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HomeMy WebLinkAboutResolution 2010-028 N.C.S. 03/01/2010Resolution No. 2010-028 N.C.S. of the City of Petaluma, California APPROVING PARTIAL ROAD CLOSURES FOR THE ENRICH AND EDUCATE FUND/ OLD ADOBE UNION SCHOOL DISTRICT/ATHLETA PETALUMA FOOTRACE ON SUNDAY, APRIL 18, 2010. WHEREAS, the Enrich and Educate Fund/Old Adobe Union School District is sponsoring the Athleta Petaluma Footrace on April 18, 2010; and, WHEREAS, the Enrich and Educate Fund/Old Adobe Union School District has coordinated the details of the Athleta Petaluma Footrace with the Petaluma Police Department; and, WHEREAS, the Enrich and Educate Fund/Old Adobe Union School District will be the authorized sponsor of the special event including the authorization of vendors within the special event perimeter. NOW, THEREFORE, BE IT RESOLVED that the City Council does hereby authorize the Petaluma Police Department to partially close the following portions of Lakeville Highway for the Athleta Petaluma Footrace on April 18, 2010 from 8:00 AM to 12:00 PM, per the identified locations in Attachment A, Special Event Application. The eastbound number two lane of Lakeville Highway from Marina Drive to Casa Grande Road. The northbound lane of Casa Grande Road from Lakeville Highway to Technology Lane The eastbound lane of Technology Lane from Lakeville Highway to the cul-de-sac at Alaman Marsh Trails. Under the power and authority conferred upon this Council by the Charter of said City. REFERENCE: I hereby certify the foregoing Resolution was introduced and adopted by the Ap Vd tCouncil of the City of Petaluma at a Regular meeting on the Is` day of March, 2010. by the following vote: City Attor y AYES: Barrett, Vice Mayor Glass, Healy, Rabbitt, Renee, Mayor Torliatt NOES: None ABSENT: Harris ABSTAIN: None !d ATTEST: C� City Clerk May, r Resolution No. 2010-028 N.C.S. Page Petaluma Police Department Application for Special Event Permit FOR OFFICE USE: Date application received: Event Day and Date: ------------------------------------------------------------------------ TO BE FILLED OUT BY APPLICANT: Applicant Number Application assigned to: --------------------------------------------- Sponsoring Organization or Group: (Name) R I S 1►J { '7"µE.U-y A� �� C `1�3 Llo X q \) Z �I �TI� wrwr� `I �r 5S 10 7 7(. x 33 9 y Address Telephone Applicant or Contact Persons(05 SAU 1�AFRE� - P T1Rt- M Y9S1� Name Address 10'7 7(-3 f 915 7a 7 L. ro 575 Work Phone Cell Phone I ] Other Altemate/Additional Contact Person: - 1 CH. Imo R Ei"'t1 A P� 3 ox l b 4 2 ���"-'4 �o v� 9 y`iSl Name Address Day Phone �- -1 o'I (a (- It - 7 a 1 .33 zo I Additional Contact Numbers: Work Phone Cell Phone Date(s) of Event: / 1 0 10 Time of Event: From gAn Z to _9 P__ Type of Event: (e.g., parade, carnival, demonstration, etc.) UME T~o A 1--t Cn I a&L 0—�r r- t r-i Estimated number of persons at event: _ J Q, O 0 Q Estimated number of vehicles at event: 3-SC7 Location or Route of Event: ( Attach map of event location or route) �r✓r LE A 'L3w� t3ErwEsN WAsuju4ro,.j w 2)Lt (•J >�b rl� % r:x-w �s' � ?Q-1-3 t. v a +- � F stir >= n.. , WAS µrN4io� t- i} , l3 s*Lid' EEC y ` w F-�gBs•IJE��! 13 s�' + Cs� C sr �,�rwar✓� 1`��r 'QLvn � a �Sv- Resolution No. 2010-028 N.C.S. Page 2 TO BE FILLED OUT BY APPLICANT: Will food or beverages by served at event? ()() Yes ( ) No If yes, describe: Fo c) p v t=,y'D,o t2 s Will alcohol be served at event? ( ) Yes X No If yes, describe: Have you obtained a permit for the sale of foodlbeverages/alcohol? ( ) Yes (,�O No If yes, a copy of permit most be attached to this application Will any booths or structures be erected at event? O Yes ( ) No If yes, describe: ?0 v "_S Will there be any sound amplification equipment at event? (X). Yes ( ) No If yes, describe: L-1 yr -- n4rhio w ►fg w n pis SP-E,A-1dF2s PtAc&D AMoU�-;P ArLEA SEE MAP FQf4- i-OC&LJQ�JS Will this event take place in a City Park or Recreation area?( ) Yes (X) No If yes, a permit may be required (13'.28.050 PMC): Petaluma Parks and Recreation Department 320 N. Me Dowell Blvd., Petaluma (707) 778-4380 Will this event take place on Private Property? ( ) Yes (K) No If yes, written permission of the landowner must be attached to this application. Have you obtained a business license to conduct your event from the City of Petaluma? ( } Yes ( ) No If yes, attach a copy of the permit to this application. BLOCK PARTY INSTRUCTIONS: Block Party Applications must include a separate form with the name, address, and signature of the residents of all dwellings along the street, which will be closed. The permission form must include the Day, Date, and Time of the plarmed Block Party. The permission form should include a description of activities (e.g. barbecue, games, etc) *Please note that the term "Block Patty" applies only to residential streets. Block parties may not be approved if they create a substantial disruption of traffic flow per 13.32.080 (A)(5). Resolution No. 2010-028 N.C.S. Page 3 ADDITIONAL INFORMATION REQUIRED FOR APPLICANTS TO CONDUCT A PARADE, BICYCLE RACE, FOOT RACE OR OTHER RACE, OR ANY OTHER EVENT ALONG A MOVING ROUTE. TO BE FILLED OUT BY APPLICANT: Assembly time: Location of assembly area: Start time of parade/event: End time of parade/event: Disbanding location: Disbanding time: Maximum length of parade: (in miles or feet) Describe vehicles/floats: (e.g., how many, how powered) (Attach additional pages if necessary) Number and type of marching units: Any animals in parade? (Describe) Please provide any additional information that may be important to the event I declare under penalty of perjury that the above information is true and correct to the best of my knowledge. Signature of Applicant Resolution No. 2010-028 N.C.S. Page 4 REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS FOR SPECIAL EVENTS ON STREETS/SIDEWALKS (Petaluma Municipal Code Section 14.21.130) OR FOR PARK FACILITY PERMITS FOR PARK EVENTS (Petaluma Municipal code Section 13.28.130) All persons/groups are required to furnish an insurance policy or a certification of insurance naming the City of Petaluma as an additional insured party for general liability coverage. The insurance requirement will be waived for persons or groups sponsoring First Amendment Events on city streets/sidewalks or Parks who cannot afford to purchase insurance for their event. First Amendment Events includes marches and assemblies to support/protest government policies or decisions, or to express religious or political beliefs. To request a waiver you must first determine whether your group can afford insurance coverage. Check with a licensed insurance agent to determine the cost of purchasing insurance for your event. If you determine you cannot afford the premium, fill out the following: WAIVER OF INSURANCE UWe, hereby apply for a waiver of insurance requirements for the special event for which we/I am/are the applicant sponsor. UWe, believe that the event's sole purpose is First Amendment expression and that the cost of obtaining insurance coverage for the event would create an unreasonable burden on the right of First Amendment expression: CHECK THE FOLLOWING: [X] I have applied for a Special Event Permit from the Police Department ] I have applied for a Park Facility Permit from the Parks and Recreation Department. [ ] Describe First Amendment purpose of event: [x] I have checked the cost of purchasing insurance coverage with a licensed insurance agent. State name and address of agent. [ ] I/We request awaiver of the insurance requirements. I declare under the penalty of perjury that the foregoi g-i ne and correct> Dated:: j l - .20 C2`t pplicant's signature Applicant's Name: Fy gn grt. Applicant's Address: 1165 SA�_) RAtFAa, bR PEr- Applicant Telephone: -IQ 1 ? io 3 Resolution No. 2010-028 N.C,S. Page 5 / 1 Sign posted-6-Petalu1r betweiaaran St. &'L .t`cQriiCOi?�.�Lt.LrX . C S, Merchant Vehielcs sd and Special Pass Parking ssible Motorcycles Golden Eagle Shopping Center Possible Motorcycle & Bicycle Parking W AHF.�I] , �'� PE7At.1lRAA BL'1/D A A , QNer 4 Resolution No. 2010-028 N.C.S. Page 7 #ave a popsicie/ '-`r�ss�eecrL �ctaxl!accsstcer3 e�"aLsctc >Eo-�ssc�Jzrcerss �h�f� A celebration of'50s and early'60s Americana on the streets where the movie was filmed! Benefiting arts, education, history, safety and the welfare of our community Happy New Year! This year, 2010, will be the 5`h anniversary of the ever-growing and now world - known Petaluma's Salute to American Graffiti. Many are even starting to call it "Graffiti Days". We had visitors from New Zealand last August who are coming back in May not just for the show, but as volunteers to help make it happen! We already know of people in Minnesota, Washington, Oregon, Pennsylvania, and Nevada who are bringing their cars! We're excited and we hope you are too! This year we will be expanding our car show area. For better traffic flow outside our area, we will be increasing our closed off area down Petaluma Blvd from B St to D St, taking 2od St from B St to C St. and B St from 4`h St to 2d St. So, if your business is located in the new area, we look forward to working with you help you get the most from this event. : The event starts off with our Henry Travers Memorial Scholarship Dinner on Thursday, May 1 P. Then on May 141h, it's the hugely popular Cruise -in at The Petaluma Plazas. And finally downtown Petaluma on Saturday the 15`h, it's Salute 2010, which includes our 2nd annual emergency vehicle show. This celebration benefits Petaluma in many -ways. It brings a big crowd of people to town, many from hundreds or even thousands of miles away. These folks spend money here and stay in our local motels and hotels, which brings in TOT funds for Petaluma. And finally we, Cruisin' The Boulevard, invest a significant portion of the net proceeds back into Petaluma. �.{�il'4'S.Rtllif �t.i��Rkf it �Partlse .etas' lnau�� Did you know that: 1. Everyone associated with Cruisin' the Boulevard, Inc. and the celebration is a volunteer? No one is paid a salary!! 2. Cruisin' the Boulevard, Inc. pays for all police and city fees to hold this event in the downtown area. 3. Over the past four years we have reinvested over $80,000 back into our community including donations to Petaluma People Services Center; Project Graduation at all three high schools; Petaluma Historical Museum; City of Petaluma; Petaluma Police Department; Petaluma Fire Department; AEDs to Petaluma, Case Grande, and San Antonio High Schools, Petaluma Riding and Driving Club, San Antonio Volunteer Fire Department and Christmas Cheer. 4. Started in 2007, our Henry Travers' Memorial Scholarships have helped 12 high school seniors with their college expenses. 5. We had visitors at the 2009 celebration that came from Sweden, France, Italy, Austria, New Zealand, and Japan? Resolution No. 2010-028 N.C.S. Page 8 We would like to thank all the businesses who have gotten involved in this fun event. This is a day of fun that will also increase the sales in your store, so get involved and reap the benefits. There are many ways that your business can get involved. One of these ways is to set up a window display or window painting that represents the fun time of the 50's and 60's, American Graffiti, or Cars. This helps draw people to your business. Another is to have a special sale, giveaway, contest, or samples. We will help get the word out about your doings if you let us know. Our trading card is another way to get people into your business. This has worked for the many businesses that have participated in the last few years. We also have many different levels of sponsorships available with different benefits. Speaking of sponsorships, one of the benefits is an ad in our program. We have been told that our program is the best, "High Quality! Excellent Pictures and Great Ads!" Did you know that every car show entrant gets one of these programs? When we travel to other car shows, we pass out programs. For instance, in 2009 we went to Hot August Nights and passed out over 300 of them! In 2010, we will once again be having our own radio station playing oldies, taking requests, doing interviews, and playing ads. Keep your shop radio tuned to 88.1 ton your FM dial to listen to some of our local celebrities playing their favorite hits. Maybe you have a special request, want to place an ad, or maybe you want to step up to the microphone and tell us about your business, We can help! With your support, we are making a difference in the quality of life here in Petaluma. If you would like to sponsor, have an ad in our program, sign up for a trading card, volunteer, make a donation or just get more information, please contact us at (707) 762-3394 or jolin o americangraffiti.net. Thank you and all of the best in 2010, John Furrer, President An all -volunteer, tax-exempt 501(c)(3) nonprofit California Public Benefit Corporation Cruisin' The Boulevard, Inc. e P.O. Box 4412 . Petaluma, CA 94955-4412 o (707) 762-3394 www.american-graffiti.net a info(cDamericangraffiti.net a EIN:20-3804722 Resolution No. 2010-028 N.C.S. Page 9 DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE OP ID KE-1 01 08/10 PRODUCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Gene Gaffney ins Services, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 428 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Occidental CA 95465 Phone:707-874-2666 Fax:707-874-1233 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: NonProfitel Insuranco Alliance INSURER B: _ Crusin' the Boulevard INSURERC: John Furrer P.O. BOX 4412 INSURER D: Petaluma CA 94955 INSURER E: v 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 DESCR18EO HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INW LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDCt TYYYY DATE MMIDDlYT1Y LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 ED PREMISES Eaoccurence S 500000 A X COMMERCIAL GENERAL LIABILITY 2010-18805-NPO 02/20/10 02/20/3.1 MED EXP (Any one person) S 20000 CLAIMS MADE [)�] OCCUR PERSONAL BADV INJURY $ 500000 GENERAL AGGREGATE S 3000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOPAGG $ 3000000 POLICY PRa LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EAACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE S $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARINERIEXECUTIVE---1 _ ITORYLIMITS I ER _ E.L. EACH. ACCIDENT S _ E.L. DISEASE • EA EMPLOYEE $ OFFICERIMEMBER EXCLVDED9 (Mandatory in NH) E.L_ .DISEASE -POLICY LIMIT $ It yes, describe under SPEC IAL PROVISIONS balow OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: American Graffiti Car Show, May 13-15, 2010 in Downtown Petaluma, Petaluma, CA. The City of Petaluma, its officers, agents and volunteers are named as Additional Insureds per the attached CG20110196. CERTIFICATE HOLDER LrA1Nla LLAI lWi9 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL II57060IR51M MAIL 30 * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT74R%'AVqVMQ= SHALL IMPOSE NQ OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Petaluma P.O. Box 61 Petaluma CA 94953 ACORD 25 (2009101) ©190'209 ACORD CORPOFZATLON %ll The ACORD name and logo are registered marks of ACORD Resolution No. 2010-028 N.C.S. Page 10 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed.,A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor. does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009101) Resolution No. 2010-028 N.C.S. Page 11 POLICY NUMBER: 2010-1 8805-NPO COMMERCIAL GENERAL LIABILITY CG 20 1101 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURE® - MANAGERS OR LESSORS OF PREMISES This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1, Designation of Premises (Part Leased to You): Downtown Petaluma, Petaluma, CA 2. Name of Person or Organization (Additional Insured): Any person or organization acting as a manager or lessor of a covered premises that you are required to name as an additional Insured on this policy, under a written contract, lease or agreement currently In effect, or becoming effective during the term of this policy, and for which a certificate of Insurance naming that person or organization as additional insured has been issued. 3. Additional Premium: INCLUDED (if no entry appears above, the Information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS AN INSURED (Section II) Is amended to Include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of the ownership, maintenance or use of that part of the prem- ises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or organization shown in the Schedule. Resolution No. 2010-028 N.C.S. Page 12 Post Card Mailing For Petaluma's Salute to American Graffiti 2010 Cruising the Boulevard, Inc. is proposing to have a Car Show and Cruise on Saturday, May 15, 2010. They are requesting street closures for the purpose of the Car Show, Live Music and a Cruise. The event is scheduled start at 9:00 AM and end at 9:00 PM (12 hours). lioad closures will take effect starting at 8:00 AM until 9:30 PM. Road closures will include; Water St, Petaluma Blvd North (between D St and Washington), Western Avenue (between Petaluma Blvd and Keller St), 4'h/Kentucky St (between B St and Washington St), American Alley, Telephone Alley, 2"d St (between C St and B St), C'St (between Petaluma Blvd and 2"d St), and A Street Parking Lot. The Police Department will be working this event to reasonably accommodate any traffic related issues. The Car Show and Cruise Event will be presented to the Petaluma City Council for approval, You can appear in person if you have any comments, they can also be directed to Police Lt. Tim Lyons at (707) 778- 4372 Resolution No. 2010-028 N.C.S. Page 13 Petaluma Police Department Application for Special Event Permit FOR OFFICE USE: Date application received: Event Day and Date: -------------------------------- --------------------------- TO BE FILLED OUT BY APPLICANT: Applicant Number, Application assigned to: ------------------------------------------------- Sponsoring Organization or Group: (Name)01 4 Q06e (Nl 00 SChnO I DLS+r'1 C,+ '9 5 cin IA Orae- C7o`t�ytos-c.}321 Address l,^016 e149cl/ Telephone Applicant or Contact Person:&f1$ 0n °�glUMq Name Address C70?)2 .5-0022 C-7o7) 291- 57cl 7 Work Phone Cell Phone [ I Other. Alternatc/Additional Contact Person: Name Additional Contact Date(s) of Event: 'q i g,1 zo i V Address Day Phone Work Phone Cell Phone Time of Event: From 1't'L. to 12,_ern Type of Event: (e.g., parade, carnival, demonstration, etc.) roo+ Race : Run I w " th 1 e. vm ao rcL ce " Estitated number of persons at event: 7700 90 0 Estimated number of vehicles at event: !Zw 2-5 0 Location or Route of Event: ( Attach map of event location or route) 1 Resolution No. 2010-028 N.C.S. Page 14 TO BE TILLED OUT BY APPLICANT: Will food or beverages by served at event? (✓f Yes ( } No If yes, describe: Will alcohol be served at event'? ( ) Yes (►�) No If yes, describe: Have you obtained a permit for the sale of foodibeverages/alcohol? ( ) Yes ( ) No If yes, a copy of permit must be attached to this application. Will any booths or structures be erected at event? (✓f Yes ( ) No If yes, describe: ,Pop up" S+v e- i:en+-.s fow c Will there be any sound amplification equipment at event? (✓� Yes ( ) No If yes, describe: la st_�smahefs and ha in In i- Will this event take place in a City Park or Recreation area? (✓) Yes ( ) No If yes, a permit may be required (13.28.050 PMC): Petaluma Parks and Recreation Department 320 N. Me Dowell Blvd., Petaluma (707) 778-4380 Will this event take place on Private Property? (rj Yes ( ) No If yes, written permission of the landowner must be attached to this application. Have you obtained a business license to conduct your event from the City of Petaluma? ( ) Yes (►lf No If yes, attach a copy of the permit to this application. BLOCK PARTY INSTRUCTIONS: Block Party Applications must include a separate form with the name, address, and signature of the residents of all dwellings along the street, which will be closed. The permission form must include the Day, Date, and Time of the planned Block Party. The permission form should include a description of activities (e.g, barbecue, games, etc) *Please note that the term "Block Party" applies only to residential streets. Block parties may not be approved if they create a substantial disruption of traffic flow per 13.32.080 (A)(5). Resolution No. 2010-028 N.C.S. Page 15 ADDITIONAL INFORMATION REQUIRED FOR APPLICANTS TO CONDUCT A PARADE, BICYCLE RACE, FOOT RACE OR OTHER RACE, OR ANY OTHER EVENT ALONG A MOVING ROUTE. TO BE I+ILLED OUT BY APPLICANT: Assembly time: 700 14M Location of assembly area: Pp_}eq I0nnA Maf tng, PAf kind Start time of parade/event: q ' 0U R-m End time of parade/event:. I ?-' Oy f'm Disbanding location: Def-aduma ma lt?Gl j arlst jq to+ Disbanding time: 12.'UOprn Maximum length of parade: (in miles or feet) 5 i'ie.S Describe vehicles/floats: (e.g., how many, how powered) (Attach additional pages if necessary) Number and type of marching units: Any animals in parade? (Describe) CAf)j m6a15 ,(,,�11 106+ Please provide any additional information that may be important to the event I declare under penalty of perjury that the above information is true and Sffrect to the best of my luiowledge. /�;) " of A Resolution No. 2010-028 N.C.S. Page 16 REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS FOR SPECIAL EVENTS ON STREETS/SIDEWALKS (Petaluma Municipal Code Section 14,21.130) OR FOR PARK FACILITY PERMITS FOR PARK EVENTS (Petaluma Municipal code Section 13.28.130) All persons/groups are required to furnish an insurance policy or a certification of insurance naming the City of Petaluma as an additional insured party for general liability coverage. The insurance requirement will be waived for persons or groups sponsoring First Amendment Events on city streets/sidewalks or parks who cannot afford to purchase insurance for their event. First Amendment Events includes marches and assemblies to support/protest government policies or decisions, or to express religious or political beliefs. To request a waiver you must first determine whether your group can afford insurance coverage. Check with a licensed insurance agent to determine the cost of purchasing insurance for your event. If you determine you cannot afford the premium, fill out the following: WAIVER OF INSURANCE I/We, hereby apply for a waiver of insurance requirements for the special event for which we/I am/are the applicant sponsor. Me, believe that the event's sole purpose is First Amendment expression and that the cost of obtaining insurance coverage for the event would create an unreasonable burden on the right of First Amendment expression: CHECK THE FOLLOWING: [ ] I have applied for a Special Event Permit from the Police Department [ ] I have applied for a Park Facility Permit from the Parks and Recreation Department. [ ] Describe First Amendment purpose of event: [ ] I have checked the cost of purchasing insurance coverage with a licensed insurance agent. State name and address of agent. [ ] I/We request a waiver of the insurance requirements. I declare under the penalty of perjury that the foregoing is true and correct> Dated: Applicant's Name: Applicant's Address: Applicant Telephone: Applicant's signature Resolution No. 2010-028 N.C.S. Page 17 SPECIAL EVENT PERMIT HOLD HARMLESS ACRE, EMENT FOR OFFICE USE: Event Date: Event Location: Applicant: The special event permittee/sponsor of event (hereafter called "Permittee") agrees to reimburse the City of Petaluma (hereafter called "City") for all losses incurred by it in repairing or replacing damage to City property proximately caused by the Permittee, its officers, employees, agents (including special event monitors), or any other person attending or joining the special event who was, or reasonably should have been, under the Permittee's control. Persons who merely attend or join in a parade or other special event are not considered by that reason alone to be "under the control" of the Pennittee. The Permittee further agrees to defend, indemnify and hold harmless the City, its officers, agents and employees from all actions, claims, damages, losses and liability arising out of or alleged to arise out of the special event which was proximately caused by the Perinittec, its officers, employees, agents, including special event monitors, or any other person attending or joining in special event who was, or reasonably should have been under the Permittee's control. I hereby agree to comply w the terms of the Special Event Permit including the Hold Harmless Agreement, and to cor pl ith all special event permit conditions. Signature of Permittee: i L - Date: ) b5 jb If special event is sponsored by an organization, the police department may also requires that this permit be signed by an authorized officer or sponsoring organization. Signature of Officer or � Sponsoring Organization: Date: ` `� I VD Resolution No. 2010-028 N.C.S. Page 18 REQUEST FOR EXTRA -DUTY POLICE OFFICERS The Police Department may require that additional Police Officers be assigned to your special Xevenoaddress traffic or safety concerns. You may also request that overtime Police Officers be assigyour special event. When Police Officers are required/requested for your event, the supervisor rep for processing your Special Event Permit will contact the event sponsor(s) with that urformati i. The contract included below will be completed and you may be required to pre -pay the esti ted costs for policing the event. (Non -profits and person(s) sponsoring a special event whose print y pinpose IS h7rst An7endnient Ex cession may obtain a waiver of the first four hours of police time f9f the event). For Office Use: Petaluma Police Department Estimated Budget for Contract Ovei-tinie Estimated Personnel Costs ice Officer Hours at an Event: # Police Officers (From: To: _ _=Y6linimum 4 Hours each 4 hoursN $57.60 per hour = $230.40 Estimated Vehicle Hosts: Police vehiclelixosts at the _ vehicles for _ hours ( PPM }__ hours hours x $2.75 per h ur — S C Estimated Administrative Costs; Sergeant's preparation timeXd/counting servicesAdministrative Fee —20% oof $,_Total Estimated Costs of Personnel,d Admin. Costs = $ Total costs for the contrac�tual services ar due by In the event of a cancellation of contractual services. Tlie Petaluma Police Depar lent Event Supervisor must be notified no later than 2�4 hours prior to the start of th event. If the event is ancelled within 24 hours, the event organizer will pay a minimum 2 hour per of , cer cost and the Administi tive Fee. Services rendered ursuant to this agreement repres it an estimate of need and are based upon past experience.for simil • events. The Petaluma Police Dep -tment shall endeavor to mitigate costs to event organizer by sen} ng assigned security personnel home arly should circumstances and events dictate less security re Girements. Conversely, the Petaluma Polic Department reserves the authority to add additional securiypersonnel should circumstances dictate such n ed. City of Petaluma P lice Department BY: Title: Date: (Organization) BY: Title: Date: Representative Resolution No. 2010-028 N.C.S. Page 19 12/28/2009 Statement of Intent: acting on behalf of basin Street Properties and/or Lakeville and Marina, LLC, hereby authorize the Petaluma Footrace committee and the Enrich and Educate (0) Fund to the use of our parking lots for the 61h Annual Petaluma Footrace. I have fully read and comprehend all of the information provided in the above "Property Use Agreement" and am authorized to sign on behalf of this property. Signature>a_1LkL,-Vi ,0 e / pate: _�/ 2-o 1 (D Attached. Course Map -2010 Petaluma Footrace (3mi/5mi distances) Resolution No. 2010-028 N.C.S. Page 20 F_ CERTIFICATE OF INSURANCE 1 11/25/2009 American Specialty Insurance & Risk Services, Inc. 142 North Main Street INSURED USA Track & Field, Inc. 132 East Washington Street, Suite 800 Indianapolis, IN 46204 ENRICH AND EDUCATE FUND 1583 CERRO SONOMA CIRCLE PETALUMA, CA 94954 n���rn w nrce THIS CERTIFICATE IS ISSUED AS A MATTER OF INFUHMA I IUN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICY BELOW, INSU COVERAGE CERT NUMBER: 1000838076 EVENT CODE: 10-38-004 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT WITHSTANDING 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 CONDITION OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INS LTR A POLICY TYPE GL POLICY NUMBER AXGLO2100182.09 POLICY EFFECTIVE 1 i/0112009 12:01 a.m. POLICY EXPIRATION 11/01/2010 12:01 a.m. LIMITS General Aggregate 3,000,000 Products -Completed Operations Aggregate 3 000,000 Personal and Advertisingin u 1:000,000 Each Occurrence 1,000,000 Dam e to Premise*t o One P e is s 1,000,000 Medical Expense Limit (Any One Person Excluded DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS - Coverage applies to USA Track & Field sanctioned events and registered practices, Including any directly related activities, such as event set-up and tear -doom, participant check -in and award ceremonies. The Certiricaleholder is only an additional Insured with respect to liability caused by the negligence of the Named Insured as per Form AXIS 1003-Additional Insured - Certiricateho:ders,bul onlywith respect to the PETALUMA FOOTRACE on April 18, 2010. W-dJ-1-all YI 1 y r&7.rr J• r&l Mn M! K- CITY OF PETALUMA, ITS OFF OFFICE OF THE CITY CLERK 11 ENGLISH STREET PETALUMA, CA 94952 EMPLOYEES, AGENTS AND VOLUNTEERS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, Sneclatty Insurance & Risk Services, Inc. also conducts business as A.S.I.R.S:1. Insurance Agency in the state of Resolution No. 2010-028 N.C.S. Page 21 / ; Y tee%^ Benefiting the ®Id Adobe Union School District's E' Fund Application Details/Event Summary for Special Event Permit Event Summary: The Petaluma Footrace is the Enrich and Educate Fund's (also known as EZ) main annual fundraising event. The EZ fund is a non-profit organization dedicated exclusively for the Old Adobe Union School District. Their mission is to support under -funded enrichment programs within the 5 schools of the district, including music, science, technology, and physical education. The 2010 event will be the 6tn annual race —100% of the proceeds go directly to the Enrich and Educate Fund. The event will be held on Sunday, April 18, 2010, starting and ending at the Petaluma Marina parking lot. The footrace features a 5 and 3 mile run/ walk through the Alman Marsh and Shollenberger Park. Participants will begin arriving at the Marina parking lot at 7:30am to check in for the race. The start of the race will be at 9:00am from the north parking lot of the marina complex. Participants will travel along the course heading on trails through Alman Marsh and around Shollenberger Park. The return route will take participants along Technology Lane, northbound on Casa Grande Road, and west on Lakeville Hwy (CA 116) in the number 2 lane of the eastbound direction. Participants will exit Lakeville Hwy prior to the intersection at Marina Ave. at 2080 Lakeville Hwy. Participants will be utilizing this portion of the course from 9:10am—11:00am. Any remaining runners/ walkers after 11:00am will be cut off and required to return to the marina via trail through Alman Marsh. This is the same route that was used for the 2008 & 2009 event. Upon returning to the finish area at the north marina parking lot, many participants will stay for an awards ceremony and raffle. The event will be concluded no later than 12:30 pm, at which point event organizers will cleanup all event materials. Lane Closure/ Traffic Control: We are requesting that the Petaluma Police Department close eastbound lane number 2 (far outside lane) of Lakeville Hwy (CA 116) from Marina Ave. to Casa Grande Road from 9:00am—11:00am. We are requesting that two extra -duty officers/ vehicles be assigned to the event for this purpose. Per Caltrans requirement, we are requesting that a lighted warning sign be used at the appropriate distance on Lakeville Hwy prior to the lane closure. Resolution No. 2010-028 N.C.S. Page 22 Recommended Schedule: 0800-0830: Prepare for work, load cones and signs 0830-0900: Deploy cones and signs on Lakeville 0900-1100: Monitor runners and walkers on streets 1100-1130: Pick up cones and signs 1130-1200: Unload cones and signs, debrief event with supervisor Race will not begin until lane closure is set. Upon the Petaluma City Counsel adopting a resolution authorizing the partial closure of Lakeville Hwy, we will obtain a permit from Caltrans authorizing the closure and traffic control. Once we obtain this permit, we will forward a copy to the Petaluma Police Dept. Event Monitors: We will supply a minimum of 10 event monitors on the course, including 3 along the portion using city streets. These monitors will be wearing reflective vests. First Aid: We will have one first aid/ water station along the course and a second at the start/finish area. We will have a minimum of one EMT at the event and Petaluma Fire Dept. will be notified. Restrooms: We will have available 7-10 port-o-potties in addition to the use of the restrooms at the Harbor Master/ Boat Launch (we have obtained permission from the Harbor Master). Background: The Petaluma Footrace started in 2005 by four Casa Grande High School students as a Senior Project. The event attracted 200 participants and raised money for music programs in the Old Adobe Union School District. Because the event was a success, two of the organizers, Chris Mason and Ian Inman decided to keep the event going and renamed it the Petaluma Footrace. Since 2005 the event has raised over $40,000 for the school district, and we have a goal of raising $15,000 at this year's race. As this is a 100%volunteer-driven effort, the support from the City of Petaluma and of local businesses has been vital to the success of this community event. In 2010, we look forward to our continuing partnership with The Gap, Inc. and Camelbak, which provides us with the necessary funding to make this event possible. Resolution No. 2010-028 N.C.S. Page 23 No dawnstrearn taper. regular traffic pattern resumes after traffic crosses Casa Grande Rt. fligntec intersecacn; ?;01, f'OCtra_-e route 'cute e^ters nark'ng l'o'. 'arl"I'M:1?c:� s ?r a'zi tX,^_Este File's.,i? ��s e r>'I pr�;i, tcI :� A�.: Gnecirw­Ee`Lre jnvti ,%s! Lengr.h of lane closure: 1055 f` Trar>sition area moves eastbound traffic out of its norrna' path. ` encth of transition area: 200ft Advartce warning area: signs include -right lane dosed ahead" and `reduce speed ahead' Total distance frcm first s=gn until trans ton area.-