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Home My WebLink About11-231MAY 24, 2011 11 -231 RESOLUTION (CARRIED 6 -0 LOST LAID OVER WITHDRAWN ) PURPOSE: APPROVAL OF SPECIAL EVENT / AURORA HEALTH FOUNDATION / UTILIZE CITY STREETS FOR THEIR THIRD ANNUAL AURORA 5K WALK/RUN FOR CANCER / JUNE 11, 2011 INITIATED BY: CITY ADMINISTRATION NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that approval is granted to Aurora Health Foundation (Steve Farwig) to utilize Aurora Medical Center and city streets: Westhaven Drive, Ninth Avenue, Oakwood Road and Havenwood Drive on Sunday, June 11, 2011, from 8:30 a.m. to 10:30 a.m. for their Annual Aurora 5k Walk/Run event 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 Street Department -- Barricades / Signs ($105 preliminary estimate) APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK GENERAL EVENT INFORMATION Official Name of Special Event: - fiNtRD ANNuAL AuRoRA SK WA 191ROM FOR CAAKE - k Start Date: :JUMP— // 201 I End Date: TuuE ll, Z0 /1 Briefly describe your event. Be sure to include the purpose of the event and all planned activities. A 5M WALk1RUN S tJ6 An1D E,t WA16 AT AUk6RA MEd►cAL CFAJ cs .4Kosd 7 W tu- gW A eRIEF AWARDS CERE& r}T Ti/ F G6A)C IL yS I -PA) DP Til /2,� e- PR O CF,EDS W>LL- 13AA1Z -FIr ft &.y TS AT ?rWC CSSY&SLl V /AICE 40, y2Dl CAN CER CL1 N i C EVENT SUN MON TUE WED THUR FRI SAT DATE SETUP TIME o66O START TIME OT3O STOP TIME 14) 30 TEAR DOWN / CLEAN UP 1130 COMPLETED Location of Event: AUADRA-MEbleAL crr 6S9.&oS4 ASS D Qoorg Mot JIG Vd 1AVE DR. .; N1AITK Aw. oAt<w bo O RD. 4ND R 4V W o8 D .w. Estimated Attendance (daily & total): 5z S Number of Booths: � T Organization(s) Sponsoring Event: A V R D R A AFAL7 FeVALDAT/d /V (including addresses) 95 IU LJF—�S fwA - VFN .DR 1ver e54,edS,01 J APR 2 5 2G l C CLERK �- s QrF'c� APPLICATION FOR SPECIAL EVENT PERMIT - TO BE RETURNED TO CITY CLERK Primary Contact: 57"e FARt,tJ Daytime Telephone: 0 12a- g - .� Cell Phone: 6 }'2_D -9►7- qi7a Fax: 92D- qY 9- 771 4 Email: s+eye _¢'arw `gQcaUr6y%a.or Address: 2( 36 Ei457"F)eAJ AV . City: PLY 4 4D J TN State: W! Zip Code: 5 3073 Secondary Contact: LI AJ DA t3rRLi N Daytime Telephone: 41 q _ Z [ Q - 4 77 9 Cell Phone: /4 i LI- 732 - 9a) I Fax: - z r - Email: __L; h d. bei- I In & aur ta.p rq Address: q5D 1J. 0 74 ST. S'' G City: M iLWA tJKr--f: State: _ Zip Code: 5 3 3 3 Onsite Primary Contact: S7'r- \/% I=RP f G Cell phone: `�12C> _q f 7 - L4 r 7C Fax: Email: Address: C ity: _ State: Zip Code: Onsite Secondary Contact: Q Aj 0,4 BeAL1 A/ Cell phone: 4 ! L1 - Fi D l 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. 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 Part X Parade un Run /�Dertv ❑ March uti izmg any ❑ 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 'C 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) 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) • Cooking Equipment (Fire Department approval required) We have made arrangements for V Restroom and hand washing facilities • Solid waste and recycling services • Event insurance j( Public safety & security / EMS services ❑ Electricity / Generators ❑ Fire extinguishers >� Advertising with banners or signs Drinking water ❑ Grey water and grease removal ;K Weather contingencies • LP Gas • Tent Heating Space Intentionally Left Blank APPLICATION FOR SPECIAL EVENT PERMIT - TO BE RETURNED TO CITY CLERK Special Event Public Safety and Security Plan Name of Event: AU 106R4 SK W441<LRUM FOR CAAJCER Location of Event: AU20RA MEWCAL - REyrE -12 OSNkaSR AND NEAR S7REE73' Date of Event: /l 20 I ! Time the Event is to Open: 7:0o A.M. Sponsor of the Event: 1IURoRA WALIW CA RE. Au 4pQA //EAyrN FayAld voN Estimated Attendance (daily and total): 525 Emergency Contact Information: Name: Daytime Phone Number: Cell Number: Name: Daytime Phone Number: Cell Number: Name: Daytime Phone Number: Cell Number: Primary Location of Event Staff at Event Site: Emergency Notification of the Public The public will be notified of safety and /or security issues in the following manner: — SiTF -5 F_['.!)Q% 6FFiC.i�Y -eS ( K?-GI -C i r ootii APPLICATION FOR SPECIAL EVENT PERMIT - TO BE RETURNED TO CITY CLERK Emergency Medical Services Name of Provider: OSN F 12 r- DC-PL, O/LI S Contact Person / Telephone Number: 13 4 - ALMA) CMEF I /M A L)SIA D 2346 - 5287 Location of Provider at Event Site: SFATI19/J / Fire Protection Name of Provider: 06 0e4SP FIRE OF Contact Person /Telephone Number: r/17r--:F - 1'iMOTN V RMIZ 23h Location of Provider at Event Site: 51 �7 D/lJ 15 Number of Fire Extinguishers: A// A Location of fire access roads: 60)ZGFRY ft ,0D gmeg6 Ajey FNiRAkt,G5 Securi Name of Provider: AVRURA Lass PREAEA)I vi10f�S �Ul2 Contact Person /Telephone Number: M kE ORO WA/ H56 7D 15 Location of Provider at Event Site: RFG 15TRATIoAl AAF--A Location of Missing Persons Station: �/A Event Parking Locations: SURCg-iQY C R PAROA!G LDT APPLICATION FOR SPECIAL EVENT PERMIT - TO BE RETURNED TO CITY CLERK Severe Weather Contingency Shelter Locations: & F-ew S l APEA iN i4b5P rn+t- SURGERY f{ - D E-A Have you confirmed that the locations will be open and available? Y-E Who will determine if your event is canceled or held? Phone number: 6:VF-nJri 7 BE 14cLO RAW OR SHI&JE 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 / 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 APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Other Provide any other information that you feel should be considered l4 / P O YEAR FOR E✓EA1 T kAVE ALREAoy cDM,P-IUAlICA7;Cb Wr9'H AfA nrgAR215 of oSNKoSa PD. 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) v 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 changes and request approval of them. RR� P • / S`fEPN f.OwiG Abumb4 om DeyraoPM6N Date (print name) (print title with organization) oFFIcE2 SPECIAL EVENT INDEMNIFICATION AND HOLD HARMLESS AGREEMENT (Medium and High Risk Events) EVENT: AURORA 5 WRal �Ru�I FO CAAICER ORGANIZER: AugoR4 -tTh1 F0u.\1h4 - r1.p 1 STtVE FARW�G 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, - AURORA /SEA L114 Fp�J,t14�,(p� 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 AURORA NFAC04 FOUM AT/ON (print name of organizer) , q-7- it (date) (date) �ignature) (title) O (signature) (title) STE-04EN F49Wt6 FV0AtbA-r4 (print name) (print title) (print name) (print title) D F.J�� oPMFiuT OFFICER A C � u Y O OL fC L cC a c 0 O a 2 0 0 91 u C Z-40 " O T � (1 • N. Westhaven Dr. MA 4! 0 O O O = Q 4A W f0 +� v� E c u s !� Q a L � o o a 3 3 c ai u C R V = O r O ' ° o Wyldewood Rd. Q 3 LM 1 Q 3 s S. Oakwood Rd. A C � u Y O OL fC L cC a c 0 O a 2 0 0 91 u C Q " O � (1 • MA 4! 0 O g Q 4A f0 +� v� E c u s !� Q a L � o o a 3 3 u C R V = O Q LM 1 Q Google Maps A, Menominee Park Zoo 215 Church Ave, Oshkosh, WI (920) 236 -5082 3 reviews 1 of 1 liltp:# maps .googlc.con 'Vmaps`tclient= linefo a &channel=s &hl= cn&sa... I Get Google Maps on your phone o 4 9 Text tf*mrd'GMAPS" to4664 S 3 � y 5/7120118:45 AM Google maps S Orr , 3 NF I Stmool OakC(eSt 1. lUy1Qrk%d.Rd.' !IfltrotAvu.:. a" � � Q A, Menominee Park Zoo 215 Church Ave, Oshkosh, WI (920) 236 -5082 3 reviews 1 of 1 liltp:# maps .googlc.con 'Vmaps`tclient= linefo a &channel=s &hl= cn&sa... I Get Google Maps on your phone o 4 9 Text tf*mrd'GMAPS" to4664 S 3 � y 5/7120118:45 AM Google maps S Orr , 3 NF I