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Home My WebLink About1857_001Kittitas County, Washington BOARD or 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 http: / /www.co.kittitas.wa.us/boc/count.vcode/ title05.asp Event Information Name of event Easton Memorial Day Parade Date(s)of event: 27 Mav 2023 Hours of oper - 2200 Description of the event: Parade and street fair with kid zone and venders Has this event taken place before? (" Estimated attendance: 3000 NO DateS: 31 years memorial weekend How is your event being publicized?News Paper, radio, signs, social media, etc Please attach any flyers, posters, etc. with your application submission. Information Name of the organizer/contact person: CindV Mclaughlin RECEIVED Address: PO Box 698 22 2fil3 Phone number(s):177 Email address:eastonmemo rialdavoa rade@o mail. com Date of birth of applicant:10t11t1964 COUNTV BOARD OF KrrrrrAs couNTy couRTHousE . 205 wEsr f , sunr 108 ELLENSBURG, wA 98926 coiltltsstoNERS 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: Cindv Mclauqhlin 509-656-4177 Name Teresa Kartes Phone Number 206-501-5268 Name Phone Number WRITTEN PERMISSION TO ENTER EVENT SITE l/We hereby permit law enforcement andf 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 Counfy 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 l/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. Name Applicant Name (Print)Applicant Signature KITTITAS couNTy couRTHousE . 205 wEST $, sutrg 108 ELLENSBURG, wA 98926 Kittitas County, Washington BOARD or COIINTY COMMISSIONERS Fire SafeW 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 Kiftitas County Fire Marshal's office. You may contact the Fire Marshal's office at509-962-7000. Will there be a temporary skucture erected for the event? Yes Y6 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 yd 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 orgatization 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 . zos wesr f', SUITE IO8 ELLENSBURG, wA 98926 Are there permanent or fixed bathroom facilities already available at the location of the event? Yes y6 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 arr 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 enEure that sani-cans remain in asanitary condition. You must include the location of the portable restrooms on a map/diagram of the event. KITTITAS couNTy couRTHousE' 205 wEsr S, sunn 108 ELLENSBURG, wA98926 Kittitas County, Washington BOARD or COUNTY COMMIS SIONERS Law EnforcemenysecuriVEmergency Medical Services Will there be security on site during the event? Yes ry6 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? t/s No If yes, please provide written verification from the providers. Will there be music, sound amplification or any other noise impacts? V" No If yes, Kittitas Counfy 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. Witl you have traffic control? V" No If yes, please provide documentation on how the traffic control will be addressed WiIl there be off-site parking? Vg No If yes, please provide the location and a parking plan. Will there be shuttle buses provided for attendees? Yes ry6 If yes, provide a map of their route. Will there be alcohol served at the event? Yes Vd If yes, a State permit is required from the WA State Liquor Control Board and must submitted with your application materials. KrrrITAs couNTy couRTHousE . 205 wEsr f , sunp 108 ELLENSBURG, wA 98926 Kittitas County, Washington BOARD oF COUNTY COMMISSIONERS Public Roads WiIl the event obstruct, interfere orrequire the closure and free use of any public road, street or right-of-way? V" 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? V" No KTTTITAS coUNTY COURTIIoUSE ' 205 wEsT S, SUITE IO8 ELLENSBURG, wA 98926 Kittitas County, Washington BOARD oF COTINTY COMMISSIONERS Garba Do you have a plan for garbage and recycling? V" No A written plan for garbage and rerycling must be attached to your application materials. For questions or assistance contact the Kittitas County Solid Waste Department at 509 -9 62-7 5 42. Insurance Have you obtained a Certificate of Insurance and endorsements, specilically naming "Kittitas Count5r" 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 $L,000,000.00 per occurrence and $2,000,000.00 aggregate coverase. This insurance must apply fir^st and on a primary non-contributiYr"g bHsis in relation to any other insurance or self-insurance available to Kittitas County. Penal Bond - Bond of Indemni fv A $5,000.00 Penal Bond - Bond of Indemnity is required to be deposited with the County Treaswer 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 Counfy Commissioners has certified no damage has been done and that the County has not incurred additional expenses Are you submitting a $1000.00 Penal Bond - Bond of Indemnity with your EventApplication? -Yes )i6 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 and Re ation Is there a cost to attend the event? Yes How much are you charging to attend your event? e(" KITTITAS coUNTy couRTHousE' 205 wEST #', sunr, 108 ELLENSBURG, wA 98926 4ob iaiir;rci i;i 3I r il a ao a000C $ I . o | ff:a1ht;rr<i$iloo I r r .1.0.+c.o\*^"""q(P"rll:!GLSaiomool-t artAlley SrRailroadSta it I I r0%6hAllcy Stltttttttt\No 277 RdNo 277 RdFire Department9Road ClosedBlockadesPort-a-PottiesParade RouteDetour RouteI DisabledParkingf parking DATE(nUDD/rrYY) ilsnm3 THE CERTIFICATE HOLDER |TIIS 'E AFFORDED BY THE POLICIES SUNG NSURER(S), AUTHORtrED THIS CERTIFICATE IS IgsUED iIS A MATTER OF ITIFORTiATION ONLY AI{D COI{FERS NO RIGI{TS UPOil CERTTFICATE DOES Nof AFFlRlrlATTl/ELY OR NEGATIVELY AMEND, E$END oR ALTER mE COVERA BELOW THls CERTIFICATE OF INSURAilCE DOES iIOT CONSTITUTE A COiITRACT BETU'EE}I THE IS REPRESEiITATNE OR PROOUCER,AND THE CERNRCATE HOLDER IURED provlsloll! or be ondoEed. an endorscment A sffiment on TMPORTANT: Itthe certificrto holdcr lc an ADDITIOI{AL INSURED, the pollcy(ics) must havc ADDITIOI|AL n lf SUBROGAION ls WAIVED, rubJecl to lhe temr and condlflons of $e pcflcy, c.d.ln pollcles may equlrr thts ccrtificate doe$ not contrr rlqlrtr to lhe cerdfcat€ holdrr ln lleu of euch cndor:cmcnt(s). ,,-,. 509€62{800 i*, qlasl@Farmsrcagenlcor IAN'IISURERISI AFFOROIIIO O fYERAGE PROOUCER Gerald M. Lael Lacl lnSurance and Flnancaal Servlces 23Ol W. Dolanray Rd Ste 5 Ellenrburs. Wa.98926 oronRERA: Mount Vcmon Flrp lnst ranco company 26522 Barbra Davldeon DBA Easlon Memorial Day Parade PO Box 698 INDICATED. NOTWTHSTANOING AT.ff REAUREMENT, TERM OR CONDMON OF A}IY CONTRACT OR OTHER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCRIBED F-XCLUSIONS AND CONDINONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CI.AIMS. IilAURED THIS TO TOUSTEDOFTHAT THE WITH RESPECT TO WHICH THIS IS SUBJECT TO AI.T THE TERMS, TYPEOF IIISURAI{CE raf,Jff xlltftFn ustfg EACH (CCURRENCE MED E PlArv@ffi)s 5.000 PER.SO IALT ADV NJURY GENEN \LAGGREGATE peooL ]16-corrP/oPAGG Y $ A COIIUERCUTL GENERAL UAdUN' cr-ArMsu,ADE lFl oor* UMIT POUCY mo- JECT APPUESr x PER LOC Y sE2016099 $ BODIL)INJURY(Pcr p.fi00)s BODIL'I IrJURr (Pds.ddent)g s t AU'OTOALELIABILITY Af{YAUTO OI/VNED AUTOS ONLY HIREO AI'TO9ONLY SCHEDULEO AUTOS NON.OWNED At,TOS ONLY EAC!{ a :()l lRtlFl'lcF t AGGNF UIBREIIAtlAA p(cEEsuAa OCCUR CTA|MS{IADE I,ATE $ DFD PFT?M6N3 3 trr EL EAI HltctoEt{T t EL.OFI ASE.EAEMAOYEI $ GOTFEtilAArIOil tl R'A E.L DTs A'sE. POLICI/ LIMIT g OEgof{l'rloilOFOPERAtlOllSrLOOAllOMl/VEI{ICLE& {ACOROlot,Arldl[onrlR trELrlct drllir,mrybctffrfrdffmrp*abtqukld, CerflficatE holdor as addltlonal lnsured o5n6l2023,{,5l2Sl20te SHOUu) AITY OF THE ABOVE DESCRIBI TI{E EXPIRATION DATE T}IEREOF, AOCORDAI'ICE Wml THE POUCY PROV D POLICES BE CAIICELLED BEFORE NOTTCE WLL BE DELNERED III 3loils- Kittttas Countyr Its agents, employees and asslgns 205 W 5th Ave Ellsnsbsrg, WA 98926 AUTHORTZED REPR€SEITATN,E**"Wil"'"/6.rr( CERTIFICATE OF LIABILITY INSU RANCE @ AcoRD 25 (2010103)The ACORD name and logo are rcgistercd marks of ACORD AII rights l€serv.d. Or,y &bbralb, PO Box 698 Easton, WA 98925 eastonmemorialdayparade@gmail.com www. eastonmemorialdaycelebration.com Kittitas County Board of Commissioners: Restroom Availability: This is our restroom plan for this year's Memorial Day Celebration on 28 May. We will have 5 standard and 1 ADA port-a-potties spread along Railroad Street. There will be hand sanitizer ineach and an additional hand wash station located next to the ADA unit. There are also permanent restrooms located at The Hitching Post. Please see map for port-a-pottie locations. Let me know if you have any questions. Cindy Mclaughlin EMDC Treasurer (s0e)6s6-4177 Tl^ar^*, Ao1/,/ ! Ea4'tatw M e*'rori^aL D ag Qk-l2ra'H.o!v hw,l wittt* www. eastonmemorialdaycelebration.com Kittitas County District 3 Fire Protection POBOX 52 Easton, WA 98925 March 2I,2023 To Whom it May Concern, The Easton Memorial Day Parade Celebration occurs on May 27,2023,and the Kittitas County Fire District 3 will be present to provide EMS services. sincerery, F t ;lhp Methxn , PhilMeehan Asst Chief |aufo,o( Qq (duArdl,bn PO Box 698 Easton, WA 98925 eastonmemorialday p ar ade@gmai l. com ww w.eastonmemorialdaycelebration. com Kittitas County Board of Commissioners: Sheriff Clayton Myers: This is our traffic control plan for this year's Memorial Day Celebration on 27 May. Railroad Street will be closed at Cross Street to Kachess Ave from 8:00am until 10:00pm. There will be detour signs routing the traffic through I't Street. The parade route is down Railroad Street from Cross Street to the west end of I't Street starting at 12:00pm to 1:00pm. We will have some volunteers to handle parking, but are requesting Sheriffsupport for 3 uniformed personnel for crowd and traffrc control from 10:00am to 1:00pm at the intersection of Exit 7l overpass, Railroad Street and Cabin Creek road plus an additional 2 uniformed citizens patrol for parking control. Please let me know if this is possible. See attached map. Let me know if you have any questions. Cindy Mclaughlin EMDC Treasurer (s09) 6s6-4177 TI4** Aau/ ! Ea4'to',w M e.wroyiaL D aa A)z6*fi,ow Cou,vwifit* www. eastonmemorialdaycelebration. com Oty (/ubrdlbn PO Box 698 Easton, WA 98925 eastonmemorialdayp ar ade@gmai l. com www. eastonmemorialdaycelebration.com Kittitas County Board of Commissioners: Kittitas County Solid Waste Department: This is our waste and recycle plan for this year's Memorial Day Celebration on 27 May. We will have a 3-yard dumpster positioned behind The Hitching Post, 1751 Railroad Street. This will be used for the trash clean-up the day before and all trash collected during the event. We will also place recycle containers at both ends of the event area and one in the middle. The dumpster will be removed the following workday and recycles will be taken to Cle Elum transfer station. Please let me know if you have any questions Cindy Mclaughlin EMDC Treasurer (s09)6s6-4177 Th+nlc Aou/ ! EaAoA' Me,wwri^aL D ag AJ,e.WafirtA, h-wr.vwtf+ee, www. eastonmemorialdaycelebration.com Soulun orv &bbra/,b, PO Box 698 Easton, WA 98925 eastonmemorialdayparade@gmai l.com www. eastonmemorialdaycelebration.com Kittitas County Board of Commissioners, We are requesting a waiver for the Penal Bond-Bond of Indemnity. During our event, vendors are positioned on the shoulders of Railroad Street which is primarily gravel. The parade route is only three blocks on the same street and is mainly rolling vehicles and foot traffic. To the best of my knowledge, there has not been any damage to the street or pavement in the past nor do we expect any during this event. Cindy Mclaughlin EMDC Treasurer (s0e)6s6-4r77 Tl'V"l"*' AO1/' ! Ea'ttovw Mw,rari^oL D og Cd,o*>ta4@t\' hw.v,a.tffe* www. eastonmemorialdaycelebration.com RAFFIE PRIZES AI Website Interested in participating in the parade, or vendingr or volunteering? It's not too late! Sign up on the website or call 2o6-Eo1-5268 eastonmemorialdaycelebration. comEI E YouTube CERTIFICATE OF LIABILITY INSURANGE DATE (MM/DD/YYYY} 31912023 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: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer riqhts to the certificate holder in lieu of such endorsement(s), PRODUCER Gerald M. Lael Lael lnsurance and Financial Services 2301 W. Dolarway Rd Ste 5 Ellensburg, Wa.98926 Jerry Lael 509-962-8800 509,962-8801 INSURER(S} AFFORDING COVERAGE NAIC# rNsuRER A : Mount Vernon Fire lnsurance Company 26522 INSURED Barbra Davidson DBA Easton Memorial Day Parade PO Box 698 Easton, WA.98925 INSURER B : INSURER C : INSURER D : INSURER E: INSIIRFP F. 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 INSUMNCE 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. POLICY EXP .MM'DD/YYYYI INSRITR TYPE OF INSUR-ANCE POLICY NUMBER POLICY EFF .MM/DD/YYYYI LIMITS EACH OCCURRENCE s 1,000,000 UAMAUE IUKENIEU PRFMISFS lFa 6ccrrrrence\E 100,000 MED EXP (Anv one person)s 5,000 PERSONAL & ADV INJURY s 1,000,000 GENERAL AGGREGATE E 2,000,000 PRODUCTS - COMP/OP AGG 6 2,000,000 A COMMERCIAL GENERAL LIABILITY x GEN'L AGGREGATE LIIVIT APPLIES PER: X X PRO-JECT L ] CLAII\,,IS-MADE OCCUR LOCPOLICY OTHER: T T sE20r6099 $ COMBINED SINGLE LIMIT $ BODILY INJURY (Per person)$ BODILY INJURY (Per accident)$ PROPERTY DAMAGE $ SCHEDULED AUTOS NON-OWNED AUTOS ONLY AUTOS HIRED AUTOS AUTOMOBILE LIABILITY ONLY ONLY ANY AUTO OWNED $ EACH OCCURRENCE bUMBRELLA LIAB EXCESS LIAB OCCUR CLAII\4S-I\4ADE AGGREGATE $ DED RETENTION $$ tsEKSTATI ITF uttr-FP E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERYMEI\4BER EXCLUDED? (Mandatory in NH) lf yes, describe under nFSCRIPTION OF OPERATIONS helow N N/A E.L. DISEASE - POLICY LIMIT s DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES (ACORDl0l,AddltionalRemarksSchedule,maybeattachedlfmorespaceisrequired) Certif icate holder as additional i nsured 0512512023-051 29 12023 CANCELLATION @1 5 ACORD CORPORATION. All rights reserved. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCOROANCE WITH THE POLICY PROVISIONS. Kittitas County It's agents, employees and assigns 205 W Sth Ave Ellensburg, WA.98926 AUTHORIZED REPRESENTATIVE-* L{*^" (f^.( ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD NEW Renewal of Number POLICY DECLARATIONS No. SE 2016099 Mount Vernon Fire lnsurance Company 1190 Devon Park Drive, Wayne, Pennsylvania 19087 A Member Company of United States Liability lnsurance Group NAMED INSURED AND ADDRESS: BARBRA DAVIDSON DBA: EASTON MEMORIAL DAY PARI\DE PO BOX 698 EASTON, WA 98925 POLICY PERIOD: (MO. DAYYR.) From: 05/2512023 To: 0512912023 FORM OF BUSINESS: Non-Profit Corporation BUSINESS DESCRIPTION: Special Event This contract is registered and delivered as a surplus line coverage under the insurance code of the state of Washington, Title 48 RCW. lt is not protected by any Washington state guaranty association law. fd.W {, ##r-8 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. Commercial Liability Coverage Part PREMIUM $715.00 Wholesaler Broker Fee Surplus Lines Tax Stamping Fee TOTAL: $50.00 $15.30 $0.77 $781.07 Coverage Form(s) and Endorsement(s) made a part of this policy at time of issue See Endorsement EOD (1/95) IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. Agent: Broker: TAPCO. KL (5576) (5576) PO Box 286 Burlington, NC 27216 Lael lnsurance & FinancialServices lnc 2301 W Dolaruray Rd Ste 5 Ellensburg, WA 98926 THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART DECLARATIONS, I tpn /nR_n7l covERAGE PART COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, TSSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. lssued: 03l0gl2023 8:53 AM \d"-' By:Authorized COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Policy No. SE 2016099 Effective DaIe: 0512512023 12:01 STANDARD TIME LIMITS OF INSURANCE Each Occurrence Limit Personal & Advertising lnjury Limit (Any One Person/Organization) Medical Expense Limit (Any One Person) Damages To Premises Rented To You (Any One Premises) Products/Completed Operations Aggregate Limit General Aggregate Limit $1,000,000 $1,000,000 $1,ooo $100,000 See L-535 $2,000,000 LIABILITY DEDUCTIBLE $o LOCATIONS OF ALL PREMISES YOU OWN, RENT OR OCCUPY Location Address Railroad Street From Cross Street To Depot Street, Easton, WA 98925 Territory 1 002 PREMIUM COMPUTATION Evt # Classification Code No. Premium Basis Pr/Co Advance Premium AIlOther Pr/Co AllOther 1 Parade (applicant is the host of the event) 00414 1,000 Attendees N/A 550.000 Set-up and/orTake-down Coverage 00442 Per Event N/A 165.000 Additional lnsured - Blanket - Special Events 49950 1 Per Additional N/A 0.000 lnsured MINIMUM PREMIUM FOR GENERAL LIABILITY COVERAGE PART: N/A N/A N/A $550 $1 65 $0 $195 $71 5 1 1 TOTAL PREMIUM FOR GENERAL LIABILITY COVERAGE PART: (This Premium may be subject to adjustment.) Mp. minimum premium 3overage Form(s)/Part(s) and Endorsement(s) made a part of this policy at time of issue: See Form EOD (01/95) and Form SOE (03/10) THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. lncludes copyrighted material of ISO Commercial Risk Services, lnc., with its permission. Copyright, ISO Commercial Risk Services, lnc.,'1983, 1984, 1988cL1s0 (10/03)Page 1 Of 1 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM SPECIAL EVENTS BLANKET ADDITIONAL INSURED ENDORSEMENT Section II - Who Is An Insured of the Commercial General Liability Coverage Form is amended to include as an insured any person(s) or organization(s) who you are required to add as an additional insured to this policy under written contract(s), written permit(s) or written agreement(s). Such person(s) or organization(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" occurring after the effective date of such written contract(s), written permit(s) or written agreement(s) that is caused, in whole or in part by: 1. Your negligent acts or omissions; or 2. The negligent acts or omissions of those acting on your behalf in the performance of your duties under such written contract(s), written permit(s) or written agreement(s) Exclusions under Coverage A, Bodily Injury and Property Damage Liability, Coverage B. Personal and Advertising Injury Liability; and Coverage C. Medical Payments are amended to add the following: We will not pay for loss or expense, including but not limited to the cost of defense for "bodily injury", "property damage" or "personal and advertising injury" occurring: (1) After all of "your worko', including labor, materials, parts or equipment furnished in connection with "your work" and performed under the above referenced written contract(s), written permit(s) or written agreement(s) has ended; or (2) When that portion of "your work" out of which the "bodily injury", "property damage" or "personal and advertising injury" arises and performed under the above referenced written contract(s), written permit(s) or written agreement(s) has been put to its intended use by any person(s) or organization(s); whichever occurs first. Coverage is not provided for "bodily injury", "property damage" or "personal and advertising injury" arising out of or resulting from the sole negligence of an additional insured under this endorsement. Coverage provided by this endorsement will be excess over any insurance available to any additional insured under this endorsement unless a written contract(s), written permit(s) or written agreement(s) specifically requires that coverage under this endorsement is primary. Section II - Who fs an Insured of the Liquor Liability Coverage form is amended to include as an insured any person(s) or organization(s) who you are required to add as an additional insured to this policy under written contract(s), written permit(s) or written agreement(s). Such person(s) or organization(s) is an insured only with respect to their alleged liability for "injury" L 820 (12-18)Page I of 2 occun:ing on or after the effective date of such written contract(s), written permit(s) or written agreement(s) that is caused in whole or in part by: 1. Your negligent acts or omissions; or 2. The negligent acts or omissions of those acting on your behalf in the performance of your duties under such written contract(s), written permit(s) or written agreement(s) but only if such alleged liability results directly from the selling, serving or furnishing of any alcoholic beverage at the Special Event shown on the Declaration page. Coverage is not provided for "injury" arising out of or resulting from the sole negligence of an additional insured under this endorsement. Coverage provided by this endorsement will be excess over any insurance available to any additional insured under this endorsement unless a written contract(s), written permit(s) or written agreement(s) specifically requires that coverage under this endorsement is primary. All other terms and conditions of this policy remain unchanged and shall apply to the coverage provided by this endorsement. This endorsement is a part of your policy and takes effect on the effective date of your policy unless another effective date is shown. L 820 (12-18)Page2 of2