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Home My WebLink About11-482 OCTOBER 25, 2011 11-482 RESOLUTION (CARRIED__7-0___LOST________LAID OVER________WITHDRAWN________) PURPOSE: APPROVAL OF SPECIAL EVENT / SPECIAL OLYMPICS / UTILIZE MENOMINEE PARK FOR POLAR PLUNGE / FEBRUARY 17 - 18, 2012 INITIATED BY: CITY ADMINISTRATION NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that approval is granted to Special Olympics Fox Valley Area (Nicci Sprangers) to utilize Menominee Park (Miller’s Bay & Parking Lot), on Friday, February 17, 2012, from 11:00 a.m. to 7:00 p.m. and Saturday, February 18, 2012, from 10:00 a.m. to 4:00 p.m. for their Polar Plunge benefitting Special Olympics, in accordance with the municipal code and the attached application, with the following exceptions/conditions: A. B. C. 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 ($580 preliminary estimate) APPLICATION FOR SPECIAL EVENT PERMIT— TO BE RETURNED TO CITY CLERK GENERAL EVENT INFORMATION Offici I Name of Special Event: Ckf P(WA e 4Ir, Srcto I O ) if s Start Date: 4, I t 2 En Date: /14)/ 12 Briefly describe your event. Be sure to include the purpose of the event and all planned activities. I apivr al,0.0 Peeto *f mid 0.4. s aAgit 016 Jti �:..• ••- ., 4_i• • ■ � � _ �I �� /ii[ ' � Ili � • �� r.•i d 1 4A. Y -II_ 6 • It lI ., �`-4 •. .1 • ,a_I ii aervie• EVENT SUN MON TUE WED THUR FRI SAT DATE a))55 °)1i1p .It$ SETUP TIME g:c,o_S:07 $-SSjr, 53-5 oc. 8:00•►�, START TIME tr.00*. io.00wv+ toire,6pr�115•Sir.,E,o� STOP TIME 1:cofa''', Woo Qr„ TEAR DOWN /CLEAN UP �.pp�rr+ COMPLETED Location of Event: n ; 11s Ark- Estimated Attendance (daily & total): 'r'dai 50° 1 Sa 359° of Booths: S-1 Organization(s' Sponsoring Event: J e c 6) ) min C.1 -64, (k !/ I? / o - (including addresses) A) 5 3 (o Cot, I& opeip -Pain Wes/ SSi9/5.. SEP 15 2011 APPLICATION FOR SPECIAL EVENT PERMIT- TO BE RETURNED TO CITY CLERK Primary Contact: !v l CC,r c rc Prs _ ` - �%'( q Daytime Telephone: 99n- 3I-vf ` � Cell Phone: c1, 0 5Q - poi y 8 Fax: °T 2,i - 3(,Q Email: n Sefrt n jprS sperm r»Pic`S Sc-cons,n . Or Address: I ) 53hI CAL L, Ro/. k/C Ste D. City: j p fri✓i State: L J;i Zip Code: Syq/5 Secondary Contact: �4. gran Shuk?e_s Daytime Telephone: aa.o- - 367 Cell Phone: sam s. Fax: Email: brsektweles ® uYb. uS Address: 4,90 S-) . City: Dsh(;'rah State: c.J 7 Zip Code: G4 q p 1 Onsite Primary Contact: • d ' i • -_ s c( %ra17 ('YS' Cell phone: Fax: Email: Address: City: State: Zip Code: a , Onsite Seconds Contact. Rr►a n .Sc l-,a I de,5 Cell phone: 'O-7 q - ?)5-7 3 Fax: L Email: brs ci-»Ides ? C 1. 051-) I-, ' w e 4 J` Address: -/ O J'aL kcon . City: ask Koch State: W ; Zip Code: SH 9 O/ 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: i/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: /Icoholic beverages Additional permit required from City Clerk) cf Food & non-alcoholic beverages (Additional permit required from Health Dept.) ❑ Non-food related sales and/or display booths (No additional permits required) ent and/or Canopy (Additional permit required from Inspections Dept.) pligger's Hotline must be contacted minimum of 3 days before digging) 5/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: 'jRestroom and hand washing facilities Solid waste and recycling services 'Pvent insurance ublic safety & security / EMS services ectricity/ Generators re/Fire extinguishers dvertising with banners or signs /Drinking water • /Drinking /W water and grease removal eather contingencies 41 V' Gas oR'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: ?c,loj- Phi e J Location of Event: MakDYY1.1Yle2 ar�� - rnt�I eec --t Date of Event: 2I r7 - 2./I s oZ 2/ IO:ooAM- LI:00 P/� Time the Event is to Open: W7 5:O0i'NI-':oOPM I'6 Sponsor of the Event: S()et+ OkyflpicA Wks( pr)St Estimated Attendance (daily and total): 2I�� - 5.00 218- 3 Sob dail Emergency Contact Information: Name: W. 6C■ari Sc.4w.ld[S Daytime Phone Number: 31' - 357 3 Cell Number: Name: fvtccr rcvvgerS Daytime Phone Number: -13t- 16 19 Cell Number: al01.0- $,SO - OP4 co Name: Daytime Phone Number: Cell Number: Primary Location of Event Staff at Event Site: -1)pl4,r Blunty Clrea o" CCi Emergency Notification of the Public The public will be notified of safety and/or security issues in the following manner: 2 PA sy s�trns w X11 be. used A0 1e.+ eV art Fart ict pants t 1 e r-kat�ra Kh.pu-> O 4 any 80,-re 4/ Or SeC i ;41 IanS . APPLICATION FOR SPECIAL EVENT PERMIT- TO BE RETURNED TO CITY CLERK Emergency Medical Services Name of Provider: RQ4 C t S ( ,plus fuvng,rbus �rs- riaphrlde(S) Contact Person /Telephone Number: c\oln; KtruJin X.3 j' 1 $Z5 Location of Provider at Event Site: ;rs,ck ,wvat r k-c-ni- Sp_4 wp a Pr+V ' cA rs\-a t d rl u,40 Fire Protection Name of Provider: it it K L.,)/ 0541. Prt 1)240- Thr tYQ InSpecJlons Contact Person /Telephone Number: Location of Provider at Event Site: Number of Fire Extinguishers: 04- �„rt Q 74-In&LIShOrs as ccoutrDc/ by osh.Fb• Location of fire access roads: r vt rn \Df 1raS o�p,n�rgs -fir 4 rt/fescue , x`11 Ye.h�c{cs Security Name of Provider: ()S1n • PotiCe PuYltinri Contact Person / Telephone Number: ('1\Dz - rlo.r r is - D36- 5E3 3 Location of Provider at Event Site: ' n Voljcf Avoci 11:6ler + aNd ch X foin1-s -W1rou ha.4.f evtv►t Location of Missing Persons Station: Police Au-ciliary tra:`er)&vnj ►ascot rCY S i Event Parking Locations: -VIco c menorninee grr t- on• one srs5 field 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: )1i02CAc OL mQi cs W►scc* Cleo- (8.50- D14 8 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 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. An476z4"-■ "I h N C G, Spri- 'ers Date (print name) (pridt'title with organization) 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. 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 Left Blank SPECIAL EVENT INDEMNIFICATION AM)HOLD HARMLESS AGREEMENT (Medium and High Risk Events) {� EVENT: (,1' 1 i u{�[ j ORGANIZER: ,Spoo ta( 0 1 y m p). l.�(.�7s( Si b ovQ11 • v ee cI0 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,except as may result from the sole negligence or willful misconduct of the City of Oshkosh,and its officers, council members,agents,employees and authorized volunteers. In consideration for the City's approval of the Special Event, PCACk( P I'l-C f ,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,except as may result from the sole negligence or willful misconduct of the City of Oshkosh,and its officers, council members,agents,employees and authorized volunteers. 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 ` S s4 IQ i £4 II CS '�_ (-cX\IQ.�I (print n: e of. ;., i er) 1 - (date) (date) A a _Ad (signature) • (title) (signature) (title) NICC i,�((� arS (s< : rPC I OM it (prin ame) -1(print title) '` (print name) (print title) Inc�.eior mp►, ..,,:;.,:i,,,,_,;:4,3,..*.,s.,,,til:,-„:-,,..-7;4„1„,...::„. ! 1II . ll .,..::::::::.::::;.v,t.:_,,,1,;:nt,4,„;u1,"-;•7::,. :1,,' I] X III W A - C ::,.:, III i \ g I 0® g C _ c , 01 .1 ii ► � � �I 0- _--. 1 cu if II :4.41, 0 —Al l , r Limil. o; 7 4g. I : _ N .41. . v ,_ . . ....-. J\