5.d Scandia Marine Lions Special Event Permit for Taco DazeSCANDIA
Staff Report
Date of Meeting: July 16, 2019
To: City Council
From: Brenda Eklund, Deputy Clerk
Re: Scandia-Marine Lions Special Event Permit for Taco Daze
Background:
Taco Daze will be held on Saturday, September 7, 2019. The Scandia-Marine Lions Club has
applied for a Special Event Permit for this community celebration under the provisions of
Ordinance No. 115.
Issue:
Should the Council approve a Special Event Permit for the Scandia-Marine Lions Club Taco Daze
activities on September 7, 2019?
Proposal Details:
The Lions permit covers the parade, the activities occurring on the Community Center grounds,
and the Gammelgarden "Running of the Meatballs" being held before the start of the parade.
The Gammelgarden Museum has applied for a gambling permit for this activity. The Boy Scouts
are responsible for taco sales inside the Community Center. The event application describes
the planned activities. Events at the Community Center begin at 9:OOam and end at S:OOpm.
Outdoor music will be provided by bands scheduled to play from 11:00 to 4:OOpm. Meisters
plans to operate a beer garden within an enclosed area south of the old maintenance garage.
They will need to apply for a Temporary Off -Premises Liquor License. The Lions will provide
outdoor food sales and will need to obtain a permit from the County Health Department. An
antique car and tractor show will again be held in the parking lot, so parking here will be
restricted, although there will be reserved space for emergency vehicles. Shuttle rides from
remote parking locations will be offered. The Lions will need to obtain a permit from
Washington County for the parade along Oakhill Road. The required certificate of insurance,
naming the City of Scandia as an additional insured, has been submitted as part of the
application.
Fiscal Impact:
None
Options:
1) Approve the Special Event Permit for the Scandia-Marine Lions Club for September 7,
2019 during Taco Daze with the following conditions:
• The event shall be held as described in the application received on June 14, 2019
except as required by the conditions of approval.
• A parade route permit shall be obtained from the Washington County Public
Works Department and all conditions shall be complied with, including the hiring
of off-duty officers for traffic control and posting of signs as recommended by
the Sheriff's Department.
• Parade participants shall not use water cannons or similar devices on their floats,
or throw items from floats that could endanger the safety of parade watchers.
• Both sides of 209th Street between Oakhill Rd. and Olinda Trail shall be posted
"no parking."
• Parking in the west bay of the Community Center parking lot may be restricted
to the antique car show, official vehicles and handicapped parking. Access and
circulation for emergency vehicles to and through the parking lot shall be
maintained at all times.
• The location of any tents, stakes, signs etc. shall be approved in advance by the
Public Works Director. Event organizers shall request any utility locates that may
be required.
• Any signs or banners shall comply with the Scandia Development Code.
• Any vendors shall possess a sales and use tax permit if required by Minnesota
law.
• There shall be no animal rides provided by any vendor on the Community Center
grounds.
2) Amend conditions listed above and then approve.
3) Do not approve the request for a Special Event Permit.
Recommendation:
Option 1.
NAI D
JUL 1 12019
$ 2-S
CITY OF SCANDIA
t7CA DIA
14727 2091x' Street North
Scandia, Minnesota 55073
(651) 433-2274 wwii-.ci.scandia.nni.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:
12th � .Co z�
Location address:
Date(s): S.F'_Ot'.p_r _\B p r % 2o 1 9
Event starting Time: �`� 00 am Event ending time: ' ; (j Q o vy1
Set-up start date and time: ,� gyp -{-p I Q', Q Qry1
Dismantle by- date and time: C, p4-P_M 10,e� R ac) 19
Anticipated number of participants and/or spectators: _'C�r_)n +
If there is a fee or donation required as a condition of
attendance, please describe:
2. Attach sketch or site plan showing the location of the following as applicable:
t/ route (beginning/ end, direction of travel.
traffic control points)
1/ ticketing/ registration/ entry locations
v' entertainment or stage locations
portable toilet facilities
_ fencing locations
parking areas for participants/ spectators
✓ sign locations
t% speaker (sound amplification) locations
__v/ food concession areas (cooking, serving,
consumption)
✓alcoholic beverage concession area
other concession areas
size and location of any tents or structures
ti/trash/recycling receptacle area
_ fireworks or pyrotechnics site
first aid facilities
other as may be applicable
Cite of Scandia, Special Event Permit Application, Page I of 7
3. Applicant information:
Name: Lu n,o p -44,p_ Title: pr'e5 j
Address:
Phone:�`J _ `� �'f �,[ Cell: '(
E -Mail: Co.
Affiliation/ organization: b a r�5
Are you an authorized applicant for this organization? Yes 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: Title:
Address:
Phone: Cell:
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.
n&e cJ
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.
S
s ■ r - 1! ■I lit!
Cite 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.
;;�Lrj' .I')I ':5C';W)cl1 a �3AOOI,
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7. Emergency/ medical services:
Describe measures that will be taken to ensure emergency vehicle access (police, fire, ambulance) to
the event area.
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8. Security/ crowd management:
Describe your proposed procedures and staffing for the event operations and crowd control.
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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?
Lbins aF ou u.5 lo e_
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C
Name of trash/ recycling hauler:
10. Lighting:
Describe any temporary or permanent lighting that will be added for the event.
Cite 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.
Val 1 n us L-UMManAvC
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.
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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.)
S 11Ui !� U Se t4
C G �- rY �n < ■ r ■ ] �1 C.,n n n
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14.
14. Fireworks or pyrotechnics:
Will any fireworks or pyrotechnics be used at the event? Yes No
If yes, describe in detail. Fire Department approval will be required.
Cit), of Scandia, Special Event Permit Application, Page 4 of 7
15. Food and beverages: 00- by
Will alcoholic beverages be served? Yes No ✓ ��
If yes, describe the type of beverages and the status of the liquor license:
� a �
Will food and/or non-alcoholic beverages be served? Yes ✓ No
If yes, describe what will be served and any plans for cooking food in the event area, including fuel
source to be used: kk
U bi) S C
Has a license been obtained from the Washington County
Department of Health and Environment? (please attach) Yes No
16. Other concessions:
Describe what vendors or concessionaires you will allow at the event, and how you intend to regulate
and monitor their activities.
S
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.
Cir) 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. P ease sign below to indicate that you have read this notice:
Signature: '^ 1 -/' Date: _ [a 9
I request that my residence address and telephone number 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. l l 9, 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: J�lzOJI.V Date: J l
Cit), of Scandia, Special Event Permit Application, Page 6 of 7
-SPECIAL EVENT SPONSOR -
RELEASE AND INDEMNIFICATION AGREEMENT
CITY OF SCANDIA, MINNESOTA
THIS IS A RELEASE OF LIABILITY INDEMNIFICATION AGREEMENT. SPECIAL
EVENT PERMIT HOLDER MUST READ CAREFULLY BEFORE SIGNING.
In consideration for being permitted to engage in the following special event activities in Scandia:
X61. Baca �2�.
Special Event Permit Holder hereby acknowledges, represents, and agrees as follows:
A. We understand that the above described activities are or may be dangerous and do or may
involve risks of injury, loss, or damage to us and/or third parties. We further
acknowledge that such risks may include but not be limited to bodily injury, personal
injury, sickness, disease, death, and property loss or damage, arising from the following
circumstances, among others:
(Special Events Permit Holder initials here) o
B. If required by this paragraph, we agree to require each participant in our special event to
execute a RELEASE AND INDEMNIFICATION AGREEMENT for ourselves and
for the City of Scandia, on a form approved by the city.
m
Participant Release and Indemnification required? YES " thNO
(Special Events Permit Holder initials here)
C. We agree to procure, keep in force, and pay for special event insurance coverage, from an
insurer acceptable to the City of Scandia, for the duration of the above described
activities.
(Special Events Permit Holder initials here) _)25r `"
D. By signing this RELEASE AND INDEMNIFICATION AGREEMENT, we hereby
expressly assume all such risks of injury, loss, or damage to us or any related third party,
arising out of or in any way related to the above described activities, whether or not
caused by the act, omission, negligence, or other fault of the City of Scandia, its officers,
its employees, or by any other cause.
(Special Events Permit Holder Initials here) U
E. By signing this RELEASE AND INDEMNIFICATION AGREEMENT, we further
hereby exempt, release and discharge the City of Scandia, its officers, and its employees,
from any and all claims, demands, and actions for such injury, loss, or damage to us or to
any third party, arising out of or in any way related to the above described activities,
whether or not caused by the act, omission, negligence, or other fault of the City of
Scandia its officers, its employees, or by any other cause.
(Special Events Permit Holder Initials here) -L V
F. We further agree to defend, indemnify and hold harmless the City of Scandia, its officers,
employees, insurers, and self insurance pool, from and against all liability, claims, and
demands, court costs and attorneys fees, including those arising from any third party
claim asserted against the city, its officers, employees, insurers or self insurance pool, on
account of injury, loss or damage, including without limitation claims arising from bodily
injury, personal injury, sickness, disease, death, property damage or loss, or any other
loss of any kind whatsoever, which arise out of or are in any way related to the above
described activities, whether or not caused by our act, omission, negligence, or other fault
of the City of Scandia, its officers, its employees, or by any other cause.
(Special Events Permit Holder Initials here)
G. By signing this RELEASE AND INDEMNIFICATION AGREEMENT, we hereby
acknowledge and agree that said Agreement extends to all acts, omissions, negligence, or
other fault of the City of Scandia, its officers, and/or its employees, and that said
Agreement is intended to be as broad and inclusive as is permitted by the laws of the
State of Minnesota. If any portion thereof is held invalid, it is further agreed that the
balance shall, notwithstanding, continue in full legal force and effect.
(Special Events Holder Initials here)
H. We understand and agree that this RELEASE AND INDEMNIFICATION
AGREEMENT shall be governed by the laws of the State of Minnesota and that
jurisdiction and venue for any suit or cause of action under this agreement shall lie in the
courts.
(Special Events Permit Holder Initials here) ,,l'iW
I. This RELEASE AND INDEMNIFICATION AGREEMENT shall be effective as of
the date or dates of the applicable special event, shall continue in full force until our
responsibilities hereunder are fully discharged, and shall be binding upon us, our
successors, representatives, heirs, executors, assigns, and transferees.
(Special Events Permit Holder Initials here) 'Ql
2
IN WITNESS THEREOF, THIS RELEASE AND INDEMNIFICATION AGREEMENT is
executed by the special events permit holder, acting by and through the undersigned, who represents
that he or she is properly authorized to bind the Special Events Permit Holder hereto.
PRINTED NAME OF SPECIAL EVENTS PERMIT HOLDER:
PRINTED NAME AND TITLE OF PERSON SIGNING ON BEHALF OF SPECIAL EVENTS
PERMIT HOLDER:
Name A AL4+,P— �\j & C -f }
Title r i �4-i-
Signature
Date / 0
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ACCW6'' CERTIFICATE OF LIABILITY INSURANCE
DATE(MMMDIYYYY)
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0512212D19
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Na 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(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
52&e7" John Adams
DSP Insurance
PHONE 1-800-316-6705 lw Nn: 847-934-6186
1900 E. Golf Road, Suite 650
Aim: Ilonselubs@dspins.com
Schaumburg, IL 60173
INSURERS AFFORDING COVERAGE MAIC M
INSURER A : ACE American Insurance Company 22667
.............
INSURED
INSURER B
INSURER C:
Scandia-Marine Lions Club
09/01/2018
Scandia Minnesota
INSURER 0:
_
INSURER E:
CLAIMS -MADE 7 OCCUR
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF
MMI001YYYY
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LIMITS
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GENERAL LIABILITY
EACH OCCURRENCE S 1,000,000
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09/01/2018
09/01/2019
FRI=I ses;Eaaccurencal 5 1,000,000
CLAIMS -MADE 7 OCCUR
MED EXP (AM oneperson) S 5,000
PERSONAL & ADV INJURY S 1,000,000
Ago. Per Named Insured
is $2,000,000
GENERAL AGGREGATE S 10,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
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PRODUCTS - COMP;OP AGG S 2,000,000
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09/01/2018
09/01/2019
comBiNED 9 1 NOLF Lagir
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BODILYINJURY (Per person) S
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per acudent) S
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HIRED AUTOS AUTOS
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D SGR9TION OF OPERATIONS below
E.L. DISEASE • EA EMPLOYEE S
E.L. DISEASE . POLICY LIMIT S
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES {AI ch ACORD 101, Additional Remarks Schedule, it more space Is required),
Provisions of the policy apply to the named insureds participation in the following activity during the policy period shown above: Taco Daze 9/7/19 & 9/8/19
The fallowing persons or organizations gfanting use of real property, including structures thereon are included as Additional Insured(s), bill only with respect to
General Liability arismg out of the use of premises by the insured shown above and not out of the sole negligence of said addilioilal insufed.
City of Scandia
PROVISIONS OF THE POLICY DO NOTAPPLY TO THE SALE OR SERVING OF ALCOHOLIC BEVERAGES
Al t r1VLLJth:
City of Scandia
14727 209th St N
Scandia Minnesota 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
=,"27,2P14,ON
011988-2010 ACORD CORPORATION. All riahts reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD