HomeMy WebLinkAbout11-135MARCH 22, 2011 11 -135 RESOLUTION
(CARRIED 7 -0 LOST LAID OVER WITHDRAWN )
PURPOSE: APPROVAL OF SPECIAL EVENT / BOYS & GIRLS CLUB OF
OSHKOSH / UTILIZE SIDEWALKS & MENOMINEE PARK FOR
BOYS & GIRLS CLUB OSHKOSH KIDS ON PARADE / JUNE 15,
2011
INITIATED BY: CITY ADMINISTRATION
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of
Oshkosh that approval is granted to the Boys & Girls Club of Oshkosh (Tracy Ogden) to
utilize sidewalks (Route: Broad Street, Parkway Avenue and Hazel Street) and Menominee
Park, on Wednesday, June 15, 2011, from 5:00 p.m. to 8:00 p.m., for their kids on parade,
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 RETURNED TO CITY
CLERK
GENERAL EVENT INFORMATION
Offic4lName of Special Event:
EVENT
SUN
MON
TUE
WED
THUR
FRI
SAT
DATE
SETUP TIME
3u
START TIME
3 `,
STOP TIME
°
TEAR DOWN
t � o
/ CLEAN UP
COMPLETED
Location of Event;
V I -
Estimated Atte dance (daily & total): "� 1�� Number of
Booths:
Organizatjoa4s) S
(including addresses
sor g E1' C� 0131 CJ
FEE 1 p 2011 C
�7Y CL� aFFICEI
rt
Start Date:, ) End Date: JLry
Brieflv describe your event. Be sure to include the purpose of the event and all
APPLICATION FOR SPECIAL EVENT PERMIT - TO BE RETURNED TO CITY
CLERK
11
Primary Contact: ( J (-, i
Daytime Telephone: 'i93 3 - L;Lll -1
Cell Phone:
Fax:
Email: --/,� n o' o 0o, Cv
Address: UI " 1 chi /5 W
City: � St
Secondary Contact: ✓` / /1 � ,
Daytime Telephone: U9 -
Cell Phone: (- /Q
Fax:
Email:
Zip Code:
Address:
City: State: Zip Code:
Onsite Primary Contact:
Cell phone:
Fax:
Email:
Address:
City: State:
Zip Code:
Onsite Secondary Contact:
Cell phone:
Fax:
Email:
Address:
City: State:
Zip Code:
NOTE Either the primary or secondary onsite
contact must be present onsite at
all times during the event.
7
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
SPECIAL EVENT CHECKLIST
(please check all boxes that apply)
Is your event a:
❑ Festival / Music Concert
❑ Religious / Educational
❑ Rally / Memorial
❑ Street / Block Party
Parade 1 Fun Run / Walk- a -Thon
❑ March utilizing any Public Property
• Public Assembly for Political Purpose
• Sport Tournament (Fishing, Soccer, etc
❑ Other
Location of event:
Park or other public property
. Public street, sidewalk, alley, or right of way
❑ Private property
Will you have
❑ Alcoholic beverages
(Additional permit required from City Clerk)
Food & non - alcoholic beverages
(Additional permit required from Health Dept.)
Non -food related sales and/or display booths
(No additional permits required)
❑ Tent and /or Canopy
(Additional permit required from Inspections Dept.)
(Digger's Hotline must be contacted minimum of 3 days before digging)
❑ 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)
E
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
Amplified Sound
❑ Animals included or allowed in event
(animals must be licensed and have proof of vaccination)
i Cooking Equipment
(Fire Department approval required)
We have made arrangements for
Restroom and hand washing facilities
❑ Solid waste and recycling services
,Event insurance
❑ Public safety & security I EMS services
Electricity / Generators
X` Fire extinguishers
Advertising with banners or signs
-ff Drinking water
• Grey water and grease removal
• Weather contingencies
❑ LP Gas
❑ Tent Heating
Space Intentionally Left Blank
9
APPLICATION FOR SPECIAL EVENT PERMIT—
TO BE RETURNED TO CITY CLERK
Name of Event:
Location of Event:
fi
TM
----k Date of Event:
Time the Event is to Open:
Sponsor of the Event:
Estimated Attendance (daily and total):
Emeraencv Co ntact Information:
Name: r' -1 n�
Daytime Phone Numb*(.
um
Cell Number:
Name:
7
Daytime Phone N ber: -/ i
Cell Number: X 0.5/6. 3 VL J
Name: 1 0,
Daytime Phone Number: -
Cell Number: t - n V, -
Prima Location of Event Staff at Event Site: ry -
Emergency Notification of the Public
The public will be notified of safety and/or security issues in the following
manner:
10
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
Emergency Medical Services
Name of Provider:
Contact Person / Telephone Number:
Location of Provider at Event Site:
Fire Protection
Name of Provider:
Contact Person / Telephone Number:
Location of Provider at Event Site:
Number of Fire Extinguishers:
Location of fire access roads:
Securi
Name of Provider:
Contact Person / Telephone Number:
Location of Provider at Event Site:
Location of Missing Persons Station:
Event Parking Locations:
11
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY
CLERK
Severe Weather Contingency
Shelter Locations:
Have you confirmed that the locations will be open and ava
Who will determine if your evgnt-is canceled or /held? Phon�
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
2. Location of first aid stations
3. Location of information 1 ticket booths
4. Boundaries of the event
5. Location of fences
6. Location of exits and gates (gates must be numbered)
7. Location of Fire extinguishers
8. Location of severe weather shelters
9. Location of Fire / EMS access road
10. Location of security staff
11. Location of emergency contact event personnel
12. Location of assembly area and approximate occupant amounts
13. Location of event parking
14. Location of barricades
15. Location of generators
16. Location of temporary roadways
12
APPLICATION FOR SPECIAL EVENT PERMIT
— TO BE RETURNED TO CITY CLERK
Other
Provide any other information that you feel should be considered
Yes No
I have reviewed and have considered the Contingency Plan
information provided by the City of Oshkosh along with this
application (pages 11, 12)
I have reviewed and understand the City's Insurance
requirements for Special Events as described in this document
(pages 13, 14, and 15)
I am enclosing the event's Public Safety Site Plan (see page 9)
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
change an request ap roval of them.
L /f
�)� (p � dnt Date
le with organization)
13
SPECIAL EVENT
INDEMNIFICATION AND HOLD HARML AGREEMENT
(Medium and High Risk Events)
_ t I
EVENT: L C , ? I
ORGANIZER:
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.
In consideration for the City's approval of the Special Event, L U 5
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.
/
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