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HomeMy WebLinkAboutSuncadia Multisport Summer FestKittitas 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. 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 Marshat, 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 [lie approval was trade. if you fail to comply with those requirements, your permit may be revoked and the event nosed. 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 'I ttitas County" as an additional insured in the minimum amount of $i,000,000.00 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 said compliance with the codes is required as part of the written documentation to be submitted at the time of application. 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. KITTITAS COUNTY COURTHOUSE - 205 WEST 5", SUITE 108 • ELLENSBURG, WA 98926 MAY —1 2016 (509) 962-7508 - FAX (509) 962-7679 www.co.kittitas.wa.us [ V�� Kittitas CaunV Contact Information www.eo.kitt!tas.wa.us Board of County Commissioners - (509) 962-7508 Community Development Services - (509) 962-75o6 Environmental Health - (509) 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 K1TTITAS COUNTY COURTHOUSE - 205 WEST 50', SUITE 108 ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.co.kittitas.wa us Kittitas County, Washington BOARD OF C OUNTY COMMISSIONERS EVENT APPLICATION "Dank you for your Interest in holding a special event in Kittitas County. PIease 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 j=:Zlwww.co.lcittitas.wa.us/bocZcouniycode/t tie45 asp Event Information Name of event: Suncadia Muitispart Summer Festival Date(s) of event:_ Ju y 29, 30 & 31 2016 Hours of operation: Friday, July 29 First Event-12:OOPM - Sunday, July 31 Last Event 10:OOAM Description of the event: MulYaporl Festival Friday 7/29, 25 Mile Bke Tour and Kids Duathlon Saturday, 7B0 Marathon, Halt MaraYton & Triathlon Sunday, 7/31 5K Run, Sprint Duathlon Friday - Sunday 7/24-7/26/2015 Summer Brewfest & Active Expo Has this event taken place before? Yes 1/i Dates: Estimated attendance: 500 How is your event being publicized? Website, social media and sporting publications. Please attach any flyers, posters, etc. with your application submission. Contact Information Name of the organizer/ contact person:_FzneLq_y_ Events J Richard Jessup Address: PO Box 70068, Vancouver, Washington 98665 Phone number(s): 360-241-8037 Email atf d cess: richard energyevents. com Date of birth of applicant 8/10/1966 K1=AS COUNTY COURTHOUSE 205 WEST 5", SUITE m • ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.co.kitfitas.wa.us 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: Brian Davis 360-909-021 Name Phone Number Richard Jessup 36D-241-8037 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. _Richa.d Jessup- ._ Applicant Name (Print) applicant Sig re Applicant Name (Print) Applicant Signature KrYFITAS COUNTY COURTHOUSE, 205 WEST 5', sUrrE m - ELLENSBURG, WA 98926 (509) 962-7508 - FAX (509) 962-7679 www.00kittitas.wa us 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 V) 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 V 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 ht!p:/ fwww.co.kittit,,is.wa-us/liealthLfood.,isp? - If yes, please submi l 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 na>ine and phone number(s) of the permitted person or organization. If yes, and the person or organization preparing and serving the food docs noL 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. K1T"CCTAS COUNTY COURTHOUSE • 205 WEST 5h, SUITE 108 - ELLENSBURG, WA 98926 (509) 962-7508 , FAX (509) 962-7679 www. co. kittitas. wa. us Are there permanent or fixed bathroom facilities already available at the location of the event? Y/s No 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 evk�Iit, specific: inforniation related to the number of portable restrooms that will t)c provided, tllC-_ cli5ta«ce from the event that patrons must walk, and a service plan to ensure that sani-cans remain in a sanitary condition. You must include the location of the portable restrooms on a map/diagram of the event. KIITITAS COUNTY COURTHOUSE - 205 WEST 5", SUITE 108 ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.co.kittitas.wa us Kittitas County, Washington BOARD of C OUNTY COMMISSIONERS Law Enforcement/SecurftyJEmergency Medical Services Will there be security on site during the event? V(s No 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? Vs No If yes, please provide written verification from the providers. Will there be music, sound amplification or any other noise impacts?,Is No If yes, Kitkitas 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? Vs No If yes, please provide documentation on how the traffic control will be addressed. Will there be off-site parking? Yes 16 If yes, please provide the location and a parking plan. Will there be shuttle buses provided for attendees? Vs No If yes, provide a map of their route. Will there be alcohol served at the event? Vs No 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'h, sur rE m • ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.co, kittitas.wa.us Kittitas County, Washington BOARD or COUNTY COMMISSIONERS S G arrbage/I-ecyclin Do you have a plan for garbage and recycling? Vs 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 Indemnitv 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 submitO ag a $5,000.00 Peno Bond - Bond of Indemnity with your Event Application? Yes Y" If no, you must request a letter in writing to the Board of County Cvmmissioiaertj requesting a waiver to the Penal Bernd - Bond of indemnity and outline the specific reasons why it should not be required of your event. County Filings and Registration Is there a cost to attend the event? Vt. No How much are you charging to attend your event? $25.00-150.00 K=AS COUNTY COURTHOUSE • 205 WEST 5 1 , SUITE 108 ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.co.kitutas.wa.us Kittitas County, Washington BOARD OF COUNTY COMMISSIONERS Public Roads Will the event obstmct, intelfere or require the closure and free use of any public Woad, street or right-of-way? y's No 1f yes, please provide a de#ailed adequate traffic and detour plans at the time of submission of the application. Will there need to be road closure or detour signs posted? Yes KMTFAS COUNTY COURTHOUSE • 205 WEST 5" SUITE 108 ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www. co. ki tti tas _ wa. us Kittitas County Office Of The Treasurer Brett Wachsndth, Treasurer 205 W 5th Avenue, Suite 102 ,a .. • ,_� Ellensburg, Wa 98926 Phone (509) 962-7535 Fax (509) 933-8212 Cash Receipts Receipt Number: 2016-3046 Date: 05/02/2016 Received From: MANDY BUCHHOLZ-DEPUTY CLERK OF THE BOARD -MA Check Amount: $200.00 Cash Amount: $0.00 Other Amount: $0.00 Total Amount: $200.00 Deputy: CECILIAR Receipt Type: CHK Template: Comments: CSR 2016-2250 SPECIAL EVENT APPLICATION FROM SUNCADIA MULTISPORT SUMMER FESTIVAL 6.29.2016 FundCode G1Code Description Amount 001 1632171 SPECIAL EVENTS FEE $200.00 Total Amount: $200.00 Kittitas County Treasurer's Office Submitted By: CECILIA RAHME (c) 2002 Cashtax All Rights Reserved www.balancedaction.com 1 ;9 r:[7►,C►Pa CERTIFICATE OF LIABILITY INSURANCE DAT/ ��- 055/01/01/22015015 Y) 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 I For Service Call: M,NQfAg;_54 7.7�Ii4........ FAX N,} 5035'r `id4 Gales Creek Insurance Services a division of JD Fulwiler E-IAIUL .. AI1DiiES_C1lil`�OII:t3CiP.9}:.COf)1 .- 5727 SW Macadam Ave INSURER(S) AFFORDING COVERAGE NAIC# Portland, OR, 97239 INSURER A: Starr Indemnity & Liability Company INSURED f Energy Events --- 10804 NW Oxbow Ridge Court INSURERC: NS Vancouver, WA 98685 IURER D_: INSURER E - CAVFRAr FC CFRTIFICATF NIIMRFR• REVISION NIIMRFR- 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. 114SR Asoak! J POLICY&F POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER I wo MIODly YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 000,000.00 •X COMMERCIAL GENERAL LIABILITY9D A CLAIMS -MADE X OCCUR X F F P'f G OTti D e FMIRFR___.1.€��:.........i....._�........0,400.00 MED EXP (Any oneperson) $ 30 0 0 . $ Excluded_ PERSONAL &ADV INJURY 1000107027 05/01/2015 05/01/2016 $ 1,000000,00 GENERAL AGGREGATE ................. _......... $ 2,000,000.00 PRODUCTS - COMP/OP AGG $ 2,0pp,.pp0,00. GEN'L AGGREGATE LIMITAPPLWS PER: $ X PCaL1CY :R0- LOC AUTOMOBILE LIABILITYIFjr 1� Jl'L I a ";no"t) IJ LE S 110001000.00 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 1000107027 05/01/2015 05/01/2015 BODILY INJURY (Per accident) $ AMA Qr accident $ A X_ HIRED AUTOS X NON -OWNED AUTOS $ UMBRELLA LIABOCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE 111 ,—.. DED RETENTION S ........ .... .. S I• WORKERS COMPENSATION AND EMPLOYERS' LIABILITYYIN ANYPROPRIETOR/PARTNER/EXECUTIVE ATU- OTH- -ER- RANY E.L. EACH ACCIDENT S OFFICE/MEMBER EXCLUDED? ❑ N / A S (Mandatory in NH) E.L DISEASE - EA EMPLOYE S If yes, describe under FC .RIPTI (1F f1P R4TIr1 n w E L DISEASE - POLICY LIMIT A LIQUOR LIABILITY Fx—, F-1 1000107027 05/0112015 05/01/2015 Each Common Cause: $1,000,000.00General Aggregate: $1,000,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) THE CERTIFICATE HOLDER IS ADDED AS AN ADDITIONAL INSURED BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF OPERATIONS OF THE NAMED INSURED DURING THE POLICY PERIOD REQUIRED BY A WRITTEN CONTRACT. GEKTIFIGA 1 t HULUI-K Kittatas County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 205 West 5th THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Ellensburg, WA Ave.,e., AUTHORIZED REPRESENTATIVE BrigittWhitescarver��`'�� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD OC LLI Lai 4 Ln N z CA. D m 00 00 V O O W nna O J n 0 z e� TAI � I�Vot 4F �x i r Z Lei D G) � F C: i z m r Z 7C m n 0 C m r l poo " z � c z , O � � o c � �z � D c)po m m Nz W v m 70 0 90 m m n m 7v m m x 7v Q C Z 9 v D 0 2 r r) 133x m n O C ao m + _ i 00© . xdc i = c N ZS o Z D G) m m C m m �o 0 �> M --I M 7o � D 70 � go r- 0 Z r.- < k < m N � o 0 C ao m f 3J1VviolJjmO3 N r t A 1 I �• 0 m rn F `n 2 •� rnn z p r m � r C t M l li m N 0 tz %0 LO O O O nna J LAJ 6a l d" LC