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HomeMy WebLinkAboutSpecial Events Application 2Rev 9/02 City of Miami Department of Off -Street Parking Coconut Grove Special Events Application APPLICANT INFORMATION Please .rint or e the information ...................... Name of applican: doe° dl u r g-g.o.V ' CH Po-t R 6 i? D ara -i lit g aC-z Address: Z S z 0 Me FA c L ii ry e o/3 D 3 Q 5 - 4/ 1- -w 7 z 7 a Phone(s): Facsimile No: 3 0 5 - `-( Email Address: info e. 00.(n vi"s re) v Web Address.: tl1 W. o © u t-• D v e 2. NAME OF CONTACT PERSON (Title/Position), if different: A.g r / To H - J) E x ,e. D Phone(s), if different: Facsimile No, if different: Email Address, if different: Web Address, if different: NAMEIQF OPERATOR (Title/Position), if differ•ent:::.—:. Phone(s), if different: Facsimile No, if different: - Email Address, if different:. Web Address, if different: 4. SPONSOR INFORMATION: Name of Sponsor(s), if other than applicant: Address: Phone(s): Facsimile No: Email Address: Web Address: 5. SPONSOR STATUS: Not for profit - Tax Exempt No. 51 S77g58 ❑ For Profit ❑ Individual ❑ Other 6. EVENT INFORMATION: � ' p Name of Event: 5'1-H i4 A)All 4 �. t1 Tbjrr grz.pV e €J CCK pp, iv Y Coconut Grove Special Events Application Form Page 2 of 4 Pro •osed Location: p a D Pro osed Event Setu. Date(s) and Time(s): Pro, . v., w 1 s • Pro • osed Event Hours of O. eration: 1 z, r ti Coe o ry u-r G :Do p, Zo Zook? 20 2©a& :co Pro e osed Street Closures Dates and Times: Nj 20 2 0 0 !� /VaaN �a �IIDPVT" 7. PROPOSED/ESTIMATED EVENT STAFFING, EMPLOYEES AND VOLUNTEERS, alon; with a descri • tion of their res . onsibil.ities in connection with the Event: 1 5ve TdOc,eDrA1'Toe :OVEla 51 •061-th ©'E1e.•TLt J of EVENT E ' T LS T REL -ribt35 2 A'1:441, 51--g.. TtvE: 01-uOTC : SE 0 r vErz.r1s'r _ 4uv �5iA1 "� a7toA) ' wb ©. •DL. . O,':/ i7) 0" it) 5 ►VE af.T. r RELn-T10,(7 !2_ ]1e0Dun- r'ski': _ _._._.._... V OA tC ► a 5 v ►U D �i ec-f r 5 07 +{1/4l 8. ATTACH TE..._....._........_.�..................:�-:�....�........ NTATIVE PRODUCTION SCHEDULE. Please attach as " Exhibit 1" a 9. ATTACH SITE PLAN depicting location. of event, -- - king, description of activities j planned for the event, securit y, emergency service area, and arrangements with .arkin: facilities. Please attach as "Exhibit 2" r 10. ESTIMATED AL)DIENCE: * 3 0 00 11. PRIOR YEAR ATTENDANCE DATA: Z 56 0 12. ANTICIPATED TELEVISION, RADIO & INTERNET COVERAGE OF THE. EVENT : 54s'.enl HIfNlUcc,� � TT_"698i6) WDNA 5 S. Se4iact5 kik• l.r>wc,�. JQbiyTPin� ovNDr'�iT/oa1•G'o PIi,ur.uc� ' �aConUf"' rev� . Goo w! 13. IS THE PROPOSED EVENT FREE TO THE PUBLIC? If not state the admission/entry fee per person: ....... t ........................._..... ...................... . 14. WILL FOOD AND/OR BEVERAGES BE SERVED? /V ' `/ E O pD R,S Note: Beverages must be dispensed in soft containers ❑ Food - # of vendors ❑ Beer - # of vendors c&ss,t-a,y PE-ST�uR,A-, 6 'EAJ Fd s' U5 g S a Wine - # of vendors ❑ Non .Alcoholic Beverages - # of vendors apl Coconut Grove Special Events Application Form Rage 3 of 4 o Arts/Crafts - # of vendors Other (specify) - # of vendors Will vendors be cooking or heating food? Yes )( No If Yes: o Gas r o Electric o Charcoal o Other (specify): 15. WILL THE EVENT INCLUDE FIREWORKS OR • MECHANICAL RIDES? If so, specify company name, insurance carrier, policy number, agent's name and telephone number. (Please attach as Exhibit "3"). jl/Q 16. WILL THE APPLICANT NEED ANY OF THE FOLLOWING FROM THE CITY PARKS DEPARTMENT: . .:_::: Podium . . � ,Yes.„, ?� No., .-s Electricity Yes x No Bleachers Yes X No . . Public Address System Yes Y No Other (specify): 17. :• FINANCIAL, INSURANCE' & NOTICE. REQUIREMENTS: `• . (a). DESCRIPTION OF THE •FINANCIAL RESOURCES OF PRODUCERS, OWNERS, AND APPLICANT FOR THE EVENT. Please attach as Exhibit "4". (b). IF APPLICANT IS SEEKING A REDUCTION OR WAIVER OF "ANY" CITY FEES OR COSTS, FOR THE EVENT, APPLICANT SHALL PROVIDE A DETAILED DESCRIPTION AND FINANCIAL : DOCUMENTATION SUBSTANTIATING THE NEED FOR THE RELIEF REQUESTED. (Please attach as Exhibit "5"). (c). The City and the_.,D. p_artment of Off -Street Parking require that applicants of special events provide a current certificate of insurance naming the City and the Department as additional insured and complying with specified insurance coverage and limits of liability as prescribed by the City and the Department within 10 business days after confirmation of approval of event application ld INSURANCE COVERAGE U A L i Jl) F,- 'p kl I1U5 0 Ot {l7CE o . Insurance Cornpanyr s Name: ,e,e 6 A S 5 U R .e /, 5, -IIU, F -- , C Air Coconut Grove Special Events Application Form Page 4 oF4 • •1 • • •• .l . A:ent's Name: C3 kt i JtI6" p A;ent's Phone No.: 3D 5 -- 3 Z — 'T I . 5 - (07 3 — 01 R o s............ (e) AFFIDAVIT, HOLD HARMLESS AND PROOF OF MAILING NOTICE OF APPLICATION TO PROPERTY OWNERS WITHIN 375 FEET OF THE PROPOSED EVENT PURSUANT TO SECTION 54-341(D)(5) OF THE CITY CODE. (Please attach as Exhibit "5" . 18. PAST RELEVANT EXPERIENCE: Describe applicant's past experience in producing similar events. Include dates, locations, attendance numbers, event sponsors, activities and copies of promotional or advertising material for said events. (Attached as Exhibit "6"). r It is understood that the Applicant is financially, administratively and programmatically responsible for all aspects of the event. As per City of Miami Code Section 54-343, the promoter of the event shall pay to the City the supplementary fee to the Department of Off - Street Parkin; at least ten 10 da s after Committee's a. • royal of s . ecial event. a,f» t21 t Y f`. JoH/fisQ otf APPLICANT'S NAME IN PRINT DATE LICANT SIGNATURE APPLICANT'S TITLE xF&J.TI V& 12 t-RECF'.-icr