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HomeMy WebLinkAboutSpecial Event - Northeast Neighborhood Back to School Picnic-Sept 26 2025APPLICATION FOR USE OF .0 ? PUBLIC RIGHT-OF-WAY FOR EVENT. The following special event has been approved by the Special Events Committee. Bess Submitted by: Denise Miller Event name: Northeast Neighborhood Back to School Picnic Event Date: Se tember 26 2025 Street Closure: Howard St between St Louis and St Peter Closure Times: 4:00 pm to 7:30 Sidewalk Closure: ❑ Yes 0 No Comments: Annual back to school cookout open to the neighborhood families and off campus ND students in Kelly Park. 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 �__ - �000r_ Breana Micou, Member XA� f tl Attest: Hillary R. Horvath, Clerk Date: September 23, 2025 � 'TH— City of South Bend Special Event Application • �j Neighborhood Event $25 application fee if filed 30 days or greater (up to 180 days) in advance of event. Please Brine 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. Neighborhood Special Event applications must be submitted more than 30 days in advance of the event date or the application will not be accented. Section A - Applicant Information Date of Application: 9/4/25 Organization Name: Northeast Neighborhood Council Applicant (Contact)Name: LUElla Webster Applicant(Contact)Phone: 574-303-4013 Contact Email: [webste1@nd.edu Address: 701 Howard St Citv/state/ZIP: South Bend, IN 46617 Secondary Contact Name: Patty Walsh Contact Phone: 574-210-0695 Contact Email: patty@pattywalsh.com Address: 315 Walsh St City/state/ZIP: South Bend, IN 46617 Section B - Event Information Event Name: Northeast Neighborhood Back to School Picnic Expected Attendance: 250 Requested Street Closure: Howard St From (Cross Street): St Louis To (Cross Street): St Peter Provide a brief description of the event: Date of Event Setup [mm/dd/yy[: 09/26/2025 Time: 3:00 pm to 4:00 pm Begin Date of Event [mm/dd/yy]: 09/26/2025 Time: 5:30 pm to 7:30 pm End Date of Event [mm/dd/yyl: 09/26/2025 Time: 7:30 pm Event Cleanup Completion [mm/dd/yy]: 09/26/2025 Time: 8:00 pm 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: 3 Number of households represented by signatures on attached sheet: Will this event have music (live or other)? 0 Yes ❑ No • • F_I L Section C - Alcohol Will alcohol be served or sold? ❑ Yes ® 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 Contact Phone: (b) Independent Security Information Name: Qualifications: Name: Qualifications: Name: Qualifications: Contact Name: Email: City/State/ZIP: Contact Phc Contact Contact Phone: Section D - Food • Will your event have food sales (food vendors, caterers, food trucks, etc.)? [:]Yes M 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.org/food-service. Please select food types: ❑ Food Vendor ❑ Caterer ❑ Food Truck ❑ Other: If a Food Truck, please list company name(s): Please describe how food will be cooked and served;, • 0 Section E - Indemnity & Hold Harmless Agreement • City of South Bend Special Events Committee Indemnity & Hold Harmless Agreement Date: 09/4/2025 Event Date: 09/26/2025 Event Name: Northeast Neighborhood Back to School Picnic Organization: Northeast Neighborhood Council Applicant (Contact) Name: LuElla Webster Applicant (Contact) Phone: Iwebste1 And. 574-303-4013 Address: 701 Howard St Event Location (Please describe): Alt. Phone: 574-210-0695 City/State/ZIP: South Bend, IN 46617 Length of Event (Dates/Times): 09/26/2025 between 4:00 pm and 8:00 pm • 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 APPLICANT to these terms. Signed on this Date: ' � O 9 5— Authorized Organizer Signature Printed Name and Title 40 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 describing the 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. M Applicant Printed Name: :�1 G.(Gt �.Jn (S�A • Member C � J Fy]*47I_ 4:10T ZIl6ferilNOIIa921�1l9:ZiP/_lI Me r ember `'Fle Date A� CERTIFICATE OF LIABILITY INSURANCE 1DArE 9nrzolN� 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 VEPRESENTATTVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. H 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 endorsemends). PRODUCER The Horton Group 10320 Orland Parkway Orland Park IL 60467 INSURED Northeast Neighborhood Council City of South Bend In 803 N. Notre Dame Avenue South Bend IN 46617-1536 nr VV Iwn numocn: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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. MMWANtE JoaLSUBR POLICY MBBEt POl1CY EFF POl1CY E7IP �$ MEN LIA�Y DE � OCCUR r]AGGREGATE 934602-09507935-22 9021mon 921/2023 EACH OCCURRENCE SIAW,006 s $3tp,(IDO MEDEXP we 510,000 PERSONAL aAov rauRY It1JX10,000 eer APPLES PER: LaC GENERALAGGREGATE S1,000,lgO PROOIICiS-COIPgPAGO i1,ODD,000 = AUTOYOBLELLNO rrY ANYAuro OWN® AUTOS X ADT��m HIRED ADIOS ONLY AUTOS ONLY 934602-095D7935-22 9212022 9212023 SDOILYNAIRY(Pa PNaeA) 51,000,000 S BOp.Y rxArtr (p's�er) S X PROPHTIYUALtAOe $ S U BRELLALLIB EIICE88 LIAR OCCUR CLAWS -MADE NIA EACHODCURRENCE It AGraE"7E 0 DEo RETENTIONSS WORKERS COMPENSATION ND AEBLOYEt4 LIARKM YIN MB RIXCL (YNMalory In NH) p yyaass,,���yPERATIONS btl DESCRIPTION OF O PER o7N4 STATUTE EL.EACHACCOE r i EJ- DISEASE -EA EFL. It F1 DISEASE -POLICY LIMIT 3 A Ply 934602-09507935-22 9212022 9212023 aw BMIM Dadirtub SA4.640 $50.000 3250 DESCRPrMOFOPEfATHMILOGTIONSIVEIBCLES IAcam tel, AddAional Ranurb Sdrgb, roy MaeAchsdtlmvrr apwa brpukse) Re: Bads to School Picnic event on September 8, 2023 at Kelly Park. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ^► ACCORDANCE WITH THE POLICY PROVISIONS. City of South Bend AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rinhfe ro�etiod ACOKU 25 (2018/03) The ACORD name and logo are registered marks of ACORD Board of Directors Bill Stenz Praident Northeast Neighborhood Council, Inc. 803 N. Notre Dame Avenue South Bend, fN 46617 574-235-9675 September 20, 2025 Dear Howard Street Neighbor, Solomon Anderson The Northeast Neighborhood Council and the Robinson Community Learning Center will be holding the annual Back To School community Mozell Arthur Bowens picnic on Friday evening, September 26'. As in the past, Howard Street will be closed between 5:30pm and 7:30pm on that day. This is to ensure Mattie Hoover safety and accommodate the fire and police vehicles that will be attending. Kisha Hoover • Chuck Nelson Gwen O'Brien Derrick Perry Beth Sanford Erin Shell Marguerite A. Taylor Nan Tulchinsky Patty Walsh LuElla Webster 40 Thank you, LuElla Webster, Board Member Northeast Neighborhood Council Northeast Neighborhood WE ARE HAVING A COOKOUT FOR All Neighborhood Families and Off -Campus Students FRIDAY, OCTOBER 4 • 5:30 - 7:30 170 At KELLY PARK 750 Howard St. (corner of Howard & St. Peter) PM 3 r F ''Free Food • Attractions • Music • Games Sponsored By Northeast Neighborhood Council ® Robinson Community Learning Center • University of Notre Dame !� IIII06' Northeast ROBINSON L u Neighborhood COMMUNITY ,� U N[ V E R S I T Y O F Council CENTER LEANING NOTRE DAME n u M C2 a) 0) v v '7 i U 9� v v 10 a m kp L x vi N m m C • Cl 6749401 CITY OF SB SPECIAL EVE 731 S LAFAYETTE BLVD SOUTH BEND, IN 46601 09'082025 13:27:44 MID: XWXXXXXXXX401 TID: IOIXXX371 CREDIT CARD VISA SALE Card ri XXXXXXXXXXXX6531 Cho Cad: VISA DEBIT AID A0000000031010 SE ! A: I Batch 50 INVOICE 1 App oval Code: 631056 Enu, Method: Contatlr;; SALE AMOUNT $251 I agree to pay above total amount according to card issuer agreement. (Merchant agreement if Credit Voucher) VISA CARDHOLDER MERCHANT COPY