I4. Big Shindig Alcohol Permit(406) 758-7756 Ltjjs ell„ .con-i
P.O. Box 1997, 201 First Avenue East
Kalispell, Montana, 59903
www.kalispell.com
REPORT TO: Doug Russell, City Manager
NEI
BACKGROUND: Flathead Beverage and the Desoto Grill have submitted an application f]
the sale and consumption of alcohol at a block party from 10:00 a.m. to 9:00 p.m. on lst Stre
West between 2nd Avenue West and 3rd Avenue West on June 25, 2016.
The Special Event Permit and Alcohol Addendum have been reviewed by the appropriate cl
departments and all supporting documentation has been deemed to be in order. I
RECOMMENDATION: It is recommended that City Council approve the alcohol addendu
that accompanied a Special Event Permit from Flathead Beverage and the Desoto Grill that won
allow for the sale and consumption of alcohol on June 25, 2016 at a block party on Ist Stre
West. I
ATTACHMENTS: Special Event Permit Application
Insurance
Department of Revenue Liquor License
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 3 weeks prior to the requested activity. YOU MUST ATTACH A DETAILED MAP OF THE EVENT.
1. Name of Event:
W1
Bate(s
2. Event 5" Start Time: A24?,�-,, End Time:
(1, 1
3. Group Name Sponsoring Event:
rl 4. Organization Officer/Authorized Representative:
5. Daytime Phone 4: Email:
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: 5
< Proposed Route (including iyian rmination points):
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:
7"
OU; (71
9. Street Closures/Parking Restrictions requested, if any:
10. Please specify what (if any) city equipment/assistance is requested (road barricades, trash containers,
traffic assistance, crowd control, etc): :-7
V
11. Pleases pecify what arrangements have been made for clean-up after the parade/special event:
41i
vy
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 attorneys office at (406) 758-7977.
Revised December, 2015
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
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 resuliing frorA,or wr participating in the parade/event.
Print Name: Jt-4, J�,J 6(—,
Fire:
ParkE
Polic
Publi
City,
Reason for Denial:
Signature:
** PLEASE CHECK APPLICABLE FEES
Parade Fee I I
Deposit
Barricade Fee
Solid Waste
Date Paid:
Date Paid:
Estimated Amount: 15°1
Estimated Amount:
Date
irc C�p Deny
pr
Approye`/ Deny
(Ap prove eny
Approve Deny
Approve / ],Deny
'"Date Permit Denied:
Date Paid:
Date Paid:
Date
Revised December, 2015
CITY OF KALISPELL
PARADE/SPECIAL EVENT PERMIT APPLICATION
If it is the request of the applicant to sell, serve, consume or possess beer and/or wine at a special
event held on City owned or maintained property the following information and documentation
must be provided:
Name and con act . -ifoAnation of requesting Organization and Non -Profit group benefitting:
Name and contact information of licensed Caterer if applicable:
Ll
Z' is�.
Provide estimate of the number and concentration of participants at the event:
e,
Provide a plan that ensures that underage persons will not obtain alcoholic beverages served at
the event, and the precautions proposed, such as fencing barriers to create separation, use of ID
bracelets, and manned security to adequately secure and supervise the area and the participants
during the event:
Check tha ou have provided proof of liquor a liability jnRirz�n coverage for the event: / - -
/I t"zv
14
Check that you have provided proof of compliance with Department of Revenue requirements
for the event:
Revised December, 2015
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 read and understand all oft policies and regulations contained in the permit.
S!��Rafdr-'e�ol tAPPIMUIR Date
Print Name
Approved by the City Council this day of 20
Revised December, 2015
THEDESO-01 BMILLER
DATE (MM/DDIYYYY)
CERTIFICATE F LIABILITY INSURANCE 4/12/2016
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 poiicy(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 NAMEcT Beth Miller
Kalispell Office PHONE - - FAx
Paynewest Insurance, Inc. (A/c, No Ext�: (406) 758-4200 _(A/C, No), (406) 755-1189
33 Villaga Loop E-MAIL s:
KaliS e(I, MT 59901 INSURER(S) AFFORDING COVERAGE
p _
NAIL #
The Desoto Grill, LLC
325 5th Ave West
Kalispell, MT 59901
INSURER A :Ohio
INSURER B : USLI
INSURER C :
INSURER D :
INSURER E
INSURER F :
110101flA Lt : • l -
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 ..-.. ADDLSUBRr _._. __ ....
LTR INSR WVD POLICY NUMBER
POLICYEFF 1 POLICYEXPj LIMITS
MM/DD/YYYY MM/DD/YYYY
A X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $
1,000,000
CLAIMS -MADE X OCCUR iBKS56821283
DAMAGE TO RENTED
09/03/2015 09/03/2016 ( PREMISESrre $
PREMISES {Ea occurre
1,000,000
MED (Any $
16,000
PERSONAL & ADV INJURY $
1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: I
GENERAL AGGREGATE $
2,000,000
' PRO -
POLICY JECT LOC III
PRODUCTS - COMP/OP AGO $
2,000,000
OTHER:
_ $
1
_..
' AUTOMOBILE LIABILITY j ,
1 COMBINED SINGLE LIMIT $
_
(Ea accident)
i ANY AUTO ! I
_
BODILY INJURY (Per person) $
ALL OWNED I SCHEDULED
BODILY INJURY (Per accident) f $
! i AUTOS , AUTOS !
NON -OWNED
PROPERTY DAMAGE
$
HIRED AUTOS : AUTOS
{Per accident)
_$
_.
UMBRELLA LIAB OCCUR
EACH OCCURRENCE . $
_.. _. ,_..
EXCESS LIAB -
,... " CLAIMS -MADE
_......
AGGREGATE !$
DED '': RETENTION$..._
�.,..$
WORKERS COMPENSATIONI
fPER OTH- "
AND EMPLOYERS' LIABILITY YIN' ' '."
: STATUTE I. ER
_.
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. . EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? N / A
(Mandatory in NH)-- :
E L DISEASE - EA EMPLOYEE! $
If yes describe under !
- -
---- - --
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT $
B !Special Event Liab X iCL1741499
06/25/2016 06/25/2016 General & Liquor
1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
ur=rc r rrn.r. r c 1.F41Vl.CLLfi I IUPd
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Kalispell THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City Of
PO Box 19ACCORDANCE WITH THE POLICY PROVISIONS,
Kalispell, MT 59903
AUTHORIZED REPRESENTATIVE
�, u�1J(
p 1988-2014 ACORD CORPORATION.l
CO 1 1 ,. ,. ,, O R l name and logo are registered marks of ACORD