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_add-on B1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 AJd. RESOLUTION NO. ______ __ A Resolution authorizing the City Manager to permit Lululemon a business located on Sunset Drive, to hold their 1st Annual Yoga Celebration on November 11, 2012, in downtown South Miami on Sunset Drive from SW 58 TH Avenue to Red Road. WHEREAS, Lululemon has submitted a Special Event Application; and, WHEREAS, this would be the 1 st Annual Yoga Celebration held in the City of South Miami; and, WHEREAS, the applicant has requested permission to hold its event on November 11, 2012; and, WHEREAS, the applicant has paid for the deposit of $60.00, and will pay the following: Police ($850.00), Public Works ($274.25), includes personnel, barricades and garbage bags, Street Closure ($150.00), (Meters ($775.00) 31 meters @$25.00 each, and Deposit ($600.00), totaling $2,649.25, which will be paid prior to the event; and, WHEREAS, the applicant would like to close down Sunset Drive from SW 58 TH Avenue to Red Road; and, (6) WHEREAS, through this new venue of yoga, this event would be the first of many more to come, providing revenue to local businesses and showcasing downtown area. NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF SOUTH MIAMI, FLORIDA: Section 1. The Mayor and City Commission authorize the City Manager to approve the 1 st Annual Yoga Celebration to be held on November 11, 2012, downtown South Miami closing Sunset Drive between SW 58 th Avenue to Red Road. Section 2. If any section clause, sentence, or phrase of this resolution is for any reason held invalid or unconstitutional by a court of competent jurisdiction, the holding shall not affect the validity of the remaining portions of this resolution. Section 4. This resolution shall become effective immediately upon adoption by vote of the City Commission. PASSED AND ADOPTED this __ day of ______ , 2012. Page 10f2 1 2 ATTEST: APPROVED: 3 4 5 CITY CLERK MAYOR 6 7 READ AND APPROVED AS TO FORM, COMMISSION VOTE: 8 LANGUAGE, LEGALITY AND Mayor Stoddard: 9 EXECUTION THEREOF Vice Mayor Liebman: 10 Commissioner Newman: 11 Commissioner Harris: 12 CITY ATTORNEY Commissioner Welsh: 13 Page 2 of2 SUMMARY OF EVE~TT This section of the permit application is intended to provide the Special Events Permit Committee with an overview of your event. Information you provide in this section is public information and may be used in developing the City of South Miami's Calendar of Special Events. Application must be submitted no less than twenty-one (21) days prior to the effective date of the event with all required documents. TYPE OF EVENT: D Filming D Charity D Festivals Qcelebration D Promotion Other: NAME OF EVENT: Sunse'+ on S\)YlS~"'" LOCATION OF EVENT: JiJbSe.+ dnV'0 l be:\vVl tV1 51·th <t 58-WI (AVfVlV£'/) (Please note: write complete mailing address, as well as name of any buildings and/or parks if applicable) Is this an anri~al event? ~ D Yes if yes, this is the __ annual event, previous date ___ _ EVENT DATE(S): NOVfYnb-ty I} I 20 }'2 EVENT DAY(S): ______ _ ACTUAL EVENT HOURS: 4 PM a.m./p.m. UNTIL: 7: 30 pyY') a.m./p.m. (Please note: event may not begin earlier then 8 a.m. or end later then 11 p.m. in residential areas, or midnight in commercial areas) . .st't vp 4 '4:~O'P~ S<-+ Q(jw\,\ 7 -7e3 ep", ASSEMBLY DATE(S): Nov. l\ 2OL2 SETUP/DOWN TIMES: a.m./p.m. a.m./p.m. ANTICIPATED ATTENDANCE: 700 Name: Gr 'LS±l Yll! SUO r Q., 2 Title: ~fy le~dey: Celi/Phone:bQS q f)J TOTAL EVENT DURATION: d hrs .80 mins Name: K{ \ (stty, DQY)} ~.J Title: ,S':toyt . IYlCtYlQg f..,'Y Cell/Phone: 'lBG Bq7 qS4-7 Email: DSuOv e7 cD )u)u)tY\,\OV), eo Vy\ Email: KdUvn eJ (l) lv)uitmIJ Y) • Lam (Alf mC4\'t.b fVtVlt )NII\ \?YI~ 'VOSC\, fOod, YVlUSl () :i CQnnectldVl-eSS '10 rut' .SOuth M\llY'fl\ CO\YlVYlun Ity. \IV!. \N"I\ lYlV/±.f... :f<lvnlh, -fn I Y\dJ . I l am 12C1SSCtdoy,s . S1vd HI.~ i C(\ VVY\$j y\lV1YlI VI& / (ycl I \(:9 O'YwtAS j d: clil . (",. l ( '\ (j" ______________________ ~i ______________________ ~ APPLICATION CHECKLIST This list is to ensure that all necessary documents are included and that all required procedures were followed. The Special Event Committee will check your application against this simpler checklist use this checklist to ensure all information was submitted as required. o APPLICATION: Completed Special Events Permit Application, with required attachments, at least 21 days prior to the proposed event o FEE: o SIGNATURE: o CITY MANAGER'S LETTER: o OTHER PERMIT: o INSURANCE: A $60 Application Payment must accompany your application upon submission in cash, check or money order. Application must be signed and notarized upon submission. Briefly. discuss your Organization/Business, the purpose of your event, the benefits, if any, that the event will have on the City and any additional information deemed pertinent to this application. Complete any applicable permit application deemed necessary for your event, such as: (Check all that applies) D Public Right-of-Way D Pole B~nner D Off-Duty Police Officer D Banner(s) Overstreet D Parking Meter Rental D Clean-Up Deposit Prior to the event, the event producer is required to submit a Certificate of Insurance naming the event and also shall name City of South Miami as an additional insured, in the amount of $1,000,000. o SITE A site plan must be submitted with your application PLAN/SKETCH: which shows intersecting street(s), location of all on- site buildings, parking areas, routes, barricades, etc. o COPY: It is strongly recommended that you make a copy of your application for your own record. VII APPLlt,-,-iNT ISPONSOR INFC~ MA TION The applicant for the Special Event Permit must be the authorized representative of the organization/business conducting the special event. This person must be available to work with the City's Special Event Permit Committee throughout the permitting process. A professional event organizer, or other representative, may apply for the Special Event permit on behalf of the organization/business. NAME OF ORGANIZATION: ADDRESS OF ORGANIZATION: ~~~~~~~~~~~~~ M \' am \ . F-L 61:> l-43 FAX: OFFICE TELEPHONE: (oDS) (PC b -847fJ ----------------------- . ~c\tty ~ \,\1} ( 'r ADDRESS: 576+ ~U~{.± dnv0 ~ If the organization is a tenant and/or renter of the event location, please have the property owner complete the following: D Applicant/Organization owns the event location ~ permission for the Applicant/Organization to use my property. Comments: Property Owner's Name: /!t:x!JJ.r/t:urJ'!Jf/o I~S PhonE(3DS) 53 ~ -L/5SS' Property/Owner's Address: 77 7 f)r~ GqcU'1!!JR.t::I #; .l/,c:£:), fYlr~ ~(FL ?>514D Property Owner's Signatur : :::::::::=;;:;;;~==::=::::~= __________ _ }-Notary Signature: L ELLINGSWORTH -----\:-+----------+t.~::II:_"i'I~-8tfTtflTf· s s ion # 0 D 908578 ~ *~ My Commission Expires 09·06·2013 ~,;4"i Q,..~1 Bonded ThfOUgh 2-1 "'(,~~,t~\\ .. ,... Atlantic Bonding Co. Inc. EVENT FEE QUESTIONNAIRE POLICE DEPARTMENT ~/DNO 1. ~ Will your event obstruct the normal flow of traffic? 2. ~ 0 Do you expect the total attendance for your event to be over 150 people _.rrt anyone given time? 3. J [Jf :Will you be requesting the use of Extra-Duty Police Officers? If yes, ~ how many.. (Please note: if you answered NO, to this question off-duty /')Q . officers can still be assigned to your event at a cost to you if deemed necessary) If NO, please describe why the event will not have a significant impact on the surrounding public streets and/or property area. Off-Duty Officer Applicant pg. 11 /See Special Event Fee Schedule tor cost detail PUBLIC WORKS YES NO 4.0'0 5. ~D Will your event interfere with any public right-of-way, such as roads, sidewalks, alley, etc.? Will your event require any full and/or partial road closures? If yes, please complete the Right.,.of-Way Application. (Please note: any right-~f-way closures will require at least one off-duty officer / and public works employee.) 6. ~ ~Will your event require the use of barricades? If yes: how many . a., ; what type .. dJJ~V./ lease note: all pubic right-of-way closures must have approved barricades) . 7. ~ Would you like the City to provide you with barricades for you event, at a cost? If yes: how many . 8. D· ~ill you be applying for a Pole Banner? Please describe your plans for the cleanup and removal of recyclable goods, waste and garbage during and after your event. .. .. . Public Right-Ot-Way Applicant pg. 12 /Pole Banner Applicant pg.15 See Special EventFee Schedule tDr cost detail 3-16 CITY OF SOUTH MIAMI PUBLIC WORKS DEPARTMENT 4795 SW 75th Avenue, Miami, FI 33155 (305) 668-7205 Fax (305) 668-7208 Application to Conduct A Special Event Function on Public Right-of-Way South Mia".' Florida b*X~ ;fiij~; ZOOl NOTE: ALL FIELDS SHALL BE FILLED. No action can be taken on this application until all questions have been answered. As set forth in Ordinance No. 21-09-2013; temporary full roadway and sidewalk closure (NO SINGLE LANE ROADWAY CLOSURE PERMITTED) for special events, eight (8) hours max. Schedule of fees is attached. Use blank paper if you need additional writing space. PLEASE PRINT clearly, except for signature. Contact Information: 1\1 )ult\fYU[Y) Ctt\1lt±, CJ(X Business/Organization Name Authorized Representative Name 5734 <S\)Y\Ui-dnY-t..,.. Mlam:} EL 63 l4-6 Business/Organization Address (3051 C,C.3-b47£> City State Zip Code 03J0\ aGO lul\)ltmon ,COm --Phone Number Fax Number E-Mail Event Information: Event Name Project Location Event Date(s) Event Start Time Event Setup Time HI u J L 2-Event Day(s) Type of Event vaga (ill bttth'QY) +-'"b D(am e Event End Time 7 ~W (am /9 Anticipated Attendance _-"-]1--"'0_0 ___ _ + (am /9> Breakdown Time ---J]!c----(am 10 Total Duration (include setup) l hY"' I HEREBY REQUEST A PERMIT FOR THE FOLLOWING: AntiCipated effects on vehicular and pedestrian traffic during Project Maintenance of traffic provisions are specific (include sketch if necessary): The ~wing documents have been submitted with this permit application: ~ Site plan I sketch of event. Clearly define boundaries and linear foot of road closures . . ~aintenance of Traffic (MOT) for vehicular and pedestrian traffic during event. ion # 00 908678 -:-:-::-=--±-::-l:-!(...!!!i=="...,---t+Pf.*:::IA'-M-iy &coI!lm.!Dm~lsslon Expires 09·06-20 13 Bonded Through . --------- Approved! "0 By Date s::: Disapproved 0 () 12-16 Permit No: ------------------ ... _- Permit Fee Comments CITY OF 'UTH MIAMI PUBLIC WORKS DEPARTME 4795 SW 75th AV8'hJe, Miami, FI 33155 (305) 668-7205 Fax (305) C/68-7208 Public Right-of-Way Schedule of Fees Ordinance Item Measurement PERMIT FEES Minimum permit fee Permit extension fee, for 60 day period PERMANENT TRAFFIC BARRICADE, GUARDRAIL AND GUIDEPOSTS Each 100 LF or fraction TEMPORARY FULL ROAD AND SIDEWALK No single lane roadway CLOSURE closure permitted. *For special event 8 hr. period max., inc!. set up Per linear ft. of road, time. Excludes city events rounded to the next and events funded by the higher whole number in city. ft., per day TEMPORARY SIDEWALK CLOSURE Each 25 SF or fraction Permit requires French barricades along curb or EOP.* Maximum permit fee TEMPORARY STAGING Flat Fee per day for first AREA, CRANE, TRAILER, 5 days TRUCK ON THE RIGHT-Every five days or OF-WAY fraction thereof after MAINTENANCE OF Intrusion into andlor TRAFFIC (MOT) using one-way lane Roadways with two-way traffic Detour, per direction Sidewalk intrusion, each WORK WITHOUT After the fact permit fee: , PROPER PERMITS F or any work performed AND/OR INSPECTIONS without proper permits Permit fe~s Andlor inspections qUadrupled Minimum, per day PUBLIC WORKS HOURLY RATE Non-supervisor Supervisor 13-16 Fee ! Sout"h MiKIIIf, ' Flo rid lI. txft¥":ii ''fiii; $150 $150 $85 $0.25 $75 $10,000 $200 $300 $100 $200 $100 $100 " I $1,000 $40 $45 \ \ o~ SITE PLAN/SKETCH A map of the event site ~s required and should indicate event layout with proposed attractions, recommended street closures, parade or run/walk routes, etc. Please draw you map on the space provided below, or attach your map to the applica);{on upon submittal. The following must be identified and labeled: 1. Event Site (label streets, building, etc.) 3. Canopies, tents, stages 5. FencinglBarricades x-7. First aid facilities + 2. Routes (races, parades, etc.) -+? -+ 4. Restroomfacilities R 6. Off duty poli ficersP 8. Parking Area PA \}.b " ~/ ,,/' /~/ ~/ ~~ ~.C/. IJ- i I I I ,pc I I " ( )~ I ~~ £ltlhS{ ])yl\l ~ ).(:'" ~-)( I ~ ~~ l ~ I I ~ ~ ~ .~ ~ Acf ~ --"" ~ ~ ~ - 00 i. ::t' ~ \.CJ n-11- <[P kj) 5-16 PLANNING AND ZONING ___ ', ___________ .'i· _____________ .... ,_., ________ _ YES~O 9. czr D Are you confident that your event is in the City of South Miami limits? (Please note: that it is the sole responsibility of the applicant to ascertain the location is within the city's limit. You may call the Planning & Zoning department ~(305) 663-6326 if you have any question(s).) 10. 0 [Zf Will you be hanging any banners over public streets? If yes, please complete the Hanging Banner Application. (Please note: that all requests for banner over public streets must be reviewed / and approved by the City Commission, which meets only twice a month.) 11. [Y1' D Have you notified the event location neighbors about your event? Hanging Banner over Street Applicant pg. 14 /See Special Event Fee Schedule for cost detail PARKING DIVISION 12. ~~DNO Will you be renting any City parking meters? If yes, how many =._.. oi2IT (Please note: that if you are closing or interfering with any right-of-way that includes parking meters you are required to pay the meter fee as welL) 13. 14. Do you have enough on-site parking to accommodate your event? Will your event involve the use of a shuttle and/or alternate parking sites? Parking Meter Rental Applicant pg. 13 /See Special Event Fee Schedule for cost detail CODE ENFORCEMENT YES NO 15. 0" D Will you be having any music and/or loud sounds during your event? 16. D ~ill your event be starting before 8 a.m.? . 17. D cg./will your event end after 11 p.m. on a weekday and/or 12 a.m. weekend? PARKS AND RECREATION YES 18. D 19. D NO ~ Will this event take place in any of the South Miami City parks? (Please note: A rental fee will be applicable if a City Park is being utilized. Reservations are made through the Parks & Recreation Department (305) 668- )232). g Will this event require the use of any Parks equipment or staff? 4-16 NJTIFICATION / PETI-LION Event Name: Su'OStt on S\J\1Se-+ Event Date: _..!..JH!.--"-L\..!-\ ~. t.!.-.:2-=--,,-,_ We, the undersigned businesses and/or residents, have been notified of street closures assoCiated with the event noted about on said date, and hereby agree or disagree to the closure(s). We are also aware that this response may not effect this application being approved or disapproved. Approved ~sapproved D Disapproved D Disapproved D B\oe.-hsh ~FO(+-Approved gDisapproved D '-.j Disapproved D Llnnrn'I<:"" ~sapproved D Approved [Q(Disapproved D 6-16 ____ ~----____ ----\I" GE~iRAL REQUIREMEN lS Section I ./' When marking any public street, curb and/or right-of-way no permanent marking substance may be used. All marking agents must be removed immediately after the completion of the event. ./' Barricades shall require an additional rental fee established by the Public Works Department if a City Sponsored Event. If not sponsored by the City, then you must rent barricades through a barricade company . ./' No pegs, stakes, or anchoring devices shall be driven into the concrete, asphalt, or City hardened right-of- way. . ./' Map of route or site plan of the scheduled event including all stations and descriptions of activities . ./' Any temporary cover for stations such as a canopy shall be flame retardant and applicant shall provide proof of such certificate . ./' Review of applicant's paper work to note location, any food sales, volume of noise/music and duration . ./' 72 hour notice given to all merchants whose street would be closed. Please initia~ --=----- Section II ./' In the event of a parade, a permit from the South Miami Police Department must be obtained . ./' If Police service for traffic and/or crowd control is required, arrangements will be made through the City of South Miami Police Department for off-duty Police officers. The Police Department will determine the number of officers required. (Please be aware that costs might change on a yearly basis) . ./' Code Enforcement Department will check on each event to make sure that all codes and regulations are being adhered to . ./' All parking issues will be reviewed through the Planning Department, Parking Department and/or Code Enforcement Department." . , "1. ..' .' .."." •• " ! > Public liability insurance coverage certificate naming "th'e City of South Miami as an additional ". insured for the time, date, place and name of the event, in the amount of $1,000,000 isrequiredp'rior to the event! ./' Barricades: The average hourly rate for 125 Barricades for one (1) day usage is approximately $80.00. Please initial ~ ---.::::.------ Section III > Specific Requirements: All organizations sponsoring special events using public property or public streets within the City of South Miami must receive prior approval by resolution from the South Miami City Commission. The resolution must include the estimated reimbursement amount to be paid to the City for all City revenue loses and City expenditures associated with the approved special event. The adopted resolution may also specify an additional monetary contribution to be made by the organization to the City: the resolution shall specify how the additional monetary contribution is to be used by the City . ./' A majority vote of approval (one-month in advance) by the City Commission will be required for large events . ./' Deposit of Six Hundred Dollars ($600.00) to defray cost of litter clean-up, must accompany application, plus a permit fee of $60.00. If clean-up is not required, deposit may be refunded. The litter deposit may differ depending upon the event. ($100.00 will be retained by the City as an Administrative processing fee deducted from the $600.00 deposit). > (Please be aware that rates shall increase on a yearly basis, due to cost of living increases). > For Grant Recipients: Payment of these charges could be deducted from the designated grant amount approved by the City . ./' Public Works -The average hourly rates are approximate $40.00 per DQIl-supervising employee, per hour, and $45.00 for supervising employee, per hour. Please initial ~ 7-16 Sept 2th 2012 I, lindsay Borden -the Regional Manager of Florida for iuiulemon athletica, give Cristina Suarez permission to sign the Indemnification Page that is part of the special event application. Please let me know if you have any questions. 239 216 6262 Best, lindsay Borden Regional Manager of Florida Lululemon athletica IND~~~V1NIFICATION AGK 3MENT " --------------------------------------------~--------~~++~~~rlT~~ THIS AGREEMENT ("Agreement") is entered into by and between ~-"LJ'--'<-~'-"--'--"-"'-"--'L---".L:LJ'-"-"-~.::-.:...-=--=-"---­ ("Applicant"), and the City of South Miami ("City") on the date on which the last of the Parties executes this Agreement. RECITALS . WHEREAS, the Applicant has submitted a Special Event Permit Application to the City for (event title) , . _ . ( SIt"'" (;lvL '" . 8u n<3t-"t 0 Y\ l<1\) Mt:.-r-at ~VhS:t* d HVt.,;· 'HI 58"'''' ~ (locatIOn) on (date(s» Novthl \?t V 1\. ZOi?.. . ("Special Event"); and WHEREAS, pursuant to of the City's Code and the City's Special Event Regulations, the Applicant must execute an indemnification and hold harmless agreement protecting the City from any and all claims which may arise out of the Special Event. NOW, THEREFORE, in consideration of the matters recited above, the mutual covenants set forth herein, and other good consideration the receipt and sufficiency of which is hereby acknowledged, the Parties hereby agree as follows: 1. The above recitals are true and correct. 2. Applicant agrees to indemnify, defend and hold the City, its officers, affiliates, employees, successors and assigns, harmless from and against any and all such claims, suits, actions, damages, or causes of action arising as a result of the Special Event, or of the condition of the site on which the Special Event is held including any personal injury or loss of life, ordamage to or loss of property, and from and against any costs, attorney's fees, expenses or liabilities incurred in and about the defense or settlement of any claims, and the investigation thereof. 3. Permits for Special Events must be on event site at all times. 4. No Street shall be closed without authorization from the City of South Miami Public Works Department and Police Department. S. Traffic shall be maintained in accordance with Florida Department of Transportation (FDOT), Miami-Dade County standards and any additional requirements by the City of South Miami Public Works Department and Police Department. 6. Event areas shall be restored to equal or better condition than they were before the event started. 7. If all restoration work is not performed within 30 days of work completion, the City of South Miami Public Works Department may restore the event area and charge the applicant for the cost of restoration plus a minimum of 1S% for administrative fee and any additional incidental fees. . 8. Applicant must pay all fees prior to the start of their event(s). 9. Applicants that receive approval for their event more than thirty (30) days in advance shall notify the Cityof South Miami Special EventiMarketing Coordinator at least forty-eight (48) hours prior to start of their event. 10. Any damage to private property shall be restored to its original condition or better and as accepted by the Owner. IN WITNESS WHEREOF, each of the parties hereto has caused this Agreement to be executed and sealed by its duly authorized signatory(ies) on the date set forth below and notarized. NO NATURE Subscribed and sworn before me, this Lf-tL day of ~dOiJ.., a Notary Pu lic in and for \-1, aM-~ County, of nOJ1,aa. Signature (NOTARY PUBLIC) 8-16 APP!.! CANT'S TITLE 8{1t=/i1- DATE: I L ELLINGSWORTH I, . . # DO 908578 commiSSion 2013 MV commission Expires 09-06- Bonded lhfOugh AtlantiC Bonding Co. 10C. DEPARTMENTAL APPROVAL SHEET REVIEW BY CITY OF SOUTH MIAMI DEPARTMENTS: Each department will provide estimate of number of personnel required from their department to provide appropriate services for this event, along with an estimate of cost to applicant. OFFICE USE ONLY: Major of Operations Authorization Signature: ____________________ _ Chief of Police Authorization: Comments/Conditions Authorization Signature: __ ~ ________________ _ Oate: ________ _ Amount.;:,:$ _____ _ Date: . -----------Amount $ -'------ Commen~s/Conditions: __________________________________________ _ Authorization Signature: ___________________ _ Oate: ________ _ Amount.;:,:$'---____ _ Comments/Conditions: ------------------------------------------- Oate: ______ -,-__ _ Amount...!.$ _____ _ Comments/Conditions: Authorization Signature: ____________________ _ Oate: ________ _ Amount..;,:$ _____ _ Comments/Conditions: Authorization Signature: ___________________ _ Oate: ________ _ Amount...!.$_--,-___ _ Comments/Conditions: SPECIAL EVENT DIVISION USE ONLY: PennitNO: --~-------- Event Name: __________ ---'-'-'-__________ Date: ______ Resolution NO: __ ---'-~ _____ _ No. of Days No. of No. of Total Remaining Til Event: __ ~_Approved Dep. _____ Disapproved Der. _____ Estimated Cost ...,;$ ___ ---'-____ _ Comments/Permit Conditions:--,.---,. _________________ --;-,--___ ---,-~-~;----___ -:---,...,i ___ _ It' $' •• ,_, Fj ~.f.J;-'; '"'" ~ ~ CiTY"MANAGEROFRCEUSEONLY':'""'·'w":"";"'''''''''''..,'''''''''' ... /N' .... '_ .... 'P'U'A'''''''''''''''' ..... /#/··tr/""''''/",..·''I'7'''''''"/¥/.''''''', .... R~~~1·;;''''';1~j;;'"i;rA$''~~6~1'·'!' .. ,.K/A'" .... /...,.""""'''';'''''''''''''''''.:/..,w __ .'' • .,'WKM.''.', .. / .. w''''''"''"'''''', •. /. 'f· t . '. j Comments/PermitConditions: __ ---,-___________________________ --c--------- Authorization Signature: Date: 9-16 www.sunbiz.org -Department of State Home Contact Us E-Filing Services Previous on List Next on List Return To List Name History Detail by Entity Name Foreign Profit Corporation LULULEMON USA INC. Filing Information Document Number F06000007086 FEIIEIN Number 753060494 Date Filed State Status Last Event Event Date Filed 11/13/2006 NV ACTIVE NAME CHANGE AMENDMENT 08/16/2007 Event Effective Date NONE Principal Address 1818 CORNWALL AVENUE 400 VANCOUVER, BC, CANADA BC V6J1C-7 CA Changed 01/04/2011 Mailing Address 1818 CORNWALL AVENUE 400 VANCOUVER, BC, CANADA BC V6J1C-7 CA Changed 01/04/2011 Registered Agent Name & Address C T CORPORATION SYSTEM 1200 SOUTH PINE ISLAND ROAD PLANTATION FL 33324 US Officer/Director Detail Name & Address Title CEOD DAY, CHRISTINE MS. 1818 CORNWALL AVENUE, UNIT 400 VANCOUVER, BC, CANADA BC V6J1C-7 CA Title CFOD CURRIE, JOHN MR. 1818 CORNWALL AVENUE; UNIT 400 VANCOUVER, BC, CANADA BC V6J1C-7 CA Title TO Document Searches Page 1 of2 Forms Help Entity Name Search I Submit l httn' / /VJVJW <;:1 In hi z.orp-Iscrintsl cordeLexe ?action= D ETFIL&ina doc number= F060000070... 9124/2012 www.sunbiz.org -Department of State NEGUS, DAVID MR. 1818 CORNWALL AVENUE, UNIT 400 VANCOUVER, BC, CANADA BC V6J1C-7 CA Title SO NICHOLAS, ERIN MS. 1818 CORNWALL ACVENUE, UNIT 400 VANCOUVER, BC, CANADA BC V6J1C-7 CA Annual Reports Report Year Filed Date 2010 01/04/2010 2011 01/04/2011 2012 01/25/2012 Document Images 01/25/2012 --ANNUAL REPORT [ View image in PDF format ] ~:;:=::;:::::==::::::;:;:;==~ 01/04/2011 --ANNUAL REPORT [ View image in PDF format ) ;:::::=::::::=====::::::::::;==~ 01/04/2010 --ANNUAL REPORT .:;( ==V::. =ie=w=im=ag::e=i=n=P=D=F=f=or=m=a=t ==~] 05/19/2009 --AN N UAL REPORT .:;[ :::::=v=I=·e=w=im=ag::e::: .. i=n=p=D=F=f=or=m=a=t :::::~] 04/25/2008 --ANNUAL REPORT .:::[==v;:;I::·e=w::;im=ag::e=i=n::;p:;D::;F;:;.f=or=m=a=t=~] 08/16/2007 --Name Chanqe [ . V ... i.e.w image inP.D .. F.fo. rm. a .. t ] :;==~=====~;;======;. 04/13/2007 --ANNUAL REPORT [ View image in PDF format ] ·11/13/2006 --Foreign Profit [ .... "'-. "'-"'-. -"V ...... ie_w....;..i_m .... a.::-.g_e_in_P_D...;..F_fo_r_m_a .... t. _ ..... 1 I Note: This is not official record. See documents if question or conflict. I Previous on List Next on List Return To List Name Historv I Home I Contact us I Document Searches I E-Filinq Services I Forms I HelD I CODyriqht© and Privacy Policies State of Florida, Department of State Page 2 of2 : Entity Name Search . I RUblJlit .1 http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inq doc number=F060000070... 9/24/2012 OLI00I03 CITY OF SOUTH MIAMI -OL Business Master Inquiry -Licenses Business: 7806 LULULEMON USA INC. Business address 5734 SW 72 STREET Mailing address 400 1818 cORNWALL AVENUE 9/24/12 17:05:20 SOUTH MIAMI FL 33143 VANCOUVER, BC CN V6JIC7 Type options, l=Select Opt Lic Nbr 13 00009864 12 00009864 11 00009864 press Enter. Classification RETAIL & WHOLESALE RETAIL & WHOLESALE RETAIL & WHOLESALE TRADE TRADE TRADE Status AC RN RN Amount F3=Exit F5=Officers Total Amount Due F7=Miscellaneous information F12=Cancel Due .00 .00 .00 Bottom .00 OL110I01 Business control nbr . : License number . . . . : Pin number . . . . . . : Business name & address CITY OF SOUTH MIAMI -OL License Master Inquiry 7806 13 00009864 8946 Last activity: Mailing address 9/24/12 17:05:35 LULULEMON USA INC. 400-1818 CORNWALL AVENUE 5734 SW 72 STREET VANCOUVER, BC CN V6J1C7 FL 33143 RWT ACTIVE 5/04/11 9/30/13 9/21/12 RETAIL & WHOLESALE TRADE 9/21/12 9/30/13 .00 9/20/12 SOUTH MIAMI Classification Exemption applied License status, date Appl, issue date . . . Expiration, valid thru Gross receipts amount . Date renewal printed Date printed, reprinted Prior license . . . . . Municipal code reference Press Enter to continue. 12 00009864 F3=Exit F5=Additional charges F6=Charges F7=Miscellaneous F9=Additional requirements F10=Receipts More ... information F24=More keys CITY OF SOUTH MIAMI PARKING DIVISION 6130 Sunset Drive, South Miami, FI 33143 (305) 668-2512 Fax (305) 663-6346 Parking Stalls/Meters Rentals Application South Mlantl Florida bftd ifl1r, 2001 Pursuant to Section 15 C-l (a) (2) (b) of the Code of Ordinance, "Rental Fees for Public On/Street curbside spaces (Parking space) are $25.00 per space per day, seven days per week based on twenty-four (24) hour use". luluLtVYlDY1 CL +h!i tf ~ Drt&+l nD &[Q y-~ '"L. Business/Organization Name Applicant Name 5704 cSUYJ,&tt-dJ'V0 Mtami F-L Business/Organization Address City State , Zip Code ~a5) G C :;-6'17'6 ___ _ Phone Number Fax Number E-Mail avo y tz Q) Iv \\)11 WlOYl. CLOW) Name of Event: I.SUYl&t.± OY) (St)nRLt Type of Event: VOSQ C1JLb~'OV) Purpose for utilizing parking meters: yoga pta dtu <sraca" +htCJ(J0b (Dad cLMv'({ d: paY t~~ JT2Q.Ol) alo~ <SVYl&L-r CH\VL be+WlI_n S~*'" CMv! .d: se~ Q,V-0 Number of On/Street?,,\. Number of Day's Start curbside spaces requested: ~U curbside spaces desired: ----''----Time: _--.J4L--_ 116 t--_-+-________ --II--' .......... _-t-.-....a.o"-'--....-~ __ __t_----___1,2.\ ~ ______ ~ ________________________ ~ __ ~~ __ ~ __ ~~~~~~~~~~~\2; (If necessary, please attach additional sheets) J Z 3 I hereby certify the above information is true, correct and complete as of the date of this submittal. It is understood that j 224 this applicant will be reviewed and may be adjusted periodically by City Staff; if any information should change that I shall . amend or supplement this application within five business days of the change. L'L5 CiJJ:1;t.;u&: (0 JJr I!J,,/ 'OJ#: It 2-~il APPlicant'~ I Dat~ FOR OFFICE USES ONLY: Permit No: --------------o DENIED D APPROVED AS PRESENTED 0 APPROVED WITH CONDITION NO. Meter Days: , ?C-NO. Meter: 3 \ X Daily Fee: ~ 115.00 commekti. PARKING DIVISION SIGNATURE 14-16 q-21-/2 DATE 1$ 'IS, ,-?O Estimated Total Cost CITY Of--=>OUTH MIAMI PLANNING & ZONING DEPA.,. MENT 6130 Sunset Drive, South Miami, FI 33143 (305) 663-6326 Fax (305) 668-7356 Hanging Banner Over Public Street Request Form for Special Event South Miami Florida 2001 Application for the purpose of requesting approval to display banners over public streets promoting events as set forth in Ordinance No. 1 0-07 ~ 1911; LDC Section 20-4.3(N). Complete this permit application form and submit the application to the Planning & Zoning Department located in the Sylva Martin Building in front of City Hall. This application must be submitted at least 30 days prior to the event date. An application fee of $300 must be paid at time of submittal. If approved by the City Commission, this fee covers installation and removal of banner. If approved, take the permit and the banner to the City's Public Works Department located at 4795 SW 75 th Avenue Miami, FL 33155, at least one week prior to the installation date. The Public Works Department will install and remove the banner on the dates specified by the approved permit. Name of Non-for- Profit Organization _________________________________ _ Organization Address Phone No. Authorized Re- presentative Name Rep. Title -----------------~-~----------- < '. ' '," < EVENT ' Event Name: Event Date: Event Type: . ----------------------------------- Approximate Installation Date Requested: . thru --------------------- Banner Location Requested: 05800 Sunset Drive D 5880 Sunset Drive Briefly describe event for which you wish to display a banner in South Miarrti: ~------------- ~ ,Applicant understands that the Banner installation is 10-14 days before the advertised event day. ~ Installation and removal dates are based on workload. The City is not responsible for the condition of the banner during this period. ~ Applicant agrees to pickup banner within seven (7) days after the event. The city may discard the banner(s) after the specified period. ~ Banner Specifications-30ft X 3-4ft wide, 60ft of ~ (halQ nylon rope with hooks and the banner must vents. Applicant's Signature PLANNING & ZONING OFFICE USE ONLY: }> Illustration of banner showing heigbt. width of the banner, and lettering }> Copy of liability and/or property damage insurance required }> . Application fee $300 (per application) City Commission.Appr6val Resolution No. ----------------------- Comment: Date SUBMITTED REC'D BY: INITIAL o o o Comm. Date: ~----------------- ---------------------------------------------- 15-16 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY) ~~ 09/28/2012 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 CONTACT NAME: Marsh USA Inc., Multinational Incoming Unit flJgNrJo Extl:21 0-691-4100 I FAX iAlC, No): 210-737-3584 a service of Seabury and Smith, Inc. E-MAIL 9830 Colonnade Boulevard, Suite 400 ADDRESS: PO Box 659520 INSURER(S) AFFORDING COVERAGE NAIC# San Antonio TX 78265-9520 INSURER A : ALLIANZ GLOBAL RISKS US INS CO INSURED INSURERB: Lululemon Athletica Inc. alo Lululemon USA Inc. INSURERC: 400 -1818 Cornwall Avenue INSURERD: Vancouver, BC V6J 1C7 INSURERE: INSURER F: COVERAGES 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 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. INSR ADDL SUBR (~J6%ivWYl (~gl-~'6ivWYl LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER LIMITS A GENERAL LIABILITY CGL2003478 11/01/2011 11/01/2012 EACH OCCURRENCE $1,000,000 i--DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES lEa occurrence) $100,000 i--o CLAIMS-MADE ~ OCCUR i--MED EXP (Anyone person) $5,000 i--PERSONAL & ADV INJURY $1,000,000 i--GENERAL AGGREGATE $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $1,000,000 I n PRO -n $ POLICY JECT LOC AUTOMOBILE LIABILITY fE~~=~~t)SINGLE LIMIT $ - ANY AUTO BODILY INJURY (Per person) $ -ALLO\NNED -SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ --NON-O\NNED ~~?~~~d~t?AMAGE HIRED AUTOS AUTOS $ -- $ UMBRELLA LlAB H OCCUR EACH OCCURRENCE $ - EXCESS LlAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION I WCSTATU-I IOTH- AND EMPLOYERS' LIABILITY TORY LIMITS ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE D NIA E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional RemarKs SChedule, if more space is required) Store #10725: Organizing a yoga event called "Sunset on Sunset" to be held on Sunset Drive between 57th and 58th Avenue in South Miami, FL from 4 PM -7:30 PM on November 11, 2012 The City of South Miami is included as an additional insured on the General Liability policy as r~Uj,.J;ed~b""~W.j;,jA;A;,ea._=ntr;aGt.,, .• __ .,,~._ .• _._ •••.... 1iJ!?< t'ERTIFICATE HOLDER City of South Miami 6130 Sunset Drive South Miami, FL 33143 I ACORD 25 (2010/05) DS#32281567 2 8 iO'7 ,_ . L. , CANCELLATION SHOULD ANY OF THE ABOVE d~kij*~~&\~JLf&~M~:6WNCELLED:~~FORE THE EXPIRATION DA TE frER1:'O'F;-~'1"lOTTC1:'-'WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ~ J\A1M1;.HJ1.. ---© 1988-2010 A~ORD CORPORATION. All rights reserved. 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