HomeMy WebLinkAboutEuro District Car Show (BPW approved 3/11/2) _ City of Jeffersonville
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�W Special Event Application
SOTI
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:parksinfot@cityofleff.net
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, which will be
based on the need for city services and determined at the committee's discretion.The permit fee
base rate is$150, but may be increased based on the need for city services, risk assessment and
other factors.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 COls are due at least 30 days prior to the event
date. Failure to turn in COIs 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
BUSINESS ORGANIZATION INFORMATION
Name: SO1r\O 1, V O \ (l\Afk1
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Address: 1'(\o 1 \IV UImA kon dux"' R 1OVVk V� �I� K 4"1
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Phone: 11,�' -41 O
Website: -eu,YokYc c\A_ �Y Q,� CDC �� l CO VIA'
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Social Media:
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Event Contact (name,phone, email): 0 -WO() S P(71t(fflll C6 t'v
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fro- Phone/Email/Website for Public Inquiries: rtOv��� C�
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List all sponsors affiliated with the event:
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EVENT INFORMATION
Name of Event: U-0 0 1S , V\-
Type of Event: N 1 S\b\Kl
Location: .� �,M hc�Y
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Date(s): \ ,J o \0 1 0
Event Times:
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Teardown Time: p ,
Alternate Date (if applicable): 10 ' ‘ 0 '2
Private or Public Event: n
Estimated Attendance: O/� rat Y
Ticketed or Free Event:
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Ticket Pricing(if applicable):
Is this a fundraiser for a non-profit organization?If so, provide name of the organization and contact info:
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Detailed Description of Event:
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FOOD/ALCOHOL
Will food be served at the event?If so, list vendor(s):
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Will alcohol be served at the event?If so, list vendor:
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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.
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REQUEST FOR STREET CLOSURE
Street Name(s) (include block numbers or cross streets): AI r1( t MaiV\S
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Date &Time of Closure: u
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Date &Time of Reopening:
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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:
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? Q S
If so, provide the name of the company and contact info:
Describe any other use of audio/visual equipment at the event(include company info if different from above):
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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 SOo0 046L
TENTS
REFUSE/RECYCLING
CLEANUP
PROMOTION AND ADVERTISING
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Describe the promotional and advertising plan for your event:
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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&DATE041-6::L)
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TITLE
*Sections below will be completed by Special Events Committee'
COMMITTEE ADVISEMENT
The City of Jeffersonville Special Events Committee hereby APPROVES DENIES
this application based on the information provided at the meeting on 31 Jo1(p iate►.
APPROVED BY
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Committee Director: QjtA( ''a �\P
Safety Director: 7fa.-
Police Department: -,..A
Fire Department: / .2LC.fStatabeliA-A
Parks Department: (Oak*
Street Department: /iii;.•7//i" ...
'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
INSURANCE
^► SECURITY CONTRACT
VENDOR COI(s)
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