Loading...
HomeMy WebLinkAboutSpecial Event - Concours d'Elegance at Copshaholm - July 13Ylli T!f �� O� ti APPLICATION FOR USE OF .p PUBLIC RIGHT-OF-WAY FOR EVENT a� The following special event has been approved by the Special Events Committee. IN65 Submitted by: Denise Miller Event name: Concours d'Elegance at Copshaholm Event Date: July 13 2024 Street Closure: W Washington Street between Laurel Street and Chapin Street Closure Times: 5:00 am to 6:00 Sidewalk Closure: ❑■ Yes ❑ No Comments: An invitation only car show exhibited in the historic Oliver Mansion gardens. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President •��. - % = Gary A. Gilot, Member r Murray L. Miller, Member ME Joseph R. Molnar, Vice President Briana Micou, Member �4 Attest: Theresa M. Heffner, Clerk Date: May 14, 2024 1 City of South Bend Special Event Application 0 x Neighborhood Event -� = $25 application fee if filed 30 days or greater (up to 180 days) in advance of event. iers _. Please Bring Completed Application and Payment to: Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN • 40 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:�r� Organization Name: (574?U l1l)fiA Musej) Y- Applicant (Contact) e. Applicant (Contact) Phone: cJr -97/� Contact Email: o t, OI�� Address: aW i r 1 City/State/ZIP: Secondary Contact Name { 6"1a,L Contact Phone: _Z35—%/TContact Email: n' Q, Address: aO� (,{1�p/ n- ryE City/State/ZIP: SOLI% Event Name: Requested Sti From (Cross Street): Law -Pt ;t, To (Cross Street): --iCAP--p I ,L- �- . Provide a brief description of the event: AK i n v;+,aiori - O Vih� C," S4vW, e)c b i+e t. I tt. +f ie- KIS•kovie, ohvev V405iC'n aY �7ei� c at ilk 36vwCase l 2s if �(yr;'ves }�asi . 6leaehE�s oh V WaS�tIN j�vV� t (7tl�K. ��1 iVC� ( [� llL. -T Fke will 6- so/ci at .2 errtt a . FultrEst prose" to behecFb big -5hap- 'ev A/At / Nltise+t(�'. "7k;,5 will tke. zixik Lear W , ka. e. -tkis et/etrt-. Date of Event Setup[mm/dd/yy]: 3 Oct Time: Sa/iL. Begin Date of Event [mm/dd/yy]:-/u/ l3 ZO' Time: /O a/yi End Date of Event[mm/dd/yy]: Ju l3 Oo Time: Event Cleanup Completion [mm/dd/yy]L. k3Time: Co pl - Have all residents on the affected block have been notified and invited? &�e ❑ 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: eZ Number of households represented by signatures on attached sheet: Will this event have music (live or other)? ['Yes ❑ No Section C - Alcohol • Will alcohol be served or sold? ❑ Yes T/No If Yes: o The applicant must apply for and receive a temporary liquor license from the Alcohol & Tobacco Commission. 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 o Deposit will be returned upon inspection of event area by the Board of Public Works. o The applicant must submit a map or drawing of: o Fencing around serving area o Trash receptacles o Events that will 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) Security Company Information Company Namec ) t je:�C,�k . P r) :r �i � �Py 17� ContactName: � T71 GY t Contact Phone: IVA5— /�`1+ 1 Email: - O Address: �V/ cJo Vz%hple— 5st. City/State/ZIP: • (b) Independent Security Information Name: Name: Qualifications: is Contact Phone: Contact Phone: Contact Phone: Section D - Food ,- • Will your event have food sales (food vendors, caterers, food trucks, etc.)? 139 1 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 on the St. Joseph County Health Department Food Service website at sichd.or�e,/flood-service IY. Please select food types: Food Vendor ❑ Caterer ❑ Food Truck ❑ Other: If a Food Truck, please list company name(s): rL/a Please describe how food will be cooked and served: �rq/ - ,�bluclwla.r ,NII. 3arbete ocl a COS VW+eA Vd, • �""re- ZD�w - }'(+ahaUlaka, ItJ. Ice, creawt, sewved. oaf Oa 4Va%1e4,- 0 Section E - Indemnity & Hold Harmless Agreement • City of South Bend Special Events Committee Indemnity & Hold Harmless Agreement Date: Event Name: Organization: 1�;IL- ll �i�sau.�tl Applicant (Contact) Applicant (Contact) Phone: oZ3-15 — 5 W14 Alt. Phone: Address: �D i �Jn�p1�L City/State/ZIP: Event Location (Please describe): Length of Event (Dates/Times): RN • APPLICANT 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, 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 APPLICANTto these terms. Signed on this Date: 0 Printed Name and Title 0 Section F - Permit & Agreement • 1. Pursuant to Local Ordinance No.10628-18, there is a $25.00 non-refundable fee for applications filed 30 days or greater in advance of the event date. Applications filed less than 30 days in advance of the event date will not be accepted. 2. All residents within the affected area must be notified of this event. The APPLICANT must obtain signatures from at least 10 residents that reside along the closed right-of-way and make an attempt to notify all other affected residents. APPLICANTS must include a copy of a brochure or letter of invitation distributed to all affected neighbors describingthe event purpose, date, and time. 3. The APPLICANT is responsible, prior to the event, for determining if there are any affected residents that need assistance accessing their residence. The APPLICANT is responsible for providing said resident(s) access or transportation to their property. 4. The cones will be delivered to the APPLICANT's address. The APPLICANT assumes full responsibility for clean-up and assures the City that all cones will be maintained and returned undamaged. The APPLICANT will be liable for the replacement cost of $50.00 per cone as a result of any missing or damaged cones. 5. Block parties must end by 8:00 p.m. 6. A street will be blocked off from intersection to intersection only. No half -blocks or alleys can be blocked Off. 7. The Special Events Committee reserves the right to deny any block party application based on traffic and speed limit records. No street may be closed with a speed limit over 30 MPH or considered to be a major arterial. 8. The Special Events Committee reserves the right to deny any block party application based on information gathered from the South Bend Police Department or other sources. 9. The APPLICANT agrees to allow residents that live on the above -referenced block access in and out of the restricted area as needed. • 10. The APPLICANT agrees to abide by all terms and conditions of the South Bend Municipal Code and Board of Public Works' policy adopted in Resolution No.10628-18 on December,11, 2018. 11. Notification of approval/denial of this request will be issued by return of this form, upon signed authorization by the Board of Public Works. 12. The City of South Bend Noise Ordinance 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 stereos, speakers, musical instruments, 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). 0 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: Aii iooC cly Applicant Signature: Printed Name: 0 SPECIAL EVENTS COMMITTEE APPROVAL Member Member Member y/ay Date im . CONCOURSWELEGANCE ATCOPSHAHOLM NOTIFICATION OF SPECIAL EVENT IN YOUR. NEIGHBORHOOD WHAT: Contours d'Elegance at Copshahohn WHERE: W. Washington Street from Laurel Street to Chapin Street [See attached location map] DATE(s): Saturday, July 13, 2024 TIME(s): Gam to 4pm WHO: Studebaker National Museum CONTACT: The on -site contact during the event is: Patrick Slebonick, cell number (574) 334-8087 On Saturday, July 13, 2024, the Studebaker National Museum will be hosting a special event at the Oliver Mansion, called the Contours d'Elegance at Copshaholm. We are thrilled to be guests in your neighborhood and it's important to us that we communicate clearly with you, the neighbors. EVENT DESCRIPTION: • We will leave your neighborhood as we found it: litter will be handled by the Studebaker National Museum. • • During the event hours, we expect between 1,500 to 2,000 attendees. • Street will be closed between Sam and 4pm on Saturday, July 13, 2024. Seethe attached map for specifics. - We will have amplified sound from Sam to 4pm: there will be a public address system and pre-recorded background music. We are working closely with the City of South Bend to minimize the impacts of the event. Our goal is to create an enjoyable and positive experience in your neighborhood. If you or any of the surrounding residents and businesses have questions or comments about impacts of this event, please email us at: Patrick Slebonick Studebaker National Museum 201 Chapin St. South Bend, IN 46601 pslebonick@stu(iebakermuseum.org V!� _5 E 1&4F 44 Printed Date • Do you have any resident(s) who may need ADA transportation assistance? YES CNDO I puai � , -f r7 .. CONCOUR.S D'ELEGANCE AT COPSHAHOLM NOTIFICATION OF SPECIAL EVENT IN YOUR. WHAT: Concours d'Elegance at Copshahohn WHERE: W. Washington Street from Laurel Street to Chapin Street [See attached location map] DATE(s): Saturday, July 13, 2024 TIME(s): Gam to 4pm WHO: Studebaker National Museum CONTACT: The on -site contact during the event is: Patrick Slebonick, cell number (574) 334-8087 On Saturday, July 13, 2024, the Studebaker National Museum will be hosting a special event at the Oliver Mansion, called the Concours d'Elegance at Copshaholm. We are thrilled to be guests in your neighborhood and it's important to us that we communicate clearly with you, the neighbors. EVENT DESCRIPTION: • We will leave your neighborhood as we found it: litter will be handled by the Studebaker National Museum. • • During the event hours, we expect between 1,500 to 2,000 attendees. • Street will be closed between Gam and 4pm on Saturday, July 13, 2024. Seethe attached map for specifics. - We will have amplified sound from 8am to 4pm: there will be a public address system and pre-recorded background music. We are working closely with the City of South Bend to minimize the impacts of the event. Our goal is to create an enjoyable and positive experience in your neighborhood. If you or any of the surrounding residents and businesses have questions or comments about impacts of this event, please email us at: Patrick Slebonick Studebaker National Museum 201 Chapin St. South Bend, IN 46601 pslebonick@studebakermuseum.org Signature Printed Street Address Date • Do you have any resident(s) who may need ADA transportation assistance? YES CNO) I,�i uil�ucig ■' m` e ISiwepm x � , of i _ o u no os s t of L .� -- o Garfield 6 1S'l IS"ldey� a E d ,,� O a o =,t C y � r 0 • e0 I F— m .� QD L r _ i lned 1S F, m w a m . o L:V �i all, U p Al ar. L O •. �.. r •'m., 3 3 E t Elm St _ _ - - o 4 p� L x F Zit +.aldeyi •__ ______--1S aide J cwp;o 81 CDP ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) a/1012024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(tes) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Gibson Insurance Agency Inc 202 South Michigan St., Suite 1400 South Bend IN 46601 CONTACT Alison Christensen PHONE FAx u N , 574-245-3521 No ; 574-236-6399 ADDRESS, achristensen@thegibsonedge.com INSURERS AFFORDING COVERAGE NAICe INSURER A: Selective Insurance Company Of South Carolina 19269 INSURED STUDNAT4)1 Studebaker National Museum INSURER B: Hartford Insurance Company of the Southeast 38261 201 Chapin St INSURRC: INSURER D: South Bend IN 46601 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 198927908 REVISION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCEL13TE0'BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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 INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADOL SUBR� POUCYNUMSER POLICY EFF MMIDDNYYYI POLICY EXP (MMIDOPFIDW LIMITS A X COMMERCIALGENERALLb18LITV CUJMS-MADE 1K OCCUR S 2410712 5H/2024 I 5/1/2025 EACH OCCURRENCE $1,000,0G0 DAMAGETORENTED PREMISE Ea o=enence $500.000 MED EXP Any one person) $15.000 PERSONAL S ADV INJURY $1,000,000 GENL AGGREGATE LIMB APPLIES PER POLICY JMECOT F5�1 LOC OTHER: GENERAL AGGREGATE $2,000,0DO PRODUCTS-COMPIOP AGG $2,000.000 I $ A AUTOMOBILEUABRITY ANY AUTO OWNED SCHEDULED AUTOS ONLYNAUTOS AUTOS ONLY ALTOS ONLDY S 2410712 5/1/2024 5/1/2025 CEOIJBIaccidenSWULELIMIT $1000000 X BODILY INJURY (Per person) $ BODILY INJURY Per acddent ( ) $ X Parr acccRtlrvenDAMAGE $ Medical Pa march $5•000 A X UMBRELLA LIAR EXCESS LLI8 X OCCUR CLAIMS -MADE S 2410712 5/1/2024 5/1/2025 EACH OCCURRENCE $4,000.000 AGGREGATE $4.000.000 DIED X RETENTION $n S B MPENSATION AND EMPLOWORKEYERS' LIABILITY YIN ANYPROPRIETOR�PARTNER/EXECUTNE OFFICERIMEBEREXCLUDED4 (Mandatory In -NH) NH) ❑ If yes, describe antler DESCRIPTION OF OPERATIONS babe, NIA 35WECAJ3HLS 12/1/2023 12/1/2024 X STATUTE ER E.L. EACH ACCIDENT f 500,000 E.L. DISEASE -EA EMPLOYE $500,000 E.L. DISEASE - POLICY LIMIT S500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be atlachad N more space Is required) City of South Bend Attention Denise Miller Department of Public Works 731 S Lafayette Blvd South Bend IN 46601 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ((&rhsem Q7iiwanx �1yu�rcy ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD