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Home My WebLink About12-27 JANUARY 24, 2012 12-27 RESOLUTION (CARRIED___6-0_____LOST________LAID OVER________WITHDRAWN________) PURPOSE: APPROVAL OF SPECIAL EVENT / OTTER STREET FISHING CLUB INC. / UTILIZE MENOMINEE PARK FOR THEIR OTTER STREET WALLEYE TOURNAMENT / 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 Otter Street Fishing Club (Scott Engel) to utilize Menominee Park on Friday, June 15, 2012 from 12:00 noon to 8:00 p.m., Saturday June 16, 2012 from 5:00 a.m. to 9:00 p.m.; and, Sunday, June 17, 2012 from 5:00 a.m. to 9:00 p.m. for their Otter Street Walleye 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 BE RETURNED TO CITY CLERK GENERAL EVENT INFORMATION Official Nam of Special E�vent� Start Date: End Date: Briefly describe your event. Be sure to include the purpose of the event and all planned activities. EVENT SUN MON DATE SETUP TIME START TIME �. 0 o Ar� STOP TIME q;00 PM TEAR DOWN ` l CLEAN UP 1 00W COMPLETED Location of Estimated Attendance {daily & total }: Number of Booths: Organizations) Sponsoring A'��5�1��jU Onclud ing addresses ECOVE � d OEC Is 2011 C�� Co APPLICATION FOR SPECIAL EVENT PERMIT — TO BE RETURNED TO CITY CLERK Address: City: — State: Secondary Contact: aV Daytime Telephone: — Cell Phone; Fax: Email: Zip Code: Address: State: Zip Code: City: Onsite Primary Contact: 5 A - rn Cell phone: Fax: Email: Addre City: State: Zip Code: onsite Secondary Contact: C 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 yo ur event W o Festival/ Music Concert • Religious / Educational • .Rally f Memorial ❑ Street / Block Party ❑ Parade / Fun Run / Walk- a -Thon ❑ ' March utilizing any Public Property o bllc Assembly for Political Purpose Sport Tournament (Fishing, Soccer, etc.) ❑ Other Locatio of event. 94 /3 ark or other public property ❑ Public street, sidewalk, alley, or right of way ❑ Private property =everages. dltional permit required from City Clerk) Food & non - alcoholic beverages (Additional permit required from Health Dept.) ❑ N -food related sales and/or display booths o additional permits required) Tent and /or Canopy (Additional permit required from Inspections Dept.) g) (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 aiver required from City Council) arricades (Approval from City Clerk's office if in right of way) W APPLICATION FOR SPECIAL EVENT PERMIT— TO BE RETURNED TO CITY CLERK Amplified Sound ❑ A imals included or allowed in event nimals must be licensed and have proof of vaccination) Cooking Equipment (Fire Department approval required) We have made arrangements for: stroom and hand washing facilities lid waste and recycling services ent insurance o ublic safety & security I EMS services lectricity 1 Generators ire extinguishers Advertising with banners or signs • Drinking wafer • Grey water and grease removal ❑ eather contingencies LP Gas o Tent Heating Space Intentionally Leff Blank 0 APPLICATION FOR SPE D T CITY CLERK TO BE RETURN Special Event Public Safety and Securit Plan Name of Event: Location of Event: Date of Event: c�D wl Time the Event is to Open: Sponsor of the Event: V 5 Estimated Attendance (daily and total): Emer en Contact Information: Name: Daytime Phone Number: Cell Number: Name: Daytime Phone Number: Cell Number: --- Name: Daytime Phone Number: Cell Number: T-tfy"A Primary Location of Event Staff at Event Site: Emer enc Notlficatlon of the Public The public will be notified of safety and/or security issues in the following manner: qA- S 10 APPLICATION FOR SPECIAL EVENT PERMIT— TO BE RETURNED TO CITY CLERK Emer enc Medical Services Name of Provider: Contact Person f Telephone Number: Location of Provider at Event Site: Fire Protection p Name of Provider: LL 4 `` Contact Person / Telephone Number: Location of Provider at Event Site: Number of l=ire Extinguishers: Location of fire access roads: 1 R- z 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 Contin enc Shelter Locations: Have you confirmed that the locations will be open and available? Who will determine if your — is c anceled or�h�ld( Phone - m Public Safet 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 I 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 ClTY 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) 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 1 will promptly notify the City of Oshkosh of these changes and request approval of them. Date (print Hama (print title with organization) 11 13 SPECIAL EVENT DgDEMNIFICATION 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 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 andlor liabilities, including casts 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 (prin� , -) l 0— (date) Ua (Signature) (title (print name) (print title) (date) (signature) (title) (print name) (print title) 17