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Home My WebLink AboutDocumentation_Regular_Tab 19_5/9/2019VILLAGE OF TEQUESTA Building Department MEMORANDUM TO: Honorable Mayor Abby Brennan and Council Members CC: James M. Weinand, Acting Village Manager FROM: Jose Rodriguez, Director, Building Department DATE: November 28th1h 2019 SUBJECT: Special Event Permit Application for Palm Be ch Roadrunners — Nov ber 28th, 2019 — Run 4 the Pies 4 Mile Running Race (-2300 Attendees) This is a Special Event application for an annual November 28th, 2019 4 mile road race, 1 mile kids race and 100 yard toddler dash organized by Palm Beach Roadrunners, a registered Florida Not -For -Profit Corporation, signed by its President, Dave Masterson, (see attached Special Event Permit Application), to take place at Constitution Park on Dover Rd. The event is to be held on Thursday, November 281h, 2019 from 6:00 a.m. - 11 a.m. No alcohol will be served. Free food will be provided at the event, and water and Gatorade will be provided along the course route as well as within the Park to spectators and participants. The projected number of attendees for the event is 2300. There will be 10 open tents set up at the event (i.e., without sides) and a truck with a ladder to display a flag. The applicant has provided for Police Detail (10 officers including supervisor) and Fire Detail. The applicant Palm Beach Roadrunners, has provided proof of General Liability (see Certificate of Liability Insurance, attached). The fee for the Special Event Application in the amount of $100.00 has been paid by the applicant (see payment receipt No. 03594078, attached). VILLAGE OF TEQUESTA 4PERMIT NO: COMMUNITY DEVELOPMENT DEPARTMENT Submittal Date: ;L 345 Tequesta Drive Deposit Amount: X l00 Tequesta, Florida 33469 Phone: (561) 768-0450 Fax: (561) 768-0698 SPECIAL EVENT PERMIT APPLICATION Any Village resident, or any Village business holding a current Village business tax receipt pursuant to Chapter 70, Article II, is eligible to apply for and obtain a special event permit pursuant to Sec. 78-561. Any such resident or business that desires to conduct any type of special event within the Village must obtain a permit from the Village in order that the Village may adequately provide for the potential impacts created by the proposed event. A maximum of four (4) such permits shall be allowed per address or per business in any single calendar year. A special event that includes multiple addresses, for example within a shopping center, shall count as one event for each address captured by the special event permit. "Special Event" is any outdoor activity, gathering or group of persons, vehicles or both, organized and having a common purpose, upon public or private property, which is likely to inhibit the usual flow of vehicular or pedestrian traffic, which is likely to create noise in excess of that typically associated with the areas upon which the event is to occur, or which is likely to preempt or restrict use of property typically accessible by the general public. Examples of Special Events include, but are not limited to block parties, parades, races or walks, grand opening events, charity fundraisers, and other similar events not specifically permitted by the Village's zoning ordinance. Special Events that are sponsored by the Village and held on Village property shall be exempt from the provisions of this section. Written application must be submitted to the Village Community Development Department at least forty five (45) days prior to the date for which the Special Event is vprroposed; which application shall contain the following information: // DATE OF SALE/EVENT: Ahyiemher o (J� I;i 0/ I HOURS: FROM: &A 1 TO: r TYPE OF EVENT: Railr1 ,( the Ties • --% mile raad race , / Mite 11-vdd race.; AlLard 4vddler dgsh • Z OF EVENT: PROPERTY OWNER: Print Name CONTACT INFORMATION: SPONSOR or PERSON(S) RESPONSIBLE FOR EVENT: MAILING ADDRESS: 8vt O ( Crci /h pallk, 6eack1 Q (Attach written consent of property owner of record.) 3alm cli Roacfrunnenf .✓ E MAI L: daye&.41 ktlb,oa� (ty-agd,,uil4/� a '_, LKVc, PHONE NO.: —,619 - 3S0 rdens , PZ__ 0416 FAX NO.: PROJECTED NUMBER OF ATTENDEES: a�i00 COUNCIL APPROVAL REQUIRED: (✓ ) YES ( )NO • Any proposed Special Event whose attendance is contemplated to exceed 200 people in total shall require final approval by the Village Council which, after considering the recommendations of the Community Development Director, the Police Chief and the Village Manager, may approve the application, deny the application in whole or in part, or approve the application with conditions. IS ALCOHOL BEING SERVED? ( )YES (V )NO • The service of alcoholic beverages at any Special Event shall require the issuance of the appropriate state alcoholic beverage permit, a copy of which must be provided to the Village in conjunction with the Special Event permit application. • The Village may require the use of physical barriers to define and contain the outdoor area within which alcoholic beverages may be consumed and/or the use of security or off -duty law enforcement personnel at the Special Event. • It is the applicant's responsibility to monitor for and prevent excessive as well as underage consumption of alcoholic beverages at all times. Page 1 of 2 INDEMNIFICATION: • By submitting a complete application, the Special Event holder/applicant and property owner (if different) expressly agree that they shall indemnify, defend and hold the Village harmless from any and all damage to any real or personal property, and from any and all injury or death suffered by any person directly or indirectly related to attendance at or participation in any activity in conjunction with the Special Event, including the consumption of alcoholic beverages. NON-PROFIT ENTERPRISES: • The Village may issue non-profit permits to any person or organization for the conduct or operation of occasional sales and/or fundraising projects held by non-profit enterprises, either regularly or temporarily, when the applicant signs an affidavit that the applicant operates without private profit, for a civic, public, charitable, youth, service, educational, literary, fraternal, or religious purpose. • A person making application under this section must comply with all rules and procedures for the granting of Special Event permits as set forth in this section. All persons operating under a non-profit permit shall operate their non-profit enterprise in compliance with this section and all other rules and regulations of the Village. THE FOLLOWING ITEMS ARE REQUIRED TO BE SUBMITTED AT TIME OF APPLICATION: • Proof of insurance in amounts acceptable to the Village for the type of event. The Village shall be named as an additional insured on all liability insurance. • Expected traffic, fire -rescue, and utilities impact, if any, and proposed mitigation plans. • Copy of all required state and county permits if event will be held on or utilize state and/or county -controlled property. • A refundable deposit is required if the event is held on any Village property. • Site Plan required with each application accompanied with drawing indicating layout for event. • All sale sites shall be left in a clean and orderly manner upon completion of sale. • Should the sale/event include the use of one or more tents, a $35.00 Fire Inspection Fee, due at time of application, and a certificate of flame resistance is required for each tent. Inspection to be done on the first day of event. SPECIAL EVENT FEES: Under 200 attendees: $40.00. Over 200 attendees: $100.00. SIGNATURE OF HOLDER/APPLICANT: 'D� °' ""'�-�� (\�.I./aw'4�DATE: v L Print Name Signature SIGNATURE OF PROPERTY OWNER: DATE: Print Name Signature RECOMMEND FOR P""""""' COMMUNI BUILDING I POLICE CH'. FIRE CHIEF PARKS/RE( APPROVED BY: VILLAGE MANAGER: TE: q TE: JE: JE: %TE: DATE: Approval/Review Notes: —/ram -Fruck rtNd F_14ej CCIC & // /'c. e Vii— c A Aed rQ u,.> o'evvil,,41r, 'lrgsA 6l L�� f/ I�I� lj /C! �.SO/✓ L/�i I G'•S (/ 'C.�%/�cS.��'U lJ �/ • ��C�% m Date of Request: 2/25/2019 Fire Dept. Contact: Contact Person(s): Village of Tequesta PUBLIC SAFETY Special Event Form Event date: 11/28/2019 Madeleine Ely Police Dept. Contact: Telephone Number(s): 561 222 7511 Location of Event: Constitution Park Expected Number of Attendees: 2,300 Number of Tents at event: 10 Will Tents Contain Sides (must include flame resistance certification and $35 fee tent): yes no X EMS Services Provided (does not have to be VOT EMS Services can be privately contracted): Yes: X No: EMS Service Provider: Tequesta Fire Rescue Police Detail Request: Yes, 10 (see attached) Brief Summary of Event: (can be typed or written with/out an attachment) Road race: 4 mile race at 8AM, 1 mile race at 7:15AM, Kids Dash at 7:15AM. Start /Finish line on Dover Road, and pre/post race activities in Constitution Park. Same set up as previous years. Race Date: November 28.2019. 6AM- L OAM Provide information (site plan, written description etc.) regarding ingress and egress: 1) Course Map 2) Site Man Constitution Park Special Request: Truck with ladder and flag if possible. To be displayed either by the start/ finish or other location close to Constitution Park, e.g. Seabrook Road. TEQUESTA POLICE DEPARTMENT oUESTq �, 357 Tequesta Drive ` FI0 ' Tequesta, Florida 33469-0273 A� Phone: (561) 768-0500 l y1 DEPT Fax: (561) 768-0695 Gustavo Medina Chief0fT011ce APPLICATION FOR EXTRA -DUTY POLICE SERVICE This application is required to engage the off -duty services of the requested number of Police Officers for public safety, health and welfare that are in addition to those generally provided to the public. It is understood that this is a NON -BINDING agreement. A minimum of Five (5) Days advance notice is requested prior to the service date. Payment for the service is required by CHECK OR MONEY ORDER made payable to the assigned off icer(s). Applicant: "Three (3) hour minimum per detail. PALM BEACH ROADRUNNERS Address: 8209 Calterra Drive Phone: 561 222 7511 City: Business: Palm Beach Gardens Number of Officers Required 10 Uniformed: YesEI No Number of Days: 1 Date(s): November 28, 2019 Hours: 3 Starting Time: 6:30AM R 4 h P' d Ending Time: 9:30AM Basic Services Requested. un t e ies roa race Exact Location: Constitution Park and along race course Estimated Attendance: 2,300 Alcohol Served Other Comments or Requests: 10 officers including supervisor Yes❑ No ❑❑ 2/25/2018 Digitally signed by Madeleine Ely DATE: Date: 2019.02.25 12:08:08 .05-00' Applicant's Signature CHARGES: Officers X Hours X $ 35.00 (rate) = Supervisors X Hours X $ S0.00 (rate) _ 2—dd Holiday Detail Officers x Hours X $ 45.00 (rate)= zC> Total Amount Due for Service = $ Approved B Date. &ZZ/ COURSE MAP RUN 4 THE PIES - -.... ...... .......... _ - _ --- ? Siarbeard Way Birnini Ad .dean Ct V _ .] G Spotle35 tJpr�ill "N' SVmdow Apfynritop - Cleannry Adva—d . Flporinq:•'rt. 2. �o4nlon5 tirV a 3 Windward A•rF r geo Ofst Presbyterian Church of a- Tequesta FV Consulting ��, r bIC a BJ Gibson -• _ `,4V _ Architect Stergas & Asscclales Tequestds ir.t Idi Btplzt Much Try' n '! aeon St O 9 ELF ro t� Nd� River Terrace Dr SITE MAP RUN 4 THE PI ES Lynne Britt From: Madeleine Ely I K2 Road Sports <madeleine@k2roadsports.com> Sent: Monday, February 25, 2019 12:20 PM To: Lynne Britt Subject: RE: SPECIAL EVENT PERMIT APPLICATION FORMS Attachments: Mimecast Attachment Protection Instructions; RUN 4 THE PIES 2019 PERMIT APPLICATION.pdf Mimecast Attachment Protection has deemed this file to be safe, but always exercise caution when opening files Hello Lynne, Attached is Palm Beach Roadrunner's Special Event Permit Application for Run 4 the Pies. 1) Special Event Permit Application (page 1-2, 2 pages) 2) Proof of Insurance (page 3, 1 page) 3) Application for Extra -Duty Police -Service (page 4, 1 page) 4) Public Safety Special Event Form (page 5, 1 page) 5) Course Map (page 6, 1 page) 6) Site Map (page 7, 1 page) A check in the amount of $100 for the special event fee has been mailed out today (2/25/2019). Please let me know if you need any additional information or documents to proceed with the permit. Thank you. Best regards, Madeleine Ely K2 Road Sports 1561222 7511 From: Lynne Britt Sent: Monday, February 4, 2019 2:01 PM To: madeleine@k2roadsports.com Subject: SPECIAL EVENT PERMIT APPLICATION FORMS Lynne Britt Ibritt(@teauesta.ore Office Manager Village of Tequesta 345 Tequesta Drive Tequesta, FL 33469-0273 Phone: 561-768-0458 Fax: 561-768-0698 Florida fh;partrrIe-1=gfSate. a i>�sz �»i a»zs»�:. Paz �r;,,•� • . ... Depertrnent of State / Division of Corporations / Sertrch Re:+cords / Detail By Document Number / Detail by Entity Name Florida Not For Profit Corporation PALM BEACH ROADRUNNERS, INC. Filing Information Document Number FEIIEIN Number Date Filed State Status Last Event Event Date Filed Event Effective Date N94000002880 65-0497413 06/06/1994 FL ACTIVE CANCEL ADM DISS/REV 07/08/2005 NONE Principal Address 8209 Calterra Drive Palm Beach Gardens, FL 33418 Changed: 01 /23/2018 Mailing Address 8209 Calterra Drive Palm Beach Gardens, FL 33418 Changed: 01/23/2018 Registered Agent Name & Address WALK, GARY 515 N. FLAGLER DRIVE 20TH FLOOR WEST PALM BEACH, FL 33401 Name Changed: 07/08/2005 Address Changed: 11/23/2010 Officer/Director Detail Name & Address Title President Masterson, David 8209 Calterra Drive Palm Beach Gardens, FL 33418 DIV;c,IQN D� CORPORATK-NS Title Secretary Flynn, Maureen 285 Bougainvillea Jupiter, FL 33458 Title VP Walk, Gary 515 N. Flagler Drive 20th Floor West Palm Beach, FL 33401 Title Treasurer Fischer, Timothy P 112 Rockingham Rd Jupiter, FL 33458 Annual Reports Report Year Filed Date 2017 01 /17/2017 2018 01 /23/2018 2019 02/15/2019 Document Images 02.162019, ANNUAL REPORT 01/23/2018 .. ANNUAL REPORT 01/17/2017 -ANNUAL REPORT 03/09/2016 -- &NNUAL REPORT 01r1Ui'20t5--ANNUAL REPORT 01:0212014 -ANNUAL REPORT 1...f 2Q13.--.:_..aNNUl;L.,RF(�nRT 02/14/2012 -- ANNUAL REPOR t 12/12/2011 -- ANNUAL REPORT p2i 17(201. J_„-„.AN N UAL;-R E;PORT 11i23i2010 -- ANNUAL REPOR 1 Ot/06i2010 -- ANNUAL REPORT 05/28i2009 -- ANNUP.L REPORT .................................................................................................. 05/14/2009 - ANNUAL REPORT 02iO6/2008 -- ANNUAI_ REPORT 01i18/2008 -- ANNUAL. REPORT ................................................................................................... 0417i2007 - ANNUAL REPORT 03/20200f5- ANNUAL REPORT 07/08i2005 -- P,EINST(. F. N1F..NT .................................................................................................. 03.11012003 -ANNUAL REPORT 04/18/2002 -- ANNUAL REPORT View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF form at View image in PDF fommat View image in PDF format View image in PDF format View image in PDF format View image in PDF format I View irnage in PDF format I 07119/2001 -- Name t;hanne 02i02120Qa._-..-_ANN U j l;_R E;PORT 04/10/2000 ANNUAL REPORT O311111999 -- ANNUAL REPORT C2O4i19t%A._-- i1NNU!{I;;,,RFf?QRT 01/23/1997 ANNUAL REPORT 03/20/1996 -- ANNUAL REPORT 95i31 ._.._N,1A::.FPOR9,/1RT View image in PDF format View irnage in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format ."l—d' : C''Pe-In nt cf scrw. i): .is;u: & Conr,-znan=_ Village of Tequesta 345 Tequesta Drive Tequesta, FL 33469 Ph: (561) 768-0700 Fax: RECEIPT NUMBER 03594078 Paid By PALM BEACH ROADRUNNERS, INC. 8209 CALTERRA DR PALM BEACH GARDENS, FL 33418 02/28/2019 Type Record Category Description Amount Permit PSEP19-0004 Standard Item Special Event - Over 200 peop $ 100.00 Total $ 100.00 Cash Check $ 100.00 Credit Transferred Tendered $ 100.00 Change $ 0.00'' To Overpayment $ 0.00 A� 0® CERTIFICATE OF LIABILITY INSURANCE DATE(M0/2019 02/2012019 THIS CERTIFICATE 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. THIS 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 have ADDITIONAL INSURED provisions or 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 holder in lieu of such endorsement(s). PRODUCER CONTACT Margaret Mayers NAME: Insurance Management Group PHONE (260) 338-2925 FAX AIC No Ell, A/C No): E-MAIL mmayers@insmgt.com ADDRESS: 959 E. 4th St. INSURER(S) AFFORDING COVERAGE NAIC # P.Q. Box 1600 INSURERA: National Casualty Company 11991 Marion IN 46952 INSURED INSURER B: Nationwide Life Insurance Co. 66869 Road Runners Club of America/2019 and Its Member Clubs INSURER C : INSURER D: 1501 Lee Highway INSURER E : Suite 140 Arlington VA 22209 INSURER F : COVERAGES CERTIFICATE NUMBER: 2019 $1MA.1. REVISION NUMBER: THIS IS TO CERTIFY THAT THE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE ToEa occurrence PREMISES $ 500,000 X MED EXP (Any one person) 5,000 $ Legal Liability to Participant$1,000,000 PERSONAL&ADVINJURY $ 1,000,000 A KR00000007654500 12/31/2018 12/31/2019 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ Unlimited �GEEN'L POLICY ❑ PEt° ❑ LOC PRODUCTS - COMPIOPAGG $ 1'000'000 OTHER: Abuse and Molestation $ 500,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS KR00000007654500 12/31/2018 12/31/2019 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY /� AUTOS ONLY UMBRELLALIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ LIAB PDEXCESS ED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NHI E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ Excess Medical $10,000 Excess Medical &Accident B ($250 Deductible/Claim) SPX0000030282400 12/31/2018 12/31/2019 AD & Specific Loss $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED AS RESPECTS THEIR INTEREST IN THE OPERATIONS OF THE NAMED INSURED. DATE OF EVENT(S): 11/28/19 Run 4 The Pies 4 Miler, Pumpkin 1 Miler and Kid's Dash INSURED RRCA CLUB/EVENT MEMBER: Palm Beach Roadrunners, Att'n: Dave Masterson, 8209 Calterra Drive, Palm Beach Gardens, FL 33418 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 11/28/19 Village of Tequesta ACCORDANCE WITH THE POLICY PROVISIONS. 345 Tequesta Drive AUTHORIZED REPRESENTATIVE Tequesta FL 33469 I C)ynJltl �. 1� 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD