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Home My WebLink About11-342JULY 26, 2011 11 -342 RESOLUTION (CARRIED 6 -0 LOST LAID OVER WITHDRAWN ) PURPOSE: APPROVAL OF SPECIAL EVENT / MIDWEST FEST LLC / UTILIZE WINNEBAGO COUNTY FAIR GROUNDS FOR THEIR MIDWEST FEST 2012 / JUNE 15, 16, 17, 2012 INITIATED BY: CITY ADMINISTRATION NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that approval is granted to Midwest Fest LLC (Craig Weborg) to utilize Winnebago County Fair Grounds, on Thursday, June 15, 2012, Friday, June 16, 2012, Saturday, June 17, 2012. 1:00 p.m. to 12:00 midnight each day, for their Midwest Fest 2012 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 no estimated cost at this time APPLICATION, .FOR SPECIAL GENE I N f S ecial Event• EVENT PERMIT — TO BE RETU CLERK RAL EVENT INFORMATION F � JUN 2 7 2011 Officia ame o p � pC0 �+ CLERKS OFFICE Start Date: a " - End Date �� ZQj Briefly describe your event. Be sure to include the purpose of the event and all planned activities. EVENT SUN MON TUE WED THUR FRI SAT DATE SETUP TIME A START TIME STOP TIME TEAR DOWN / CLEAN UP (�'; 66 p COMPLETED Location of Event: Estimated Attendance (daily & total): Booths: fib Organization(s) on orin v 4. (including addresses) r1a I F_ . ADc (j1 = r 6 " 'C' � Af CPA 6 1 0 W 1 W OD Number of A A0 (—) ) ft�ok 6 -APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Primary Contact. _ Daytime Telephone Cell Phone: Fax: Email: 01 Address: City: _ qZo- 92o- q2r, - 73 Elias 4 72 / E L, 3 3 - 67` aor c� sf Secondary Contact: Daytime Telephone: Cell Phone: zz)iaie: w t up uooe: Fax: Email: Address: City: _ State: Zip Code: Onsite Primary Contact: ,,nom q CJ�r� Cell phone: 2 ( 5 - J - 3 b Fax: Email: CG w,l u-S f> .r o.o (- co.�� Address: 7?-/ E S 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 Parry • 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 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) X Barricades (Approval from City Clerk's office if in right of way) APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Y 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 X Event insurance X Public safety & security / EMS services y�' 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 Special Event Public Safety and Security Plan Name of Event: �w �<"3t qo ) a, Location of Event: Date of Event: lac 6- 4o1 i Time the Event is to Open: u� I e ��- 1 S�� l� )Z Sponsor of the Event: �� s� �I11,' I�ec ZWA e L Estimated Attendance (daily and total): e5d,! Emergency Contact Information: Name: YU Cbor Daytime Phone Number: Cell Number: I flo Name: Daytime Phone Number: Cell Number: Name: Daytime Phone Number: Cell Number: Primary Location of Event Staff at Event Site: '06 eJ '14a 2 ;'! 2 gfex nn ) �n Emergency Notification of the Public The public will be notified of safety and /or security issues in the following manner: ( � io_ I - A in APPLICATION FOR SPECIAL EVENT PERMIT - TO BE RETURNED TO CITY CLERK Emer -gency Medical Services Name of Provider: Contact Person / Telephone Number: 92o - q 19 - ta`j Location of Provider at Event Site: S.1rry V ie,,j �k Fire Protection Name of Provider: ® F 0 Contact Person / Telephone Number. % -5Zyo Location of Provider at Event Site: w wT Number of Fire Extinguishers: - 7 - -o 9.e, Location of fire access roads: ex,;-He, 1 Security Name of Provider: kn e 2 l< «� Contact Person / Telephone Number: / �Q - 9- y f�rv�L Location of Provider at Event Site: a?"4 Location of Missing Persons Station: 9Vr r\yVdPj,,J Event Parking Locations: L„ -# 3 1 1 , 11 PLICATION FOR SPECIAL EVENT PERMIT – TO BE RETURNED TO CITY AP CLERK Sev ere Weather Conti ngency Shelter Locations: �N(\y V p- ".&) E *� �� Have you confirmed that the locations will be open and available? — Who will determine if your event istcgan�ele�or held? Phone number: Public Safety Site P lan Provide a ust be schematic drawing of the event site location. The drawing the fo lowing legible and drawn to scale. The public safety p items if they will be provided, or if they are requi Ian must inclu red. 1. Location of booths, stages, and event structures 2. Location of first aid stations 3. Location of the event/ ticket booths 4. Boundaries 5. Location of fences (gates must be numbered) 6. Location of exits and gates (g 7. Location of Fire extinguishers g. Location of Fire shelters g. Location / EMS access 1 o. Location of security staff tact eve personnel 11. Location of emergency con a occupant amounts 12. Location of assembly area and approximate 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 w tiIl I ^C� CL51 I have ati in pro by have the City Contingency ty of O hkosh along wit Phis information pr 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 changes a req ue s a6proval of them. 6 - d,'7 - 20 1 1 ( I r (print na ) print title with organization) Date 1q SPECIAL EVENT INDEMNIFICATION AND HOLD HARMLESS AGREEMENT (Medium and High Risk Events) EVENT: ac ORGANIZER: x c 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, rCx; � DY 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 ORGA� e �� g (OSht name of organizer) Z - 7-- ZQ 1 V /4 kvnel (date) p r-. 4r r (si e) (title) (print name) (print title) (date) (signature) (title) (print name) (print title) i U _ ' U sx Y 3 s ., O Q. i � x .7A f == f!