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2. Alcohol Special Event Permit - Street FestivalHme Post Office Box 1997 - Kalispell, Montana 59903 Telephone: (406) 758-7701 Fax: (406) 758-7758 -3� REPORT TO: Doug Russell, City Manager - FROM: Theresa White, City Clerk SUBJECT: Alcohol Special Event Permit Request — Flathead Industries MEETING DATE: May 19, 2014 BACKGROUND: Flathead Industries has submitted an application for the sale and consumption of alcohol at a street festival on June 27th to celebrate its 40th anniversary. The celebration will be held on I st Avenue East between East Idaho and East Montana streets. The Special Event Permit and Alcohol Addendum have been reviewed by the appropriate city departments and all supporting documentation has been deemed to be in order. RECOMMENDATION: City council moves to approve the Special Event Permit to allow for the sale and consumption of alcohol at the Flathead Industries Street Festival on June 27th. Respectively Submitted, Theresa White City Clerk Attachments: Special Event Permit Application Insurance (City of Kalispell) Alcohol Addendum MT Liquor Control Division Special Permit Date Issued: CITY OF KALISPELL PARADE/SPECIAL EVENT PERMIT APPLICATION Application must be filled in completely. Requests for a Parade/Special Event Permit must be received at least 30 days prior to the requested activity. " -I _111a j�r - I- 1. Name of Event: I cue _._'Q t" 0 2. EventDate(s): Start Time: 2 End Time: V'13&'3' 3. Group Name Sponsoring Event: t7-k'aot'o"i) 4. Organization Officer/Authorized Representative: d, C, Tve- 5. Daytime Phone#: mail: Q J, 6. Description of Parade/Special Event. Please include whether the parade/event will occupy all or only a portion of the width of the streets, the location of any event areas, and the type of event including any activities planned (floats, animals, etc). Please attach any other documentation that may be helpful: 4e I 1 9 ','e- C " 7. Proposed Route (including starting and termination points): C t 0-;, .71V - 8. Describe any recording equipment, sound amplification equipment, banners, signs, or other attention - getting devices to be used in connection with the parade/special event: � _ di �e 40, 1 n [� C, 9. Street Closures/Parking Restrictions requested, if any: Ajtj� —I 10. Please specify what (if any) city equipment/assistance is requested (road barricades, trash containers, traffic assistance, crowd control, etc): I-1- U`t A—"-i ,--'_ ->'.� %-,-- y; -ke,4-:, ho io— a aa+al. Ae4--� 11. Please specify what arrangements have been made for clean-up after the parade/special event: e'xk- & Revised July 2013 INSURANCE A Certificate of Liability Insurance in the amount of at least $750,000 per occurrence and $1.5 million aggregate must be submitted to the Kalispell City Attorney's office prior to any permit being issued, The Certificate of Insurance must name The City of Kalispell as additionally named insured on the policy. For insurance questions please contact the city attorney's office at (406) 758-7977. PARADES NO CANDY OR OBJECTS MAY BE THROWN TO SPECTATORS. The applicant will ensure that participants do not ride on floats with their legs hanging over the side. The applicant will brief C, participants to maintain a safe and constant interval during the parade. This will help prevent the .'accordion effect" which results in gaps in the parade procession. TERMS AND CONDITIONS As an agent and acting on behalf of the requesting agency or organization, I hereby certify that the information above is complete and correct. I further understand that it is my responsibility to ensure that participants for the parade/event as requested fully understand that the City of Kalispell and the State of Montana does not endorse, encourage, condone,, or protest the said parade/event. It is further my understanding that each participant will be advised by the parade/event sponsor that the City of Kalispell and the State of Montana will be held harmless and will not be responsible for injuries, damages, or deaths resulting, from or while participating in the parade/event. 311 Signature of Applicant Date Print Name: (-1 r-'- U CL A e, c� Signature Circle One Date Fire:�T qI7 -- App`r`o)/ Deny Parks: Approve Deny Police: Deny Public Works: -Appp"ev Denv City Attorney: ApprovelDeny J, Date Permit Issued: Date Permit Denied: Reason for Denial: Signature: ** PLEASE CHECK APPLICABLE FEES Parade Fee Date Paid: Deposit Date Paid: Barricade Fee Estimated Amount: Date Paid: Solid Waste Estimated Amount: Date Paid: Revised July 2013 TIFF F LIABILITY DkTE{MMYY) 4/3012014014 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 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 hcialer in lieu of such endorsement(s). PRODUCER Kalispell Office Pa neWest Insurance, Inc. 33 Villaga LoopE-MAIL Kalispell, MT 59901 CONTACT NAME: PHONE FAX A/c E No xt): (406) 758-4200 {AT /c, No); (406) 755-1189 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # _ INSURER A: United States Liability Co. INSURED INSURER B : i INSURERC: Flathead Industries, Inc. INSURER D P.O. Box 1916 Kalispell, MT 59903 INSURER E : INSURER F : ---fff MIFA q ' 2YI9Lr7c I:al01ITIIc3 r t. ) a 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 LTA TYPE OF INSURANCE ~- -- DUE S�IBR(` _._- POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDDIYYYY ---- -- LIMITS A X COMMERCIAL GENERAL LIABILITY I� CLAIMS -MADE L_I OCCUR X ( CL1649687 06/27/2014 06/29/2014 EACH OCCURRENCE $ 1,000,000 Ea occurrence $ 100,000 EPREMISES MED EXP (Any one person) $ 1,000 1 PERSONAL & ADV INJ_UR_Y_ -- $ 1,000,000 I N'LAGGREGATE LIMIT APPLIES PER:GENERAL POLICY PRO- (�---- JECT �J LOC AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG ----- — $ 2,000,000 � $ —_- — OTHER: j AUTOMOBILE LIABILITY I OaaccidentBIEDSINGLE LIMIT E $ BODILY INJURY (Per person) - —_ $ ANY AUTO ._.-.; ALL OkNNED I SCHEDULED AUTOS IAUT05 j I i BODILY INJURY Per accident ( ) $ NO HIRED AUTOS _ AUTOS I PROPERTY DAMAGE Per accident --- $ UMBRELLA LIAB EXCESS LIAB i OCCUR I_ CLAIMS -MADE i EACH OCCURRENCE $ AGGREGATE 1$ 1 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N PER QTH- ____, _STATUTE_., I__ ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? DI N / A ( E.L. EACH ACCIDENT $ (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE! - -- --- E.L. DISEASE - POLICY LIMIT $ — $ I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Flathead Industries Special Event Festival on 6127/14 at 40 East Idaho, Kalispell, MT City of Kalispell, Parks and Recreation Department are named as additional insured for liability coverage per form attached to the policy. City of Kalispell Parks & Recreation Dept. 306 1st Ave. E. Kalispell, MT 59901 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ck. v� U T'Si3U-2t)14 ACOKU CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 04/29/2014 16:08 406-756-7787 FLATHEAD INDUSTRIES PAGE 02/02 ALCOHOL ADDENDUM CITY OF KALJSPELL PARADF,/SPE CJAL EVEXT VERMIT APPLICATIOTS; If it is the request of the applicant to sell, serve, consume or possess beer and/or wine at aspecial event held on City owned or maintained property the -fallowing information and documentation must be provided: Narne and contact information of requesting Organization and Non -Profit group benel'itting front event: l ccc VA G ao eaags Narne. and contact information ot'licensed Caterer if applicable - A Provide estimate of the number and concentration of participants at the event, Provide a plan that ensures that underage persons will not: obtain alcoho)ic beverage,, served at the event, and the precaution-, proposed, such as fencing barriers to create separation, use of ID bracelets, and maimed 5=11-ity to adequately secure and supervise the area and the participants during the event: r---" (heck that ,you have provided proof of liquor liability hlRirance coverage for the event:[ I Check that you have provided proof of compliance with Department of Revenue requirements (6r the event- LK I Revisod .My 2013 EX, a i 614 el V I WIAV 11 0 a i > The holder of this special event permit is solely responsible for all actions of his/her group, and for the welfare of the public at the event, for all property belonging to the group and to the City, and for adhering to the Kalispell Municipal Code and the Laws of the State of Montana. ➢ I understand that a trained volunteer or employee in one of the preapproved MDOR training courses must be present at all points of sale and service. I understand that I must pay all fees and deposits as required. I understand that my permit can be revoked at any time for just cause, that my deposit may not be returned, and I may not be able to obtain a new permit in the future for violations of the law such as providing alcohol to a minor (MCA 16-6-305), providing alcohol to an intoxicated person (MCA 16-36-304), drinking if not of legal drinking age (MCA 45-5-624), or driving while intoxicated (MCA 61-8-401). I have reaan;,nderstand all of the policies and regulations contained in the permit. Signature of Applilt Date C-C�- Print Name Approved by the City Council this day of , 20 Revised July 2013 6pecial Hermit: Ub6K i-ee'. �'iu.uu SPECIAL PERMIT FOR THE PERIOD BELOW THIS IS TO CERTIFY that FLATHEAD INDUSTRIES of KALISPELL, MONTANA is hereby granted a special permit to sell Beer and Table Wine to the patrons of the Fundraiser at 40 East Idaho, the location described on the application. This permit starts on June 27, 2014 and ends June 28, 2014. All permit holders are required to follow the laws and rules of the Montana Alcoholic Beverage Code (MABC) regarding the sale of Beer and Table Wine. DATED at Helena, Montana this 21st day of March, 2014. DEPARTMENT OF REVENUE LIQUOR CONTROL DIVISION Brandon Hoang, Authorize'd Signature (#06) 444-40 15 Please Note: Legal hours for sale of Beer and Table Wine are between 8:00 a.m. and 21-00 a.m. except when further restricted by city ordinance, CERTIFICATE F LIABILITYINSURANCE p(MMIDDIYYYY)ATE 5/73/2a1474 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ARID 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 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 Kalispell Office PayneWest Insurance, Inc. 33 Village Loop Kalispell, MT 59901 CONTACT NAME: PHONE FAX Ala No, EXt1: (406) 755-4200 (arc, Nej: (406) 755-1189 AIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: United States Liability Co. _ _ INSURED INSURER B INSURER C : Flathead Industries, Inc. INSURER D : P.O. BOX 1916 Kalispell, MT 59903 _ INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE "SuBTU. I POLICY EFF POLICY EXP -- LTA POLICY NUMBER MM/DDJYYYY MM/DD/YYYY LIMITS A .X 1 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X CL1649687 06/27/2014 06/29/2014 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,000 EXP (Any one person) $ 1,0aa .._........._w___. - jMED PERSONAL & ADV INJURY $ 1,000,000 _GENERAL AG_GREGATFE s 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: i POLICY PE LOC PRODUCTS - COMP/OP AGG $ 2,000,000 _ Is OTHER: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS r NON -OWNED j HIREDAUTOS AUTOS ''... COMBINED SINGLE LIMIT $ Ea accident �_ _ BODILY INJURY (Per person) ! $ -------- BODILY INJURY (Per accident) $ PROPERTY DAMAGE 1— (Per accident) $ i$ I UMBRELLA LIAB OCCUR EXCESS LIAI I CLAIMS -MADE --- -- DED RETENTION $ I i I EACH OCCURRENCE w. AGGREGATE $ _ $ 'WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N ANY PROPRIETORtPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N / A '�. PER H- STATUTC OT ___. T ER --- E.L.ACH AGCIDENT -..._ .�---_----- E.L. DISEASE EA EMPLOY J $ If yes, describe under DESCRIPTION OF OPERATIONS below ! __.. _... _ EL. DISEASE - POLICY LIMIT $ 1 I i I i I DESCRIPTION OF OPERATIONS t LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: Flathead Industries Special Event Festival on 6127/14 at 40 East Idaho, Kalispell, MT State of Montana, City of Kalispell, Parks and Recreation Department are named as additional insured for liability coverage per form attached to the policy. I��lli�I•i�Y� State of Montana, City of Kalispell Parks & Recreation Dept. 306 1 st Ave. E. Kalispell, MT 59901 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE c4 v� V 19BB-ZO14 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD THE CITY OF KALISPELL` MONTANA BARRICADE FEE CODE FLATHEAD INDUSTRIES B229026 AMOUNT PAYMENT RECEIVED AMOUNT CHECK: 4286 50.00 TOTAL 50.00 ------ -- - - --'-- -------- ----