HomeMy WebLinkAbout11-384AUGUST 23, 2011 11 -384 RESOLUTION
(CARRIED 6 -0 LOST LAID OVER WITHDRAWN )
PURPOSE: APPROVAL OF SPECIAL EVENT / APRIL ZINK / UTILIZE ABE
ROCHLIN FOR ALLIE'S ANGELS FUNDRAISER / SEPTEMBER
10, 2011
INITIATED BY: CITY ADMINISTRATION
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of
Oshkosh that approval is granted to April Zink to utilize Abe Rochlin Park on Saturday,
September 10, 2011 from 1:00 p.m. to 7:00 p.m. for Allie's Angels Fundraiser 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
none
APPLICATION FOR SPECIAL EVENT PERMIT— TO BE U�I yTY
CLERK u Y IE
GENERAL EVENT INFORMATION
AUG 05 2011
Start Date:
EVENT
SUN
MON
TUE
WED
THUR
FRI
SAT
DATE
SETUP TIME
START TIME
I M
STOP TIME
'?
TEAR DOWN
30
/ CLEAN UP
I M
COMPLETED
Location of�Event:
Official Name of
OVA VI r OFFICE
End Date: QS 19- +, 1 C C)
Number of
e
Estimated Attendance (daily & total):
Booths:
Organization(s) Sponsoring Event:
(including addresses)
6
0
Briefly 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
Primary Contact: A if) rs k 7 1 Y"k-
Daytime Telephone: q 20 - 231- q L - 1 n
Cell Phone:
Fax:
Email: 1 . z �`n K I rs w (, , ) r'4
Address: ZLIO CAS
City: 1,61, 0 6L2011
State:
g -5 arc r �►-\.A -H- ! l
Zip Code:
Secondary Contact: L r- -�.-YY
Daytime Telephone: qZG- ZS Z - 3Zb:
Cell Phone: Sfii"P_
Fax:
Email:
Address:
City: _
State:
Zip Code:
Onsite Primary Contact: 56.M S 010 VP
Cell phone:
Fax:
Email:
Address:
City: _
State:
Zip Code:
Onsite Secondary Contact: , ��Lmto QS above,
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 vour 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
`� 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 Pp s'5 ;
(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)
I
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
Fire extinguishers
Advertising with banners or signs
Drinking water
❑ Grey water and grease removal
❑ Weather contingencies
❑ LP Gas
❑ Tent Heating
Space Intentionally Left Blank
0
APPLICATION FOR SPECIAL EVENT PERMIT —
TO BE RETURNED TO CITY CLERK
Name of Event:
Location of Event:
Date of Event:
4
Time the Event is to Open: j 4
Sponsor of the Event: l 0US
Estimated Attendance (daily and total): hncv � iv (l Ind
Emergency Contact Information:
Name: No � z i r\ K
Daytime Phone Number: CiW Z3l- LI"1 qQ
Cell Number: q20 - 21 (c- 31 LJ - 1
Name: I , Inc t . P 4re- �
Daytime Phone Number: 1 1 32-0 3
Cell Number: ",C-Lp,
Name:
Daytime Phone Number:
Cell Number:
Primary Location of Event Staff at Event Site: ?0-vi l I, o n
Emergency Notification of the Public
The public will be notified of safety and /or security issues in the following
manner:
Special Event Public S afety and Secu
10
APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO C /TY
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 Location
Have you confirmed that the locations will be open and available?
Who will determine if
Public Safety Site Plan
ur event is canceled or held? Phone number:
Ziyk. 520 -21U -3`181 Uyda Qrfi-1( --
92-0-zs2 -3zo3
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
Yes /
V
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.
changes and request approval of them.
a
�T V
( rint name) (print title with organization)
Date
13
Provide any other information that you feel should be considered
APPLICATION FOR SPECIAL EVENT PERMIT — FOR REVIEW ONLY
CONTINGENCY PLAN
Event sponsors should review and consider the following issues when
they are planning or preparing for an event. Many of these issues are required
by one or more regulations, or are components of larger regulations.
Considering other issues which may not be required should contribute to the
planning and operation of the event. Developing responses to these questions
should result in more productive and fruitful discussions with the various
departments with the City during their review of the Special Event Application.
1. 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?
b. Develop a plan for the sudden onset of severe weather. Where will the
people go and who is designated to assist in their safe arrival at the safe
refuge place?
c. Is there an area of safe refuge in case of a tornado?
2. Medical Issues
a. Where will ambulance access to the event be in case one is needed?
b. Who will conduct crowd control in the event of a medical emergency?
C. Will a first aid station, with trained first aid provider, be provided at
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 crowd of what to do if
they encounter unruly behavior. Have communications equipment.
14
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.
b. If volunteers or private agencies provide security, will they have appropriate
phone numbers for EMS, Fire, and Police?
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?
e. Provide communications equipment. Portable radios, cell phones, and
access to land lines.
f. If applicable, secure monies in an area not accessible to the attendees.
5. Event Logistics
a. Where will there be, or will there be, a staging area for support staff?
b. What time will the crowd be disbursed and by whom?
c. Who will conduct clean up?
d. Remember to maintain fire lanes and access roads.
e. Appoint one person to oversee and take responsibility for the event. Who?
f. Will an adequate amount of restroom facilities be provided? Where?
g. Is there adequate safe parking provided? Where?
Space Intentionally Leff Blank
15
SPECIAL EVENT
INDEMNIFICATION AND HOLD HARMLE AGREEMENT
(Medium and High Risk Events)
EVENT: VS 41A W.1
ORGAN=:
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,
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
(print name / of organizer)
( te)
n (signs e) (title)
4 10 r r Z- ;A)
(print name) (print title)
(date)
(signature) (title)
(print name) (print title)
17
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