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Home My WebLink About01. 12-173 APRIL 17, 2012 12-173 RESOLUTION (CARRIED___6-0____LOST________LAID OVER________WITHDRAWN________) PURPOSE: APPROVAL OF SPECIAL EVENT / LA CANADA PROMOTIONS / TO UTILIZE SUNNYVIEW EXPO CENTER TO HOLD THEIR MEXICAN DANCE / APRIL 21, 2012 INITIATED BY: CITY ADMINISTRATION NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that approval is granted to La Canada Promotions (Heidi Vargas) to utilize 500 E. County Road Y (Sunnyview Expo Center) to hold their Mexican Dance on Saturday, April 21, 2012, from 8:00 p.m. to 2:00 a.m., 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 MAR 12 2012 Official Name of Special Event: n -e- CITY CLERK'S OFFICE Start Date: LI Z I - I Z_ End Date: - Z z-- I Z Briefly describe your event. Be sure to include the purpose of the event and all p nned activities. vu pas e. L ✓-� I l l��c i �� r, ckyrNck 5 • e��' =jc�eS C O cone( not) - koti G bk-y-ems eS EVENT SUN MON TUE WED THUR FRI SAT DATE SETUP TIME 41•00,,,,., START TIME SOD�-.►-, . STOP TIME a.m. TEAR DOWN f-) 1 /CLEAN UP COMPLETED dq Location of Event: Sor,n vi tJn Ce v.� ear . ��"� IZe \-I Estimated Attendance (daily & total): =Ea 1000- I gC7t\lumber of Booths: 1 - w \ V00d■ -jo [ bogy-- Organization(s) Sponsoring Event: 1 ,u C { 1 G S G, lol. HcAd:. Vc-t (-Aq S (including addresses) v 2__17c) C , Zd r r,c t^ /AD T ,9-19 S( D EcEo pct MAR �� ?012 C/ CLF RtilS CFff CE APPLICATION FOR SPECIAL EVENT PERMIT- TO BE RETURNED TO CITY CLERK Primary Contact: H ei ct- Var) cL5 . Daytime Telephone(c■a J) (-1 tal -517 5/(;L2-31 �b "0005 Cell Phone: C9zJ) (-}z1- 5"155 / - 3-la 1 �`" -, , � " Fax: ��2�) G1Lp� - 0005 - - Ea 1 --A\ o Email:hVc,0T,s hct.v . cr. c--_)(y Address: Z..00C, C , ,,, A-, e_ck T-- City: N.1--e-4, nc. �k- ' State: LL)TI Zip Code:` 14 15C..P Secondary Contact:C 110_5 Vc o5 qS Daytime Telep one: C I ZJ) yz7- -7300 /(4'ZO9 5(1 9 -,9,306- Cell Phggne: '7l3) `-/Z7- 7,3( 0 Fax: ( 5 9/, 9-O()) 5 Email: — Address: ZOOS Co,..),-/v led --.E City: Nee na k._ State: LU J Zip Code: cS"y ��6 Onsite Primary Contact: SC/ 'Y) c 2S 0L-h3 v-P Cell phone: Fax: Email: Address: City: State: Zip Code: Onsite Secondary Contact: oc-7 rne_. 6'5 co v--' 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. 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 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 Sun n L)4,00 street, sidewalk, alley, or right of wa ❑ Public st y. g 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) ❑ 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: . Restroom and hand washing facilities Solid waste and recycling services Event insurance • 'ublic safety & security/ EMS services ❑ Electricity/ Generators E.',) s A e. .31 - ❑ Fire extinguishers -C --}c Or •� Advertising with banners or signs rinking water ❑ rey 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: i'Y\ e x i L,o,y r1 L Location of Event: SL. �"�,�1� e� Ni_ �� Ce.,�--e Date of Event: LA - Z 1 - 1 Z Time the Event is to Open: ' 00 e .,r-Y1 - Sponsor of the Event:C'_,,% ck Pr,)iy\ak-1 on S Nr'iC i 4 I,' Gs VcrJgS Estimated Attendance (daily and total): 500 On Emergency `Contact Information: Name: 4csc ' Vac cts Daytime Pho e N ber: �j ZJ ) L Li- 5 -15 Cell Number:'Z.0 ' 2 7 - 5 5 Name: C—') i G 5 V ci r' S Daytime Phone Number-02 9 2-.1 ? ,"500 Cell Number: 7 '-0-7 -- -1,-))00 Name: Daytime Phone Number: Cell Number: Primary Location of Event Staff at Event Site: 1 i'1 6.A.:1 'GU c)ci Z� 1)0 Emergency Notification of the Public The public will be notified of safety and/or security issues in the following manner: APPLICATION FOR SPECIAL EVENT PERMIT- TO BE RETURNED TO CITY CLERK Emergency Medical Services Name of Provider: fL� Contact Person /Telephone Number: Location of Provider at Event Site: Fire Protection Name of Provider: rL Contact Person /Telephone Number: Location of Provider at Event Site: Number of Fire Extinguishers: Location of fire access roads: Security pp Name of Provider: - . IZ - I� �J �� c- Contact Person /Telephone Number: Lb,G c (-er -1 C7 a 3'33 Location of Provider at Event Site: r■ \3t..,-;c1_4 e_\ p pcJ -) 111 . CV,0 0 ')CA 5 Location of Missing Persons Station: Event Parking Locations: APPLICATION FOR SPECIAL EVENT PERMIT— TO BE RETURNED TO CITY CLERK Severe Weather Contingency Sheltgr Locations: eS�r()orn n in � �.�r i0r n-c 10l � n - 3o Have you confirmed that the locations will be open and available? Who will determine if your event is canceled or held? Phone number: c,S � s C.cl.z-o 7:2)00 tija +^ cts c12---3) H 21 - Si SS 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 Location of barricades Location of generators Location of temporary roadways • +` r k� c J qi s ,, t. r o v� Vr fj ` k7 tL� J J >C><x r N \O- .y o c 0 J x APPLICATION FOR SPECIAL EVENT PERMIT - TO BE RETURNED TO CITY CLERK Other Provide any other information that you feel should be considered O} o r 1 + 0 a Y`S . LCD C h V"-e. e .}� e i e r� c -C rrY\ I C-r)0;.A.I ? cva_ d 1^e VHF Yl t -e 4° p c.r`+"\ c 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) XI 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. .AA 3jIi VAt.\ Va 05 - PnrYokz, ,r- Date (print name) (p ' t title with organization) SPECIAL EVENT INDEMNIFICATION AND HOLD HARMLESS AGREEMENT (Medium and High Risk Events) EVENT: clll La✓l G, C ORGANIZER: G I i g S c,cl.& VGi c,c 5 n a d a e:o mod 1 V» 5 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, Cy i��c� o, Pco rroA"■on\, 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. 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