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Home My WebLink About11-233MAY 24, 2011 11 -233 RESOLUTION (CARRIED 6 -0 LOST LAID OVER WITHDRAWN ) PURPOSE: APPROVAL OF SPECIAL EVENT/ COMMUNITY BLOOD CENTER/ UTILIZE OPERA HOUSE SQUARE & MARKET STREET FOR THEIR OPERATION DONATION /JUNE 16, 2011 INITIATED BY: CITY ADMINISTRATION NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that approval is granted to Community Blood Center (Ruth Welhouse) to utilize Opera House Square and Market Street on Thursday, June 16, 2011 from 10:00 a.m. to 5:00 p.m. for their Operation Donation (blood drive) 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 RETURNRITdCk ' fir^ L CLERK GENERAL EVENT INFORMATION �I APR 06 2011 Official Name of Special Event: CIT C �\ L�' O FFICE 1\ n li ✓7 i ',=..n �n sIl /Y - {"1 Ifl l/� Start Date: Go �1�, l End Date: to (1 C Briefly describe your event. Be sure to include the purpose of the event and all EVENT DATE SUN MON TUE WED THUR FRI SAT SETUP TIME t M AM START TIME 10'.000 STOP TIME 5'. Do em TEAR DOWN / CLEAN UP COMPLETED �'.( IN Location of Event: Estimated Attendance (daily & total): Number of Booths: Organiz�tion(s) Sponsori (inclua u wa+rti nci ckym APPLICATION FOR SPECIAL EVENT PERMIT - TO BE RETURNED TO CITY CLERK Primary Contact: 0 �- I $i f r✓I Daytime Telepho �, 2 �- ILI - 3 Cell Phone: Fax: Email: 0) A % / Iftion State Secondary Contact: 1121 C, I Gl K.i' Daytime Tele hone: Cell Phone: Fax:. j 31_Co Email: +V-lSSin6 Address: City: � Zip Code: State WJ� Zip Code: Onsite Primary Contact . .1111 Cell phone: • Fax: MIAA. :_ Addr City: State 'VV Zip Code: WWI To Address City: y State: VV- 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 Party ❑ Parade / Fun Run / Walk- a -Thon ❑ March utilizing any Public Property • Public Assembly for Political Purpose • Sport Tournament (Fishing, Soccer, etc.) Y Other 191D o d jP -1 Location of event: Park or other public property Public street, sidewalk, alley, or right of way •— 00 bCcX"i WC WC fSWV� _D ❑ Private property Will you have ❑ Alcoholic beverages (Additional permit required from City Clerk) Food &non- alcoholic beverages ;, e (Additional permit required from Health Dept.)' jW OQ�I�t ❑ Non -food related sales and /or display booths (No additional permits required) i Tent and /or Canopy (Additional permit required from Inspections Dept.) — . - U1 c(�,�1Q�� - tin -►'��2 X�2 (Diggers 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) :3 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 Restroom and hand washing facilities Solid waste and recycling services Event insurance Public safety & security / EMS services ❑ Electricity / Generators X Fire extinguishers Advertising with banners or signs Drinking water ❑ Grey water and grease removal �i Weather contingencies • LP Gas • Tent Heating Space Intentionally Left Blank 101 APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Special Event Public Safety and Security Plan Name of Event � -1 ' (MAdEla Location of Event: �l'� 1► ,t..i Date of Event: Time the Event is to Open: Sponsor of the Event: Estimated Attendance (daily and total): Emergency Contact Information: Name: Q.aIb Vk 0(lQ tlSt Daytime Phone Number:� 3$�3 Cell Number: Lg20 � Name: Daytime Phone Number: ftff E� GE Cell Number: 1171cl C, - - `ice /.1'��hl�[�i[ti�iri Y Primary Location of Event Staff at Event Site: ( M Emergency Notification of the Public The public will be notified of safety and /or security issues in the following mnnnar APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Emergency Medical Services Name of Provider: I I_(Ito of Ix yl S Contact Person / Telephone Number: I Location of Provider at Event Site: o U tq &_ �l� - zn± of m `f Fire Protection Name of Provider: 1 ++ j Contact Person / Telephone Number: q 1 I Location of Provider at Event Site: Ina Odd AO 0� M ft� A t `r° V1w Number of Fire Extinguishers: y Location of fire access roads: + 13 Ud J' * Mai S+. Securit Name of Provider: Contact Person I Telephone Number: Location of Provider at Event Site: NJ Location of Missing Persons Station: Event Parking Locations: APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Severe Weather Contingency S Have you confirmed that the locations will be open and available? LAkS Who will determine if your event is canceled or held? Phone number: 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 Yes No I have reviewed and have considered the Contingency Plan information provided by the City of Oshkosh along with this application (pages-J,;; ?) 1` I have reviewed and understand the City's Insurance requirements for Special Events as described in this document (pages and X I am enclosing the event's Public Safety Site Plan (see pagq g' 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. &7M � J VWUS e , CDC- * �- Date (print name) (print title with organization) 13 The Community Blood Center Inc. March 16, 2011 City Council City Hall P.O. Box 1130 Oshkosh, WI 54903 Dear City Council, My name is Ruth Welhouse and I'm your local representative from the Community Blood Center. The Community Blood Center is your local sole blood provider and we have been providing 100% of the blood products used at Mercy Medical Center since September of 1995 and at Aurora Medical Center since July of 2003. We also provide the blood products used in hospitals surrounding your community such as Berlin Memorial Hospital, Ripon Medical Center, and Theda Clark Medical Center in Neenah. The last five years, The Community Blood Center hosted a special event blood drive in Opera House Square called "Operation Donation ". In 2010, we recruited 54 blood donors from area businesses as well as from community organizations to come down to the square and save some lives right here in our community. Because this event was overwhelmingly successful, we are looking to host the 6 th Annual event on June 16. We would like to use the Opera House Square on June 16 from 8 a.m. - 7 p.m. (the blood drive will run from 10 a.m. - 5 p.m. but we will need set -up and take down time). We are hoping that you will allow us to park our bloodmobiles on Market Street alongside the square, as well as to use the park area for our registration set -up and reception area for donors. Please contact me at (920) 560 -6653 with any questions or concerns regarding this request. I look forward to hearing from you soon. Sincerely, Ruth Welhouse Donor Recruitment Specialist The Community Blood Center 4406 W. SPENCER STREET • APPLETON, WISCONSIN 54914 -9106 920 - 738 -3131 • 800- 280 -4102 • Fax: 920 -738 -3139 SPECIAL EVENT INDEMNIFICATION AND HOLD HARMLESS AGREEMENT (Medium and High Risk Events) EVENT: � �p(/ Gt,CI ORGANIZER: Wm YY1MA U 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 app of the Special Event, �.,..� 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 ' 2U - I , W�Aio u-S t (print name of organizer) tu - I!► (date) (date) (signature (titic) S>�GIGt (signatur (tit e) Z�l 1S'YlEa2 '►� � �n�el hot,�S 2 , n = i� me;� ( n 'c IdLss; Y1 ge Ir nn sor, (print name) (print title)Sfe- (A6Qi1S (print name) (print duel /