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Home My WebLink AboutEllensnburg Tri Special Event ApplicationKittitas County Office Of The Treasurer /, Brett Wachsmith, Treasurer A01 W-1_ . 205 W 6th Avenue, Suite 102 Ellensburg, Wa 98926 Phone (509) 962-7535 Fax (509) 933-8212 Cash Receipts Receipt Number: Received From: Check Amount: Cash Amount: Other Amount: Total Amount: Deputy: CECILIAR Template: Comments: 2018-1769 MANDY BUCHHOLZ DEPUTY CLERK OF THE BOARD-MANDY $200.00 $0.00 $0.00 $200.00 Receipt Type: CHK Date: 03/22/2018 CSR 2018-1330 SPECIAL EVENT APPLICATION PERMIT FEE FOR ELLENSBURG TRIATHLON & CAREY LAKE RUNS 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.balancedacfon.com Kittitas County, Washington BOARD OF COUNTY COMMIMONhO 'l Y 3' 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 and endorsements specifically naming "Kittitas County" as an additional insured in the minimum amount of $1,000,000.00 per occurrence and a$2,000,000.00 aggregate coverage must be included with the Event Application. This insurance must apply first and on a primary non-contributing basis in relation to any other insurance or self-insurance available to Kittitas County. 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. KITTITAS COUNTY COURTHOUSE • 205 WEST 5", SUITE 108 • ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www. c o. kitti tas. wa. us Kittitas County Contact Information www. co.kittitas.wa.us Board of County Commissioners — (509) 962-7508 z Community Development Services — (509) 962-7506 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 KITTITAS COUNTY COURTHOUSE • 205 WEST 5"', SUITE 108 • ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.colittitas.wa.us Admissions Tax Kittitas County Ordinance 2016-003 Ordinance amending Ch.3.22 Kittitas County Code to impose an Admissions Tax "Admissions charge," in addition to its usual and ordinary meaning includes but shall not be limited to a charge for participation in an event or activity; a charge made for season tickets or subscriptions, or a charge made for use of seats and tables, reserved or otherwise, and other similar accommodations; and a charge made for rental or use of equipment or facilities for purpose of recreation or amusement, and where the rental of the equipment or facilities is necessary to the enjoyment of the privilege for which a general admission is charged, the combined charges shall be considered as an admission charge. A donation for admittance shall also be deemed an admission charge. Admission charge includes any money paid within or without of Kittitas County for any of the kinds of admission charges defined herein_ so long as the facilities, entertainment, recreation or amusement privilege derived from such admission charge occurs in Kittitas County. The tax imposed shall be collected at the time admission charge is paid by the person seeking admission to any place and shall be reported and remitted by the person receiving the tax to the Treasurer in quarterly installments on or before the last day of the month next succeeding the end of the quarterly period in which the tax is collected or received. Any person conducting or operating any activity for which an admission charge is made shall register with the Auditor. In order to complete the registration process, you will need to register online. Any questions, please contact the Treasurer's office at 509-962-7535; Auditor's office at 509- 962-7502 or email at admissionstax@co.kittitas.wa.us. 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.V:ZZwww.co.kittitas.wa.usZbocZcountycode/title05.asj2 Event Information Name of event: Ellensburg Triathlon and Carey Lakes Runs _ Date(s) of event: 7/14/18 Hours of operation: Gam to 1 pm Description of the event: Triathlon with swim, bike and run portions, as well as a 5k and 10k run Has this event taken place before? V No Dates: 10th year Estimated attendance: 200-250 How is your event being publicized? Event fliers, brochures andop sters Please attach any flyers, posters, etc. with your application submission. Contact Information Name of the organizer/ contact person: Deanna Muller Address: 31405 47th Ave South, Auburn, WA 98001 Phone number(s): 206-920-3983 Email address: Deanna BuDuRacing. com Date of birth of applicant: 8/28/1967 KITTITAS COUNTY COURTHOUSE • 205 WEST 5"', SUITE 108 • ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.colittitas.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. BuDU Racing. LLC (same address), Emergency contact name(s) and phone number(s) that can be contacted during the event: Deanna Muller 206-920-3983 Name Phone Number Rory Muller 253-334-4433 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. Deanna Muller �&Mllf Applicant Name (Print) Applicant Signature Rory Muller Applicant Name (Print) f t nature r — Sig KITTITAS COUNTY COURTHOUSE • 205 WEST 5", SUITE 108 • ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.colittitasma.us -� Kittitas County, Washington BOARD of COUNTY COMMISSIONERS t. Fire Safetv 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 V6 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? No 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.c_a_.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. KTITITAS COUNTY COURTHOUSE • 205 WEST P, SUITE 108 • ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.colittitasma.us Are there permanent or fixed bathroom facilities already available at the location of the event? 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 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 sani-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 108 • ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.colittitasma.us Kittitas County, Washington BOARD of COUNTY COMMISSIONERS Law Enforcement/Security/Emergency 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? V No If yes, please provide written verification from the providers. Will there be music, sound amplification or any other noise impacts? Vs No 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? Ves No If yes, please provide documentation on how the traffic control will be addressed. Will there be off-site parking? Yes lid If yes, please provide the location and a parking plan. Will there be shuttle buses provided for attendees? Yes If yes, provide a map of their route. Will there be alcohol served at the event? Yes If yes, a State permit is required from the WA State Liquor Control Board and must submitted with your application materials. KI TTITAS COUNTY COURTHOUSE - 205 WEST 5`" , SUITE 108 - ELLENSBURG, WA 98926 (509) 962-7508 - FAX (509) 962-7679 www.colittitas.wa.us 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? t/` 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? Vs No KITTITAS COUNTY COURTHOUSE • 205 WEST 5"', SUITE ] 08 • ELLENSBURG, WA 98926 (509) 962-7508 - FAX (509) 962-7679 www.colittitas.wa.us Kittitas County, Washington BOARD of COUNTY COMMISSIONERS Garbage/Recycling 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 and endorsements, specifically naming "Kittitas County" as an insured? V No A copy of the Certificate of Insurance amd endorsements 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. This insurance must apply first and on a primary non-contributing basis in relation to any other insurance or self-insurance available to Kittitas County. Penal Bond - Bond of Indemni 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 64 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. County Filings and Registration Is there a cost to attend the event? V No How much are you charging to attend your event? Tri $60-90, Runs $25 KITTITAS COUNTY COURTHOUSE • 205 WEST 5", SUITE 108 • ELLENSBURG, WA 98926 (509) 962-7508 • FAX (509) 962-7679 www.colittitas.wa.us CERTIFICATE OF INSURANCE AGENCY: Integro USA Inc_ i d/b/a Integro Insurance Brokers 2727 Paces Ferry Road, Building Two, Suite 1500 Atlanta, GA 30339 678-324-3300 (Phone), 678-324-3303 (Fax) NAMED INSURED: PRINT DATE: 12/14/2017 CERTIFICATE NUMBER: 201 71 21 4577249 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE: USA Triathlon of Colorado DEANNA MULLER INSURER A: Philadelphia Indemnity Ins Co. NAIC #: 18058 5825 Delmonico Drive Colorado Springs CO 80919-2401 INSURER B: Philadelphia Indemnity Ins. Co. NAIC #: 18058 EVENT INFORMATION: Ellensburg Triathlon (Olympic and Sprint) (7/14/2018 - 7/14/2018) J POLICY/COVERAGE INFORMATION: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY I HE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL I HL TERMS, EXCLUSIONS ANL' CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS IN$ TYPE OF INSURANCE; POLICY NUMBER(S): EFFECTIVE: EXPIRES: LIMITS: A GENERAL LIABILITY X Occurrence PHPK1738697 12/1/2017 12/1/2018 GENERAL AGGREGATE (Applies Per Event) $2,000,000 12:01 AM 12:01 AM _ X Participant Legal Liability EACH OCCURRENCE $1,000,060 DAMAGE TO RENTED PREMISES (Each Occ.) $1,000,000 MEDICAL EXPENSE (Any one person) EXCLUDED PERSONAL & ADV INJURY $1,000,000 PRODUCTS-COMP/OP AGG $2,000,000 B UMBRELLA/EXCESS LIABILITY X Occurrence PHUB607478 12/1/2017 1211/2018 EACH OCCURRENCE $10,000,000 12:01 AM 12:01 AM _ _ AGGREGATE $10,000,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLF-S1EXCLLiSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS: The ceilificate holder is an additional insured, where requnod by written contract or wtitten agreomont, but only with respect to the aperatlorls of the named insured, and subject to liya provWons and limitations of form CG2026 - Additional Insured - Dosignaled Person or Organization, W1 only with respect to the VSAT sanctioned or approved event spni=fied on this eettlfidate The General Liability policy is primary as per Fo,m CG0001 (04/13), The General Liability policy contains Form CG2404 (05/09): Waiver of Transfer of Rights of Recovery Against Others to US, but only as required by written contract or i agreement executed by the named insured prior to an occurrence resulting in a loss or a claim, CERTIFICATE HOLDER: Kitittas County, It's Officers, Officials, Employees 205 W 5th Ave Ellensburg WA 98926 NOTICE OF CANCELLATION: 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: USA Triathlon of Colorado Effective 12/1/2017-12/1/2018 Policy # PHPK1738697 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE lame Of Additional Insured Person(s) Or Organization(s): Kitittas County, It's Officers, Officials, Employees 205 W 5th Ave Ellensburg WA 98926 As required by written contract executed by the Named Insured prior to an occurrence resulting in a loss or claim Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 0413 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. O Insurance Services Office, Inc., 2012 INSURED COPY Page 1 of 1 Olympic Turnaround Swim Course 4-- Olympic=Haff loop and 2 full loop$ Sprint=Hal€ loop Bike Course w `s Central Ur D 1 Ellensbt, Sprint Turnaround Run Course .� d Olympic 2 Loops�y''r�"�c W Dolarway Rotary Pari NO