HomeMy WebLinkAboutDocumentation_Regular_Tab 05_2/12/2026 Agenda Item #5.
Regular Council
STAFF MEMO
�,lti S
1 .a
i
Meeting: Regular Council - Feb 12 2026
Staff Contact: Wayne Cameron Department: Building
IMEW M
Consider Special Event application for an annual July 4, 2026 four-mile running race by Believe With
Me, a registered Florida Not-For-Profit Corporation, to take place at Constitution Park. The event is to
be held on Saturday July 4, 2026 from 7:00 a.m. - 10:00 a.m. No alcohol will be served. The projected
number of attendees for the event is 1500. The purpose of the event is to honor families of fallen
soldiers and all proceeds will directly benefit families that have lost a loved one in the line of service.
IR ��11AM Ml�
Consider Special Event application for an annual July 4, 2026 four-mile running race by Believe With Me, a
registered Florida Not-For-Profit Corporation, to take place at Constitution Park. The event is to be held on
Saturday July 4, 2026 from 7:00 a.m. - 10:00 a.m. No alcohol will be served. The projected number of
attendees for the event is 1500. The applicant has provided proof of insurance and will hire Police and Fire
Detail for the event. The purpose of the event is to honor families of fallen soldiers and all proceeds will directly
benefit families that have lost a loved one in the line of service. Please see attached completed special event
permit application reviewed and signed by Fire Department, Police Department, Building Department and the
Village Manager.
This document and any attachments may be reproduced upon request in an alternative format by
completing our Accessibility Feedback Form, sending an e-mail to the Village Clerk or calling 561-
768-0443.
BUDGET • - •
BUDGET AMOUNT N/A AMOUNT AVAILABLE N/A EXPENDITURE AMOUNT: N/A
FUNDING SOURCES: N/A IS THIS A PIGGYBACK:
❑ Yes ❑ N/A
DID YOU OBTAIN 3 QUOTES?
❑ Yes ❑ N/A
COMMENTS/EXPLANATION ON SELECTIONN/A
012026 - 4th of July Running Race - Special Event ApOcation - 07.04.2026
Page 60 of 325
Agenda Item #5.
V * 11ae
oTeq� N� �� 4�a1gf ��� �� ��
345 requasta Drive 5e1'7e8'0700
Tequmsta' FL 334e9 www.tequoste.o,g
TO: Jeremy Allen, Village Manager
FROM: Wayne Cameron, Director, Building Department
DATE: January 91h2OZG
SUBJECT: Special Event Permit Application for Believe With Me July 4, I026 4 Mile
Running Race (~250OAttendees)
This is a Special Event application for an annual July 4, 2026 4 mile running race by Believe
With Me^ a registered Florida Not-For-Profit Corporation, signed by its President,, Lvette
Reback (see attached Special Event Permit Application), to take place at Constitution Park
on Dover Rd. The event btobe held on July 4, 2O26 from 7:OOa.rn. lO:OOa.rn. Noalcohol
will beserved.
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 1500. There will be ] open tents set up at the event (i.e.,
without sides).
The purpose of the event is to honor families of fallen soldiers and all proceeds will directly
benefit families that have lost a loved one in the line of service. The applicant, Believe With
me, has provided General Liability and Umbrella Liability insurance. The fee for the Special
Event Application in the amount of$50.00 has been paid by the applicant.
Page 61 Of 325
Agenda Item #5.
4W
Village
�CTequesta
Building
Department
��;
Special
Event
Permiet
Application
345 Tequesta Drive
Tequesta' FL3346g
(56I) 746'O45Q Fax: (5Bl) 768'O698
Any Village resident, or any Village business holding a current Village business tax receipt pursuant to Chapter
70, Article U, 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 D1USt obtain G 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 sha|l be allowed per address or per business in any
Single calendar year. A special event that )DC/UdeS multiple addresses, for example within G 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 propedy, 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 vent 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 I0D/ng 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 Building Department at least forty five (45) days prior to
the date for which the special event is proposed; at the discretion of the Building department, an application
may be submitted less than forty five (45) days in advance if extenuating circumstance are present.The
application shall contain the following information:
Page 62 of 325
Agenda Item #5.
Event Details
Date of event:July 4th, 2026
Hours of event: 7:00a.m. - 10:00a.m.
Type of event: Run
Location of event'. Constitution Park
Property owner name:Village of Tequesta
You must attach the written consent of the property owner on record.
Contact Information:
Sponsor/persons responsible for event: Believe With Me/Lyette RebaCk
Mailing address-, 11420 US Hwy 1 , PMB 122, NPB FL 33408
Phone number: 561 -236-2005
Fax number: N/A
Email address: Iyette.reback@believewithme.com
Projected number of attendees: 1 7500
Is Village Council approval needed? Yes[E—] 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 Building 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? YesL] No A❑I
• 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 63 of 325
Agenda Item #5.
�
n ��
HoHowmany tents will be used at event? ��
Will tents have sides? Yes|� N"��
w Should the event include the use of one or more tents' e $35.00 Fine 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.
• By submitting a complete application, the applicant expressly agrees that it 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 the consumption of alcoholic
beverages in conjunction with the special event.
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,
fore 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 e non-profit
permit shall operate their non-profit enterprise in compliance with this section and all other rules and
regulations of the Village.
Required Documents
The following items must be submitted at the time of application:
• Summary of event on official letterhead of organization, signed by the applicant
w Proof of insurance in amounts acceptable to the Village for the type of event. The Village shall be
named as additional insured on all liability insurance (not a certificate holder).
w 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.
m Site Plan required with each application accompanied with drawing indicating layout for event.
o All event sites shall be (eft in a dean and orderly manner upon completion of event.
Special Event Fees
m Under ZOOattendees: $40.00
w Over 200 attendees: $100.00
w Per Village Resolution 36-19' fees for property owners that are 501(c)(3) non for profit entities shall be
reduced by5O%.
Page 64 Of 325
Agenda Item #5.
Applicant Signature
Applicant name: Lyette Reback
Applicant signature.
Date:7110/2025
Office Use Only
Permit number:
Submittal Date:
Deposit amount:
Recommended for Approval
Building Department:
Date:_ It 126 ---
Police Chief:
Date: a o
Fire Chie •
Date: 1jrjesa. ;26
70 r
Parrs & Recreation:
lz/?- e44&-
Date: 1/28/2026
Approved by
Jeremy
Digitally signed by Jeremy Allen
Allen Date:2026.01.28 11:25:07-05'00'
Village Manager:
Date:
Approval s:
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Page 65 of 325
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Agenda Item #5.
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Page 67 of 325
Agenda Item #5.
Believe With Me
f. A DO l c3 non-profit t organization
a De i ated to Pringing Hoe and Help fo Artlericla'9 p
may a 0 l 9
To the'pillage of Tequestar
Believe With Me has been actively engaging the community about our
upcoming July 4th event at the beautiful Constitution Park. our efforts
have been well received and many have commented about their
excitement to help families of fallen soldiers. The support for our oaUse is
unwavering. Registrations have been ongoing and successful and we are
excited about all of our sponsorships and rnedia attention. Within the last
month we have been featured on most major media outlets including Fox
News, Inside Edition, The /Vew York Post, The Washington Post, and all the
major media networks and radio morning shores across the country.
e are writing to the Village of Tecluesta not only to report on our good
success but to also request vie be able to add signage around the village
for additional community involvement. We want the Village residents to
continue to support the race and even choose to participate bigger and
better than last year!
Below is the signage we are requesting be approved:
Thism upto
of a 44N45 no placed
outside t;�e Country Club.
July 4th
7:15 am start
Constitution Park
I N'11o'c 0 111_S
Page 68 of 325
Agenda Item #5.
These signs are double sided and we
would like to harig them on the lamp
Idge.They are the
posts over the bri
E` Frecommended
And the last sogn Is one that we would like
to
placeof outsidepr
-4- t complex In front of 1he fire 5tation and
han. another
on
Constitution Park,
if 03511 # & D
Believe With Me would like to sincerely thank the Village of Tequesta for
di
this consideration and we look forward to serving your residents and
featuring your beautiful park as a venue bringing gratitude and true he�p to
4 { I
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�t i� ,F:-*f Y.�i F�-I•� i 1.r�•��'.tf�-�;,�i�.�`.�Fa r:l.h�'kFT��i}�`�"F���'(•�f.�,�,�i!���Crl'�•}ta�i.�,�l
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7
... �i _ ... �, �•1 ji I .Y �it .i.. _ � "
our * '` of i #
Lyette Reback
Foijnd.er, -'
Agenda Item #5.
2023 SPONSORSHIP REQUEST
Freedom 4 N-liter ITcqsiesta, FL, I July 4th
Bel i eve With Ike
A '0 1(c.)3 Non Profit organizzition
Deli caLed to Bringing Flope and Help to America's Gold Star F am i hes
aiid Bus-inesses-
To Our C onimunim
lie]i ev e wit ii.. N1 e i s a 5 01(03 non prop Fi I c h ari tab le o rgan i zat ion I fiat is tl od icti tol.-I to su ppoilffl A t-n eiic a'.5
Gc)[,,,,l Star Emililies. These families, wtio havo. lost a loved one in service to our nations military, are
5erviced thrOLN-1-10L11 t1le Year thrOLLUh Believe With Me in an -Ixtensilve prqject list that ilICIU&S(bUt is not
limited to :
..In Anzerietm Gold Swr Chrlsongs- in 204163, 2000 Gold Star Children who are orphans of the War on
Tel-Tor will be given Christmas gifts sponsored by th(Atsa-rids of grateful Ainericans. To date we have
servEced over 7000 Gold Star family members.
W
.4n.4 mej,iccin Si veethearl- H U ndred s of vv i d 0�rS o f war are en a Va le nE ine's Day gift. This iS a SUrplist
(A
for each NN,idow and many respond�a-vinur it is the first Vallonfi ay line's D gift since the death of theii- lov,,-d
one.
The Hou�ye Thai Love Ruih- Believe With tMe purc hases a nd.-`or rerio�rateS, and Ai I ty furnishes a home, for
the farnfly off-�i fallen 5-oldlh.-r. In 7-022%ve completed TWO ()F these honies-
W
Believe With Me also L,1C11Cf0L1S1Y supports Gold Star families needing Cinancial,Ls-sistance thrOUgh their
darkest times to meet as nianv needs as possi ble.
go
'X-e are offerinj-,1,OL11' loca[ businesses the opl)ortunity to market throug,.h our event, Believe.With
Free&)m 4 Nfilcji%kvi Ili varIOL]s levels of marketing sponsorship. Believe With Me"s Freef.lom
k '11 tz-&e place JL *.V .9- 1
,vi i1v 41h,10'73 at 7:15AM in TeclLICSta, FL. All proceeds from the race will benefit Believe
With Me's work in nietfling the needs of Anit-3rica"s Gold Star farnifies.l3L1Si11CSSQS that supported Off
evem Lbroug-th %carious mark-ellarx levels at last ear's event' reported an incredibli.3 surge ofsUpport through
rneetino new CLV-00111erS. a Hefiev-e With IN-le i-'-'l a charity that WalltS YOUr
#�. and expanding th,eir client bas.- I
Financial help. but%-ve%k-'ant,VOU LO heneFIL by sponsormgry our event! We�Nrork hard to give you bankj. For
YOU buck-!
Rise look,at what a tbw of our,spotissors had to say about marketing thr migh Believe With Me."s Freedom
4 N-fiter:
B 0 1 cq ST)0 ns o rec 18 elie.t{e With iVe's F r e Mo i�-1 4;I-V I e I-If z 5 1 Year 4.-�I I f.-I V V I j I,V e r e versa �imp Fe S S ee I 1v i I h the
organizt ir ccnLve, Hui in inarket
.7tion's c-omunihnent to riot on y the ing our b,us nee through�Iieir eveni. 1--Ve
ph
("hrk G't7nnon CEO Rolaysponsoi-i h fis cv-enl el,,ery yeal, theftetlbaek-i-ras TKA Tgoo(i.
"Kalvlei-Eke ti-ic&fi�v S Uj?17o r-ied Befieve ff-ith Xle's Freeclom 4 Nfilei-1as I Y-ec ir zind we l�vere
pleers -iih the reltirn on our kywe Reback took-het,in,e,5sqge to the-mef-lia rmel mact sure
oup eonij-)c7ity of in on the local media.5j)o1Ugj-its as ,,veil as 1--nwinole(l m exfensfvely--direr�,jy-t her
social meziia i-each. wei-e thf-ifle l if)have hurl 1he qppoi-timit y to posifive�v hnpaafivnifies Qffallew
sukliei-s as (is the braaelirkq Qf Kcisj?er Eli Zvi h-5nch an an-i az in g ect I I S e Ji is 11-1-1 K�is 1:7 e r,
1'reshlent, Kasj�,et,E)ecty-lcal
Page 70 of 325
Agenda Item #5.
Belie 1,ve With Nle's Freetlot A ` er•will be a familv friers v event�%rjffi
0 1000 participants that includes a
I M racy ile ra distance for all ages through the SCelft CLAxse of Tequesta neig
.-Ilbodi-ood area. Each rnile is
log 4igly named for a local fallen hero and their families are at the finish litre! The Little Pafi-iat'5 ;Vile
wi 11 be ft)r children ales 8-1.1, and-a Tiny C'4xle.is Dash for the 7 wid u nde r kLj,,e group. A fte r the race, there
rill l:ie t1j I
I food(sponsored b-v Bolay), music, local vendors and other activities for everyone to e ' vo . Last
ht
vear s event %vas sold 01.1t and exceeded OUr expectations with more than 900 registrants. We del"L
.1 1--
in our inessage of brinaling[lope and help to Uold Star Families! All the press and word of mouth has
Z7
been exteniiv-e and positive, Believe With Nle"s Freeclom 4...Uiler irs nli re t11LU1j'usL a rLinning,race, it is a
meaning gful and meni-orable event'
Your sponso rship w-ill bt.recogni7Qd at the event in several wz�ys that fja�rc been m apped out in the
sponsorship fl[eflU. We are Orateftil for your support and trully-appreciate your considerati0fl.
Sponsorship and Marketing Menit
Private First Class
$500 Social. Media shout-out on all 10 0 F OUr pages(40K 661 lowers)t Lobo on sponsorship banner at
event., one free race entry included.
Se rgea n t
S 1000 Logo on 1000 t-shirts and sponsorship banner,social media shoLit-OUt.2 free race entries
included.
Captain
$1500 Personalized orie mintilto Video Social Media Shout-Out, logo on 1000 t-shirts and sponsorship
fmc-Al-ter.business na'11le/to,(w in even, email communication with OUr mailino list.,3 free race entries
i roc I tided.
Majoi-
$20-500 Orie Ni4ile Sponsor. Your company's name prominently displa 0�-ed on each si 11 dUring the course
2-1 L-.
of one Tuile(5 signs per mile total")- Video Social Nfiedia ShOLA-0LIt, l000 on 1000 t-shirts and sponsonship
barmier,bL[SiTICSS name/logo in ewry email cc-mimunicaflon with our mailing list.. 4 free race entries
i[IClUded.
Colonel
$5000 Social Media'Takeover DaN--. Your bLlSitleSS f0,'11L.1red permanently on OUr Instkgrarn and Facebook
W
your compa-ily;�.s logo, dedication to our.G'01(l
pages "iffi person alized conterit fora d,,L ky's store illClLtding
Star Community-,. VIP Loungye enu- race.dav,4 SLar llaric)t.treatriletit for 2) people(special event parkinu,,
refreshi-nents-, Ovate air conditioned restrooms), present i qg-t sponsor for Tiny Cadet Dash, Video Social
N'tedia shOLlt-Otlt. IOC)O Oil 1000 t-ShiFts and sponsorship hanner,business nanle/lo.00 in every ernail
COMMUnication%vith our niailingtr list, 10 firee race entries included.
General
$10.000 Pr.--sentinu �'Ponsonllocyo on every printed materia] (if provided in Lime). Logo on signag-e at
Z-1 t7 a g
MOM t111111 300 bL1Si11C5-SCS wtcre race will be adverfisedff lago provided prior to N-lair 1st), Logo Oil 1000
t-shirts and spons(ir-ship banner- BUSiness naine/logo in ever e-mail conirnunication with our mailing list..
Logo displayed as a partner on RefieveWitliMe.com -)isplaved prornineatly on all social media
d I L ogo I V, I ta
pages, L000 disphlyed prominc-ndy oil Ruri.SignUp site,Name and Loq)o on all 1heaftradio shots and
L- go Z='
Wt�bs it�s and a I I n e v -� media interactions.nee s station we bs It es(4 n e 1,v-s stations to c()ve r the event
Page 71 of 325
Agenda Item #5.
4 9ar Pwriot treatment for 6 people including race entHes(special event parking., refreshnients, Social
MediLi Takeover Day, Social Media Take Over Day to rernain in"highlights"oil K-i aiid Pinned ofl
"highlights"
fiwebook, V1 deo Sac[a] Pvledla shout-nut, I IN free race entries inc I Lided.
I
Undej-ivriting Opportunities
Woul1d)�OLI S1111ply like to contribute to the cost of the event,allowin,OUr riice to bring MORf, hope and
help to Gold Star Famil iis? YoLi can simply;. donate at RelleveWith Me.com or choose LO Linden vvrite any
c)f the follmving costs:
.I,shirts S 10,000 Tiny C-adel 100 Yard Dash S1000
Finish Line S2000 Water station supplies/lice$1500
Volwiteer Slifits/Visors$7:50 Whsound system$1500
Meda Is S4800 Printing Costs$2500
Box Truck Rental/Staffint;$750. Frult/Bagels/C;:itorade�Pori er;a(le$500
EMIT/ Fire Services]Permitting $2200. Gold Star Menjorial At-ea $2000
Paper Goods S500
11ort-a-Pot-fies$1500 Signage/Balloons$1000
2n P1
For all illCtLlirles. please do not liesitate to contact me personally and disctiss- how vie can \,vork togrether in
g OUr G�,tipporfin o ld Star faniil'es wid helping your business be recognized as a patriotic,rind social ly-
responsible venue for coinmerce!
Sinc-erel'y.
Lvette Reback
FOL[Rder, Believe With Me
llel ieve WithNte.coni
Ivettereb�tc,k-,'Tt�.�TTiziii.corii 1561 21.36 20005
Page 72 of 325
m #5. DATE(MMIDDIYYYY)
ji CERTIFICATE OF LIABILITY INSURANCE
o 1/12/2026
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 Thomas Mayes
NAME:
JDA Insurance Group PHONE (561)296-0373 FAX (561)828-0997
A/C No Ext: (A/C,No):
120 N.Federal Hwy.,#301 EMAIL thomas@thejdagroup.com
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
Lake(North FL 33460 INSURER A: Penn-America Insurance Company 32859
INSURED INSURER B:
Believe With Me Inc. INSURER C:
10180 Riverside Drive Suite#8 INSURER D:
INSURER E:
Palm Beach Gardens FL 33410 INSURER F:
COVERAGES CERTIFICATE NUMBER: CL2611206704 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 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 CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDLSUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WV❑ POLICY NUMBER (MMIDDIYYYY) (MM/DDIYYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE �OCCUR PREMISES{Ea occurrence) $ 100,000
IVIED EXP(Any one person) $ 5,000
A Y CCP-1335369 07/24/2025 07/24/2026 PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
JECT
X POLICYFI PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident)
ANY AUTO] BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
QED I I RETENTION $ $
WORKERS COMPENSATION PER OTH-
AN❑EMPLOYERS'LIABILITY YIN STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Freedom 4 miler Running Race
Constitutional Park Tequesta,Florida
Date July 4,2026
The certificate holderlisted below is an additional insured but only with respects to liability arising out of claims during the policy period.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
The Village of Tequesta ACCORDANCE WITH THE POLICY PROVISIONS.
399 Seabrook Drive
AUTHORIZED REPRESENTATIVE
Tequesta FL 33469
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Page 73 of 325