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HomeMy WebLinkAbout22 Challenge Annual Ruck March (BPW approved 2/12/25) • - - S. oi• a(-4- _s BUSINESS/ORGANIZATION INFORMATION Name: ,ot. CNGt 11-e (le Annual DOCK /‘ika,,e1,1 For Profit Non-Profit pC Government Neighborhood Assn Other Address: 4124, 3 SUnriU po ,�� $� l(erSbvr) � N L 7 / -72_ Phone: g l Z- qv 0S/ Website: 2 2 CIAO,( ,Or) Social Media: Face boOK , COI / 22Cta(l er,p, d rJ Event Contact (name, phone, email): --j',-p M eevrr1,1 Y0 !o- q&8/ My 1.174 ary S kee cA:ik .CO Yt Phone/Email/Website for Public Inquiries: Sit -y04—gas/ / MY t,rarr;orS ("cape(5m JJ @Qa Cia((t\.CcM / 22er3eor 9 List all sponsors affiliated with the event:ZZCI`alie..v.orj K.enkv V' c�,anc ek«- ComnM1ur',ay 'ti15.rc,.-1:0n Caa.l r torsi l-Aef), VA Care 5•,ve,r 5orperi maws Q`o',� ��� i7o�.c,, locti -ftqg so/die-is RieG-f- EVENT INFORMATION Name of Event: 2.2 Ckq (i Q„t3 A eptj (C Nl o,rc& Type of Event: AWa„,,„QS viCiI'/MArGk Location: 'a;c y ? - [�.. C,A p a) Uhtcct,rs eN f-,,tear �7svt—c Date(s): M°`y I, i 20 25 Event Times: V. 30 0,,41A. — I,1 ; 3a 2 Setup Time: (p;3p Gt,rk Teardown Time: 12 : OO p Alternate Date (if applicable): Private or Public Event: 'i) b 1 ; fit, £ v--' Estimated Attendance: y q"I Ticketed or Free Event: Fr ✓e 0.4 Ticket Pricing (if applicable): N/14. Is this a fundraiser for a non-profit organization? If so, provide name of the organization and contact info: 22C,(t.c...tk 9g. or5 "IMP )-AGe-urc y Pi-y06 - 90P Detailed Description of Event: Spa, o�d C ‘"k 51. `l 514.4; 'S . C 0Si,3.0 Rv f,,, nor co lots caYs, "Ott SctG br t eC ay.-el e,..c(6rs -ctifp, Re leap Q.pprox rAala ly aq oo, w;ti we t k ?ro Pc*'2d M4? tou1-e Pr-e . Ma.cl4S w:11 p�tl -}rv��r'' c;h� 52 all S�d� w�.l k5 G.�1 o�ey awd SAa9gef- in 5; n1c _. , to S co 1 u i As 40 civo',� v\;��•,r'i r sk,..et i-rrk, 4; 4 FOOD/ALCOHOL Will food be served at the event? If so, list vendor(s): Will alcohol be served at the event? If so, list vendor: p MC o'o S U. 9-3 Note:All vendors are required to provide a Certificate of Insurance that lists City of Jeffersonville as additional insured. Vendor COIs are due at least 30 days prior to the event. If alcohol is being served, the policy must include alcohol liability coverage. 3 REQUEST FOR STREET CLOSURE Street Name(s) (include block numbers or cross streets): 1.10 C f p S u r e s U r` I eJS S v j3e S 4e c b�l �Q FG�fsar`v;ale Pe irte bee Date &Time of Closure: Date &Time of Reopening: REQUEST FOR ELECTRICAL SERVICE *The Committee will approve the use of City-provided electrical service as it sees fit. Applicant should plan to use portable generators for all electrical needs unless otherwise advised by the Committee. Describe the electrical needs for the event:SiMI)tt "PIA Syfk.Jvl Tor ope."1^- CQ i' 6n ILf AMPLIFIED SOUND *The City of Jeffersonville's noise ordinance requires that all amplified sound cease by 11 pm. Will amplified sound be used at the event? y es , ivNis nho ��Y If so, provide the name of the company and contact info: Cr i G 1--(a w1 Sot -3 q (o— 74 (o Describe any other use of audio/visual equipment at the event (include company info if different from above): 4 FACILITIES AND EQUIPMENT *The City does not provide ancillary facilities, equipment, etc.for special events. List the company and contact info for each of the following that will be used at the event: FENCING RESTROOMS A I Por G, Po HibP del\vereci @ Skar41 RA;511 5i4-f TENTS 4,t vst Ie,,cy Covt.,rtA a��o- a a;3 y �4�K REFUSE/RECYCLING C.on-kra.eknr 60.ys for la N l_e L.lu. • (3o/+/ 'j CLEANUP We it/Al Qro r` O., C Sweep a area; Odwif9 er44 of es PROMOTION AND ADVERTISING Describe the promotional and advertising plan for your event: S o c c ca. M-Q,4:1\cam. t j C rs Ia Jo c. o� 'I�V j/d 2�✓S 5 CONSENT OF APPLICANT Applicant agrees that the contents of the application are complete, true and accurate to the best of their knowledge, information and belief, and agrees to ensure compliance with the policies and regulations set by the Committee. SIGNATURE& DATE &.-x C M 0I!24//202- S- PRINTED NAME Er()PS-- C M ° Cur J-1 TITLE Pc- sir del, / F ci'i 22 Cr^e4-J (-e jQ.. arr *Sections below will be completed by Special Events Committee* COMMITTEE ADVISEMENT The City of Jeffersonville Special Events Committee hereby PPROVE DENIES this application based on the information provided at the meeting on CPO, '-� 2OZcj� (date). APPROVED BY Committee Director: NA.O r kZ\--) Safety Director: Police Department: Fire Department: 231:6taii10- 4-‘ Parks Department: Street Department: /41,171 -, *The Committee reserves the right to rescind approval of this permit at any time if requirements are not met by applicant in a timely manner, or if the event is determined to be a risk to public safety. REQUIRED SUBMISSIONS (Dates Received) PERMIT FEE - `S lb0 - pVe 2. 06, 2S INSURANCE —Due CH • VI 2025 SECURITY CONTRACT -N(RIVED VENDOR COI(s) - pjQ, : Oy' 202,c3 ► p..ppl-c0.tde 6 ( ••;1. • • • • '..;•-1• ••:'• r : . 1.1;*ti• 'S. • ;•'; f.c. • ..!•'; •. •... ' . • - • • s• t:• • . . : i •••.; :`.: F ; • ' • ViN=1.i3r.1:',i; • . . •i•:!:72 ti• ‘I";ES•ri!..1,E . : • ' ! 1)i ifs"e. ! 1 L. I.:1.• )1;'!'"!:::"• :,!•1:q '.4t.;c4 ff".' 7:!;. Y City of Jeffersonville N � w O Specialoa Event A lication pp FRsoN1 Any individual, business or organization planning a special event on any property owned by the City of Jeffersonville, or is requesting any type of city services for the event, a Special Event Permit must be issued. The permit application should be submitted at least 60 days prior to the event in order to be considered. This application must be completed in its entirety. Any applications not properly completed will be denied. The applicant is required to attend a multi-departmental Special Events Committee meeting, which takes place each month at Jeffersonville City Hall on the first Tuesday of the month at 10:00 AM. An invitation to the meeting will be emailed once the application, route plan and/or site plan is received. To be placed on the agenda, email your completed Event Permit Application and documents to: ...._'•-:.a..^-"-•-r:-u-7" This is the first step in a two-step process. Once the Special Events Committee has reviewed it, it will be taken to the Board of Public Works for final approval. SITE PLAN Applications must include a detailed site plan which clearly shows all temporary structures including but not limited to tents, portable toilets, stages, bleachers, dumpsters, fencing, inflatables, etc. at the time of submission. PERMIT FEE All events approved by the Committee will be charged a non-refundable permit fee up to $200, which will be based on the need for city services and determined at the committee's discretion. This applies to individuals, businesses and non-profit organizations. The fee also is applied for events that are "sponsored" by the City of Jeffersonville or one of its departments. The fee is payable by cash, check, money order, or credit card. Permit fees are due 14 days after the event is approved. INSURANCE Event host must provide a current Certificate of Insurance that lists the City of Jeffersonville as additional insured. The policy must include at least $1,000,000 for general liability coverage. Any vendors for said event serving food, beverages, or alcohol must also provide a COI that lists the City as additional insured. The Committee has the right to require additional coverage as it sees fit or terminate an event if requirements are not met. All COIs are due at least 30 days prior to the event date. Failure to turn in COls by the deadline may result in the event permit being revoked. SECURITY Most events approved by the Committee are required to have security on-site during all operating hours. The number of guards required will be determined by the committee, based on an event safety assessment—estimated attendance, alcohol service, risk factors, etc. The Committee may waive the security requirement for small events with minimal risk. Security must be contracted with the companies that are currently approved by the committee, Vigilance Security or Spartan 5 zos - GY5°o Security. The security contract/invoice must be turned in to the Committee at least 30 days prior to the event date. *The Jeffersonville Police Department does not provide security for events. Their role is limited to enforcing laws and facilitating street closures. ALCOHOL Anyone requesting to have alcohol served at an event must use a vendor that has an alcohol catering license and is currently approved by the committee —The Alcove, Ramiro's Cantina or Pearl Street Taphouse. The event must also adhere to the following guidelines: • ATC Catering Permit for the event on the specified date(s) • COI listing City of Jeffersonville as *additional insured (must include alcohol liability) If event is located in the City's DORA district: • DORA Permit for the event on the specified dates(s) • Barricades surrounding the POINT OF SALE ONLY (fencing, bike rack, etc.) o Alcohol is allowed outside the POS perimeter, must be in a DORA cup o Alcohol is only allowed in the DORA district perimeter If the event is not located in the City's DORA district: • Barricades surrounding ENTIRE area where alcohol will be *consumed (fencing, bike rack, etc.) o Alcohol is not allowed outside the consumption perimeter *All permits and COIs must be submitted to the Committee at least 30 days prior to the event date. IDHS PERMIT Amusement and entertainment permits are required for events that include concerts and other shows, amusement rides, movies, and dances. It is the applicant's responsibility to obtain necessary permits from the Indiana Department of Homeland Security. The Special Events Committee does not advise on these requirements. "-' for the IDHS website to learn more about the permit requirements and application.