5.h Tour de Hugo Bike Ride Special Event PermitSCANDIA
Staff Report
Date of Meeting: July 17, 2018
To: City Council
From: Brenda Eklund, Deputy Clerk
Re: Special Event Permit for Tour de Hugo Community Bike Ride
Background:
City Ordinance No. 119 requires a Special Event Permit for any "outdoor gathering of at least
100 individuals whether on public or private property, assembled with a common purpose for a
period of one hour or longer but may not exceed twelve hours in duration..." This includes races
or bicycle events occurring on city streets. The City Council may place conditions on the
approval of the permit that may pertain to any of the following:
a) Location and hours during which the event may be held;
b) Sanitation/availability of potable water;
c) Security/crowd management;
d) Parking and traffic issues;
e) Emergency and medical services;
f) Clean-up of premises and surrounding area/trash disposal;
g) Insurance;
h) Lighting;
i) Fire service/safety;
j) Temporary construction, barricades/fencing;
k) Removal of advertising/promotional materials;
1) Noise levels;
m) Alcohol consumption;
n) Notification of residents or businesses;
o) Any other conditions which the Council deems necessary.
Issue:
Should the Council approve a Special Event Permit for the Tour de Hugo Community Bike Ride
scheduled for September 22, 2018?
Proposal Details:
The City of Hugo Parks Department is sponsoring the 81h Annual Tour de Hugo Community Bike
Ride on September 22, 2018. The ride will start and finish at Hugo City Hall. Two years ago, a
longer route was added that travels around Big Marine Lake by heading north on Manning Trail,
then east on Mayberry Trail to 195th Street, then south on Olinda Trail on a route that will
return back to Hugo. All participants will be required to sign a waiver and wear helmets while
riding. Washington County Public Works is reviewing an access permit for travel along the
County roads. A map of the route is included with the application. No incidences related to the
bike ride were reported in the last 2 years that this route has traveled through Scandia.
The organizer has furnished a certificate of insurance naming the city as an additional insured.
A copy of the Special Event Permit application is included in your packet.
Fiscal Impact:
None
Options:
1) Approve the Special Event Permit with the following conditions:
• The event shall be held as described in the application received on July 3, 2018
as provided by the conditions of approval.
• As required, the route and traffic control shall be approved by the Washington
County Sheriff's Department and a permit issued by the Washington County
Public Works Department.
• The permit holder shall agree to defend, indemnify and hold the City, its officers
and employees harmless from any liability, claim, damages, costs, judgments, or
expenses, including attorney's fees, resulting directly or indirectly from an act or
omission including, without limitation, professional errors and omissions of
event promoter, its agents, employees, arising out of or by any reason of the
conduct of the activity authorized by such permit and against all loss caused in
any way be reason of the failure of the event promoter to fully perform all
obligations under Ordinance No. 119.
2) Do not approve the Special Event Permit
Recommendation:
Option 1.
JUL 32018
5
CITY OF CANDIA
SC.[ 1ND L ]F.
14727 2091" Street North
Scandia, Minnesota 55073
(651) 433-2274 www.ci:scandia.mn.us
Special Event Permit Application
INSTRUCTIONS. Fill out this form completely, sign it and include all required attachments. If additional space is
needed, attach additional sheets. Submit to the City of Scandia at least 30 days prior to the date of the event with the $25.00
permit fee. You will be notified at the time of application of the date for City Council consideration of the request.
1. Name, purpose and description of event:
Cad
7: 3o LU= 30" -fn
un rocuA r ; &L obe s �I fa we_ lu.ws no Srty m
Location address:
Date(s):
Event starting Time:
Set-up start date and time:
Dismantle by- date and time:
v
%(XD Event ending time: ❑): WPn1
Anticipated number of participants and/or spectators:
If there is a fee or donation required as a condition of
attendance, please describe: Lto Sid onsi k� re[.0^5 �
2. Attach sketch or site plan showing the location of the following as applicable:
route (beginning/ end, direction of travel,
traffic control points)
ticketing/ registration/ entry locations
entertainment or stage locations
portable toilet facilities
fencing locations
parking areas for participants/ spectators
sign locations
speaker (sound amplification) locations
food concession areas (cooking, serving,
consumption)
alcoholic beverage concession area
other concession areas
size and location of any tents or structures
trash/recycling receptacle area
fireworks or pyrotechnics site
first aid facilities
other as may be applicable
City of Scandia, Special Event Permit Application, Page I of 7
3. Applicant information:
Name: 5hL"41kTitle: Falks F"ne,e, -
Address: 4 []
Phone: Cell: NO _ Ll ay —1 y,4 %
E -Mail: J][.�.Lt�C�t. L� . 1OLU-4L7. M n -U.s
Affiliation/ organization: �.t iii}-� iJ�•�[]
Are you an authorized applicant for flus i s organization? Yes X No
Will this person have authority to cancel or modify event plans? Yes %� No
Will this person be present at the event and in charge of the event
at all times? Yes No
If no, provide contact information for person who will be the
responsible party on the day of this event
Name: wvavlin >k Title:
Address:
Phone: Cell: 1 60SI l -be, a `"D i3y,
E -Mail:
4. Entertainment:
Describe entertainment plans. If there will be music,.sound amplification or any other noise impact,
please describe.including the intended hours.
5. Sanitation/ potable water:
Describe the toilet and hand washing facilities present on the site (type, number & location) as well as
temporary/ portable facilities to be provided. Describe the source of potable (drinking) water.
r
City of Scandia, Special Event Permit Application, Page 2 of 7
6. Parking and traffic control:
Describe the location and number of parking spaces available. Describe arrangements that have been
made for traffic control.
7. Emergency/ medical services:
Describe measures that will be taken to ensure emergency vehicle access (police, fire, ambulance) to
the event area.
NIA -
8.
I-1
8. Security/ crowd management:
Describe your proposed procedures and staffing for the event operations and crowd control.
Nlti
9. Trash/recycling, event clean-up:
Describe the number, type and location of trash/ recycling containers to be provided. What provisions
have been made for clean-up of the site and surrounding area after the event?
N A -
Name of trash/ recycling hauler:
10. Lighting:
Describe any temporary or permanent lighting that will be added for the event.
City of Scandia, Special Event Permit Application, Page 3 of 7
11. Temporary structures or construction.
Describe any tents, canopies, enclosures, stages, platforms, scaffolding, risers, bleachers, fences, and
any other type of temporary structure or construction for the event. Event sponsor is responsible to
obtain any building or electrical permits that may be required for such construction. '
12. Advertising and promotion.
Describe how this event will be advertised and promoted. Describe any signs (size, type, location.)
All signs must comply with Scandia Development Code Chapter 2 Section 9.13 including a permit if
required.
1.1-V1 GAL In �Cl
13. Noise:
Describe expected type, duration and timing of any noise sources. Describe measures to be taken to
ensure compliance with city noise ordinance (Ordinance No. 65.)
14. Fireworks or pyrotechnics:
Will any fireworks or pyrotechnics be used at the event?
If yes, describe in detail. Fire Department approval will be required.
Yes No
Al—
City of Scandia, Special Event Permit Application, Page 4 of 7
15. Food and beverages:
Will alcoholic beverages be served? Yes No
If yes, describe the type of beverages and the status of the liquor license:
Will food and/or non-alcoholic beverages be served? Yes X_ No
If yes, describe what will be served and any plans for cooking food in the event area, including fuel
source to be used:
ozkiLt l V;a Gt I
Has a license been obtained from the Washington County
Department of Health and Environment? (please attach) Yes No'k,",
16. Other concessions:
Describe what vendors or concessionaires you will allow at the event, and how you intend to regulate
and monitor their activities.
N000,Gln Sic c.E iCk
17. Gambling:
Will there be any gambling (raffles, pull -tabs, bingo, etc.) at the
event? Yes No
If yes, a lawful gambling permit will be required as provided by state law and Scandia Ordinance No.
100. Describe the gambling activity and the status of the gambling permit.
18. Workers compensation compliance:
In accordance with Minnesota Statutes all applicants for license and permits to operate a business in
Minnesota must submit acceptable evidence of compliance with workers' compensation insurance
requirements. Please complete the certificate of compliance and attach to this application.
City of Scandia, Special Event Permit Application, Page 5 of 7
19. Indemnification:
Ordinance No. 119 requires that a special event permit holder shall agree to defend, indemnify and
hold the City, its officers and employees harmless from any liability, claim, damages, costs, judgments,
or expenses, including attorney's fees, resulting directly or indirectly from an act or omission
including, without limitation, professional errors and omissions of event promoter, its agents,
employees, arising out of or by any reason of the conduct of the activity authorized by such permit and
against all loss caused in any way by reason of the failure of the event promoter to fully perform all
obligations under this ordinance. Please complete the release and indemnification agreement and
attach to this application:
20. Insurance
As a condition of the granting of a permit for a special event conducted on public property or public
streets'or parking lots, the permit holder shall provide to the City a public liability insurance policy
naming the City as an additional insured entity with limits of not less than one million dollars per
occurrence. Please attach the certificate of insurance to this application.
THE MINNESOTA DATA PRACTICES ACT requires that we inform you of your rights about the private
data we are requesting on this form. Private data is available to you, but not to the public. We are requesting
this data to determine your eligibility for a permit from the City of Scandia. Providing the data may disclose
information that could cause your application to be denied. You are not legally required to provide the data;
however, refusing to supply the data may cause your permit to not be processed. Your residence address and
telephone number will be considered public data unless you request this information to be private and provide
an alternative address and telephone number. Please sign below to indicate that you have read this notice:
Signature: ADate:
I request that my residence a dress and telephone num err be considered private data.
My alternative address and telephone number are as follows:
Address:
Telephone:
Acknowledgement/ Signature:
I hereby acknowledge receipt of a copy of this application form and Ordinance No. 119, Establishing Rules and
Regulations for Special Events, and agree to abide by the ordinance and any other conditions that the City of
Scandia may place upon issuance of this permit.
Signature: Date:
City of Scandia, Special Event Permit Application, Page 6 of 7
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DDNYYY)
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
5/21/2018
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 holder in lieu of such endorsement(s).
PRODUCER
CONTACT
NAME; Gordon Beulke
Beulke Insurance Agency, Inc.
PHONE 651-429-3383 x205 [UX,•N4}:(651)429-0843
fiord
4782 Washington AvenueMAS
IL @beulkea
ADDRESS: g Y gency. com
A
INSURER{8) AFFORDING COVERAGE NAIL e
White Bear Lake MN 55110
INSURERA:League of Mn Cities Ins Trust 0019
INSURER B :
INSURED
City Of Hugo
_ M
fNSURERC; _
14669 Fitzgerald Ave No
_
INSURERD:
INSURER E:
Hugo MN 55038
INSURER F
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.
INSRR TYPE OF IINSURANCE ADDLi5UBn POLICY EFF POLICY EXR -
INSn POLICY UMBER IAMQD[yyYY M D YI LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCES 11500,000
A
.
X CLAIMS -MADE ' I OCCUR
DAM GEED
PREMISES lEa occurrence S 50,000
CMC 1001891-2
3/1/2018
3/1/2019 MED EXP (Any one person. .S 1,000
.. ...—
PERSONAL 8 ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE 1 2,000,000
%{ POLICY D PRO-
D
JECT LOC
PRODUCTS - COMP/OPAGG $ 2,000,000
OTHER
$
AUTOMOBILE LIABILITY
COMBINED
eBIINED N NIN LI $ 1, 000, 000
X ANY AUTO
A •
BODILY INJURY (Per person) $
ALL OWNED SCHEDULED
BODILY INJURY (Per accident) $
. AUTOS AUTOS
CMC 1001891-2 3/1/2018
3/1/2019
NON -OWNED
HIRED AUTOS AUTOS
PROPI EtTY DAMAGE
$
ppc srl!
Underinsurea Mworim $ 1,000,000
X UMBRELLA LIABJCILAIMS.MADE
OCCUR
EACH OCCURRENCE $ 1 00.0, 000
A EXCESS LIAB
MEL 1001892 3/1/2018
3/1/2019
AGGREGATE $ 110D.0,000
DEO X RETENTIDN 10 0.60
S
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
STUTTtITE
_
E.L. EACH ACCIDENT $ 1 ,500,000
ANY PROPRI£TORIPARTNER/EXECUTIVE
❑NIA
E.L. DISEASE - EA EMPLOYE $ 1, 500,000
A
andatoryInNH)EXCLUDED?
WC 1001890 3/1/2018
3/1/2019
Hye s, describe under
E . 1151=ASE -POLICY LIMIT 8 1 500 000
OESCRIPTiON OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Tour de Hugo 2018
City of Scandia
14727 209th Street North
Scandia, MN 55073
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
B Schumacher/CO1
U 19BB-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)
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