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Home My WebLink AboutTUP APPLICATIONEVENT IN ORMATIt Type of Event _ Public Concert — Fair _ Fetal X Community event _ Parade _ Demonstration — Circus — Block Party _ Motion Picture — Grand Opening — Other Event Title: 5th Annual National City Health Et Wellness Fair @ Paradise Event Location: Employee Parking Lot @ Paradise Valley Hospital Event Date(s): From 11/2/13 to 11/2/13 Actual Event Hours: loam amom to 3pm amrpm Total Anticipated Attendance: 500 ( 100 Participants 400 Spectators) Setup►rassemblyiconstruction Date: 11/01 / 13 Start time: 3pm Please describe the scope of your setuptassenibly work ((specific details): put up canopies - set up stage - put up signs - set up tables and chairs - delivery of portables - and other logistics to prepare for the event. Dismantle Date: 11/2/13 Completion Time: 7pm an'Jpnn List any street(s) requiring closure as a result of this event. include street name(s), day and time of closing and day and time of reopening. NONE. �. ,,1 1... _..11 ,. F .1.....r•..:,. , Pfi4;. aAPPLICANT AIsj PNSORI14r ORGANIZATION 1NFORMAT1- N Sponsoring Organization: Paradise Valley Hospital a The Southbay Times Chief Officer of Organization (Name) c/o Ditas Yamane Applicant (Name): Ditas Yamane Address: 140 W 16th Street National City, CA 91950 Daytime Phone: ( ) 619-474-5300 Evening Phone: (___) 619-474-5300 Fax: 619-474-6888 E-Mail: thesouthbaytimes@cox.net Contact Person "on site' day of the event: Ditas Yamane C'elluiar: 619-921-5125 NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS '4.,. Is your organization a "Tax Exempt, nonprofit organization? _ YES X NO Are admission, entry, vendor or participant fees required? If YES, please explain the purpose and provide amount(s): YES X N C: S 5,000.00 Estimated Gross Receipts including ticket, product and sponsorship sales from this event. $ 4,500.00 S 500.00 Estimated Expenses for this event. What is the projected amount of revenue that the Nonprofit Organization will receive as a result of this event? 11.17 OVERALL EV : ouTE M 'SIT 'MOTION' PA/ ANITATI Please provide a DETAILED DESCRIPTION of your event. include details regarding any components of your event such as the use of vehicles, animals, rides or any other pertinent information about the event. 5th Annual National City Health Et Wellness Fair - FREE ADMISSION Et FREE SERVICES TO OUR COMMUNITY! - featuring FREE flu shot - plus FREE workshops on Health information - FREE wellness counseling - healthcare education - diabetes awareness blood pressure - glaucoma tests - weight check - and health Et wellness awareness to our community . A social responsibility - giving back to the community's support to a better quality of life! 5th Annual NC Health Et Wellness Fair is brought to the our community by Paradise Valley Hospital Et The Southbay Times in cooperation with the Health Et Human Services -Southbay Agency, and nonprofit organizations i.e. Lions Clubs ; Rotary Club ; American red Cross ; American Lung Association plue more. _ YES X NO If the event involves the sale of cars; will the cars come exclusively from Nationaa City car dealers? If NO, list any additional dealers involved in the sale: NONE. 9VERALL EVENT DESC i CONTINUEE1 _ YES X NO Does the event involve the sale or use of a coholic beverages? _ YES X NO Will items or services be sold at the event? If yes, please describe: _ YES X NO Does the event invoice a naming route of any kind along streets, sidewalks or highways? If YES, attach a detailed map of your proposed route indicate the direction of travel, and provide a written narrative to explain your route_ X YES _ NO Does the event invotve a fixed venue site? If YES, attach a detsi led site map showing ail streets impacted by the event. X YES NO Does the event involve the use of tents or canopies? If YES: Number of tent/canopies 50 Sizes 1 Ox 10 NOTE: A separate Fire Department permit is required for tents or canopies. _ YES X NO Will the event involve the use of the City or your stage or PA s steii? SPECIFY: in addition to the route map required above, please attach a diagram showing the overall layout and set-up locations for the following items: Alcoholic and Nonalcoholic Concession and/or Beer Garden areas. Food Concession and/or Food Preparation areas Please describe how food will be served at the event: if you intend to cook food in the event area please specify the method: GAS ELECTRIC CHARCOAL OTTER (Specify'): ri Portable andlor Permanent Toi et Faci ities Number of portable toilets: 1 for every 250 people is required, unless the applicant can show that there are facilities in the immediate area available to the pubic during the event) Tables # and Chairs # Fencing, barriers and/or barricades Generator locations and/or source of electricity Canopies or tent locations (include tenttc :nopy dimensions) Booths, exhibits, displays or enclosures Scaffolding, matchers, platforms, stages, grandstands or related structures Vehicles and/or trailers Other related event components not covered above Trash containers and dumpsters H H (Note: You must properly dispose of waste and garbage throughout the term of your event and immediately upon cond usion of the event the area must be returned to a c can condition.) Number of trash cans: 15 Trash containers with lids: 2 Describe your plan for clean-up and removal of %Neste and garbage during end after the evert: venue will he cleaned - all trash will he disposed of properly. Please describe your procedures for both Crowd Control arc Interns' Security: PVH will provide security detail. Volunteers will provide cmooth flow of program. _ YES X NO Have you hired any Professional Security organization to handle security arrangements for this event? If YES, please list: Security Organization: Paradise Valley Hospital Security Security Organization Address: Paradise Valley Hospital Security Security Director (Name): Phone: _'YES X NO Is this a night event? i YES, please state how the event and surrounding area wily be Huminated to ensure safety of the participants and spectators: Pease indicate what arrangement you have made for providing First Aid Staffing and Equipment. First Aid booth provided by the voulunteer medical practitioners. Please describe your Accessibility Plan for acmes at your event by individuals with disabilities: the venue is very accessible to individuals with disabilities. Please provide a data ed descr -ton of yc Jr PARKING plan: parking lots of the hospital. Pease describe your plan for DISABLED PARKING: Paradise Valley Hospital Disabled parking. Please describe your plans to notify all residents, businesses and churches impacted by the event advertising via flyers; electronic sign at the hospital - email - newspapers. NOTE: Neighborhood residents must be notified 72 hours in advance when events are scheduled in the City parks. NTERTAL„, ENT/AT`T ACT.ID NS ELATED EVENT ACTIVITIES X NO Are there any musical entertainment features related to your evert? If YES, please state the number of stages, number of bands and type of music_ Number of Stages: 1 Number of Bands: NONE Type of Music: DJ 1.10 Will sound amp`ific atop be used? If YES, please indcate: Start time: 10am am pm Finish Time 3pm ant+pm X YES _ NO Will ec uicl checks be conducted prior to the event? If YES, please indicate: Start time: gam nr~l'"pm Finish Time 930am aril/pm Please describe the sound equipment that MI be used for your event DJ YES X NO Fireworks_ rockets, or other pyrotechnics? If YES, pease descr€be: NONE. X YES NO Any signs, banners, decorations, special lighting? If YES, please describe: banners for backdrop - signs and balloons. Revised 0229/12 City of National City PUBLIC PROPERTY USE HOLD HARMLESS AND INDEMNIFICATION AGREEMENT Persons requesting use of City property, facilities or personnel are required to provide a minimum of $1,000,000 combined single limit insurance for bodily injury and property damage which includes the City, its officials, agents and employees named as additional insured and to sign the Hold Harmless Agreement Certificate of insurance must be attached to this permit Organization 5th Annual National City Health Et Wellness Fair @ Paradise Person in Charge of Activity Ditas Yamane Address 140 W 16th Street National City, CA 91950 Telephone 619-474-5300 Date(s) of Use I 1 /02/ 13 HOLD HARMLESS AGREEMENT As a condition of the issuance of a temporary use permit to conduct its activities on public or private property, the undersigned hereby agree(s) to defend, indemnify and hold harmless the City of National City and the Parking Authority and its officers, employees and agents from and against any and all claims, demands, costs, losses, liability or; for any personal injury, death or property damage, or both, or any litigation and other liability, including attorneys fees and the costs of litigation, arising out of or related to the use of public property or the activity taken under the permit by the permittee or its agents, employees or contractors_ Signature of Applicant Official Tile Date ar Offee Use Oy Certificate of Insurance Approved Date anuany piIDn3 2013 National City Health &Wellness Fair! Saturday, NOVEMBER 2, 2013 • 10AM - 3PM Paradise Valley Hospital - Employee Parking Lot (corners of E. 8th Street & Euclid Avenue) National City, CA 91950 kid's activities Sth Annual National City Health &Wellness Fair n' Paradise pm:osencnc. -Sti by \\ '' Lc�a .r'� East 8th Street „.. f�....--