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Home My WebLink AboutTUP APPLICATIONType of Event: _ Public Concert — Fair — Festival — Community event _ Parade _ Demonstration _ Circus _ Block Party Motion Picture — Grand Opening — Other Event Title: 21st Annual Fiesta Filipiniana Mexicana Karaokee Competition Event Location: Seafood City 1420 E. Plaza Blvd. Event Date(s): From 11/9/13 to 11/9/13 Actual Event Hours: 10 am/pm to 10 am/pm Total Anticipated Attendance: 200+ ( 50 Participants 100+ Spectators) Setup/assembly/construction Date: 11/8 Start time: 8 a.m. Please describe the scope of your setup/assembly work (specific details): Entertainment stage will be set up 11/8/13 a day prior to the event. Sound system, tables, chairs, decorations will be done on 11/8/13. Dismantle Date: 11/11 Completion Time: 1 am/pm 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. N/A Sponsoring Organization: Seafood City National City Market Chief Officer of Organization (Name) Fily Applicant (Name): Pedro Sanchez Address: 1420 E. Plaza Boulevard Daytime Phone: (619) 477-6080 Evening Phone: (619) 477-6080 Fax: (619) 477-1024 E-Mail: Contact Person "on site" day of the event: Susan DelosSantos Cellular: (619)755-0755 NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS Is your organization a "Tax Exempt, nonprofit" organization? _ YES _ NO Are admission, entry, vendor or participant fees required? If YES, please explain the purpose and provide amount(s): YES VNO t Estimated Gross Receipts including ticket, product and sponsorship sales from this event. p p Estimated Expenses for this event. $ What is the projected amount of revenue that the Nonprofit Organization will receive as a result of this event? 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. -°4 a QAk. V/001A-ix. icAL 021 S-f a .-a\vukL, C tcjttx -pc 46,k,. z \ R C01 CaY� t-t ® c,LICja.- 34 9 c✓ 4-AAA, ev 4 Ci• YES _ NO If the event nvolves the sale of cars, will the cars come exclusively from National City car dealers? If NO, list any additional dealers involved in the sale: YES NO Does the event involve the sale or use of alcoholic beverages? _ YES /NO Will items or services be sold at the event? If yes, please describe: _ v YES j/NO Does the event involve a moving 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. YES 1 NO Does the event involve a fixed venue site? If YES, attach a detailed site map showing all streets impacted by the event._ ES % NO Does the event involve the use of tents or canopies? If YES: Number of tent/canopies 3 Sizes 10 x (0 NOTE: A separate Fire Department permit is required for tents or canopies. _ YES ✓ NO Will the event involve the use of the City or your stage or PA system? 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 OTHER (Specify): Portable and/or Permanent Toilet Facilities Number of portable toilets: (1 for every 250 people is required, unless the applicant can Fow that there are facilities in the immediate area available to the public during the event) Tables # 4 and Chairs # SY Fencing, barriers and/or barricades 1---Generator locations and/or source of electricity VI -Canopies or tent locations (include tent/canopy dimensions) Booths, exhibits, displays or enclosures Scaffolding, bleachers, platforms, stages, grandstands or related structures Vehicles and/or trailers Other related event components not covered above Trash containers and dumpsters 111111211.11 (Note: You must properly dispose of waste and garbage throughout the term of your event and immediately upon conclusion of the event the area must be returned to a dean condition.) Number of trash cans: / Trash containers with lids: Describe your.plan for cleanup and removal of waste and arbage during and after the event: Please describe your procedures for.,both Crowd Control and Internal Security: / / YES _ \JO Have you hired any Professional Security organization to handle security arrangements for this event? If YES, please list: Security Organization: -SQ Cwu t Security Organization Address: /rc U �l�i.�1-- iic/g / Z 4169 ('A Secu ity Director (Name): 12-44-/ Phone: YES "" NO Is this a night event? If YES, please state how the event and surrounding area will be illuminateded t�ure safety th participants arud spectators: Aek, Litz Please Please indicate what arrangement you have m e for providing First Aid Staffing and Equipment. ��uhv Lem d 4".„ 014-6p,01)4-4 Please describe your Accessibility Plan for access at your event by individuals with disabilities: ottL`c.,(. Please provide a detailed description of your PARKING plan:, A A 4 �;P \AZ P - '$ ire. ,U avu Please describe your plan for DISABLED PARKING: r Please describe your plans to notify all residents, businesses and churches impacted by the Bvent: NOTE: Neighborhood residents must be notified 72 ho s in advanc6 when events are scheduled in the City parks. _ YES _ NO Are there any musical entertainment features related to your event? If YES, please state the number of stages, number of bands and type of music. Number of Stages: C Type of Music: Number of Bands: 1 t/i'ES _ NO Will sound amplification be used? If YES, please indicate: Start time: m Finish Time U am c/Yt5 NO Will sound checks be co nducted prior to the event? If YES, please indicate: Start time: / O am/pm Finish Time am Please describe the sound equipment that will be used for your event: YES 'NO Fireworks, rockets, or other pyrotechnics? If YES, please describe: /ES _ NO Any signs, banners, decorations, special lighting? If YES, please describe: ate- L —ecit 4-1) Revised 02/29/12 • • Organization Person in Charge of Activity Address )1-90 E , Gilet5tA C CA %% 11) Telephonq' 0) 7.55 ' Date(s) of Use 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. CL 1 & CA 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 Title Date *as, For Office Use Only Certificate of Insurance Approved Date • '`,--- CERTIFICATE OF LIABILITY INSURANCE DATE(MAVDD1YYYY) 10/3/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTA"IVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED IMPORTANT: IF the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and i;onditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Michael Ehrenfeld Company n 2655 Camino Del Rio North 00 San Diego CA 92108 CpNTAC7 NAE Jim Eggert UM. No. Ertl: (619) 683-9990FAX (AIC No): (619)683-9999 EMAIL jeggert@ehrenfeldinsurance.com ADDR#2 INSURER(S) AFFORDING COVERAGE NAIC $ INsuRERA:Argonaut Great Central Ins CO INSURED Fortune Management Fortune Coin nercial Corp. SFC Markets Incorporated 2883 Surveyor Street Pomona CA 91768-3251 INSURER B :Springfield Insurance Company INSURER C: INSURER D: INSURERS: INSURERF: • ww. lWlrI fl. THIS IS TO CER- IFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO'1MTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE M11Y BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AN) CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYP 1. OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF (MMlDD1YYYY) POLICY EXP IMM/DD/YYYY) LIMITS A GENERAL. X LIABII ITY COMMERCI kL GENERAL LIABILITY X SIR915148608 6/3/2013 6/3/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300, 000 CLAIM: -MADE X OCCUR MED EXP (Any one pa/son) $ Excluded X SIR $2! ,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 5,000,000 GENL AGGREG/ TE LIMIT APPLIES PER. POLICY !EcrRo- n LOG PRODUCTS - COMP/OP AGG $ 2,000,000 Liquor Liability $ 1,000,000 A AUTOMOBILE X X LL IBILITY ANY AUTO ALL Ot$NE( AUTOS X SCHEDULED BA915148608 6/3/2013 6/3/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BDDILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ SPEC $ A X UMBRELLA LIAB EXCESS LU.B _ OCCUR CLAIMS MADE UM3915148608 6/3/2013 6/3/2014 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED X RETENTION$ 10,000 products/compApy $ 10, 000, 000 B WORKERS COMI SENSATION AND EMPLOYEE $ LIABILITY ANY PROPRIETC R/PARTNER/EXECUTIVE OFRCERIMEMBER EXCLUDED? (Mandatory in NI I) If yes, descrbe ur der DESCRIPTION 0 = OPERATIONS below Y / N N / A L,PCD001T3310 12/1/2012 12/1/2013 X WC STATU- TORY LIMITS OTH- ER EL EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 EL DISEASE -POLICY LIMIT $ 1,000,000 A WA Stop Gap SIR915148608 6/3/2013 6/3/2014 DESCRIPTION OF OPE iAT10NS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Solder is named as Additional Insured as required by written contract, as respects to Comm'1 General Liability, but limited to the operations of the Insured under said contract, and always subject to the polio terms and conditions. Re: Fiesta Filipina Mexicana, November 2, 2013. CERTIFICATE HI)LDER susands4@yahoo.com City o' National City 1243 National City Blvd. National City, CA 91950 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jim Eggert/TONI ACORD 25 (2010,05) INS025 (201005).01 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD III 411 A CERTIFICATE OF LIABILITY INS URANCE THIS CERTIFII:ATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THU. CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTA FIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. DATE (MM(DDIYYYY) 10/3/2013 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate hoic er in lieu of such endorsement(s). PRODUCER Michael Ehrenfeld Company 2655 Camino Del Rio North #200 San Diego CA 92108 INSURED Fori:une Management Fortune Commercial Corp. SFC Market$ Incorporated 2883 Survelor Street Pomona CA 91768-3251 COVERAGES CERTIFICATE NUMBER:13-14 CONTACT NAME: Jim Eggert PHONE tAlC. No. Exit FAX (A/C, No (619) 683-9999 • ADDRESS: 7eggert@ehrenfeldinsurance . com INSURER(S) AFFORDING COVERAGE INsuRERA:Argorlaut Great Central Ins Co INSURER8:Springfield Insurance Company INSURER C: NAtC # INSURER D : INSURER E : INSURER F rsi..r ...MOM .wmoc R. THIS IS TO CER tIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO itMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MNY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS Al) D CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRINSR TYF E OF INSURANCE DL ANSR SLIER WVD POLICY NUMBER POLICY EFF (MM1DD/YYYY} POLICY EXP (MMIDp/YYl'Y} LIMITS A GENERAL X LIABI ITV COMMERC Al GENERAL LIABILITY X SIR915148608 6/3/2013 6/3/2014 EACH OCCURRENCE $ 1,000,000 ENTED PREM SESO a occurrence) $ 300, 000 CLAIMS -MADE X OCCUR MEDEXP(Any oneperson) $ Excluded X SIR $2!i,000 PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 5,000,000 GEM. AGGREG 1TE OMIT APPLIES PER A I POLICY r 1 E a n LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Liquor Liability $ 1,000,000 A AUTOMOBILE X X U 4BILITY ANY AUTO ALL OWNED X SCHEDULED AUTOS N NON -OWNED )3A915148608 6/3/2013 6/3/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PPRDAMAGE �O accident) $ SPEC $ A X UMBRELLU LIAB EXCESS LiU3 OCCUR CLAIMS -MADE OMB915148608 6/3/2013 6/3/2014 EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 DED X RETENTIONS 10,000 Plullgg/CpmpAgg $ 10,000,000 B WORKERS COM PENSAT}ON AND EMPLOYE} S' LIABILrrY ANY PROPRIET( gt/PARTNER/EXECUTIVE OFFICER/MEMB}REXCLUDED? (Mandatory in N i) If yes, descbe u der DESCRIPTION C F OPERATIONS below Y / N NIA WCD00173310 12/1/2012 12/1/2013 X WC 5TATU- OTH- TORY LLMITS ER EL EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 EL_ DISEASE - POLICY LIMIT $ 1,000,000 A WA Stop Cap SIR915148608 6/3/2013 6/3/2014 DESCRIPTION OF OPE RATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 2 more space is required) Certificate Holder is named as Additional Insured as required by written contract, as respects to Comm'1 General Liatility, but limited to the operations of the Insured under said contract, and always subject to the policy terms, conditions and exclusions per endorsement RE: Fiesta Filipina Mexicana, November 2, 2013 CERTIFICATE HOLDER SusanDS48Yahoo.com ROIC Bay Plaza Center A California LLC c/o Retail Opportunity Investment Corp. 8905 TDwne Center Dr. #108 San Diego, CA 92122 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jim Eggert/TONI ACORD 25 (20111105) INS025 (201005).01 The ACORD name and logo are registered marks of ACORD 01988-2010 ACORD CORPORATION. All rights reserved. ?•Y, r pAr4. e-.4a-)Nair5341) j4ik/yr-ro CC_ADD CoC‘ 03 Ck 0 Li • • .• oo I 3 1! • EJ