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HomeMy WebLinkAboutApplicationCITY OF NATIONAL CITY NEIGHBORHOOD SERVICES DIVISION APPLICATION FOR A TEMPORARY USE PERMIT RECOMMENDED APPROVALS AND CONDITIONS OF APPROVAL SPONSORING ORGANIZATION: American Cancer Society EVENT: Relay For Life of National City DATE OF EVENT: August 16-17, 2014 TIME OF EVENT: 9 a.m. Saturday to 9 a.m. Sunday APPROVALS: RISK MANAGER YES [ x ] NO [ ] SEE CONDITIONS [ x DEVELOPMENT SERVICES YES [ x ] NO [ ] SEE CONDITIONS [ x PUBLIC WORKS YES [ x ] NO [ ] SEE CONDITIONS [ x FINANCE YES [ x ] NO [ ] SEE CONDITIONS [ x ] FIRE YES [ x ] NO [ ] SEE CONDITIONS [ x COMMUNITY SERVICES YES [ x ] NO [ ] SEE CONDITIONS [ x POLICE YES [ x ] NO [ ] SEE CONDITIONS [ x NEIGHBORHOOD SERVICES YES [ x ] NO [ ] SEE CONDITIONS [ x CITY ATTORNEY YES [ x ] NO [ ] SEE CONDITIONS [ x ] CONDITIONS OF APPROVAL: RISK MANAGER Applicant to provide insurance certificate and specific endorsement naming the City of National City as an additional named insured. We should then be ok to proceed. FIRE (619) 336-4550 Fees will be required for after hour inspection, tents and canopies ($600.00). Please contact the National City Fire Department for payment of fees. Provide (CLEAR) site map of site area. Stipulations required by the Fire Department for this event are as follows: 1) Access to the street to be maintained at all times, to both entrances and Fire Department connections for fire sprinkler systems, standpipes, etc 2) Fire Department access into and through the camp areas are to be maintained at all times. Fire apparatus access roads shall have an unobstructed width of not less than 20 feet and an unobstructed vertical clearance of not less than 13 feet 6 inches 3) Fire Hydrants shall not be blocked or obstructed 4) Participants on foot are to move immediately to the sidewalk upon approach of emergency vehicle(s) 5) Vehicles in roadway are to move immediately to the right upon approach of emergency vehicle(s) 6) Provide a 2A:10BC fire extinguisher at stage. Extinguisher to be mounted in a visible location between 3%2' to 5' from the floor to the top of the extinguisher. Maximum travel distance from an extinguisher shall not be more than 75 feet travel distance 7) All cooking booths or areas to have one 2A:10BC. If grease or oil is used in cooking a 40:BC or class "K" fire extinguisher will be required. All fire extinguishers to have a current State Fire Marshal Tag attached. Please see attached example 8) Additional fire extinguisher shall be placed around the circumference of the track and bowl area so as to provide fire protection for" Luminary Bags". Fire extinguisher to be mounted in a visible location between 3Y2' to 5' from the floor to the top of the extinguisher. Extinguisher shall be labeled "Fire Extinguisher" 9) If Charcoal is being used, provide metal cans with lids and label "HOT COALS ONLY" for used charcoal disposal 10) Internal combustion power sources that may be used for "Light Towers" shall be of adequate capacity to permit uninterrupted operation during normal operating hours 11) Internal combustion power sources shall be isolated from contact with the public by either physical guards, fencing or an enclosure 12) A fire safety inspection is to be conducted by the Fire Department prior to operations of the event to include all cooking areas etc 13) Required inspections taking place, after hours, holidays, and weekends will be assessed a minimum of two hundred ($200.00) dollars 14) Any electrical power used is to be properly grounded and approved. Extension cords shall be used as "Temporary Wiring" only 15) If tents or canopies are used, the following information shall apply: • Tents having an area from 0-200 square feet shall be $200.00 • Tents having an area more than 201 square feet shall be $400.00 • Canopies having an area from 0-400 square feet shall be no charge • Canopies from 401-500 square feet shall be $250.00 • Canopies from 501-600 square feet shall be $300.00 • Canopies from 601 square feet or greater shall be $400.00 • Multiple tents and or canopies placed together equaling or greater than the above stated information shall be charged accordingly • Tents shall be flame-retardant treated with an approved State Fire Marshal seal attached. A permit from the Fire Department must be obtained. Fees can only be waived by the City Council • A ten feet separation distance must be maintained between Tents and canopies • A permit from the Fire Department must be obtained. Cooking shall not be permitted under tents or canopies unless the tents or canopies meet "State Fire Marshal approval for cooking. Certificate of flame resistance shall be provided to the National City Fire Department prior to the event 16) First Aid will be provided by organization 18) Provide map of site area. Map to include placement of Fire Department requests 19) Fire Department Fees can only be waived by City Council Approval contingent upon final field inspection and compliance with all applicable codes and ordinances Fire Department Fees can only be waived by City Council Approval contingent upon final field inspection and compliance with all applicable codes and ordinances POLICE Will request for extra patrol and reserves if available. PUBLIC WORKS Street Division: No involvement. Facilities Division: • Electrician, 15 hrs OT @ $33.32/hr, for a total of $499.80 • Custodians have no involvement in this event. Parks Division: • Two hours at $46.58 per hour overtime rate ($93.16) for one staff to inspect after event and fill out Storm Water Compliance Inspection for Special Event Report and littler clean up. • Two hours at regular pay of $31.05 per hour ($62.10) for set up of park safety area. • Event organizers to clean up litter during event DEVELOPMENT SERVICES BULDING: No comments ENGINEERING: No comments. PLANNING: Lights and light towers to be directed away from residential areas and Paradise Creek FINANCE American Cancer Society needs to update their Business License. COMMUNITY SERVICES No involvement. CITY ATTORNEY Requires an indemnification and hold harmless agreement, and a policy of general liability insurance, with the City and its officials, employees, agents and volunteers as additional insureds, with amounts of coverage to be determined by the Risk Manager. 3 Type of Event: _Public Concert Fair Festival _ Parade Demonstration _ Circus Motion Picture Grand Openingin/ Other � ,,, Event Title: ge'" i �-or L� ' ` 0 ►" ie la / Event Location: )Crmfjill Par Event Date(s): From a//!o to g,/ 7/ /'/ Actual Event Hours: 9 Total Anticipated Attendance: Setup/assembly/construction Date: /pm to �0 /pm ( )( Participants Spectators) Start time: if, Community vent Block Party Please describe the scope of your setup/assemb y work (specific details): 's kbftPPgS to/ /( cha/%C cut ,/it'SrkS ptrfielet /5 7 a/7 ad a-(eVerrt' Dismantle Date: 6/17 Completion Time: /9 -z a 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. 0 :7 .et CIO surer S n �l1nC / Sponsoring Organization: `' f�/rnr1(21 I/ Chief Officer of Organization (Name) DavI Veh11/°1 Applicant (Name):M/cho/te �Z 6 --1-/ 'Z Address:2 55 (.rnino d' / 06 / - /C?J, sin Dela C/ 3/ 23 Daytime Phone: 01 Evening Phone: ( ) Fax: 213 .33 le) E-Mail: rnielklie. 9L el ks(0CNi el" D Contact Person "on site" day of the event: M l & Cellular: g t'L/ 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? n YES _ NO Are admission, entry, vendor or participant fees required? YES NO If YES, please explain the urp se and,provide amounts co Cipv7T Try' /Sit /i O 2 7 '�3r -- $ 76/ 66° Estimated Gross Receipts including ticket, product and sponsorship sales from this event. Estimated Expenses for this event. $ 3� 000 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. f) 2 q heUreven-t 740 7 U?di / S:e1 r p leinwr'ea P) Can« S& / e //'ft" 5 WI'T7q Such a,s ressa, ar,d aciro e, y.. � 7 Gu�IZ�/?S .1 ) (dmument ?/ l0 /%) A 45-n eat/-/ de7 71 and ettheA. Alt 710 a$ a Crr?rntct)re,Vu-re _ YES NO If the event involves 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 KNO 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: _ YES i�NO Does the event involve a moving route of any kind along streets, sidewalks or highways? 11 YES, attach a detailed map of your proposed route indicate the direction of travel, and provide a written narrative to explain your route. YES NO Does the event involve a fixed venue site? If YES, attach a detailed site map showing all streets impacted by the event. )(YES _ NO Does the event involve the use of tents or canopies? If YES: Number of tent/canopies 5- Sizes / /0 Id f ZdX7L� a /OK 2©1 NOTE: A separate Fire Department permit is required for tents or canopies. / VOX ciU YES /` NO Will the event involve the use of the ay 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 yqu intend to cook food in th`e event area please specify the method: GAS X ELECTRIC X CHARCOAL OTHER (Specify): Portable and/or Permanent To,ilet Facilities Number o1 portable toilets: Li' (1 for every 250 people is required, unless the applicant can show that there are facilities in the immediate area available to the public during the event) Tables # and Chairs # Fencing, barriers and/or barricades Generator locations and/or source of electricity 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 (Note: You must properly dispose of waste and garbage throughout the term of your event and immediately upon conclusbn of the event the area must be returned t a clean condition.) Number of trash cans: o o _j� Trash containers with lids: , j�( /pc� jej-S Describe your plan for clean-up and removal of waste and garbage during and after the event: Jdca i S Ohevent f r?5 r, veknfi Prs AN /I aii ? 01- e 517 /"YES _ NO Are there any musical entertainment features related to your event? If YES, please slate the number of stages, number of bands and type of music. Number of Stages: t' Number of Bands: /� Type of Music: %Y tk YES _ NO Will sound amplification be used? If YES, pleases�indicate: Start time: ' 3O am/pm Finish Time 1 `tdo am/pm YES NO Will sound checks be conducted prior to the event? ,IIff YES, please indicate: Start (/ time: O:30 am/'pm Finish Time ' 3C.J am/pm Please describe the sound equipment that will be used for our event: vari' MT/if-ran/en ;�5 b-Iu/ init5/C4v NO Fireworks, rockets, or other pyrotechnics? If YES, please describe: XYES _NO Any signs, banners, decorations, special lighting? If YES, please describe: 9171 -i tuer, banners , anq lure; r)an a tg53 Revised 02/29/12 Please describe your procedures for both Crowd Control and Internal Security: wit/ a' provided XYES _ NO Have you hired any Professional Security organization to handle security arrangements for this event? If YES, please list: Security Organization: F/ 4 52t&S) G Security Organization Address: L257 Ci'ml nO de/ go ti ufW-) #2 cD Security Director (Name): M//�� `'° ASd>1 Phone: /6% • 5 7Y. 1 YES _ NO Is this a night event? If YES, please state how the event and surrounding area will be illuminated to ensure safety of the participants and spectators: Y_ 79r7,9 10/7 141 Please indicate what arrangement you have made for providing First Aid Staffing and Equipment. Fi 71.- aid tor do S Geyernd / c12 Please describe your Accessibility Plan for access at your event by individuals with disabilities: Pat -le MMM Cep/ /ar+ Please provide a detailed description of your PARKING plan: Please describe your plan for DISABLED PARKING: /4-el par' i-)9 //3 // L Please describ,e yo_ur pianyo�,S�o n all residents, businesses and churches impacted by the event:mai / / U77Cp� /2i P7Or , - everit NOTE: Neighborhood residents must be notified 72 hours in advance when events are scheduled in the City parks. Telephone/4 / 7. c / 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 i 1Ctn Concler a/t _Thc Person in Charge of Activity Miil-e Are '49j - Address 2Co5Ca/n/rJ 7O ?/, N/. #/CQ, 52/14g jb G%fOg Date(s) of Use /4- 2/, 7 , Y 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. t Director of Operations 1/29/14 SignatuTh of Applicant Officia! Title Date For Once Use Only Certificate of Insurance Approved Date PRODUCER Commercial Linr Is — (404) 923-3700 Wells Fargo Insurance Services USA, Inc. 3475 Piedmont Itoad NE, Suite 800 Atlanta, GA 303115-2886 INSURED American Cancer Society, Inc. 250 Williams Stnlet Atlanta, GA 303( 3 A RI ) CERTIFICATE OF LIABILITY INSURANCE THIS CERTIF ICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.I4 THIS 1/29/20 CERTIFICATIE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TI-IS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms anll conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate ho der in lieu of such endorsement(s), 139199 DATE (MMl0Dfyyyy) COVERAGES CERTIFICATE NUMBER: 7225015 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVEBFOR. THE POLICY PERIOD REVISION See below 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 A VD CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TY'E OF INSURANCE ANSp SOU COMMERI:IAL GENERAL LIABILITY NAME: Alexander Mortimer PHONE 404-923-3732 IA/C, No. E Ui1 E-MAIL _ADDRESS: aexander.mortimer@wellsfargo.com INSURER A INSURER($) AFFORDING COVERAGE Federal Insurance Company INSURER e : Pacific Indemnity Company INSURER C FAX (A/C Not, 877-362-9069 NAIC 0 20281 20346 INSURER D INSURER E A A X CLAIMS -MADE X OCCUR GEN'L AGGREC ATE LIMIT APPLIES PER: POLICY L. PRO- JECT LOC OTHER: x AUTOMOBILE L (ABILITY x X B ANY AUTO ALL OWNE D AUTOS HIRED AUTOS UMBRELL t LIAR EXCESS L. AB DED X SCHEDULED AUTOS NON -OWNED AUTOS POLICY NUMBER 35943463 73563471 73563476-Puerto Rico 73563477-Hawaii INSURER F POLICY EFF (MM/DD/YYTY) 9/1/2013 09/01/2013 POLICY EXP IMM/DD(YYYY) 9/1/2014 09/01/2014 LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (My one person) PERSONAL $ADV INJURY GENERAL AGGREGATE PRODUCTS -COMP/OPAGG COMBINED SINGLE LIMIT (Ea aaident) BODILY INJURY (Per person) $ 1,000,000 300,000 $ 2,500 $ 1,000,000 25,000,000 2,000,000 $ 1,000,000 $ BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) OCCUR CLAIMS -MADE RETENT ON$ WORKERS COM 'ENSATION AND EMPLOYEE S' LIABILITY ANY PROPRIETC R/PARTNER/EXECUTIVE OFFICEPoMEMBI'R EXCLUDED, (Mandatory In N j) R yes. describe a ider DESCRIPTION C F OPERATIONS below Y/N INI NIA 71741355 09/01/2013 09/01/2014 EACH OCCURRENCE AGGREGATE $ $ $ PER X E STATUTE I ERR E.L. EACH ACCIDENT 1,000,000 E.L DISEASE - EA EMPLOYEE E L DISEASE - POLICY LIMIT 1,000,000 1.000,000 DESCRIPTION OF OPF RATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is repel ed) Re: Relay For Lile on August 15 - 17, 2014 at K mball Park, 1249 D Avenue, National City, CA 91950. City of National (;ity and its officials, employees, agents and volunteers are included as an additional insured in accordance with the terms and conditions of the general iiaoility policy. CERTIFICATE I -OLDER City of National City Attn: Vinay Rohn 1243 National C ity Blvd. National City, C k 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 974 The ACORD name and logo are registered marks of ACORD ACORD 25 (201.01) © 1988-2014 ACORD CORPORATION. All rights reserved.