HomeMy WebLinkAboutSpecial Event - Studebaker Car Cruise In - September 29APPLICATION FOR USE OF
PUBLIC RIGHT-OF-WAY FOR EVENT
The following special event has been approved by the Special Events Committee.
Submitted by: Denise Miller
Event name: Studebaker Car Cruise -in
Event Date: -September 29 2024
Street Closure: St Louis Blvd from Jefferson Blvd to Washington St
Closure Times: 12:00 pm to 5:00 pm
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Sidewalk Closure: ❑ Yes ❑■ No
Comments: Studebaker car show sponsored by Barnaby's of South Bend.
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
Elizabeth A. Maradik, President
Gary A. Gilot, Member
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Murray L. Miller, Member
Joseph R. Molnar, Vice President
Briana Micou, Member
Attest: Theresa M. Heffner, Clerk
Date: May 14, 2024
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City and Regional Event
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$100 expedited application fee if filed 30-59 days in advance of event
Please Bring Completed Application and Payment to:
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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
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Section A - Applicant Information
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Date of Application: atf�171IA01tiF Organization Name: �✓RRK!}P>`rS
Applicant (Contact) Name: `I-v *A,( sT4A%1 &os
Applicant (Contact) Phone: lb 7V) 397- 6o8S Contact Email: 6�4AB�h/SA/ZL8 �! �l()fK1LPtl CONS
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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.
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Contact Phone: 7& 7A Y0 Contact Email:
• Address:
City/State/ZIP:
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Event Classification: 9 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
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Begin Date of Event [mm/dd/yy]:Q9.1a9 Z7. ;k4t' Time:
End Date of Event [mm/dd/yy]: W AI Time:
• Event Cleanup Completion [mm/dd/yy]: O� 4ja flZ f Time:
Total anticipated attendance: // O
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If yes, list the number of sponsors at each level of partnered sponsorship:
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If yes, provide the date, location, and attendance of past special events and/or future planned events in the
series:
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continue to Section D.
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Describe any sound equipment that will be used in the parade/race:
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separate walking/marchi ggroups.
❑ Yes EKNO
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If ✓nl Ir mmnf ie a mrovio luhef ie fhe onnrnvimefn nl Imhor vnvi hmulcl of onimelc vuhirluc enrl flmfc nnriirinefine
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:
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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:
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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.
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o Depending on the potential fire risk, applicants may need to receive approval of the South Bend Fire
Department (process facilitated by event coordinator).
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o If yes, describe the type of music, schedule of sound check/performances, and the names of any artists
performing:
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If your route crosses over a state road or abridge please contact the following for permission:
State, INDOT: County bridges:
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219-235-7528, Mhurtl@indot.in.gov 574-235-9626, ahayes@co.st-joseph.in.us
Section E - Food
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o If yes, the event coordinator must apply for and receive a St Joseph County Health Department
Temporary Event Permit.
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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
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Please select food sales types: ❑ Food Vendor ❑ Caterer ❑ Food Truck ❑ Other:
If a Food Truck, please list company name:
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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 Drior 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
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o rrApplication 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,
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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).
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Company
Contact Name:
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Contact Phone:
Email:
Address:
City/State/ZIP:
(b)
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Qualifications:
Name:
Contact Phone:
Qualifications:
Name:
Contact Phone:
Qualifications:
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For each of the following, please provide detailed descriptions. If you run out of space, attach a response to this
application submission.
Fm.roo.nr�i Cnf.h, Dhn _Thic melon chnnlrl inrL vi. hi h is nnf limif.ri fn:
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.
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o Proposed internal communications systems and public address systems.
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o Measures in place to collect and remove trash, litter and recyclables.
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o Safety measures that will be taken in the event of a tornado warning, tornado watch,
thunderstorm, and extreme temperatures.
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o A description of the use of signage, announcements on public address systems or pre -event
handouts.
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wFor 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 gym, it-v-n4 will not h-,ieinaa a nr-_���rrn,-rl ror- rn, ito th- nrn�nc-rl -v-nt mnn chrn,lrl inrh vl- o rni it-_ nl o_n
clearly identifying the timing and locations of proposed street closures, and the direction of parade
movement.
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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.
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• 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 Tooci 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.
Curtinn 1 _ KAM.o +inn of Immrt
If you are using and/or closing public sidewalks or streets, you are required to notify area business owners and
residents. You must:
_ DreSent'irn,r cvont rnnrept fn tho n,rrm ,nrlino _cto4ohnlrier_e (ro_cirlontc _h, ieinocmc _�nrl nc_iooh_hnrhnnri
groups) that represent the venue area.
Attach a copy of the brochure or door hanger distributed to all affected residents/businesses/neighborhood
erouos describine the event ouroose. date and time.
•
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 ([) weeks prior to the date of the event.
40
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City of South Bend Special Events Committee
• InA.mnihr C. 14MA 6lermlPec Aoroomont
Date: ogllle/202ci Event Date: XE07EMA3ek 2942OZY
Event Name: J 7-a4,S,9,4xG — C4/Z C21�/St —1N
Organization: af}�/✓s4 8t/S
Anni;,�nf Ir"nnt�rtl Ah_mP• ITOFtN S'TR ii7/GOS
Applicant(Contact)Phone: CS%y� aE7—&0(6S Alt. Phone: fs7zfi al20 —.2c/93
Email: 60PI)3�S 1S,0/2280 hOfMail • CDC
Address: '1/3 Ar• lTcv'FrSRSQN 73c-t/0 City/State/ZIP: A &H 49&VJ r -7 ✓ cF&(017
Event Location (Please describe):
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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 Pi rhlir Wnrir< ac arlriif;nnally inti irPrl fnrthP PVPnt
Organization Name: &99AW� Yi I-Ilf—✓klo 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. arisine out of the approval of this reauest by the Civil Citv 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.
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Authorized OrgYnizer Signature
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Printed Name and Title
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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
r4Pcrrlhln0 the PVPnt nl IrnncP rin+P time nnrl rnnfnrt Infnrmmflnn miict hp inrll lrlprl 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.
A
ThP APPI (CANT shall nrnvirlP to the Rnnrd A CPrtifiratP of Ina irnnrP chnwinv A linhility nnliry in fi ill
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 ADDI irAMT xo,mcc fidlrornnncihilifirfnr nrnvirlino emnlP rlienneal rnnfninere fnr rofnm/rcrvrlino
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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ni AihlP fifty (r,n) fPPt nwi v nc wail ac chni,tino vPilino hnntino whictlino nr cinaino in the ctrPPtc 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
uepartment.
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.
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Applicant Signature:
Printed Name: /ohw M.
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SPECIAL EVENTS COMMITTEE APPROVAL
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