HomeMy WebLinkAboutSpecial Event - Cinco de Mayo Festival - May 4APPLICATION FOR USE OF '
PUBLIC RIGHT-OF-WAY FOR EVENT
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The following special event has been approved by the Special Events Committee. '. raes
Submitted by: Denise Miller
Event name: Cinco de Mayo Festival
Event Date: -May 4 2024
Street Closure: Grace Street between Meade Street & S Olive Street
Huron Street between Meade Street & S Olive Street
Closure Times: 12:00 pm to 9:00 pm
Sidewalk Closure: ❑ Yes ❑■ No
Comments: Cinco de Mayo Festival on the grounds of St Adalbert Parish
featuring music, food and non-alcoholic beverages.
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
Elizabeth A. Maradik, President
Gary A. Gilot, Member
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Joseph R. Molnar, Vice President
Briana Micou, Member
Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk
Date: March 12, 2024
,,, B 4 City of South Bend Special Event Application
\c City and Regional Event
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• t $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 Aoolication 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: 2/7/2024
Applicant (Contact) Name: Fr
Section A - Applicant Information
Organization
Pietrocarlo, CSC
St. Adalbert Parish
Applicant (Contact) Phone: 574-288-5708 Contact Email: rpietrocarlo@stadalbertschool.org
Address: 2505 W. Grace St City/State/ZIP: South Bend, IN 46619
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: St. Adalbert Parish Contact Name: Juan Ramos
Contact Phone:
isAddress:
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574-288-5708
2505 W. Grace St
Event Name : Cinco de Mayo Festival
Contact Email: juan@lacasadeamistad.org
City/State/ZIP: South Bend, IN 46619
Cell: 574 - 276-6195
Section B - Event Information
Event Type: (Festival, Race, Parade, Other): Festival
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 Hof this
application. The description should be a summary overview.)
Date of Event Setup [mm/dd/yy]:
Begin Date of Event [mm/dd/yy]:
End Date of Event [mm/dd/yy]:
5/04/2024
5/04/2024
5/04/2024
Event Cleanup Completion [mm/dd/yy]:
Total anticipated attendance:
2000
5/04/2024
Time:
B:00am
10 nf) ,.
Time:
Time: 8:00pm
Time: 9:00pm
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:
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Does the event have any partnered sponsorships? ® Yes ❑ 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? ❑ Yes ® No
If yes, provide the date, location, and attendance of past special events and/or future planned events in the
series:
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?
Describe any sound equipment that will be used in the parade/race:
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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.
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 Logistics
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:
Will you be staking any tents, inflatables, portable restrooms or any other anchorings? ❑ Yes ® 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 ® 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? ® Yes ❑ No
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o If yes, describe the type of music, schedule of sound check/performances, and the names of any artists
performing:
There will be Mexican music from 12:00 - 7:30pm. Sound check starting at 11:00am.
For stage inspections, contact the Department of Homeland Security at 317-232-2222.
If your route crosses over a state road or abridge please contact the following for 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
Are you having food at your event (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 at the St. Joseph County Health Department Food Service
website: sichd.org/food-service.
Please select food sales types: ❑ Food Vendor ❑ Caterer ❑ Food Truck
If a Food Truck, please list company name:
Describe how food will be cooked and served:
Other: Parish groups
Food will be cooked in our school kitchen and will be served at post right outside the school.
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 Name: Contact Name:
• Contact
(b)
Qualifications:
Name:
Qualifications:
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.
See attached -
• Proposed Cleanup Plan - This plan should include, but is not limited to:
o Measures in place to collect and remove trash, litter and recyclables.
See attached -
• 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.
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See attached -
• 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.
See attached -
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
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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 forTRANSPO bus route changes.
Section I - Mitigation of Impact
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.
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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.
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Section K - Indemnity & Hold Harmless Agreement
City of South Bend Special Events Committee
• Indemnity & Hold Harmless Agreement
Date: 2/7/2024 Event Date: 5/4/2024
Event Name:
Organization:
Cinco de Mayo Festival
St. Adalbert Parish
Applicant (Contact) Name: Fr. Ryan Pietrocarlo, CSC
Applicant (Contact) Phone:
574- 288-5708 A 11 Phone: 574- 334-0049
Email: rpietrocarlo@stadalbertschool.org
Address: 2505 W Grace St City/State/ZIP: South Bend, IN 46619
Event Location (Please describe):
Length of Event (Dates/Times): 5/4/2024 from 12:00 - 8:OOpm
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: St. Adalbert Parish
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: J- IF o!
M
Authorized Orkanizer Signature
Fr. Ryan Pietrocarlo, CSC, Pastor
Printed Name and Title
Section L - Permit & Agreement
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
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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 f ull 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
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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: —a 1 % l,2 Y
Applicant Signature:
Printed Name: Fr. Ryan
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CSC, Pastor
SPECIAL EVENTS COMMITTEE APPROVAL
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Lost and Found Plan
We will have a lost and found table inside the school in the cafeteria where we will
put any lost items during the event.
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Inclement Weather Plan
In case of inclement weather or a tornado, we would send people into the school on
the bottom floor since there are secure areas without windows.
Cleanup Plan
We have plenty of garbage cans to put around the grounds during the event and a
dumpster right on site. Our volunteers will take care of all the cleanup during and
after the event.
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Emergency Safety Plan
Since our Cinco de Mayo festival is held on parish grounds, we will use volunteers to
help with any medical emergency. Of course, in case of any emergency requiring
medical care we will call an ambulance.
In terms of security, we will also have volunteers maintaining the security of the
event.
The coordinator of the event will be our two logistics coordinators who will also serve
as the coordinators for internal communication. They will communicate with the
parish groups who will be doing the food sales. We have a public address system
within the school building, but it does not extend to the outside.
In case of the need of evacuation or to clear the grounds, we can secure people
inside the church and the school buildings.
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Certificate of Coverage Date:' 1' '0'4
Certificate Holder
The Diocese of Fort Wayne -South Bend, Inc.
Chancery Office
P O Box 390
This Certificate is issued as a matter of information oniy and
confers no rights upon the holder of this certificate. This certificate
does not amend, extend or alter, the coverage afforded below.
Fort Wayne, IN 46801
Company .Affording Coverage
THE CATHOLIC MUTUAL RELIEF
SOCIETY OF AMERICA
10843 OLD MILL RD
Covered Location
ST ADALBERT CHURCH
OMAHA, NE 68154
2505 GRACE STREET
SOUTH BEND, IN 46619-0000
Coverages
This is to certify that the coverages listed below have been issued to the certificate holder named above for the certificate
indicated, notwithstanding any requirement, term
or condition of any contract or other document with respect to which this
certificate may be issued or may pertain, the coverage afforded described herein is subject to all the terms, exclusions and
conditions of such coverage. Limits shown may have been reduced by paid claims.
Type of Coverage
Certificate Number
Coverage Effective
Date
Coverage Expiration
Date
Limits
Property
Real & Personal Property
D. General Liability
Each Occurrence
00.000
Occurrence
® Claims \lade
S679
10/1/2023
101'_0_'a
General Aggregate
1.000.000
Products -Comp OP AYt
Personal & Adv Injun'
Fire Damage (Any one fire)
\fed Exp (Any one person)
Excess Liabilih
Each Occurrence
Annual Aggregrate
Other
Each Occurrence
Claims Made
Annual Aggregrate
LimiuCoverate
Description of OperationsLocationsAVeWeks/Special Items (the following language supersedes any other language in this endorsement or the C enlficate in
conflict with this language)
Coco De Mayo Festival on May 4, 2024 from 8am until 9pm.
Holder of Certificate
Cancellation
Additional Protected Person(s)
Should any of the above described coverages be cancelled
before the expiration date thereof, the issuing company will
City of South Bend, IN, Special Events Committee and Board
of Public Works
731 S Lafayette Blvd
South Bend. IN
endeavor to mail 30 days written notice to the holder of
certificate named to the left, bat failure to mail such notice %hail
impose no obligation or liability of any kind upon the company,
its agent% or representatives.
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Authorized Representative',, 'All
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0067005138
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ENDORSEMENT
(TO BE ATTACHED TO CERTIFICATE)
Effective Date of Endorsement 5/4/2024 Charge Credit
Cancellation Date of Endorsement 5/5/2024
Certificate Holder The Diocese of Fort Wayne -South Bend, Inc. Chancery Office P O Box 390 Fort Wayne, IN 46801
Location ST ADALBERT CHURCH 2505 GRACE STREET SOUTH BEND, IN 46619-0000
Certificate No. 8679 of The Catholic Mutual Relief Society of America is amended as follows:
SECTION II - ADDITIONAL PROTECTED PERSON(S)
It is understood and agreed that Section II - Liability (only with respect to Coverage D - General
Liability), is amended to include as an Additional Protected Persons) the organization(s) shown in
the schedule below.
CSyrl-ll�ll=�1 � l��l�ll'�l�f l�Jl3�ll3.
731 S Lafayette Blvd
South Bend, IN
Remarks:
Cinco De Mayo Festival on May 4, 2024 from 8am until 9pm.
However, the following limitations apply to coverage:
1. The maximum limits of coverage provided by
Catholic Mutual Relief Society of America to
the Additional Protected Person(s) named
in this endorsement shall not exceed the
coverage dollar amount specifically required
by contract or agreement and agreed to by the
Protected Person(s). In the absence of
specific coverage limits within a referenced
contract or agreement, the limits of liability
afforded to the Additional Protected
Person(s) must be listed on a separate
Certificate of Coverage form attached to this
endorsement. All limits of liability extended by
this endorsement are inclusive of both Section II
Coverage D and Section VII ooverages ('If
applicable).
2. Unless specifically agreed to by contract or
agreement, the coverage extended to the
Additional Protected Person(s) by this
endorsement is excess and non-contributory
over any other available coverage or
insurance.
3. This endorsement does not apply to any
Occurrence outside the specific date(s) of a
facility use agreement or terms of a lease.
4. This endorsement does not extend coverage to
the Additional Protected Person(s) for
Occurrences which cannot be attributed to
primary acts or omissions of the Protected
Person(s).
5. Provided that a premises is utilized by the
Protected Person(s) in a manner consistent with
its intended purpose and in accordance with the
applicable contract, agreement, or lease, this
endorsement does not extend coverage to the
Additional Protected Person(s) for premises
defects or other Occurrences which could not be
discovered by the Protected Person(s) with
reasonable diligence.
6. The limited coverage afforded to the Additional
Protected Person(s) by this endorsement only
applies to the extent permissible by law and shall
not apply to non -delegable duties unless
specifically agreed to by contract or agreement.
This extension of coverage shall not enlarge the scope of coverage provided to the Certificate Holder
under this Certificate nor increase the limit of liability thereunder. Unless otherwise agreed by contract
or agreement, coverage extended under this endorsement to the Additional Protected Persons) will
not precede the effective date of this endorsement or extend beyond the cancellation date.
PKS-122C(10-23) THE CATHOLIC MUTUAL RELIEF SOCIETY OF AMERICA
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