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Home My WebLink AboutCC RESO 15,082RESOLUTION NO. 15,082 RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY APPROVING THE SWEETWAltat HIGH SCHOOL'S FIREWORKS DISPLAY PERMIT ON OCTOBER 3, 1986 BE IT RESOLVED by the City Council of the City of National City that it hereby approves the Sweetwater High School's Fireworks Display Permit for October 3, 1986, as set forth in Exhibit "A", attached hereto and incorporated herein by reference. PASSED and ADOPTED this 16th day of September, 1986. Kile Morgan, yor ATTEST: Campbell, City erk APPROVED AS TO FORM: Georgre H. Elser, III -City Attorney C City of National City Fire Department 333 E. 16th St., National City, Ca. 92050 Phone: (714) 477-1187 45 o82_ ' APPLICATION FOR PERMIT - PUBLIC FIREWORKS DISPLAY (File in duplicate) INSTRUCTIONS: Applications in DUPLICATE shall be submitted to the Chief of the Fire Department or the Chief Fire Prevention Officer of the city or county in which the display is to be held, or to the State Fire Marshal, or to such authorized deputy as he may designate for such purpose, if there is not a Fire Chief or Chief Fire Prevention Officer in the area. I (we) hereby make application for permit to conduct a display of fireworks as defined by the California State Health and Safety Code, and agree to comply in every particular with the law pertaining thereto as set forth in Part 2 of Division 11 of the Health Safety Code, and the rules and regulations adopted by the State Fire Marshal. 1. Sponsoring Organization Sweetwater High School (San DiPgn Fir?wnrkc, Inc.) Address'2900 Highland Ave. (P.O. Box 203187) State License No GPD500 NationalCity Ca. 92050 / San Diego, Ca. 92120 2 Responsible Person in charge of display Ron Dixon 583-6141 APPROX. 5 min. between times: 3. Date of display Oct. 3, 1986 from 8:30 PM. to 9:30 P M. 4. Location Sweetwater Hish Schooll.tStadium A diagram of the grounds and firing area is ATTACHED. 5. Persons who will actually discharge fireworks: (Minimum of two) NAME STATE LICENSE NUMBER Tony Parkhurst # 1132-02 (pyrotechnic Operator in charge) and assistants 6. Number, size and kind of fireworks: 1 low level bombardment device. 40-67MM aerial shells, 25-3" aerial shells 4-4" aerial ChPi1G Ana 1 set piece 7. Description of storage facilities and location on grounds: Delivered on site on date of display 8. Certificate of Employees' Compensation Insurance date: 11/5/86 issued by State Compensation Insurance Fund Company is attached. (# 621958-85) 9, Documentary proof of insurance for $5,000,000 combinedsingle.limits personal injury and property damage. Firework's Display Sponsor and City of National City shall be named as additional insured. C 10. Documentary proof of Certificate of Worker's Compensation Insurance. City of National City shall be named as an additional insured. 11. Documentary proof of Comprehensive forms. 12. Documentary proof of Explosion and Collapse Hazard Insurance. 13. Documentary proof of Contractual Insurance. 14. City of National City shall be given a"30 day cancellation notice ice the event a display is cancelled.. Applicant's Signature Applicant's Address San Diego, Ca. 92120 PERMIT FOR PUBLIC DISPLAY OF FIREWORKS to be held (date)Oct. 3, 1986 hereby rant (denied). cross out one V �1 STATE COMPENSATION INSURANCE SUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE October 8, 1985 P.O. BOX 807, SAN FRANCISCO, CALIFORNIA 94101 POLICY NUMBER: 621958-85 CEFTIFICATE EXPIRES: 11-5-86 L; This?is to certify that we have issued a valid Workers' Compensation insurance in a form a Insurance Commissioner to the employer named below for the olic policy P y�period indicated. pProved by the California This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, Y described herein is subject to all the terms, exclusions and conditions of suchpolicies.e,insurance afforded b the policies Job: All Operations L • EMPLOYER San Diego Fireworks, Inc. P.O. Box 203186 San Diego, CA 92120 RESIDENT SCIF 10262 (REV. 8.84) OLD'ROA e II IIIIIIIIIIIIIIIIIIIIIIIIIIIIIINNIIIIIIIIIIIIIIIIII111111illll lllllli111111llllllll IIIIItlINIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIMIIIII 1I11111111111II11111111111111NNIN NI IIIIIIIIIIIIIIIIIIIIIIII11111111111 l IMIIINIIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIIINIIIIIIIIIIIIIIIIIIIIIIIIIII M111IIIIIIIIIIIIpN11 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111111M1111IINIIIIIIIIIIIIIiIIII1111111111Nlllllllllllll Illlilllllll a a CALIFORNIA =i °��'�E °� STATE FIRE MARSHAL a 9m. 7-4 STATE FIRE MRE..MAR AL Fireworks License - a I M. ;. „..t..K� Licensee SAN DIEGO FIREWORKS = r- T,AT r FIR .�fAitint : rrs 4 %"l,' SA"A a. Ea - # K 16,913 , . Registration Number. CP11—q00 I _ Issued MAY 200, 1983 Expires June 30 • Street P,O, BOX 28791 City : SAN DIEGO State CA 7ip 92128 Location of Special or Limited Display: Street City The named licensee is authorized to perform aii acts .permitted a fireworks GENERAL RIM IC DIM AY pursuant to Part II; Chapter .I of the Health and Safety Code of the State of California. STATE FIRE MARSHAL BY = a FW-39 (REV ]SS,IHO too CS OSP STATE FIRE MARSHAL 7171 BOWLING DRIVE. SUITE 600 SACRAMENTO. CA 95823 SAN DIEGO FIREWORKS P.O. BOX 203186 SAN DIEGO. 921200000 CA EXPIRES: JUNE 30. 1967 ID NO: GPD 500 RENEWAL NUMBER: N01750 GENERAL PUBLIC DISPLAY ISSUE DATE (MIA.` 8-7-86 PRODUCER Xi Robert F. Driver Co., Inc. P.O. Box 670 San Diego, CA. 92117 (619) 699-1357 INSURED San Diego Fireworks P.A. Box 203186 San Diego, CA. 92102 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE LETTER A Golden Eagle Insurance Co. COMPANY c LETTER COMPANY D LETTER THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- TIONS OF SUCH POLICIES. O .TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/D011'Y1 POLICY EXPIRATION DATE (MM/DOM') ALL LIMITS IN THOUSANDS � GENERAL 7L— X COMMERCIAL X LIABILITY GENERAL CLAIMS MADE LIABILITY OCCURRENCE QL017356 7 26--86 7 26-87 GENERAL AGGREGATE $ 500 1 PRODUCTS-COMP/OPS AGGREGATE $ 500 PERSONAL & ADVERTISING INJURY ' $ J00 - OWNER'S & CONTRACTORS PROTECTIVE EACH OCCURRENCE $ 500 FIRE DAMAGE (ANY ONE FIRE) I $ 3a MEDICAL EAPENSE iA'!i ONE PERSON; I $ P. ,.. z.:'. ar AUTOMOBILE — - LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY LSL $ ' eODaY INJURY ,PER PERS()NI $ �ODILLY JuRY (PER ACGDEN?i PROPERTY DAMAGE $ P _ EXCESS 1 LIABILITY • OTHER THAN UMBRELLA FORM n< Es<E OCCURRENCE $ WORKERS' COMPENSATION AND•$ EMPLOYERS' LIABILITY STATUTORY ,s "' TEACH' ACCIDE N-. Ji ra OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/ VEHICLES / REST RICTIONS / SPECIAL ITEMS All operations -Fireworks Exhibitions at Sweetwater High School, Oct. 3, 1986 T CERT.IFECATE.HOLDER-::—:- • Sweetwater High School 2900 Highland Ave. `National City, CA. 92050 LL CANCEEwATIQ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE a PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR ' -. MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO Ti:L LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION O:'1 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVE: - AUTHORIZED REPRESENTATIVE ACORD25rS-(11/85), .0L INVACORD CORPORAII . :'ODUCER X Robert F. Driver Co., Inc. P.O. Box 670 San Diego, CA. 92112 (619) 699-1357 ED San Diego Fireworks P.O. Box 203186 San Diego, CA. 92102 ISSUE DATE (MM/DD/YY) 8-7-86 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, ''O'WITHST.ANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- TIONS OF SUCH POLICIES. r TYPE OF INSURANCE POLICY NUMBERDATE POLICY EFFECTIVE (MOONY) . POLICY EXPIRATION DATE (NIMiDOM') ALL LIMITS IN THOUSANDS A GENERAL LIABILITY X—,--,COMMERCIAL GENERAL x x 1 C_:.iMS MADE LIABILITY OCCURRENCE 0L017356 7-26-86 'i ) -26 87 GENERAL AGGREGATE $ 500. PRODUCTS-COMP/OPS AGGREGATE $ 580 PERSONAL & ADVERTISING INJURY $ 500 EACH OCCURRENCE $ 500 a O'NNER'S & CONTRACTORS PROTECTIVE FIRE DAMAGE (ANY ONE FIRE) $ `/ MEDICAL EXPENSE (ANY ONE PERSON) $ i AUTOMOBILE — 1 LIABILITY ANY AUTO CSL $ B s BODILY INJURY (PER PERSON) $ 4 BODILY I((NaFJURY AcCIOENTI $ PROPERTY DAMAGE I EXCESS LIABILITY t OTHER THAN UMBRELLA FORM Aw OCCUARENCE AGGREGATE i WORKERS' COMPENSATION ! AND EMPLOYERS' LIABILITY - STATUTORY # _- $ (EACH ACCIDENT) .- $ (DISEASE -POLICY LIMIT) $ (DISEASE -EACH EMPLOYEE) ;2 ' OTHER ESCRIFTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS All bperations *Additional Insured as their interest may appear * City of National City % National City Fire Dept. 1243 National City Blvd. National City, CA. 92050 Att: Chief Kimball SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE oil - CORD CORPORATION=1985x''.