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I5. Housing Tour Alcohol Permit(406) 758-7756 �:_i!y��,LeLk-(g)kztLisL)eli.cofn [•'.O. Box 1997, 201 First Avenue East Kalispell, Montana, 59903 www.kalispell.com REPORT TO: Doug Russell, City Manager FROM: Judi Funk, Deputy City Clerk SUBJECT: Alcohol Addendum Request — Kalispell Housing Tour and Reception — ay 23, 2016 BACKGROUND: The Montana Housing Partnership has submitted an application for the sale and consumption of alcohol at a reception from 4:30 p.m. to 8 p.m. in Depot Park at the conclusion of a tour of Kalispell's housing. 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: It is recommended that City Council approve the alcohol addendum that accompanied a Special Event Permit from the Montana Housing Partnership that would allow for the sale and consumption of alcohol on May 23, 2016 at a reception in Depot Park. 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. 1. Name of Event: MUST ATTACH A DETAILED MAP OF THE EVENT. b t �& 100 K ot-� 2. Event Date(s): . VO4 ZiD � Start Time: '3C) P43.End Time: C) iDrv\ 0 4-7 3. Group Name Sponsoring Event: 4. Organization Officer/Authorized Representative: - 5. Daytime Phone Nc)4Email: 0 r-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: e�E,� w i u occ_u(� )o r��,War­ Vol A - 7. Proposed Route (including starting and termination points)- 000t__� 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: s ( 9. Street Closures/Parking Restrictions requested, if any: /S C) l E, 10. Please specify what (if any) city equipment/assistance is requested (road barricades, trash containers, traffic assistance, crowd control, etc): NO�� 11, Please specify what arrangements have been made for clean-up after the parade/special event: 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. 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 d the resulting from or w ' artici ting in the parade/event. rdW/gg 1 Signature o App icant V V / /Date 9 Print Name: M uy- a/ �.1 , /U& �'/�Y_ 06YLA V" DO NOT WRITE BELOW THIS SPACE (FOR CITY USE ONLY) Signature Fire: Parks: Police: Public Works: 9 �. ' City Attorney: Date Permit Issued: Reason for Denial: Signature: ** PLEASE CHECK APPLICABLE FEES Parade Pee [ }" Date Paid: Deposit [ j Date Paid: Barricade Fee [ ] Solid Waste [ ] Estimated Amount: Estimated Amount: Circle One Date pprov / Deny 1 pprove Deny pprove / Deny �pproyO / Deny Q royv /-Deny � Date Permit Denied: Date Paid: Date Paid: 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 contact a01'STNC---V- : A 50q 01 NVE, 6� tAT 23qQ &4E; /�Q�'76 �586 ,.I -- Name and contact information of licensed Caterer if applicable: RNs MT, Provide estimate of the number and concentration of participants at the event: k7 RC)031.k�(:y � Lj 0(S, 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: W(u- 1-\'L-L 6E- &' < 0 kpv AC) C)QL ��,tAQK'j 0(-5— opt RDuu- t)UqK� (5t Co rA 1A k TVF �-- V� G �-L - !V1 Check that you have provided proof of liquor liability insurance coverage for the event: Check that you ha provided proof of compliance with Department of Revenue requirements for or the event: Revised December, 2015 ACKNOWLEDGMENT OF LEGAL RESPONSIBILITIES ➢ 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 of the policies and regulations contained in the permit. Approved by the City Council this day of — ��6/& ---- Date 20 Revised December, 2015 MONTHOM-07 SPAULSON CERTIFICATE F LIABILITY INNCE DATD/YYYY) 3/8/2Q16 3/8/2 THIS CERTIFICATE 1S 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 Great Falls Office Paynewest Insurance, Inc. 90013th Avenue S., Suite 1 Great Falls, MT 69406 CONTACT NAME:PHONE F X A/c No t:(406) 761-1160 A/c Ne; (406) 452-1172 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Insurance Co INSURED INSURER B : Montana Homeownership Network, Inc, dba NeighborWorks Montana 5091 st Ave So INSURERC: INSURER D : INSURER E : Great Falls, MT 69401 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 CONTRACTOR 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 LTR TYPE OF INSURANCE ADM INSR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY FXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ®OCCUR X PMPK1385658 10/01/2015 10/01/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE To RENTED PREMISES Ea occurrence 100,000 MED EXP (Any one person) _$_ $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- a JECT LOC GENERAL AGGREGATE $ 2,000,000 GEN'L PRODUCTS-COMP/OP AGO — — -- $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY ANY AUTO PHPK1385658 10/01/2015 10/01/2016 COMBINED SINGLE LIMIT Eaaccldent $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per ( ) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE per acadent $ X I UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A HEXCESS LIAB CLAIMS -MADE PHUB512902 10/01/2015 10101/2016 AGGREGATE $ 1,000,000 DED X RETENTION $ 10,000 _ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA T STATUTE ER E.L. EACH ACCIDENT $ E.L, DISEASE - EA EMPLOYE $ (Mandatory In NH) It yyas describe under DESG�RIPTION OF OPERATIONS below — E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Montana Housing Partnership Conference - Depot Park - May 23, 2016 Additional Insured per form PI-SE-001 (1212005) - Fund Raising Event Endorsement I,CR r it 1"r r c nvLur=rN %,ANk,CLLA I IUN City of Kalispell; Kalispell Parks & Recreation Department PO Box 1997 Kalispell, MT 59903 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 l � ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD