HomeMy WebLinkAbout12th Annual 22 Challenge Ruck March (BPW approved 3/11/26) r'.GiTY pF. City of Jeffersonville
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�' �1Special Event
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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.
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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'
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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):
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Phone/Email/Website for Public Inquiries:
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iist al!sponsors affiliatedi with the e vent:
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EVENT INFORIi/IATION
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Type or Event:
Location ! t r �) IC
Date(;): May t 1,tk z d 2 6
Event Times: (0!o0 arm — pM
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Time: tJ'a.wte.
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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:
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Detailed Description of Event: /
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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
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REQUEST FOR STREET CLOSURE
Street Name(include block numbers or cross streets):
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Date & Time of Closure:
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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
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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?
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Describe any other use of audio/visual equipment at the event(include company info if
different from above):
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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
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REFUSE/REC V CLING
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How will the event he promoted?
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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.
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SIGNATURE& DATE
PRINTED NAME 1 1 p £r,4e.1-1- Plc C v(-4/
TITLE
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*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-
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Safety Director: �I,
Police Department:, , 4.,
Fire Department: %�: `c 4 6-iii-ti4.-
Pa r•�cPart cnt:
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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.
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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.