Kern C) Southlawn Cemetery South on 931 East on Roosevelt South on 331 (Bremen Hwy.) West on New Rd. North on Oak Rd. (turns into Mayflower) West on SR 23 D) FOP 36 9 0 0 0 !