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Home My WebLink About12-28 JANUARY 24, 2012 12-28 RESOLUTION (CARRIED___6-0_____LOST________LAID OVER________WITHDRAWN________) PURPOSE: APPROVAL OF SPECIAL EVENT / MASTERS WALLEYE CIRCUIT / UTILIZE MENOMINEE PARK FOR THEIR MASTERS WALLEYE CIRCUIT TOURNAMENT / JUNE 29, 30 & JULY 1, 2012 INITIATED BY: CITY ADMINISTRATION NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that approval is granted to Masters Walleye Circuit (Dan Johnson) to utilize Menominee Park on Friday, June 29, 2012, from 6:00 a.m. to 6:00 p.m. Saturday, June 30, 2012 from 6:00 a.m. to 6:00 p.m. and Sunday, July 1, 2012 from 6:00 a.m. to 4:00 p.m. for their Masters Walleye Circuit Tournament event 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 none APPLICATION FOR SPECIAL. EVENT PERMIT – TO BERET CLERK LE- TO' D GENERAL EVENT INFORMATION DEC 0 1 2011 0 Official Name of Special Event: r rum CLERK'S OFFICE Start Date: �,- IAA 11 Co I2 , _ End Date: f, IA' P) 0 EVENT SUN MON TUE WED THUR ERI SAT DATE SETUP TIME AJl START TIME i STOP TIME 34 m TEAR DOWN f I CLEAN UP COMPLETED Location of Eve t; cC� rC Organization(s) Sponsoring Eve 0 &0-d f wAr1raceaa1 DEC 0'2 2011 6 CITY OFFICE Briefly describe your event, Be sure to include the purpose of the event and all Estimated Atte dance (daily & total): Number of Booths: 1 APPLICATION FOR SPECIAL EVENT PERMIT -- TO BE RETURNED TO CITY CLERK Primary Contact: J Daytime Telepho Cell Phone: WO „- 0 L2 � Fax: 3 Email: 4OP. .V 7 - V a /1 00. 00vYL -- Add City. Secondary Contact: — Daytime Telephone:. — Cell Phone: Fax: W- �-,r Email: Address: City: State: Onsite Primary Contact: Cell phone: Fax: Email: Zip Code: Address: City: _ State: Zip Code: Onsite Secondary Contact: y ',/ G/,{ ,7 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 1 Music Concert • Religious I Educational • Rally / Memorial • Street I Block Party _R Parade I Fun Run I 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 Fours (Waiver required from City Council) Barricades (Approval from City Clerk's office if in right of way) L-01 APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK A Amplified Sound n Animals included or allowed in event (animals must be licensed and have proof of vaccination) i Cooking Equipment (Fire Department approval required) We have made arrangements for: -W Restroom and hand washing facilities o Solid waste and recycling services ,Event insurance o Public safety & security 1 EMS services y. Electricity/ Generators )�' Fire extinguishers ,,\!r Advertising with banners or signs -ts Drinking water o Grey water and grease removal Q Weather contingencies o LP Gas o Tent Heating Space Intentionally Left Blank 9 APPLICATION FOR SPECIAL EVENT PERMIT --- TO BE RETURNED TO CITY CLERK Name of E Location of Date of Eve S eci l Event Public Safety o nd Security Plan vent: s k CSC L Event: 7 " �� l`' nt: r`- t 7 Time the Event is to Open: �C Sponsor of the Event: -� L 0/1" � t f� Estimated Attendance (daily and total): Emergency Contact Information: Name: 4 Daytime Phone Cell Number: Name: I Y _ " V Daytime Phone Amber: f Cell Number: Name: ► Daytime Phone mber: I Cell Number :Q l Primary Location of Event Staff at Event Site: & )/," - z - � Emergency Notification of the Public The public will be notified of safety and/or security Issues in the following manner: is l APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Severe Weather Contingenc Shelter Locations: Have you confirmed that the locations will be open and avai Who will determine if your qy-ept4s canceled orjhelp? PhonRi mbe f: 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 1 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 I 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 c l have reviewed and have considered the Contingency Plan information provided by the City of Oshkosh along with this application (pages 2)(N, is-) I have reviewed and understand the City's Insurance requirements for Special Events as described in this document (pages 13; 4 and4ff X 21 I am enclosing the event's Public Safety Site Plan (see page 9) 4-L 1 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 Oshkos of these changes and request approval of them. Date with or anizatlon) 13 AAR" T milt i �'tv SPECIAL EVENT INDEMWICATION AND HOLD HARMLESS AGREEMENT (Medium and High Risk Events) EVENT: ORGANIZER: 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 of cOrs, employees, agents, and volunteers, along with event vendors, contractors, subcontractors, participants, and visitors. /L 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 setilement 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, me (signature) (title) .�-- W// , Cam' (print name) (print title) date) ti / ,(SI in a 'a0 t e dc, (print name) (print title) 17