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HomeMy WebLinkAbout12th Annual 22 Challenge Ruck March (BPW approved 3/11/26) r'.GiTY pF. City of Jeffersonville t . Application L. �' �1Special Event 11, _ 1v pp 4.ON 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: parksinfo@cityofieff.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. p 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 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 BUSI \itSS/OR ANiZATiON iI'JFOR ::A 9 iOi' IYd11iC: LLL11diieI ge.VIb' For Profit Non-Profit Government Neighborhood Assn Other Arlrlrncc• n7L Crrnrisr Drive n!nrchnrs IN /1717? Phone: Si 2-406-9081 Website: 22ChalIenge.org Social IV IWV11U. facebook.colii/22Challeriga.org Event Contact (name, phone. email): Er4B5f �f� mc-e„ d , s)(Z- G- QO?( f-tywad-hor'ske2irsQ.30.1a',t.corn Phone/Email/Website for Public Inquiries: L-ift)lo-ROB(JoNy wa-rri o(5/<eQ.tcrS @3 iQ-i . Co' / 22C1,‘a tie rt9e.0(. iist al!sponsors affiliatedi with the e vent: Z2-tt"11(elep 1 th4ueziopa \relcran•5 t*invnib+{ Inke ra4eJ C0: ;4-ibrl EVENT INFORIi/IATION N mn of Evn t: 1211". AnnucLA ZZ C t(e.,nye.0r ��k. fAarcV Type or Event: Location ! t r �) IC Date(;): May t 1,tk z d 2 6 Event Times: (0!o0 arm — pM �••,,__ Setup Time: tJ'a.wte. rui . _- iijicicu iV/. Z2c( te ^p e,O r" KV C- Alternate Date (if applicable): N.i Private or Public Event: To ; Estimated Attendance: 7 90 aA-;- eC,S Ticketed or Free Event: F cee, e Tickot Pricing (if ppiic :blc_): N/A is this a fundraiser for a non-profit organization? \i s If so, provide name of the organization and contact info: 22 C-tAo cte+� o � h'; C 1 qi0 6.96 ( Detailed Description of Event: / L: ve w `� \v_', t?J 5?J?Q.c,(„ Calo►r 9Ua-rc /�,py� c/ tOt , l.)c A-i o-( ►-t !i►`. wA- Q.nJ 0,, re-f rd t-b-ors 5 utei a e. A JJ FOOD/ALCOHOL Will food oe served at the event? if so, list vencior(s): Will alcohol be served ai the event? If so, list vendor: ivote:.Aii vendors are required to provide a Certificate of insurance than lists City of Jeffersonville as additional insured. Vendor COls are due at least 30 doe;prior to the event. if alcohol is being served. the policy must include alcohol liability cor/era_ae I REQUEST FOR STREET CLOSURE Street Name(include block numbers or cross streets): '3 1 Vovr 5 4o..fian Cor Aer AA6VWck IM(A (aa.•rry Date & Time of Closure: AO { ko! 44- 6 :0 0 a wt. — `2 : a 0 p- i.Timo of^4- r.ning: tAcoi oU p * REQUEST FOR ELECT RAL EERViS_t th Committee will approve the use of city-provided electrical SCTVICe as it Sees lit.Applicant should aeon to use portable generators for oil electrical needs unless otherwise advised by the Committee rlrcrrihn thr'r!_rtrirn! n _ak frsr thr, ryrrlt: B&c c l \0 \' Ou0Q)r Ary n:rru I, Sasuisv The City cf J_ffersonvilie's noise ordinance requires that all amplified sound cease by 10 pm on Sunday-Thursday and ii pm on r-ridav-.Saiurday. Pmp!ified sound be used at the event? -a b P-or a0,At9V vs,c.Q GA-4,(-•c Gram,•, 0�`l .t p the nar o Dt th - .��,..� compare,/Anil contact r.ifv. E C i C 1A0 - Describe any other use of audio/visual equipment at the event(include company info if different from above): -.v e ? Sys->�e t 5� v - cS axe-wogs 'fr r r^:! 1TIrr --:r all 11r^. I'Y1�.:L!I ILJ t%I\V Ltr.V 1r IYIL!' 1 The City does not provide ancillary facilities, equipment, etc.for special events. List the company and contact info for oath of the following that will be used at the event: FENCING tkJ J ll r.rr-rnr.t'n nr o )'hlz oiJI•C g siccoIMS TENTS d Ctke. S T y 1 D ti 5,2 o-p sP;Kp S 22 ci.ttf 1 e w, ll �� ,,,�ssg �e -ka q'<< aiiQ-- ce3 REFUSE/REC V CLING fj iirAN p ---.22 CL((. • °"g (LA U }-x,k e cu a_ 8 3 ra-s k Q I,)ay U Or C1o>tlre How will the event he promoted? Soc;at eta t ��l tv TU J UJorcl o-4 AA-dv�� 11T1-J1R N(YT�G 1-k.;5 u;,t.t bt' `1' , +L ?.e,';ids 1: yea..r.s 6e. C d u p(e G t`Q-)o urges Q,, Je-cf F'o r` �.„J .ThC5- - f`e1/Qsukirs Y-6 a ct5 S t I 1"\ CONSENT OF APi ii 41\T Applicant _that. ..t _ f:__.:: a c(.N+titiei t- true and accurate to thiY Applicant ocTcc� ufa•. •... . __..._..._ .. the^i•vffv.^•. .�4' best of their knowledge, information and belief,and agrees to ensure compliance tr'ith the policies and regulations set by the Committee. 64, C14°e 4)fl11aI2O2(o SIGNATURE& DATE PRINTED NAME 1 1 p £r,4e.1-1- Plc C v(-4/ TITLE ?tt-5)g i j Ro0' - Z2CAcille & Q.aC *Sections below will be completed by Special Events Committee' COMMITTEE ADVISEMENT The City of Jeffersonville Special Events Committee hereby APPROVES DENIES " this a placation based on the information provided at the meeting on ... 1 ra eFdate). APPROVED OI \ O✓ Committeesil/ Director:: �-�""` P- c(-3 Safety Director: �I, Police Department:, , 4., Fire Department: %�: `c 4 6-iii-ti4.- Pa r•�cPart cnt: Yrl\� ✓•..VV• Iltrli�• Street Department: /400,.., *The Committee reserves the right to rescind approval of this permit at any time if requirements if determined be I. to ore not met by applicant in a timely manner, or the event is deter mined to a risk public safety. /iN I MEM foi l with waive the security icgtiircii'iciil Iv' SlTiall events with Innu'nai risk. Security must be contracted with the companies that are currently approved by the committee, Vigilance Security or Spartan Security.The security contract/invoice must he for ned in to the Committee at least 30 days prior to the event date. `The Jeiieisonviiie i mice Lieparintent does nut provide security for evenly.Their role is limited io entorcing laws and tacilitating 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: • DOP A Permit for the event on the specified rlates(s) • Barricades surrounding the POINT OF SALE ONLY(fencing, hike rack,etc.) Alcohol is allowed outside the POS perillletei,lilust be in d DORA Lull Alcohol is only allowed in the DORA distiil.t peiiieuiei If the event is not located in the City's DORA district gook • Barricades surrounding ENTIRE area where alcohol will be *consumed (fencing,bike rack,etc.) Alcohol is not allowed outside the consumption perimeter 'All permits and COls Trust be submitted to the Committee at least 30 days prior to the event date. IDHS PERMIT Amusement and c'tertainmen. 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.Click here for the 1DHS website to learn more about the permit requirements and application. NOTES Due to the amount of city services required,and the restrictions caused to the public, non-city parades will not be approved. Anyone rein resting Sk nr other pin/walk Pveni, will he ariviceri to rice Chapel take Park New requests for run/walk events that require street closures will not be accepted.