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Home My WebLink About11-82FEBRARY 22, 2011 11 -82 RESOLUTION (CARRIED 6 -0 LOST LAID OVER WITHDRAWN ) PURPOSE: APPROVAL OF SPECIAL EVENT/ POKER ON THE FOX/ UTILIZE LEACH AMPITHEATRE /AUGUST 6, 2011 INITIATED BY: CITY ADMINISTRATION NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that approval is granted to Poker on the Fox, Inc (Todd Kempinger) to utilize Leach Ampitheatre, on Saturday, August 6, 2011, from 9:00 a.m. to 11:00 p.m., for their Poker on the Fox, in accordance with the municipal code and the attached application, with the following exceptions /conditions: BE IT FURTHER RESOLVED that as a condition of approval, the Event Organizer shall pay the City's actual costs for extraordinary services. Cost Estimates for Extraordinary Services none APPLICATION FOR SPECIAL EVENT PERMIT— TO BE CLERK GENERAL EVENT INFORMATION Official Name of Special Event: Poker on the Fox Start Date: August 5, 2011 Date: YKNED'�:T O CITY JAN 2 �: 2011 CI 1 - 1 k:� tp"� L k August 7, 2011 Briefly describe your event. Be sure to include the purpose of the event and all planned activities. Poker on the Fox is an annual event dedicated to supporting our local community by providing financial assistance to help maintain the water ways and recreational activities in the Fox Valle and surroundin areas. The event will include a 1 day poker run with a concert and card opening at the Leach Ampitheatre. Location of Event: Leach Ampitheatre Estimated Attendance (daily & total): Booths: 10 Organization(s) Sponsoring Event: n nn the FOX. Inc 1,000 Number of (including addresses) 2115 Fairview St Oshkosh, WI 54901 g��11 MON TUE WED THUR 8�5�1 118�6�1 E ATE D SETUP TIME 4 pm 9 am START TIME 11 p STOP TIME 12 pm TEAR DOWN / CLEAN UP COMPLETED Location of Event: Leach Ampitheatre Estimated Attendance (daily & total): Booths: 10 Organization(s) Sponsoring Event: n nn the FOX. Inc 1,000 Number of (including addresses) 2115 Fairview St Oshkosh, WI 54901 APPLICATION FOR SPECIAL.EVENT PERMIT — TO BE RETURNED TO CITY CLERK Primary Contact: Todd Kempinger Daytime Telephone: 920-379-5111 Cell Phone: same Fax: none Email: support@pokeronthefox. co Address: 2115 Fairview St City. Oshkosh State: wI Zip Code: 54901 Secondary Contact: Jeremy Probst Daytime Telephone: 920- 385 -1113 Cell Phone: 608 - 642 -7446 Fax: 920-757 -6591 Email: -jprobst@technicalprospects. com Address: 1870 white Swan Dr Zip Code: 54901 City: Oshkosh State: WI Onsite Primary Contact: Todd Kempinger Cell phone: Fax: Email: Address same as above City: State: /_ip uoae: Onsite Secondary Contact: Janine Faught Cell phone: 920 - 410 -3683 Fax: none Email: JMFaught @bemis . com Address City: — n,fO An ('t Oshkosh State: WI Zip Lone: 54901 NOTE Either the primary or secondary onsite contact must be present onsite at all times during the event. APPLICATION FOR SPECIAL EVENT PERMIT— TO BE RETURNED TO CITY CLERK SPECIAL EVENT CHECKLIST (please check all boxes that apply) Is your event a: N Festival I Music Concert • Religious / Educational • Rally / Memorial ❑ Street / Block Party o Parade / Fun Run I Walk- a -Thon ❑ March utilizing any Public Property ❑ Public Assembly for Political Purpose ❑ Sport Tournament (Fishing, Soccer, etc.) :n Other Poker Run card deali Location of event: m Park or other public property (Leach Ampitheatre) ❑ Public street, sidewalk, alley, or right of way ❑ Private property Will you have cK Alcoholic beverages (Additional permit required from City Clerk) N Food & non - alcoholic beverages (Additional permit required from Health Dept.) :n Non -food related sales and /or display booths (No additional permits required) Tent and /or Canopy (Free Standing) (Additional permit required from Inspections Dept.) (Digger's Hotline must be contacted minimum of 3 days before digging) ffi Generator(s) and /or additional electrical facilities (Additional permit required from Inspections Dept.) ❑ Fires or Candles (Additional permit required from Fire Dept.) ❑ Fireworks (Additional permit required from Fire Dept.) Activities in a park outside of normal operating hours (Waiver required from City Council) Barricades (Approval from City Clerk's office if in right of way) APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK N Amplified Sound ❑ Animals included or allowed in event (animals must be licensed and have proof of vaccination) Ei Cooking Equipment (Leach facilities) (Fire Department approval required) We have made arrangements for N Restroom and hand washing facilities x Solid waste and recycling services Event insurance Public safety & security / EMS services a Electricity / Generators ❑ Fire extinguishers 2; Advertising with banners or signs Drinking water ❑ Grey water and grease removal Weather contingencies ❑ LP Gas ❑ Tent Heating Space Intentionally Left Blank 14 APPLICATION ETOURNED PERMIT — TO O CITY CLERK S ecial Event Public Safety and Securily Plan Name of Event: Poker on the Fox Location of Event: Leach Ampitheatre Date of Event: Au st 6 2011 (8/5/11 set up 8/ 7/ 11 take dow Time the Event is to Open: Sponsor of the Event: Poker on the Fox Inc . Estimated Attendance (daily and total): 1, 0 0 0 Emer ge^g`J Contact Information: Name: Todd Kem in er Daytime Phone Number: 920 -379 -5111 Cell Number: same Name: Jeremy Probst Daytime Phone Number: 608-642 -7446 Cell Number: same o Name: Jason Faught Daytime Phone Number: 920 -420 -681 Cell Number: same Primary Location of Event Staff at Event Site: Ticket booth and around event. We will be wearing matching shirts. Emer enc Notification of the Public The public will be notified of safety and /or security issues in the following manner: In the event of an emer ency, we will Put uP si ns sa irl the event was canceled; wh t o the event. or an announcement will be made over the PA urin 10 APPLICATION FOR SPECIAL EVENT PERMIT— TO BE RETURNED TO CITY CLERK M il Emergency Medical Serv Name of Provider. Oshkosh Fire De artment Contact Person /Telephone Number: 911 Location of Provider at Event Site: across the street Fire Protection Name of Provider: Oshkosh Fire Department Contact Person /Telephone Number: 911 Location of Provider at Event Site: across the street Number of Fire Extinguishers: unknown Location of fire access roads: adjacent to the Leach Securi Name of Provider: To Be Determined Contact Person / Telephone Number: Location of Provider at Event Site: Location of Missing Persons Station: Ticket Booth Event Parking Locations: City streets and Leach parking lot. 11 APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Severe Weather Contingency Shelter Locations: Leach washrooms Have you confirmed that the locations will be open and available? ves Who will determine if your event is canceled or held? Phone number: Todd Kem in er - 920 - 379 -5111 Public Safety Site Plan Provide a schematic drawing of the event site location. The drawing must be legible and drawn to scale. The public safety plan must include the following items if they will be provided, or if they are required. 1. Location of booths, stages, and event structures on schematic 2. Location of first aid stations on schematic 3. Location of information / ticket booths 4. Boundaries of the event Leach grounds 5. Location of fences around Leach grounds 6. Location of exits and gates (gates must be numbered) on schematic 7. Location of Fire extinguishers on Leach grounds 8. Location of severe weather shelters on schematic 9. Location of Fire / EMS access road on schematic 10. Location of security staff on Leach grounds 11. Location of emergency contact event personnel on Leach grounds 12. Location of assembly area and approximate occupant amounts 13. Location of event parking on schematic 14. Location of barricades Unknown at this time 15. Location of generators Unknown at this time 16. Location of temporary roadways none 12 APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Other Provide any other information that you feel should be considered This is the second year of the event A percent of the p go to chosen organizations that help ma intain and p note safe recreational activities a round the Fox Valley. Yes No x I have reviewed and have considered the Contingency Plan information provided by the City of Oshkosh along with this application (pages 11, 12) X I have reviewed and understand the City's Insurance requirements for Special Events as described in this document (pages 13, 14, and 15) x I am enclosing the event's Public Safety Site Plan (see page 9) x I am enclosing other information that I believe is necessary or helpful to describe the planned event SIGNATURE I am allowed to sign this application on behalf of the event sponsor. The information contained in this application for a Special Event permit is true, correct, and complete to the best of my knowledge. If there are any changes to the Special Event, I agree that I will promptly notify the City of Oshkosh of these changes and equest approval of them. -� / zs /� Todd Kem i r -- Pre ident Date (print name) (pri le with organization) 13 SPECIAL EVENT INDEMNIFICATION AND HOLD HARMLESS AGREEMENT (Medium and High Risk Events) EVENT: Poker on the Fox ORGANIZER: Poker on the Fox, Inc. The event organizer agrees that it, and not the City, will be solely responsible for all incidents related to the event. This responsibility of the organizer to the City includes but is not limited to the actions of the event organizer, its officers, employees, agents, and volunteers, along with event vendors, contractors, subcontractors, participants, and visitors. inconsideration for the City's approval of the Special Event, Poker on the Fox, Inc. the organizer of this event agrees to indemnify and hold harmless the City of Oshkosh, and its officers, council members, agents, employees, and authorized volunteers, from, for, and against and agrees to defend the same from and against, any and all suits, claims, grievances, damages, costs, expenses, judgments and/or liabilities, including costs of defense and reasonable attorneys fees, and further agrees to pay any settlement entered into or on behalf of, or judgment entered against, the foregoing individuals and/or entities. The event organizer shall abide by the City's insurance requirements for the event, including the addition of the City of Oshkosh, and its officers, council members, agents, employees, and authorized volunteers as additional insured's for the event. The individual(s) signing this agreement has the authority to enter into this agreement on behalf of the organizer(s) of the Special Event. EVENT ORGANIZER Poker on the Fox, Inc. (print name of organizer) 11 11l I (date) (date) (sign a e I ('tle) (sign afore) (title) Todd Kem r-President John Konrad - Treasurer (prin t name) (prin t title) (prin t name) (prin t title) 17 H Gate 1 - Only entrance anus exit 2- Registration tent 8- Ticket booth, ID check, money collection, emergency rally point, information, staff check point 4- Alcoholic beverage sales 5- Gard dealing and raffle item display 6- 1/2 of concession area; food and beverage sales 7- wash rooms - severe weather shelter 8- Band staff and volunteer parking g- Vender and Guest free parking 10- Vendor tents Gate Locations (1 umber on Inside of gates)