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2To: From: Date: CITY OF SOUTH MIAMI OFFICE OF THE CITY MANAGER INTER-OFFICE MEMORANDUM The Honorable Mayor & Members of the City Commission Steven J. 'Alexander, City Manager April 16, 2013 Agenda Item No.: South Miami hftd fqrr 2001 Subject: A Resolution authorizing the City Manager to permit Team FootWorks Educational and Fitness Corporation, a non-for-profit organization to hold its 2Sth Annual Twilight SK WalklRun event on Sunday, June 2, 2013, in South Miami's downtown area and surrounding streets. Background: Team FootWorks Educational and Fitness Corporation is a non-for-profit organization, which submitted a Special Event Application to request permission to hold its event, the Twilight 5K Walk/Run, on Sunday, June 2nd, 2013, in South Miami's downtown area and surrounding streets. For the past 25 years, Team FootWorks Educational and Fitness Corporation has held their Twilight 5K Walk/Run in the City of South Miami, providing a health initiative, along with the ability for avid and beginning runners to participate in this special event. Each year Team FootWorks Educational and Fitness Corporation awards a charitable designation to receive a donation, and this year it is the South Miami Police Explorers. The applicant paid a total amount of $660.00 for the deposit and application fee. In addition, the applicant will pay the following fees: • Police: $2,340.00 • Public Works: $ 720.00 • Street closure & MOT: $463.75 (lOSS linear feet X .25 = $263.75 + $200 MOT) • Parking Meters: $ 1,450.00 (58 meters X $25.00 per day) Final amount for services rendered is $4,973.75; the applicant will pay prior to the event; unless directed differently by the City Commission. Expense: $4,973.75 Account: Not Applicable Attachments: Proposed Resolution 1 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 RESOLUTION NO. _____ _ A Resolution authorizing the City Manager to permit Team FootWorks Educational and Fitness Corporation, a non-for-profit organization to hold its 25th Annual Twilight 5K WalklRun event on Sunday, June 2, 2013, in South Miami's downtown area and surrounding streets. WHEREAS, Team FootWorks Educational and Fitness Corporation, a non-for-profit organization, has submitted a Special Event Application; and, WHEREAS, for the past 24 years Team FootWorks has held the Twilight 5K Walk/Run in the City of South Miami, sponsored through various local businesses; and, WHEREAS, the applicant has requested permission to hold its event on Sunday, June 2, 2013; and, WHEREAS, the applicant has paid $600 for the deposit and $60.00 for the application fee; and, WHEREAS, the applicant will pay for all services rendered by Public Works $720.00, Police $2,340, Street Closure $463.75 (l055 linear feet X.25 = $263.75 + $200.00 MOT), and Parking Meters $1,450.00 (58 meters X $25.00 per day per meter), totaling $4,973.75. 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 25 th Annual Twilight 5K Walk/Run event to be held on Sunday, June 2nd, 2013, downtown South Miami and surrounding streets. Section 2. Payment for this special event will be provided by the applicant prior to the event; unless directed differently by the City Commission. Section 3. 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 _____ , 2013. ATTEST: APPROVED: CITY CLERK MAYOR Page 1 of2 1 2 3 4 5 6 7 READ AND APPROVED AS TO FORM, LANGUAGE, LEGALITY AND EXECUTION THEREOF CITY ATTORNEY Page 2 of2 COMMISSION VOTE: Mayor Stoddard: Vice Mayor Liebman: Commissioner Newman: Commissioner Harris: Commissioner Welsh: 5724 Sunset Dr. South Miami, FL 33143 To: Steve Alexander City Manager City of South Miami Mr. Alexander, 305-666-RACE www.teamfootworks.org 3/6/2013 This letter is to accompany our special event application for the Twilight 5k Run Walk. The Twilight 5k is a healthy and wholesome family event based on exercise, fun, and music. This will be the eighth year my grandchildren along with many of their friends and extended families have participated. The attached route map and venue layout should provide a fair overview ofthe event. Supported by the Baptist South Miami Hospital and Town Kitchen and Bar, the run/walk will take place on Sunday evening, June 2nd, 2013. As we have in the past, the Twilight 5k will designate the South Miami Police Explorers as the charitable beneficiary for the run. If you have any questions please do not hesitate to calL Sincerely, ~ JO~" Huseby Race Director TeamFootworks is a 501(c)(3) not-for-profit corporation committed to fitness education through the production of events and educational material. Throughout the year, we offer training programs and events to promote fitness. FEIN: 65-0455073 SUM1viAR Y OF EVENT 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 GZJ Charity 0 Festivals D Celebration o Promotion Other: -4te~~N~t-U~~=ut~ _____ _ NAME OF EVENT: Z:'I-14t1l7 s« &.tAl tVAc.If LOCATION OF EVENT: __ ~J~~~~Z~~~~~r_' _~~~8~~~S~7~C~/ __________________ ___ (Please note: write complete mailing address, as well as name of any buildings and/or parks if applicable) Is this an annual event? D No [aYes if yes, this is the l. S annual event, previous datecik .IiOU .. EVENT DATE(S): ____ D--'l..~J ..... \JtIJ,."".-I$-=~-../'_"l"__ __ EVENT DAY (S): ___________ _ ACTUAL EVENT HOURS: ':0<> a.m.([ffi> UNTIL: 8:(1() a.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) ASSEMBLY DATE(S): 8~ JvtAJS SETUP/DOWN TIMES: /2. ~.Ip.m. a.m.lp.m. --~~~===--------- ANTICIPATED ATTENDANCE: ____ /I.=..:..CS'O--,,-_ TOTAL EVENT DURATION: , hrs .$0 mins ---"-- Name: Name: _-"'Jor....;f'-----'-J.l~v~$S~4¥-r _____ _ Title: Title: /Jilt tJlC!rM Cell/Phone: JoS _ "" 12..1. 1 Cell/Phone: J()S ~c" 1 l.1 J Email: .;.t.H~ <:!> t§)!t~~S.(!)"j Email: JP <vk~/·~ ~,§yg~I~:gJ~~§.Bl~t!QJ-j1~NR;;eARag:§'g:;;*t!!¥,';f'~~\;c~fn,1\~1i, sA-,fvN tJNt &. G-rlUlSll ~ {;;N 1-16 APPLICANT/SPONSOR INFORMATION 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. --I'~ NAME OF ORGANIZATION: ~~~~~M~~U~~~ZL~~~~k~~~~~~~~~~~~~~_ ADDRESS OF ORGANIZATION: $71.4 S""~~l I~'VS S.:> Mc..;\ ... , fi .s.~/1' l OFFICE TELEPHONE: &OS pb' lJ,l.l FAX: JOS I:/pJ 17" 0 SECRETARY: _~_~ ____ ~_ ADDRESS: ..sa M...w.t E( J~/~J PRES. PHONE: 40$ """ luJ EMAIL: /£.,.,!. 0 t.QM:W~S '~j SEC. PHONE: ___________ EMAIL: _____________ _ If the organization is a tenant and/or renter of the event location, please have the property owner complete the following: o Applicant/Organization owns the event location o I give permission for the Applicant/Organization to use my property. Comments: --------------------------------------------.-------------- Property Owner's Name: __________________ Phone: _________________ _ Property Owner's Address: Property Owner's Signature: _________________ _ Date: ________________ _ Notary Signature: ___________ ~ 2-16 NOTIFICATION I PEIl'II0N Event Name: ~\L..~l'" St R.v~~Ac..k. ~ Event Date: c!) 2.. 3",;)'&-2...0\ ~ We, the undersigned businesses and/or residents, have been notified of stree't 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. ' %f136. 13bl Sw Sl~ Court ~ \SO 6-16 Disapproved D Disapproved 0 IAor)rovl~a ~isapproved 0 NOTIFICATION I PEITI'ION --=-Event Name: \~\Ll&.~ sk. Rv,.)vjA"", Event Date: 02. ~~"& t...o( ~ f 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. nnrr'\I"'n~ Disapproved D 6-16 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) ~ 3/8/2013 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 Judy Weaver NAME: STAR Insurance -Fort Wayne Office , rlJg~~o. Extl: (260) 467-5697 I rffc. Nn\: (260) 467-5651 2130 East DuPont Road E·MAIL judy.weaver@starfinancial.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# Fort Wayne IN 46825 INSURER A: National Casualty Company 11991 INSURED INSURER B: Nationwide Life Insurance Co. 66869 Road Runners Club of America 2013 & Its INSURERC: Member Clubs INSURERD: 1501 Lee Highway, Suite 140 INSURER E: Arlington VA 22209 INSURERF: COVERAGES CERTIFICATE NUMBER'2013 -$2M A. I. 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 TYPE OF INSURANCE ~~~i ~; I lOLICY EFF 11~3r6%~ LIMITS LTR POLICY NUMBER MM/DDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 t--~~~~~~J?E~~~~~~ncA\ r1L AMMERCIAL GENERAL LIABILITY $ 500,000 A CLAIMS·MADE W OCCUR X ~O 000000 3086700 ~2/31/2012 ~2/31/2013 MED EXP (Anyone person) $ 5,000 r--t--' r1L Le2al Liabilitx to 12:01 A.M. 12:01 A.M. PERSONAL & ADV INJURY $ 2,000,000 Participant $2,000,000 GENERAL AGGREGATE $ NONE t-- @'LAGGRnE LIMIT AnS PER: ~use & Molestation PRODUCTS· COMP/OP AGG $ 2,000,000 X POLICY ~fP.,: LOC ~ggregate $5,000,000 ABUSE & MOLESTATION $ 500,000 AUTOMOBILE LIABILITY fE~~~b~~~tfINGLE LIMIT $ 2 000 000 c-- A ANY AUTO BODILY INJURY (Per person) $ ,-ALL OWNED r--SCHEDULED ~O 000000 3086700 12/31/2012 ~2/31/2013 AUTOS AUTOS X BODILY INJURY (Per accident) $ X rx NON-OWNED 12:01 A.M. ~2:01 A.M. rp~~~;Sle~t~AMAGE $ HIRED AUTOS AUTOS -r- $ UMBRELLA LlAB HOCCUR EACH OCCURRENCE $ -EXCESSLIAB CLAIMS·MADE AGGREGATE $ OED I I RETENTION $ $ WORKERS COMPENSATION IT"X~~T~#~I IOJ~' AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE D N/A EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE· EA EMPLOYE $ g~~'M~i[~~ '!)'$'i)PERATIONS below E.L. DISEASE -POLICY LIMIT $ B EXCESS MEDICAL & ACCIDENT X ~PX 00000 25699000 ~2/31/2012 2/31/2013 EXCESS MEDICAL $10,000 ($250 DEDUCTIBLE/CLAIM) ~2:01 A.M. 2:01 A.M. AD & SPECIFIC LOSS $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED AS RESPECTS THEIR INTEREST IN THE OPERATIONS OF THE NAMED INSURED. DATE OF EVENT: 06/02/13 Twilight 5K INSURED CLUB/EVENT MEMBER: TeamFootWorks, attn: John Huseby, 5424 Sunset Drive, South Miami FL 33143 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 06/02/13 City of South Miami ACCORDANCE WITH THE POLICY PROVISIONS. 6130 Sunset Drive South Miami, FL 33143 AUTHORIZED REPRESENTATIVE John Lefever/LORENZ ~-/.J?\.~ c::::------,?/ ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (?01nn.~\ 01 Tho A~()Rn n::llmo :::lInn Inn" :::.ro ronic:fororf tn::llrltc::: nf Ar.:nRn \ \ \ \ \ \ \ TwfU:ght 5k . Miami, FL. .t: ~ I S Red Rd~~. -----:----:-7-....,-..: £J ~r---i ---,-----, .-. oS I....-jf-lf . ~ i . i en .r:: ~ ·z 3MI Lr J~1--I_ . SW 59th. Ave... 00 r----------...., Start Detaii ~ SW 58th. Ave. . . I...,:· I !. i 3:' en Finish Is 13 Ft 3 Inches south of light post at drive thru entrance to First· NatlQnal S·ank of .. ~outli Miami ori 57 Court.· . SW 62nd Ave. .-d.! '4-. 1 mile Is on 87 st Just before 60th Ave. . 2 Ilill~ Is on 84 St Just past 62 Ct. 3 l)1i1e Is on 74 Ter Just past turn off of 58 St .. USATF Cert. # F~ 1 0055E8M effective 6/03/2010 to 12/31/2020 ~ SW.65th Ave. l .\ l· ~\~, , ·1 I Start is 81 ft. 11 inches north of S~nitary sewer at middle of:the slreet at SW 74 Ter and 58 th ~ve. \ I (/) ~ .. ..... oc;t. ....... ;: (f) ~ct. i~! Course measured by Don Matus:zal( and David Raybon. 786-525-3540, donaldmatuszak@comcast.net INDEMNIFICATION AGREEMENT --. --1-THIS AGREEMENT ("Agreement") is entered into by and between tlS'",M. t;-"e'I W~F ~ ("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) 'T '"'U\.Y.WL7 ~ \c:. &.,,~ ~",c..k. at. ~~ 1 ~ ~ !-~'-V S'1 C\ (location) on (date(s» <!)1, j.,A)'S ).,.0 \'\. . ("Special Event"); and \VHEREAS, 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 indemnity, 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, or damage 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. 5. 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 15% 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 City of South Miami Special EventlMarketing 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. U~ k=:oTvj~ So PRINT NAME APPLICANT APPLICANT'S TITL k~ 8-16 ~~~~~:r~ DAPH~E. CHARBONNEAU f,.: ~~ ComIl1lSSIOll #EE 125453 ~ ·11 Expires October 27, 2015 "':f,P.r.~~i< Bonded Thru Troy Fain Insumnce 8QO.385-7019 CITY OF SOUTH MIAMI POLICE DEPARTMENT 6130 Sunset Drive, South Miami, FI 33143 (305) 663-6301 South M"1a. .. '1 1:""'1 0 ... Ida Ib~~ Extra-Duty Police Officers Application ~lilr' "%001 A police officer for employment that is indigenous to their law enforcement authority commonly referred to as "Extra-Duty" employment. The following policies and procedures must conform in order to schedule a police officer for employment on a temporary or infrequent basis: >-The South Miami Police Department shall be the final authority in determining the minimum number of officers required to police a particular event. If more than three officers are hired, a supervisor must also be hired. The City Manager Office and South Miami Police Department will determine the supervisor to officer ratio for larger events. >-The Applicant will be required to compensate the assigned officer for a minimum of three (3) hours even if the event is of a shorter duration. Currently the rate for Extra-Duty Police Officer is $40 per hour & $50 per hour for Supervising Officer, plus a S3.00 charge for radio usage for each officer. >-The Applicant must compensate the officer(s) for their services at feast one (1) day prior to the start of the scheduled event that the officer(s) will be assigned to. No monetary payment will be accepted. No payment by exchange of goods or services is acceptable. >-If, during a scheduled event, the Applicant determines thathe/she needs to extend the time an officer{s) works at the assignment, the Applicant shall compensate officer(s) for a full hour worked if the Officer(s) works for more than 20 minutes and/or less 59 minutes beyond the regularly scheduled time of the event. >-Applicant must notify of a cancellation request of an Off-Duly Police Officer forty-eight (48) hours prior to the scheduled date of service. Failure to do so will require the Applicant to compensate the assigned officer for a minimum of three (3) hours. APPLICANT INFORMATION '1" i", iY··? < • eo" Business/OrganizatIon Name Sl~ ·~vOo)c.:s-T ~,,"J Business OrganizatIon Address -e ... ? ' b-' {.' Applicant Name ~ r\ '''''''''''' City State Zip Code -, '--4 Phone Number Fax Number :\\~s.~t.~~t~~'~:a E-Mail 4:t. "' 1Si_1llla: ; ... it ... EVENT INFORMATION 6 ? . On-Site Contact Person ~\ \\(.cAT S k K-.J~ 0,,~ Name of Event " s: ".I!lf * p Cellular Number Event Location • J~ -• -i II $ ; -< g ._.5 .n>-; Type of Event lL.uC Anticipated Attendance I acknowledge and accept financial responsibilities to pay all costs and fees associated with this request form prior to ttie service date(s): ~~~nature Date FOR OFFICE USESONL Y: APPROVED AS PRESENT:,)9 0 DENIED D APPROVEDWITH CONDITION NO. Office: /3 x. NO. Radio: jZ) :x NO. HoursSe:, 7 --~~------ COMMENT: ____________ ~~~77--_r---------~--------------~_;------------~~~~~~~ ----J3·i ,Ie I J:J.. Estimated I ,,) POLICE DEPARTMENT SIGNATURE 1 DATE ~:sjJt) /0 Total Cost $ 23$1(L 0 V 11-16 , Stout-Tate, Maria From: Landa, Rene Sent: Monday, April 01, 2013 3:35 PM To: Stout-Tate, Maria Subject: FW: Maria: FYI Major Rene Landa Operations Major, SMPD FBINA 206 6130 Sunset Drive South Miami, FL 33143 305.663.6310 office 305.663.6353 fax 305.663.6301 main line Page 1 of2 Please note: Florida has a very broad public records law. Most written communications are public records and available to the public and media upon request. Your e-mail communications may therefore be subject to public disclosure. If you feel that you are not the intended recipient, then pplease delete this message. From: Barzola, John Sent: Monday, April 01,2013 2:12 PM To: Landa, Rene Cc: Corbin, Larry P. Subject: RE: Major I utilized last year's numbers to calculate the number of officers and approximate initial cost. I broke down the numbers below: 1 supervisor- 2 officers- 10 officers- (I) ',(g/1 1200-2200 hours @ $50.00 an hour $500 It.> 1400-2200 hours @ $40.00 an hour $640 It... 1800-2100 hours @ $40.00 an hour $1200 3() Supervisor and 2 early officers work the staging area. Total: $2340 last year they utilized 15 explorers for this event. I spoke with Det. Mendez who is the Explorer advisor and advised they normally work this detail and receive a $2500 donation from the event. These explorers assist on traffic posts with minimal traffic. From: Landa, Rene Sent: Monday, April 01,2013 11:08 AM To: Barzola, John Subject: FW: 4/2/2013 CITY OF SOUTH MIAMI PARKING DIVISION South l\t:I.ml FJ~r.d. bed 6130 Sunset Drive, South Miami, FI33143 (305) 668-2512 Fax (305) 663-6346 ;1-'1(; Parking Stalls/Meters Rentals Application ~ , - ." '" ;;,", \, ~OOI Pursuant to Section 20-4.4 (l\-1)(3)(B) of Land Development Code. "Rental Fees for Public On/Street curbside spaces (Parking space) are $18.00 per space per day, seven days per week based on twenty-four (24) hour use". ~-;;.'\ ~<),..;'=-~ -1~..:) *~~ ~..:a~\'.7 Business/Organization Name Applicant Name S1LC\-~~Wfi ~4,,\l0" Business/Organization Address State Zip Code ~~ (Q~~ 11.1. '\. ~s ~ 1 ctl ~ _----"'-~...L:~~&t=__.:--"~=:;.... .. -'=-'~'--'---'~~-"'--...;.....;~_\Of. ___ ~....- Phone Number Fax Number E-Mail --Name of Event: \ '-o.)\hu,.(t S lc:. RwN ~A~ Type of Event: S \s ~..J 0 .... """ Purpose for utilizing parking meters: ---'~=3lI~C!ol...)'-l----------------- Number of On/Street curbside spaces requested: ---- '5 Number of Day's Start ~ End 1 \ I.' "'-" ~ __ -,,--_curbside spaces desired: _-"--_ Time: __ -_"'_'i.l_ p.m. Time: a.m. (If necessary, please attach additional sheets) I hereby certify the above information is true, correct and complete as of the date of this submittal. It is understood that 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. ~~~gnature Date FOR OFFICE USES ONLY: Permit No: -------------------o DENIED APPROVED AS PRESENTED 0 APPROVED V\(ITH CONDITION NO. Meter Days: __ 1,--"'"7"'1_ . Meter: 6<2.:> x: Daily Fee~2S. Q6/f£e 11e.~ /; Comment: ________ ~7L--77L-7.n~ ____ ----------------------------?_----------~ 3-ZCo~13 $ \450.00 PARKING DIVISION SIGNATURE DATE Estimated Total Cost 13-16 s.~ S) c ~ Ct!)~ • 4"oa ~l.~ ~L~ ~Ll... «t-l..~ 42.'" If.-t.. S _"L~ Cf..1.1 40~ ~\ ~(., ~S "" ~c.J.. ~~ 40~ ~l ~ THE CITY OF SOUTH MIAMI PUBLIC WORKS DEPARTMENT 4795 SW 75 th Avenue, Miami, Florida 33155 Phone: (305) 663-6350 -Fax (305) 668-7208 PERMJT# PERMIT APPLICATION FOR WORK WITHIN THE PUBLIC RIGHT-OIF-WAY Note: ALL FIELDS SHALL BE FILLED PROJECT LOCATION: S'-'.J 1 ~ ~ T t§ $ ~ S 1 c.. T APPLICANT: T ~ ~oI't ~ «lA-ie:. So NAME: JOWP'> 4\",..» .\\"s,S'S\.j' PHONE/CELL. # 1.0:) Cob" 11..t\ E-mail: 1\ ... ><:> ±-e~.\o:St..~~:'.Ot~ APPUCANrSADDRES&~S~l~l~~~~~~~.~~~~~~~~~~~~~~~'~~~~~~~~\~~~!~$~~~)~~~ . STREET CITY STATE ZIP I HEREBY REQUEST A PERMIT FOR THE FOLLOWING: (BE SPECIFIC ANDATTACH PLANS AND ADDITIONAL SHEETS) S k Kva.J ~ ,,\.ok. ESTIMATED PROJECT COST: $ ____ e~ ____ _ PROJECT DURATION: __ \;....l.L,'!'-=--=\.\~~~S ___ _ ANTICIPATED EFFECTS ONVEHICULAR AND PEDESTRIAN TRAFFIC DURING PROJECT IMAINTENANCE OF TRAFFIC PROVISIONS (INCLUDE PLANS OR SKETCHES): ~ . .An~~ . . . "IN SIGNING THIS APPLICATION, I UNDERSTAND THAT SEPARATE CITY AND/OR COUNTY PERMITS MAY BE REQUIRED FOR THIS PROJECT. FURTHERMORE, I AM AWARE THAT I AM RESPONSIB RING THAT THE f' OJECT IS COMPLETED IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AS STIPU ED IN THE PE IT APPROVAL OITIO· PRINT NAME & CONTRACTORS LICENSE NO. DATE FOR OFFICE USE ONLY RECEIVED APPROVED I COMMENTS PERMIT FEES + DATE DISAPPROVED + DATE PUBLIC WORKS AUTHORIZATION: __________ DATE: ______ _ V.l1.2007 ! SUNSET DRIVE. --=----! ~(.Ab~$ ------' REGISTRATION FIRST NAT BANK . __ --II I o~ I DISPLAY . • I o ')--w . ~~IfILl~L l~[ SW73ST -DISPLAY I Z 2 2 Z REFRESHMENTS s.S "" s: " ,If 2 PARKING FINISRI « • -,. ...... SW74ST -----_ .. _. __ ._--.. _---_._._-_ ... _ •... __ .. _ ..... _---.--------_. ------------'. CITY OF SOUTH MIAMI PLANNING & ZONING DEPARTMENT 6130 Sunset Drive, Soutll Miami, FI33143 (305)663.6326 Fax (305) 668-7356 Hanging Banner Over Public Street Request Form for Special Event South Mf~m' "1"'" o· r .. d" ' .. !ll!!w~d fijfll Application for the purpose of requesting approval to display banners over public streets promoting events as set ·forth in Ordinance No. 10-07-1911; LOC 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 Departmentlocaled at 4795SW 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 ?pecifiedbythe approved permit. -: .... '. . :., .. '" Nam~6fNon~for- Pr6fitOrganization 7cS'4M lPcr41C21?1ss Organization Address $71,$ ..r..J~7 ~,\JJ Phone No. so.S 61>6 7l,,2,3. Authorized Re-• pre~entative Name J()~IJ. HAMS' -I-/v~7 Rep. Title ?~4oYl Event Name:/tJ,l-.l6f.1T Z Event DateQ2.. . ]"""4 '1.$ Event TypesA?..J~ 0AJ\ Approximate Installation Date Requested: 24 tfA1 WI") . . . thru cP.l Jw.,4 UJ/J Banner Location Requested: D 5800 Sunset Drive ~880 Sunset Drive Briefly describe event for which you wish to display a banner in South Miami: ______ ----'-__ _ sit ~ ~ ~. NA) .f b"A»'~S ~ Applicant tinderstandsthat1he'Sariher-iristallaijonis10~14daysbeforethe advertisedevept diW ~ 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 thebanner(s) after the specified period. ;;-Banner Specifications-30ft X 34ft wide, 60ft of Y2 (halfj nylon rope with hooks and the banner must vents. . . S:±::~~t's Signature :lot 1;r lo/~ PLANNING & ZONING OFFICE USE ONLY: SuBlvITTfED REC'D BY: INITIAL ;;. Illustration of banner showing height, width of the banner, and lettering D >-Copy of liability and/or property damage insurance required ;;. Application fee $300 .(per application) City Commission Approval Resolution No. Comment: D D Comm. Date: -------------- ------------------------------------------------------- 14-16 II South Miami Hospital . BAPTIST HEALTH TeamFootWorks ~ 305.666.7223 ffi.QJI(U ~ ~[(U®~~ M~~ CJ FAMILY EVENT! FOOD A' MUSIC A' KIDS ZONE TWilightSk.org I ffi.Mm ~ ~cru®&& W'2ill~ CJ FAMILY EVENTJ FOOD,.., MUSIC,.., KIDS ZONE TWilightSk.org 110018 -~y \~ D[PARTM[NT OF REVENUE I Consumer1s Certificate of Exempt~ Issued Pursuant to Chapter 212, Florida Statutes DR-14 R.04/05 02/17/11 85-8012600365C-4 01/31/2011 01/31/2016 501 (C)(3) ORGANIZATION Certificate Number Effective Date This certifies that TEAM FOOTWORKS EDUCATIONAL AND FITNESS CORPORATION 5724 SUNSET DR SOUTH MIAMI FL 33143-5316 Expiration Date Exemption Category is exempt from the payment of Florida sales and use tax on real property rented, transient rental property rented, tangible personal property purchased or rented, or services purchased. -~y \~ DEPARTMENT OF REVENUE Important Information for Exempt Organizations DR-14 R.04/05 1. You must provide all vendors and suppliers with an exemption certificate before making tax-exempt purchases. See Rule 12A-1.038, Florida Administrative Code (FAC). 2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's customary nonprofit activities. 3. Purchases made by an individual on behalf of the organization are taxable, even if the individual will be reimbursed by the organization. 4. This exemption applies only to purchases your organization makes. The sale or lease to others by your organization of tangible personal property, sleeping accommodations or other real property is taxable. Your organization must register, and collect and remit sales and use tax on such taxable transactions. Note: Churches are exempt from this requirement except when they are the lessor of real property (Rule 12A-1.070, FAC). 5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for payment of the sales tax plus a penalty of 200% of the tax, and may be subject to conviction of a third degree felony. Any violation will necessitate the revocation of this certificate. 6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Central Registration at 850-487-4130. The mailing address is PO BOX 6480, Tallahassee, FL 32314-6480. Internal Revenue Service Department of the Treasury Washington, DC 20224 Person to Contact: [> Team Footworks Educational Telephone Number: and Fitness corporation c/o John K. Huseby 5724 Sunset Dr. South Miami, FL 33143 Refer Reply to: Date: (202) 622-8140 CP:E:EO:T:2 NOV 9 1994 Employer Identification Number: 65-0455073 Key District: Atlanta Accounting Period Ending: May 31 Foundation statris Classification: 509(a) (2) Advance Ruling Period Begins: January 1, 1994 Advance Ruling Period Ends: May 31, 1998 Form 990 Required: Yes Dear Applicant: Based on-information supplied, and assuming your operations will be as stated in 'your "application for recognition' of exemption, 'we have 'determined you are exempt'from-federal income tax undersecti6n501(a) of the Interrial Reventie Code as an organization describe~·in section 501(c) (3). Because "you are a newly created organization, we 'are not now making a final determination of your foundation status under section 509(a) of the Code. However, we have determined that you can reasonably be expected to be a publicly supported organization described in the section(s) shown above. Accordingly, you will be treated as a publicly supported organization, and not as a private foundation, during an advance ruling period. This advance ruling period begins and ends on the dates shown above. Within 90 days after the end of your advance ruling period, you must submit to your key District Director information needed to determine whether you have met the requirements of the applicable support test during the advance ruling period. If you establish that you have been a publicly supported organization, you will be classified as a section 509(a) (1) or 509(a) (2) organization as long as you continue to meet the requirements of the applicable support'test. If you do not meet the public support requirements during the advance ruling period, you will be classified as a private foundation for future periods. Also, if you are classified as a private foundation, you will be treated as a private foundation from the date of your inception for purposes of sections 507(d) and 4940.