HomeMy WebLinkAboutCrime Stoppers ApplicationBernadette Matson A1liantComm
jW
YAKIMA COU1,1=
February 28, 2016
Kittitas County Board of County Commissioners
205 West 5th, Suite 108
Ellensburg, WA 98926
(1/13) 03/02/2016 09:19:47 AM -0800
P O Box 11056
Yakima, WA. 98909-1056
509-248-9980
RE: Yakima County Crime Stoppers "Your Canyon for a Day" Bike Event
In preparation for Yakima County Crime Stoppers' annual "Your Canyon for a Day" bike event on May 22, 2016, 1
have enclosed the following:
• Event Application
An attachment to the Event Application
• Certificate of liability insurance from State Farm Insurance Company naming Kittitas County, Washington
State Patrol, Dept of Transportation, Bureau of Land Management, US Government and Yakima County as
additional insured or certificate holders_
• Application for exemption from permit.
a $200.00 administrative fee.
Once again we are requesting a waiver of the $5,000.00 cash or bond provisions of KCC 5.2.100. This will be the
twelve year for our bike ride in the Yakima Canyon and we believe we have sufficient liability insurance. We
believe we have demonstrated over the years that we have sufficient precautions in place during the ride to mitigate
the inherent risks.
Thank you for your consideration of our application.
Ron Holmes
Yakima County Crime Stoppers
MAR - 2 7016
Bernadette Matson AlliantComm
(2/13) 03/02/2016 09:20:20 AM -0800
Kittitas County, Washington
BOARD of COUNTY COMMISSIONERS
EVENT APPLICATION PROCESS
1. Submit a completed Event Application and materials to the Kittitas County
Commissioners Office at least 6o days prior to the event. There are several
departments who review the Event Applications and make their determination based
upon the application, written plans and documentation that has been provided. Please
note that additional permits may be required in addition from individual departments
including: the Fire Marshal, Public Health, Environmental Health, Community
Development Services, and the Public Works Department. A $200.00 permit fee is to be
submitted at the time of application for each event. Applications will not be processed
until the permit fee has been received.
2. Once a special event has been approved by the County Commissioners, the site and
facilities may need to be inspected by County officials (including but not be limited to the
Fire Marshal, SherifFs Department, and Public Health Department) up to five days in
advance prior to opening to the general public. This is to ensure that you are complying
with the stated plans upon which the approval was made. If you fail to comply with those
requirements, your permit may be revoked and the event closed.
3. Depending upon the nature and scope of the proposed event, other permits may be
required as determined through the application process (liquor license, etc.). Some
events may require approval from other agencies or jurisdictions.
4. Permittee covenants and agrees to indemnify, defend and hold harmless the County, its
officers, agents and employees from any and all claims actions, damages, liability, cost
and expense, including reasonable attorney fees in connection with or occasioned, in
whole or in part by any act or omission of Permittee, its officers, agents, employees,
customers or licenses, or arising from or out of Permittee's failure to comply with any
provision of the Event Permit granted as a result of this application, regardless of
whether it is alleged or proven that the acts or omissions of the County, its officers,
agents or employees caused or contributed hereto.
5. Insurance Requirement: A Certificate of Insurance specifically naming "Kittitas County"
as an additional insured in the minimum amount of $1,0oo,00o.00 per occurrence and a
$2,000,000.00 aggregate coverage must be included with the Event Application. The
County Prosecutor's office may require a greater amount if it is determined to be
necessary for the proposed event.
6. Written statements signed by the applicant and property owner allowing permission to
enter the event site for inspections and stating responsibility for the event and
compliance with the codes is required as part of the written documentation to be
submitted at the time of application.
7. Before applying for an event it is encouraged that you schedule a time to meet with
County departments so they may assist with questions you may have prior to submitting
your application.
KrrTITAS COUNTY COURTHOUSE, 205 WEST 5", SUITE 108 ELLENSBURG, WA 98926
(509) 962-7508 - FAX(509)962-7679
www co.kittitas.wa us
Bernadette Matson AlliantComm (3/13) 03/02/2016 09;21;12 AM -0800
Ki.ttitas County Contact Information
www.co.kittitas.wa.us
Board of County Commissioners - (509) 962-7508
Community Development Services - (509) 962-75o6
Environmental Health - (5o9) 962-7698
Fire Marshal — (509) 962-7000
Prosecutor — (509) 962-7520
Public Health — (509) 962-7515
Public Works Department — (509) 962-7523
Sheriffs Office — (509) 962-7525
Solid Waste Department — (509) 962-7542
KITTITAS COUNTY COURTHOUSE 205 WEST 5"', SUITE 108 ELLENSBURG, WA 99926
(509) 962-7508 - FAX(509)962-7679
www.co.kittitas:wa.us
Bernadette Matson AlliantComm
(4/13) 03/02/2016 09:21:32 AM -0800
Kittitas County, Washington
BOARD of COUNTY COMMISSIONERS
EVENT APPLICATION
Thank you for your interest in holding a special event in Kittitas County. Please
complete and return this application along with any other materials to the Kittitas
County Board of Commissioners at least 60 days prior to the day upon the event is
scheduled. Any misrepresentation in the application materials or deviation from the
final agreed upon route and/or method of operation described may result in the
immediate revocation of an issued permit. Specifics outlining Event Permits can be
viewed at htt a: tivww.co.krttit�s.wa.us boc coon! Inde titic�f5.p
Event Information
Name of event: Your Canyon for a_day
Date(s) of everit: May 22, 2016
Hours of operation: 8:00-4:00
Description of the event: Bicycle ride through the Yakima River Canyon
Has this event taken place before?S
Estimated attendance: 1000
No Dates: PeL11 yeason about Iha same late May dale
How is your event being publicized? Bike shops. email
PIease attach any flyers, posters, etc. with your application submission.
Contact Information
Name of the organizer/ contact person: Ron Holmes
912 S 18th Ave
Phone number(s): 509-480-9855
Email address: ronh912(@-gai.com
Date of birth of applicant:_l 0/09/1954
KIT ITAS COUNTY COURTHOUSE 205 WEST 5", SUITE 108 • ELLENSBURG, WA 98926
(509) 962-7508 • CAX (509) 962-7679
www.co.kitti tas.wa. us
Bernadette Matson AlliantComm
(5/13) 03/02/2016 09:22:10 AM -0800
If the application is made on behalf of a partnership, please submit full names with their
residence and post office address for a period of six months prior to the date of
application together with the location of principal office or place of business of such
corporation.
Emergency contact name(s) and phone number(s) that can be contacted during the
event:
Ron Holmes 809-480-9855
Naii-te Phone Number
Dave Purcell 509-307-1889
Name Phone Number
WRITTEN PERMISSION TO ENTER EVENT SITE
I/We hereby permit law enforcement and/or County officials to enter the site for which
the Event Application has been granted at the time of the event and up to five days
prior to the event for the purposes of inspecting and enforcement of County Code and
other applicable laws, and pursuant to my agreement and representations made in
connection with this Event Application.
SWORN STATEMENT OF COMPLIANCE
I/We hereby acknowledge that I/We have read Kittitas County Code, have
familiarized myself with County requirements. I/We agree that either my designated
agent or I/we shall be on site at all times and shall be responsible for the operation of
the event and for compliance with all legal requirements in connection with this event.
I/We understand that failure to comply with the rules, regulations and conditions set
forth in Code may be deemed a gross misdemeanor and that drug or narcotics
violations are crimes under RCW. f
Ron Holmes
Applicant Name (Print)
Applicant Name (Print)
Applicant Signature
Applicant Signature
KITTITAS COUNTY COURTHOUSE • 205 WEST 5", SUITE 108 ELLENSBURG, WA 98926
(509) 962-7508 - FAX (509) 962-7679
www.co.kitliW warns
Bernadette Matson AlliantComm
(6/13) 03/02/2016 09:22:46 AM -0800
Kittitas County, Washington
BOARD of COUNTY COMMISSIONERS
Fire Safety and Protection
If more than 50 people are expected at your event, you must complete a separate
application process which can be obtained through the Kittitas County Fire Marshal's
office. You may contact the Fire Marshal's office at 509-962-7000.
Will there be a temporary structure erected for the event? Yes Vo
If yes, you must attach a drawing including the dimensions. The structure may
require an inspection by County staff prior to the event.
Public Health Environmental Health
Will there be food served at the event? Yes
If no food will be served at the event then, no permit or application is required.
If yes, is the food and beverage that you intend on preparing and serving at the event
exempt from permit requirements http://www.co.kittitas.wa.us/health/food,asp?
- If yes, please submit an application for exemption from permit and proof of food
handlers training to the Kittitas County Public Health Department (KCPHD).
If yes, and the food or beverage is not considered exempt from permit, then does the
person or organization preparing and serving the food have a food service permit,
temporary food service permit, or catering permit from KCPHD?
- If yes, please provide a list of foods and beverages that you intend on having
prepared and served at the event along with the name and phone number(s) of
the permitted person or organization.
If yes, and the person or organization preparing and serving the food does not already
have a food service permit.
- Then a temporary food service permit or catering permit will need to be acquired
from KCPHD prior to the event.
Please allow at least 2 weeks to complete the food service permitting, process.
KITTITAS COUNTY COURTHOUSE 205 WEST 5"', SUITE 109 ELLENSBURG, WA 98926
(509) 962-7508 • FAX(509)962-7679
www cu.kittitas warns
Bernadette Matson AlliantComm
(7/13) 03/02/2016 09:23:26 AM -0800
Are there permanent or fixed bathroom facilities already available at the location of
the event?
Yes V
If yes, please provide an estimated attendance for the event, a detailed map that
identifies the name and address of the physical facility that will provide lavatory
facilities for the event, quantity of toilette facilities available for each gender, and the
distance from the event that patrons must walk.
If no, please provide an estimated attendance for the event, specific information
related to the number of portable restrooms that will be provided, the distance from
the event that patrons must walk, and a service plan to ensure that sari -cans remain in
a sanitary condition. You must include the location of the portable restrooms on a
map/ diagram of the event.
KITTITAS COUNTY COURTHOUSE • 205 WEST 5"', SUITE LOB • ELLENSBURG, WA 98926
(509) 962-7508 • FAX (509) 962-7679
www.co.kittitas.wa.us
Bernadette Matson AlliantComm
r
RC-Ukk%r 111
(8/13) 03/02/2016 09:23:49 AM -0800
Kittitas County, Washington
BOARD oFCOUNTY COMMISSIONERS
Law Enforcement/SecurityZEmergency Medical Services
Will there be security on site during the event? Yes V"
If yes, please provide a complete list of names and contact information for who will be
providing the security.
Will Emergency Medical Services (EMS) be on site during the event? Y/s No
If yes, please provide written verification from the providers.
Will there be music, sound amplification or any other noise impacts? Yes
If yes, Kittitas County has a noise ordinance in effect (see County Code for details). If
your event is scheduled for outside of the allowed time, you must submit a written
letter to the Board of County Commissioners requesting a waiver and it must be
included with your application materials.
Will you have traffic control? V(s No
If yes, please provide documentation on how the traffic control will be addressed.
Will there be off-site parking? vfs No
If yes, please provide the location and a parking plan.
Will there be shuttle buses provided for attendees? Yes l6
If yes, provide a map of their route.
Will there be alcohol served at the event? Yes V6
If yes, a State permit is required from the WA State Liquor Control Board and must
submitted with your application materials.
KITTITAS COUNTY COURTHOUSE • 205 WEST 5", SUITE 108 ELLENSBURG, WA 98926
(509) 962-7508 - FAX (509) 962-7679
www,co.kittitas wa.us
Bernadette Matson AlliantComm (9/13) 03/02/2016 09:24:23 AM -0800
Kittitas County, Washington
BOARD of COUNTY COMMISSIONERS
Public Roads
Will the event obstruct, interfere or require the closure and free use of any public
road, street or right-of-way? VZ- No
If yes, please provide a detailed adequate traffic and detour plans at the time of
submission of the application.
Will there need to be road closure or detour signs posted? �s No
KJTTITAS COUNTY COURTHOUSE 205 WEST 5h, SUITE- 108 • ELLENSBURG, WA 98926
(509) 962-7508 FAX (509) 962-7679
www.cu kittitas wa.us
Bernadette Matson AlliantComm (10/13) 03/02/2016 09:24:46 AM -0800
Kittitas County, Washington
BOARD aF COUNTY COMMISSIONERS
Garbage/Recycling
Do you have a plan for garbage and recycling? vls No
A written plan for garbage and recycling must be attached to your application
materials. For questions or assistance contact the Kittitas County Solid Waste
Department at 509-962-7542.
Insurance
Have you obtained a Certificate of Insurance, specifically naming "Kittitas County"
as an insured? s No
A copy of the Certificate of Insurance must be included with your application materials.
Kittitas County must be named as an additional insured in the amount of $1,000,000.00
per occurrence and $2,000,000.00 aggregate coverage.
Penal Bond - Bond of Indemnify
A $5,000.00 Penal Bond - Bond of Indemnity is required to be deposited with the
County Treasurer to save and protect the streets, pavements, bridges, etc. from
damage. The deposit or its balance will be returned once the event has been held and
the Board of County Commissioners has certified no damage has been done and that
the County has not incurred additional expenses
Are you submitting a $5,000.00 Penal Bond - Bond of Indemnity with your Event
Application? Yes V
If no, you must request a letter in writing to the Board of County Commissioners
requesting a waiver to the Penal Bond - Bond of Indemnity and outline the specific
reasons why it should not be required of your event.
Coun , Filings and Registration
Is there a cost to attend the event? Vs No
How much are you charging to attend your event? $65.00 per rider
KITTITAS COUNTY COURTHOUSE 205 WEST 5"', SUITE 108 - ELLENSBURG, WA 98926
(509) 962-7508 - FAX (509) 962-7679
wwty co kittitas.wa us
Bernadette Matson AlliantComm (11/13) 03/02/2016 09:25:24 AM -0800
Attachment
To
Special Use Event Application
For Event on May 22, 2016
RE: Your Canyon for a Day Bike Tour
Yakima County Crime Stoppers, Inc,
DESCRIPTION OF ACTIVITY AND EVENT AT THE YAKIMA CANYON MAY 15, 2016 BY THE
YAKIMA COUNTY CRIME STOPPERS' "YOUR CANYON FOR A DAY BIKE TOUR"
The Yakima County Crime Stoppers' "Your Canyon for a Day Bike Tour" is a fun ride designed for the
whole family to enjoy the Yakima Canyon without any through traffic. This is Yakima County Crime
Stoppers' only fund raiser with the funds to be used for rewards paid out to tipsters who are instrumental
in the apprehension of felons. This will be the tenth year we have sponsored the bicycle tour in the
Yakima Canyon. We had approximately 1,000 riders last year with over 50% of them starting the ride at
the Yakima River RV Park in Ellensburg. The majority of our riders come from the Westside of
Washington.
We will be using the Roza Recreation site and the Yakima River RV Park as our staging areas for the
bicycle ride. The riders will leave from the Roza site or the RV Park and travel north or south on SR 821
then turn around at Thrall Road or the Roza site and return the their staging site. The RV Park and the
Roza site will mainly be used for participants to park and unload/load their bicycles. In the NE corner of
the Roza parking lot we will also be selling concessions as we have done in years past. Coca-Cola may
be providing a small trailer which will be at the concession site to dispense soft drinks with all profits
going to the Yakima County Crime Stoppers. Even though we have worked with the Department of
Transportation to close SR821 to through vehicle traffic, we understand there will be others using the
canyon and we will be sharing the facilities at the Roza Site with them.
We will be providing the following:
1. Portable toilets (8 total)
Two at the Roza site (both with hand sanitization equipment and one for handicapped access).
One at Big Rock rest site.
One at Umtanum/Big pines rest site.
Two at Thrall Road site (both with hand sanitization equipment and one for handicapped access).
Two at Yakima RV Park.
Bernadette Matson AlliantComm (12/13) 03/02/2016 09:26:00 AM -0800
2. Traffic Control - we will have 8 officers
• Yakima Police Officers and 2 Yakima County Sheriff Deputies patrolling the canyon
during the ride.
• Yakima County Sheriff Deputies on duty at each barricade on both ends of the canyon. 2
at Thrall road on the Ellensburg side and two at the Firing Center entrance of the canyon.
3. Road closure signs will be posted 48 hours before the ride at each end of the canyon and during the
ride
• All residents will be notified five days before the ride and given a pass they can show the
day of the ride.
• All campers will be notified the day before the ride of the 25 mile an hour speed limit in
the canyon during the ride (Red's Fly Shop will also be notified).
• 25 mile an hour speed signs will be posted in the canyon during the ride.
3. Emergency medical personal from ALS Ambulance will be posted during the ride in the canyon.
4. Garbage and Recycling
At each rest stop we will have garbage and recycling cans. At the end of the ride we will
carry all garbage and recycling out of the canyon.
• We will have 5 rest sites with the garbage and recycling cans.
5. All food given out at the rest sites will be prepackaged granola bars, sport drinks, and water. At the
Roza site Coca-Cola may be providing a small trailer to dispense soft drinks with all profits going to the
Yakima County Crime Stoppers.
Should you have any questions or need further information, please feel free to contact me.
Thank you,
Ron Holmes
Yakima County Crime Stoppers, Inc.
912 S 18th Ave, Yakima, WA 98902
Cell: 509-480-9855
2
Bernadette Matson AlliantComm
(13/13) 03/02/2016 09:26:29 AM -0800
CERTIFICATE OF LIABILITY INSURANCE D 02/11/201 YY{
02!11!2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. nIIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIFS
BELOW. THIS CERTIFICATE OF INSURANCE ROES NOT CONSTITUTE A CONTRACT t3ETWEFN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: if the eertiilcate holder Is an ADDITIONAL INSURED, the pollcy(ies) must las 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 endarsemant(sj,
PRODUCER BRUCE SEARS - STATE FARM
A_ +L _ hrletlna RIoxI
PO BOX 669 PPIOa ..09 64� Frcjl Shc!-6fl_fl3aa _
QSELAH, WA 98943 _agogE 10L--
INSURED CRIME STOPPERS OF YAKIMA COUNTY INC
PO BOX 11056
YAKIMA,WA 98909
NAIC 11
INSUR59 F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER.
THIS IS TO CERTIFY T IIAT THE POLICIES OF INSURANCE LISTED BELOYS1 HAVE BEEN iSSUPD TO THE ENSURED NAMED ABOVE FOR THE POLICY PJ:R10D
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH 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.
!•FR TYPE OF INSURANCE P .ICYkUMFIER ���WMIMi-Y {Pj r£x V{ g
A G6616RALliHeILnY IF- PS0000003159006 04114/2014 04114/2017 6ACHoccvReE-NCE Is Sona 000
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DESCRIPTION OFOPERAMONS a LOCATIONS VEHICLES (ANach ACORD 101, AddWona(Remarks Schedule, Nmore space Is required)
ADDITIONAL INSURED - CERTIFICATE HOLDER
WASHINGTON STATE PATROL
DEPT OF TRANSPORTATION
BUREAU OF LAND MANAGEMENT
US GOVERNMENT AND YAKIMA COUNTY
KITTITAS COUNTY
CERTIFICATE HOLDER
KITTITAS COUNTY
205 WEST 5TH, STE'108
ELLENSBURG, WA 98926
YOUR CANYON FOR A DAY RIDE - MAY 22, 2016
TION
S 5o,o0e
i
t z.00a,Uno
5
S
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
n REPRESENTATIVE
01988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.6 11-15-2010
-o Kittitas County Office Of The Treasurer
tl205Brett Wachsmith, Treasurer
W 5th Avenue, Suite 102
--••---�., „• �.,._ Ellensburg, Wa 98926
Phone (509) 962-7535 Fax (509) 933-8212
Cash Receipts
Receipt Number: 2016-1531 Date:
Received From: MANDY BUCHHOLZ - DEPUTY CLERK OF THE BOARD -N
Check Amount:
$200.00
Cash Amount:
$0.00
Other Amount:
$0.00
Total Amount:
$200.00
Deputy: AMYC
Receipt Type: CHK
Template:
03/07/2016
Comments:
CSR 2016-1192
YAKIMA COUNTY CRIME STOPPERS - YOUR CANYON FOR A DAY SPECIAL EVENT APPLICATION PAYMENT
FundCode GlCode Description Amount
001 1632171 SPECIAL EVENTS FEE $200.00
Total Amount: $200.00
Kittitas County Treasurer's Office
Submitted By: AMY CZISKE
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