HomeMy WebLinkAboutSpecial Event - Living Stations of the Cross - March 29Tit
� G
APPLICATION FOR USE OF z
PUBLIC RIGHT-OF-WAY FOR EVENT ,a ,
The following special event has been approved by the Special Events Committee. lgbs .„"
Submitted by: Denise Miller
Event name: Living Station of the Cross
Event Date: March 29 2024
Street Closure: Brief crossings Rum Village neighborhood surrounding
Our Lady of Hungary Parish, bounded by W Dubail, Chapin St,
W Donald St, Kemble Ave
Closure Times: 3:00 pm to 7:00 pm
Sidewalk Closure: ❑ Yes ❑■ No
Comments: Re-enactment of the 14 stations of the Cross of Jesus in
neighborhood surrounding Our Lady of Hungary Parish.
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
Elizabeth A. Maradik, President
Gary A. Gilot, Member
Murray L. Miller, Member
Joseph R. Molnar, Vice President
Briana Micou, Member
414
Attest: Theresa M. Heffner, Clerk
Date: March 12, 2024
1
.rH Rf City of South Bend Special Event Application
• Neighborhood Event
$25 application fee if filed 30 days or greater (up to 180 days) in advance of event.
Please Brina 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. 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: ALL IS862ug
Organization Name: ! liA
Applicant (Contact) Name:/f &54
Applicant (Contact) Phone: �i `�, Contact Email: i�A/Q1p�phthl b. Am
Address: ,,jl14). I)I �_ 54. City/State/ZIP: �p� j1 !>Q /A
Secondary Contact Name: �tRJ V�1�Q�M1 n r 1/ j
Contact Phone: \57y) .99 1' ) [ UD Contact Email 10 I&JOIA&M f7 t
Address: -7 9 1 W. tulVtr�Sl. City/State/ZIP: f a � ��� �!!3 t3
• I� C Section B - Event Information //''��
Event Name: jVIiIA SfCI&Aal��S Expected Attendance: ISV'aoo
Requested Street Closure:
From (Cross Street):
To (Cross Street):
Provide a brief description of the event: I /�
4Zaaac4x944 �4-he
�� S %tv�S +fU LrDsS o fZSul lnbu✓
r ,cghbVAVL7dl Su,4Y-dak_^C110 Dt,(vLtcc({ tk Cud ,r1
-I ae Q'XM\lt I loge tit q ba>rtc,�00( ( �
Date of Event Setup [mm/dd/yy]: _4 A101 A1670 7r' Time: 1jam
Begin Date of Event [mm/dd/yy]: NADPth 9 28114 Time: gpm
End Date of Event [mm/dd/yy]: elgrp2p2q /Time: to,
,
'f A �UrJn1
Event Cleanup Completion [mm/dd/yy]: 1 1( ' L4 rtNf7Time: T OI d
Have all residents on the affected block have been notified and invited? ❑ 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:
Number of households represented by signatures on attached sheet:
Will this event have music (live or other)? ❑ Yes ❑ No
Is the event ticketed or include fees? ❑ Yes E0 No If yes, list fees and fee groups below:
•
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:
40
Does the event have participant categories? For example, a run that has different race divisions or a parade with
separate walking/marching groups.
• ❑ Yes Q 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:
b nQ -1YUCk- W li-h s" .tq U i pmkAl .
Section D - Equipment, Set-up, and Logistic
•s
Are you hiring a company to provide entertainment, games or inflatables? ❑ Yes B 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 91 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:
0
Will there be any musical entertainment features at the event? ❑ Yes EE] No
o If yes, describe the type of music, schedule of sound check/performances, and the names of any artists
• performing:
Section E - Food
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 ❑ 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 IR 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 Phone: Email:
Address:----- City/State/ZIP:
(b)
Name: _—_ Contact Phone:
Name:
Qualifications:
Name:
Qualifications:
Contact
Contact
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.
• Proposed Cleanup Plan - This plan should include, but is not limited to:
o Measures in place to collect and remove trash, litter and recyclables.
0
• Inclement Weather Plan - This plan should include, but is not limited to:
c Safety measures that will be taken in the event of a tornado warning, tornado watch,
• thunderstorm, and extreme temperatures.
• 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.
Section H - Site Plan / Route Mao
isFor 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
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.
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.
is
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.
Section K - Indemnity & Hold Harmless Agreement
•
is
•
City of South Bend Special Events Committee
Date:
Event Name: l] f,Q�__�j
Organization: 1
Applicant (Contact) Name: _
Applicant (Contact) Phone:
Email:-Kare'ne -olh5
Address: JBI I I2
Event Location (Please describe):
Length of Event (Dates/Times):
Indemnity & Hold Harmless Agreement
Event Date:
J
Alt. Phone:
City/State/ZIP:
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: _ �__�A� agrees to indemnify, defend
and hold harmless the Civil City of South Bend, ndiana, fr 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: A _ q'l O q _
Authorized Organizer Signature
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
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.
B. 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: ------
Applicant Sigm
Printed Name:
SPECIAL EVENTS COMMITTEE APPROVAL
si Member
J lele-Ludlbw CTczmS)
Member
a -a? -ay
Member
Member
Date
[lagnrana r000 Mar,
6
-- -----
1D24121768141...
View on Google Maps
V W
Dubail SIG- <- <- <- <- <-
W Dubatl St
V
0
r
ti
O
1
W G
N
-3'
rD
�
{
A
Bruce St
1 Our Lady
Ert�Ce'�4 -_...__..
En
rn
H n ry Parish
c
2ahoran Funeral
Home -•
��� ��dY
_
9
TTJ
clothing Ac
p
b
—
AA
a v rt St
by Calvert St
US Marine Corps .
-
�1
A
Reserve Units
,
1
V
Sherrill St r
m
Z
A
a
Q
t
m
n
A
,U)
0
O
Y
Go
L9
W Donald
St >
> > > ',N DQrIald Si > >^
Concept Homed
Remodeling
�W Donald c
Music Go
Round
ro
�
cr
Q
1v
tr.
o
W
cp
y
rn
T W Transportation •
W Ewing Ave
IN Evririg Ave W 1=wing Ave
W Ewir
Goggle
Map i Report -a map error
tDsJAw gmglacmvrnas/amit Ord! 1m101 1 m8l ImT 1d2961.09254053345..2d-W-2595082411564T:i,W1fst7ena�M�Sae
Certificate of Coverage Date:21132024
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 only 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 AM -ERICA
10843 OLD MILL RD
OMAHA, NE 68154
Covered Location
OUR LADY OF HUNGARY CHURCH
829 W CALVERT ST
SOUTH BEND, IN 46613-0000
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
1,000,000
General Aggregate
Occurrence
❑ Claims Made
8679
10/1/2023
10/1/2024
Products-Comp/OP Agg
Personal & .4dv Injury
Fire Damage (Any one rue)
Med Exp (Any one person)
Excess Liability
Each Occurrence
Annual Aggregrate
Other
Each Occurrence
Claims Made
Annual Aggregratc
Limit/Coverage
Description of Operations/LocationsNehicles/Special Items (the following language supersedes any other language in this endorsement or the Certificate in
conflict with this language)
Coverage is verified for claims arising out of Our Lady of Hungary Church during their Living Stations of the Cross on March 29, 2024.
Ibddcr of(r rtilicatc
Cancellation
Should any of the above described coverages be cancelled
before the expiration date thereof, the issuing company will
City of South Bend, IN
endeavor to mail 30 days written notice to the holder of
certificate named to the left, but failure to mail such notice shall
impose no obligation or liability of any kind upon the company,
its agents or representatives.
Authorized Representative
7EE:1
0067005140
OUR LADY OF HUNGARY CHURCH
b(Av kac6q
�w s s Tc\lw
3-�q-aoa�
OUR LADY OF HUNGARY CHURCH
731 W. CALVERT ST.
SOUTH SEND, IN 46613
PAY
T L j�,���
A
1160075996' 1:07i212i281: 1009 742l,-6ii-
0
7599
----7599
ff Soume• ro. wz +wv DATE
Bank �� •� (� f,
71-1212/712
AMOUNT
s co
t
0