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Home My WebLink AboutGran Fondo Application and Ins.Kittitas County, Washington RECENED BOARD OF COTINTY COMMISSTOTffi.S EVENT APPLICATION BoASlrtBf;fi'$*'*' fr*\ you for your interest in holding a special event in Kittitas County. Please lomplete and return this application along with any other materials to ihe KittitasCgqt Bgard of Commissioners at least 60 days prior to the day upon the event is scheduled. Aty misrepresentation in the application materials or d'eviation 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 htrp : / / www. co. kittitas. wa. us / boCl countyco de / titleO5. asp Event Information Name of Ellens Date(s)ofevent 6-11-23 Hours of opera tion: 8:00 am - 5:pm Description of the event 90 mile b e ride Has this event taken place before? Y{t No Dates; 6 12122 Estimated attendance: 1 50 How is your event being publicized?www-ridevici e.com Please attach any flyers, posters, etc. with your application submission Contact Information Name of the or gmizer f contact person:Jake Maedke 1 ESWE 3 Phone number(s): (509) 750-0977 Email address enhratahikes mail.com Date of birth of apphcant: 10-14-77 KrrrrrAs couNry couRrr{ffi?, ,3ff *rfrrJ.jfi ffi 108 e. ELLENSBURG, wA e8e26 www.co.kittitas. wa. us If the application is made on behalf of a partrership, please submit full names with their residence and post office address for a period of six months prior to the date of tion of principal office or place of business of suchapplicationwith the loca corporation. Emergency contact name(s) and phone number(s) that can be contacted during the evgnt Jake Maeclke 1509) 750-097 Name Karen Maedke Phone Number (509) 760-3620 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 r/We hereby acknowledge that r/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 or narcotics violations are crimes under RCW Jake Maedke Applicant Name (Print) Karen Maedke Applicant Name (Print) KITTITAS coItNTy couRTHousE . 205 WEST 5s, sutrE 108 ELLENSBURG, wA 98926 (s09)962-7508 FAX (509) 962-7679 www.co.kittitas.wa.us If more than 50 people are expected at your event, you must complete a separate application process which can be obtained through the Kittitas Cbunty Fire Marshal's office. You may contact the Fire Marshal's office at 5Og-gG2-7000. Will there be a temporary structure erected for the event? Yes S If yes, you must attaclr a drawing including the dimensions. The structure may require an inspection by County staff prior to the event. Kittitas County, Washington BOARD or COUNTY COMMISSIONERS Fire Safety and Protection Public Health/En vironmental Health Will there be food served at the event? Yes S If no food will be served at the event then, no permit or application is required. If yes, isthe food and beverage that you intend on preparing and serving at the event exempt from permit requirements http:/ /www.co.kittitas.wa.us/healthTfood.asp? - ]f y"l, please submit an application for exemption from permit and proof of food handlers training to the Kittitas County Public Health D-epartrnent (KCPHD). If yes, and the food or beverage is not considered exempt from permit, then does the person ot or,ganization preparing and serving the food have a food service permit, temporary food service permi! or catering permit from KCPHD? - If yes, pl_essg_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(sf of the permitted person or organization. If yes, a1d F. person or organization preparing and serving the food does not already have a food service permit. - Thut a ternporary 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. KrrrrrAs corrNry couRrHffi:r-r3g *.rrfr;i.dfi ffi r08 e. ELLENSBURG, wA e8e26 www.co.kittitas.wa.us Are there permanent or fixed bathroom facilities already available at the location of the event? Yes S If yes,please provide an estimated attendance for the even! a detailed map that identifies the name and address of the physical facility that will provide lavatory facilities for the even! glantity of toilette facilities aviilable for each gender, at d th" distance from the event that patrons must walk. If no, pleas_e provide an estimated attendance for the event, specific information related to the number of portable restrooms thatwill be provlded, 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 56, strrrE 108 ELLENSBURG, w{ggg26 (s09) 962-7508 FAX (509) 962-7679 www.co.kittitas.wa.us Kittitas County, Washington BOARD or COUNTY COMMISSIONERS Law Enforcemen Medical S Will there be security on site during the event? yes S If yes, please provide a complete list of n.unes and contact information for who will beproviding the security. will Emergency Medical services (EMS) be on site during the event? yes V If yes, please provide written verification from the providers. will there be music, sound amplification or any other noise impacts? yes V6 If yes, Kittitas Cfq? lu-t u noise-ordin-ance in effect (see County Code for details). Ifyour 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? Yes V6 If yes, please provide documentation on how the traffic control will be addressed. Will there be off-site parking? Yes V If yes, please provide the location and a parking plan Will there be shuttle buses provided for attendees? yes S If yes, provide a map of their route. WiIl there be alcohol served at the event? yes V If yes, a Slate permit is required from the WA State Liquor Control Board and must submitted with your application materials. KITTITAS COTJNTY COURTHOUSE . 205 WEST 5'h, SUITE IO8 ELLENSBURG, WA98g26 (509)962-7s08 FAX(509)962-7679 www.co.kittitas.wa.us Kittitas County, Washington BOARD or COUNTY COMMIS SIONERS Will the event obstruct, inter{ere or require the closure and free use of any public road, street or right-of-way? Yes - \i6 If yes, please provide a detailed adequate tr#fic and detour plans at the time of submission of the application. Will there need to be road closure or detour signs posted? yes V6 PubIic Roads KrrrtrAs couNTy couRTHousE . 205 WEST 5e, surrE 108 ELLENSBURG, wA 98926 (s09)962-7s08 FAX(s09)962_7679 www.co. kittitas.wa. us Kittitas County, Washington BOARD oF COLINTY COMMIS SIONERS Garba Do you have a plan for garbage and recycling? V" No A written plan for garbage and recycling must be attached to your application materials. For questions or assistance contact the Kittitas County Soiid Waste Departrnent at 5 09-9 62-7 542. Insurance Have you_obtained a Certificate of fnsurance and_endorsements, specifically 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 mustbe named as an additional insured inthe amount of $1,000,00-0.0-0 per occurrence and $2,000,000.00 aggregate coverase. Thisinsurance must apply fir'st and on a primary non-contributii! bHsis in relafon loi"y other insurance or self-insurance available t<l Kittitas County. Penal Bond - Bond of Ind emnitv KIT'TITAS COLINTY COURTHOUSE . 205 WEST 56, SUITE 108 ELLENSBURG, WA 98926 (s09)962_7s08 FAX (509) 962_7679 www. co. kittitas. wa.us 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 eveit 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 y.ou sub_mitting a $5,000.00 Pengl Bond - Bond of Indemnify with your EventApplication? Yes y. 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 andoufline the specific reasons why it should notbe 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? $25 Gran Fondo Ellensburg: June LL,2023 Kittitas County Roads: Dry Creek Rd McManamy Rd WA 10 Airport Rd Westside Rd Woods and Steele Rd Mohar Rd Upper Peoh Thorp Prairie Rd East Taneum Rd Thorp Highway Gladmar Rd Course map can be seen online at: http://r'idewithqps.ggm/routes/6833060?privacv code=qzktW4qs0qacWhZC 0 3.2 0.1 1.9 14.3 0.1 3.5 0.4 0.1 0.9 0.3 0.3 1.2 0.2 0.1 0.1 2.4 1.6 4.7 5.0 14.9 1.8 9.2 GO! Right Left Right Left Right Right Right Left Left Right Left Right Left Right Straight Right Left Left Right Left Right Right Left Right Left Straight Straight Right Straight Left Right Left --+ +- --) <- ---+ ---+ ---t <- <_. ---) Gran Fondo Ellensburg Start on Dry Creek Rd Turn right onto U5-97 N Turn left onto McManamy Rd stight right onto wA-10 w Turn left onto wA-10 w/wA-970 w Turn right onto Airport Rd Turn right onto E 1st St Turn right onto N Short Ave Turn left onto E 3rd 5t Turn left onto N Pennsylvania Ave turn rlght on Railroad Ave Turn teft on 5o Cte Elum Way Turn right onto Madison Ave Turn [eft at the 2nd cross street onto 6th St 6th St turns right and becomes Marie Rd Continue onto Westside Rd Turn right to stay on Westside Rd AID 1 on LEFT Turn left onto Woods and Steete Rd Turn teft onto NF-4510 AID 1.5 on RIGHT Stight left onto NF-3300 Stight right to stay on NF-3300 AID 2 on RIGHT iurn teft onto NF-133 Turn right onto NF-119 Turn left onto NF-3350 Continue onto Westside Rd AID 3 on RIGHT Continue straight onto Mohar Rd Turn right onto Upper Peoh Point Rd Continue onto Thorp Prairie Rd Turn left onto E Taneum Rd Turn right onto Thorp Hwy Turn [eft onto Gladmar Rd 0 3.3 3.3 5.2 19.5 19.6 23.1 23.5 23.6 24.6 24.9 25.2 25.9 26.0 26.2 26.3 28.3 29.9 30.6 35.6 45.5 47.3 s6.5 56.6 58.5 60.5 67.0 67.1 69.2 74.9 82.3 85.0 87.2 0.1 1.9 2.0 6.5 0.1 2.0 5.7 7.4 2.6 2.2 {-- ---) +- -+ 1 ---t <-- <- ---+ €- ---+ ---) €- --+ +- I ,t I --> t I {-- -) +- Sani-cans will be provided and maintained by Brown and Jackson for Gran Fondo Ellensburg. There will be four at Mt Stuart Elementary school and 1 on the course at the intersection of Westside Rd and FS3300. We anticipate 150 participants and this has proven to be a successful san-can plan based on previous experience. February 22,2023 Kittitas County Commissioners 205 West 5th, Suite 108 Ellensburg, WA 98926 RE: Requesting a waiver to the Penal Bond - Bond of Indemnity Dear Kittitas County Commissioners: On behalf of Vicious Cycle Events Inc., we are requesting a waiver to the $5000 Penal Bond- Bond of Indemnity. We don't anticipate damage to any county roads during the Gran Fondo Ellensburg Bicycle Ride on June 11. We have done several bicycle rides throughout different counties in Washington and have had no problems with damage. We have worked with Grant, Douglas, Chelan and Klickitat counties as well as the WSDOT and WDFW utilizing their roads for the purpose of these bicycle rides. There are betwegn 100-200 riders on the road spread out over the course of approximately 7 hours for an 88 mile bike ride. Riders will be advised they are to obey all traffic laws. We appreciate your consideration. Sincerely Jake Maedke Vicious Cycle Events Inc. Vicious Cycle Events lnc. 139 E ST SW Ephrata, WA 98823 509-750-O977 February 22,2023 Kittitas County Solid Waste Department 205 West 5th, Suite 108 Ellensburg, WA 98926 RE: Solid Waste Plan for Bicycle Event Dear Kittitas County Solid Waste Department: This letter is to inform you of our Garbage/Recycling plan for the Gran Fondo Ellensburg scheduled to take place on June 11,2023 All refuse generated from the Bicycle event will be picked up and disposed of by the event Director. There will be a follow vehicle that will be picking up refuse at the end of the event. Recyclable water bottles and/or cans will be collected and recycled by the event Director. Sincerely, Jake Maedke Event Director Vicious Cycle Events lnc. CERTIFICATE OF LIABILITY INSURANGE DATE (MM'DD'YYM 03t01t2023 MATTER OF II{FORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AilIEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTTTUTE A CONTRACT BETI,ITEEN THE ISSU|NG TNSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. THIS CERTIFICATE IS ISSUEDAg A McKay lnsurance Agency, lnc.842-2135 (641)828-2013 NAIC #tA 50138 COVERAGE A statomont ontfSUBROGATIONtotefmstherswAlvED,conditionsand theof cefiainsubject an ondorgement-pollcy,maypolicies requirc ccrtlflcatethis notdoos confer to certificatetho lnholder oflieu such is an the must have or be PRODUCER meg@mckayinsagency.com Evanston 106 East Main Straet P O Box 151 Knoxville TNSURERB: Gerber Life lnsurance Company 70939 INSURERC: INSURERD: INSURER E : Silent Sports Association - NBTS SE Vicious Cycle Events, lnc. 139 E. Sheet SW Ephrata wA 98823 INSURED INSURERF: COVERAGES CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCEAFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOVI/N MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE tNen lllh POLICYNUMBER FQLIGY EFF IMM'DD'YYYYI UMITS A COMMERCIAL GENERAL UABILITY lX *"r* Participants CLAIMS-MADE lncludes Athletic LIMITAPPLIES PER: PRGJECr I I LOCPOLICY Event Y 3607AH010099-5 06111t2023 o6t12t2023 EACH OCCURRENCE $ 1,000,000 s 300,000 MED EXP (Anv one oeBon)$ Excluded PERSONAL &ADV INJURY $ 1,000,000 GENERALAGGREGqTE $ 2,000,000 PRODUCTS. COMP/OPAGG $ 2,000,000 $ AUTOMOBILE UABILITY ANYAUTO OWNED AUTOS HIRED AUTOS ONLY ONLY SCHEDULED AUTOS NONOVIJI{EO AUTOS ONLY $ BODILY INJURY (Por person)$ BODILY INJURY (Per a6idont) s UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION S $ WORKERS COMPENSAION AND EMPLOYERS' LIABIUTY ANY PROPRI ETORiPARTNER/EXECUTIVE OFFICERYMEMBER EXCLUDED? (Mandatory ln NHI lf yes, describs under DESCRIPTION OF OPERATIONS below Y'N N/A Pht{ STATUTE OTH-FR E.L. EACH ACCIDENT $ E.L. OISEASE - EA FMPLOYEE $ E.L, DISEASE - POLICY UMIT $ B Accident Medical 15-070944-22 06111t2023 o6t12t2023 Excess Deduc'tible $250 $2s,000 DESCRIPflON OF OPERATIONS t LOCATIONS / VEHICLES (ACORD l0l, Addltloml Rsnutkt Schodulq may be 8ttichod r nrore space ls ruqutmd) Gran Fondo Ellensburg: June 11 , 2023. Certificate holder is an additional insured but only with respect to liability arising out of the operations of the abovenamed insured. "This policy is issued, pursuant to lowa Code section 515.147, by a nonadmitted company in loiva andls such is not covered by the lowa lnsurance Guaranty Association." Kittitas County 205 W. SthAve Ellensburg wA 98926 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAIION DATE THEREOF, NOTICE WLL BE DELIVERED IN ACCORDANCE WITH TI{E POLICY PROVISIONS, AUTHORIZED REPRESENTANVE @ 1988-2015 ACORD CORPORATTON. Ail rlghts reserved. TheAGORD name and logo are rsgistercd marks of ACORDACORD 25 (2016/03) 3607AH010099 - 5 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision Kittitas County 205 W 5th Ave Ellensburg, WA 98926 lnformation required to complete this Schedule, if not shown above. will be shown in the Declarations. POLICY NUMBER A. Section ll - Who ls An lnsured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your be- half for which the state or governmental a- gency or subdivision or political subdivision has issued a permit or authorizatlon. However: a. The insurance afforded to such additional insured only applies to the extent permit- ted by law; and b. lf coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance afforded to such ad- ditional insured will not be broader than that which you are required by the con- tract or agreement to provide for such ad- ditional insured. lnsured: Silent Sports Association - NBTS SE Vicious Cycle Events, lnc. Event: Gran Fondo Ellensburg: June 1 1,2023 GOMMERCIAL GENERAL LIABILITY cG 20 120,4 13 2. This insurance does not apply to: a. "Bodily injury", "property damage" or"personal and advertising injury" arising out of operations performed for the fed- eral government, state or municipality; or b. "Bodily injury" or "property damage" in- cluded within the "products-completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section lll - Limits Of lnsurance: lf 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 ln- surance shown in the Declarations; whichever is less. This endorsement shall not increase the appli- cable Limits of lnsurance shown in the Decla- rations. cG 20 1204 13 Copyright, lnsurance Services Office, lnc., 2O12 Page 1 of 1 Kittitas County Ofrce Of The Treasurer Amy Cziske, Trersurrr 205 titl Sih Ar*rrur, $uli+ lU.tr Frlensbury,Wa 98926 Phone (509)962-7535 Fax(5CI9) 933-8212 Cash Rcceipts Receipt Nun'rber: Receivecl From: 2023-t482 MANDY BUCHHOLZ OFFICE ADMINISTRATOR Date:03/13t2023 Check Amount: $200.00 Cash Amount: $0.00 Other Amount: 1i0.00 Total Amount: $200.00 Deputy: KRISTENW Receipt Type: CHK Ternplate: Cornrnents: csR 2023- I 200 SPECIAL EVENT APPLICATION FOR JAKE MAEDKE FOR THE GRAN FONDO ELLENSBURC FundCodc ClCode t6321'71 Description SPEC]IAL EVENTS FEE Amount s200.00 $200.00 001 Total Arnount: Kittitas County Treasurer's Office Submitted By: KRISTEN WASHINGTON (c) 2002 Cashtax All Rights Reserved 03 I 1 312023 1 3'.4 1 :28 KRISTENW