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Home My WebLink About11-236MAY 24, 2011 11 -236 RESOLUTION (CARRIED 6 -0 LOST LAID OVER WITHDRAWN ) PURPOSE: APPROVAL OF SPECIAL EVENT / ELKS LODGE #292 / UTILIZE RAINBOW PARK FOR THEIR 21 ANNUAL OSHKOSH ELKS SHEEPSHEAD FISHING TOURNAMENT/ JULY 16, 2011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 Elks Lodge #292 (Jason Ellis) to utilize Rainbow Park on Saturday, July 16, 2011 from 7:00 a.m. to 5:00 p.m. for their 21 s ' Annual Oshkosh Elks Sheephead Fishing Tournament 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 s'r Official Name of Special Event: j Ao)oc)i J Start Date: �� - � H �� End Date: M IIJ4 14 3 1 EVENT SUN MON TUE WED THUR FRI SAT DATE SETUP TIME START TIME , ObAi STOP TIME 5' ;0 TEAR DOWN / CLEAN UP 7: z �f COMPLETED Location of Event: Estimated Attendance (daily & total): Booths: 10 Number of Organization(s) Sponsoring Event: (including addresses) QSQ kor14 y40 N MAY - D �Orrl C/ TyCCERK'S CEI Briefly describe your event. Be sure to include the purpose of the event and all ninnnPri activities. APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Primary Contact: Daytime Telephone: �si 5- x r - Cell Phone: 0 1 1 - Fax: Email: 0 Address: City: _ Zip Code: Secondary Contact: �`►t ►�+ �'� Daytime Telephone: Cell Phone: 279 Fax: Email: Address: �� .�� ty'u'.1J�1k � � City: 6tjq 1� State Zip Code. Onsite Primary Contact: SaMz�U� Cell phone: Fax: Email: Address: City: State: Zip Code: Onsite Secondary Contact: �1 6rP 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 / 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 % erk) I �'�1 Sv�CQS�r Y.�t �� Alcoholic beverages a.�� j X (Additional permit required from City p 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 CLERKMIT — TO BE RETURNED TO CITY . 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 • Fire extinguishers • Advertising with banners or signs • Drinking water • Grey water and grease removal ❑ Weather contingencies ❑ LP Gas ❑ Tent Heating Space Intentionally Left Blank APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Spec Event Public Safety and Se curity Plan Name of Event: � 11 ` �� , " ' Location of Event: Date of Event: Time the Event is to Open: Sponsor of the Event: Estimated Attendance (daily and total):OU Emergency Contact Information: Name: Daytime Phone Number. Cell Number: j23= -'�' Name: Daytime Phone Number: Cell Number: Name: Daytime Phone Number: Cell Number: c. Primary Location of Event Staff at Event Site: Jcari = ✓ �' Emergency Notification oft ie Public The public will be notified of safety and/or security issues in the following manner: in APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Emergency Medical Servic Name of Provider: Contact Person / Telephone Number. Location of Provider at Event Site: _ Fire Protection Name of Provider: �� h 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 available? 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 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 r�( 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) 3_ 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 request approval of them. 1a � ; Tw�Ua r-1',r �� e.tJ Date (print name) (print title with organization) APPLICATION FOR SPECIAL EVENT PERMIT — FOR REVIEW ONLY CONTINGENCY PLAN when Event sponsors should review and consider of folio i ng is u e they are planning or preparing for an event. Many r are components of larger regulations. by one or more regulations, o be to the Con sidering other issues which may not be required shhould to these questions planning and operation of the event. Developing responses should result in more productive and fruitful discussions with the various ' departments with the City during their revie w of the Special Event Application. . Weather related issues: rain, snow, severe storms, tornadoes, etc. a. If the weather forecast includes bad weather, will the event be cancelled? If so, how will attendees be notified? here b Develop a plan for the sudden onset of severe a sta e arrival at th safe pe go and who is designated to assist in refuge place? c. Is there an area of safe refuge in case of a tomado? 2. Medical issues in case one is needed? a. Where will ambulance access to the event b of a medical emergency? b Who will conduct crowd control in the even be p rovided at Will a first aid station, with trained first aid provider, C. the event? Where . d. If applicable, is there adequate shade to prevent heat stroke? Will water be provided? Where? 3. Crowd Control a Who will monitor the barricades? b. Who will work the entry gates? Maintain egress and access? C. Who will patrol the area to prevent incidents from getting out of control? d. Develop a plan for those patrolling the ve communications equipment. they encounter unruly behavior. H APPLICATION FOR SPECIAL EVENT PERMIT — FOR REVIEW ONLY 4. Security a. Will there be Police Officers providing security? If so, contact the Police Department for applicable requirements or guidelines relating to the number necessary. ro appropriate b. If volunteers or private agencies provide Police? curity, will they have app p phone numbers for EMS, Fire, and c. If applicable, what will security officials do if non - paying attendees breach the gate or perimeter? d. If a complaint is received, for example, for loud music, how and who will handle the complaint? equipment. Portable radios, cell phones, and e. Provide communications access to land lines. nies in an area not accessible to the attendees. f. If applicable, secure mo 5. Event Logistics a. Where will there be, or will there be, a staging area for support staff? d be disbursed and by whom? b. What time will the crow c. Who will conduct clean up? and access d. Remember to maintain o oversee a and take responsibility for the event. Who? e. Appoint one person f. Will an adequate amount of restroom facilities be provided? Where? g. Is there adequate safe parking provided Where . Space Intentionally Left Blank SPECIAL EVENT INDEMNIFICATION AND HOLD HARMi F SS AGREEMENT (Medium and High Risk Events) EVENT: ORGANIZER: � k s ' 4"r � 1- 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, Js�t't� AI I S 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 organ of the Special Event EVENT ORGANIZER (print name of organizer) (date) 0L ro-p-Irl 1' (signature) title) (print name) (print t itle ) (date) (signature) (title) (print name) (print title) e,21r � j�+ e `v�� a �3 � � o..�.J