Loading...
5THE CITY OF PLEASANT LIVING To: FROM: Via: DATE: SUBJECT: BACKGROUND: REVENUE: CITY OF SOUTH MIAMI OFFICE OF THE CITY MANAGER INTER-OFFICE MEMORANDUM The Honorable Mayor & Members of the City Commission Steven Alexander, City Manager Quentin Pough, Director of Parks & Recreation r April 17, 2018 Agenda Item NO.:~ A Resolution authorizing the City Manager to permit Team FootWorks Educational and Fitness Corporation, a not-for-profit organization, to hold its 30th annual Twilight 5K Run/Walk event and to waive the cost of parking meters. Team FootWorks Educational and Fitness Corporation ("the applicant"), a not-for-profit organization, has submitted a Special Event Application to hold its 30th annual Twilight 5K Run/Walk event on Sunday, June 3 rd , 2018 from 6:00 PM to 9:00 PM. The Twilight 5K Run/Walk allows participants of all skill levels to partake in a fun, safe run/walk in the downtown South Miami area and surrounding streets, beginning at 74th street and 58 th avenue, ending at 57th court and 73 rd street. The applicant will have a stage and tents at the end of the race located at 57th Court and 73 rd Street; all sidewalks will remain open to the public. All public property including sidewalks, street gutters, etc. shall be cleaned by the applicant. Barricades and police vehicles will block traffic at all intersections. The applicant has submitted the necessary Notification/Petition Form signed by businesses that will be affected by the requested street closure. Upon approval of this event the applicant must provide the City with the required Certificate of Liability Insurance that complies with the City's standard insurance requirements, including naming the City of South Miami as an additional insured prior to the event. The applicant has paid the City $660, which includes a $60 application fee, $100 administrative fee, and $500 refundable security deposit. The applicant is responsible for all services rendered by the City: THE CITY OF PLEASANT LIVING FEES TO BE WAIVED: AnACHMENTS: CITY OF SOUTH MIAMI OFFICE OF THE CITY MANAGER INTER-OFFICE MEMORANDUM CITY SERVICES POLICE DEPARTMENT PUBLIC WORKS (I.E. STAFF, BARRICADES) STREET CLOSURE & MOT TOTAL AMOUNT $3,200 $544.48 $2,391.85 $6,136.33 The applicant is requesting a waiver for the following fee: CITY SERVICES AMOUNT PARKING METERS ($25 x 58 METERS) $1,450 Resolution Special Events Application • 1 RESOLUTION NO.: ________ _ 2 3 A Resolution authorizing the City Manager to permit Team FootWorks Educational and 4 Fitness Corporation, a not-for-profit organization, to hold its 30 th annual Twilight SK 5 Run/Walk event and to waive the cost of parking meters. 6 7 WHEREAS, Team FootWorks Educational and Fitness Corporation ("the applicant"), a not- 8 for-profit organization, has submitted a Special Event Application to hold its 30th annual Twilight 9 5K Run/Walk event on Sunday, June 3 rd , 2018 from 6:00 PM to 9:00 PM; and 10 11 WHEREAS, The Twilight 5K Run/Walk allows participants of all skill levels to partake in a 12 fun, safe run/walk in the downtown South Miami area and surrounding streets, beginning at 74th 13 street and 58th avenue, ending at 57th court and 73 rd street; and 14 15 WHEREAS, the applicant has paid the City $660, which includes a $500 refundable security 16 deposit, $100 administrative fee and $60 application fee; and 17 18 WHEREAS, the applicant is responsible to pay the City for Police Services ($3,200) Public 19 Works ($544.48), Street Closure and MOT ($2,391.85) totaling $6,136.33; and 20 21 WHEREAS, the applicant is requesting a waiver for fifty eight (58) parking meters in the 22 amount of $1,450; and 23 24 WHEREAS, the applicant has completed the Special Event Application and has submitted 25 the necessary Notification/Petition Form signed by businesses that will be affected by the 26 requested street closure; and 27 28 WHEREAS, upon approval of this event the applicant must provide the City with the 29 required Certificate of Liability Insurance that complies with the City's standard insurance 30 requirements, including naming the City of South Miami as an additional insured prior to the 31 event. 32 33 NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OFTHE CITY 34 OF SOUTH MIAMI, FLORIDA THAT: 35 36 Section 1. The City Manager is hereby authorized to permit Team Footworks Educational 37 and Fitness Corporation to hold its 30th annual Twilight 5K Run/Walk event on Sunday, June 3 rd , 38 2018 from 6:00 PM to 9:00 PM. 39 40 Section 2. The City Manager is also authorized to waive fifty eight (58) parking meters in 41 the amount of $1,450. 42 43 Section 3. If any section clause, sentence, or phrase of this resolution is for any reason 44 held invalid or unconstitutional by a court of competent jurisdiction, the holding shall not affect 45 the validity ofthe remaining portions of this resolution. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 Section 4. Effective Date. This resolution shall become effective immediately upon adoption by vote of the City Commission. PASSED AND ENACTED this __ day of ____ -', 2018. ATIEST: CITY CLERK READ AND APPROVED AS TO FORM: LANGUAGE, LEGALITY AND EXECUTION THEREOF CITY ATIORNEY APPROVED: MAYOR COMMISSION VOTE: Mayor Stoddard: Vice Mayor Harris: Commissioner Gil: Commissioner Liebman: Commissioner Welsh: Permit #: 0 to \):,llO () I THE CITY OF PLEASANT LlVI:-.IG SPECIAL EVENT APPLICATION This application must be submitted for special events that will be held on city property or requiring city services at least sixty (60) days prior to the date of the event. Please refer to the Special Events Handbook for more information about applying for a special event in the City of South Miami. APPLICANT INFORMATION APPLICANT NAME: ']ob~ "J pt' I-J useky TITLE: VI c.~ Pres'lden/-- DAY TIME PHONE: .,30 S -Co p" '7a.=:J.3 MOBILE: ~OS -" 7 ~ 93.:2;t. EMAIL: jp @ tearnihrrcwrk5 . O~ 20d CONTACT NAME: Lau.rl e,., "B. tk.tse 1 TITLE: frps.,d@nt . DAYTIME PHONE: .3oS--fo"~·(~~ MOBILE: 7geJ -~9S-7~(P1 EMAIL: Jaud-ec;>-GxsbmrkslblS\m '"corn ORGANIZATION INFORMATION NAME OF ORGANIZATION: Jearuh;,tk\b ... 1<5 ADDRESS: 57;}4 5un:se± br'''e..) 2:ou+h M,ami, FL 331'+3 PRESIDENT/MANAGER NAME: Lau.rt€J "E. JJLlDe~y PHONE:~a5 -(q'6-'7:J.:l3 Is your organization a non-profit, 501(c) (3) certificate holder? 0 NO ~YES -If YES, please provide a copy of your certificate with the application. EVENT INFORMATION TYPE OF EVENT: 0 FESTIVAL/CELEBRATION ]li. RUN/WALK 0 FILM/PHOTO PERMIT o CHARITY 0 OTHER: ___________ _ NAME OF EVENT: TWi/~t 5k. Bur/Wo.-Ik.. LOCATION OF EVENT: ~ ill 73!:!:i :Sfreet If;,;JW 5771f Ca'uT' EVENT DATE(S):~Urd~ j ::JUne. L~ dOLE' 0 NEW EVENT ~ETURNING EVENT WILL THIS BE AN ANNUAL EVENT? 0 NO )if-YES IF YES, THIS IS THE _YEAR OF THE EVENT ANTICIPATED AnENDANCE: t 50 0 ACTUAL EVENT TIME: ,: 0'0 AMBo q: 00 AM!@ ASSEMBLY DATE(s):5(~cb~ ,j"GIOf' ~JO/StUPTIMEs:I.22:O¢ AM@O_ . -lAM@ c::. .. d J-'l~OI8 BREAKDOWN DATE(S)"-"U11 "~/, t.(no£ BREAKDOWN TIMES: 9: 00 AM/61)to /()'.:30 AM/11V1l I ~ 1 EVENT NARATIVE A detailed written description/summary of your event is required. Please describe all activities, schedule of activities, inventory of any sold items, giveaway items, list of vendors and any other important information. If additional space is needed please use a blank sheet of paper and attach to the application. LOCATION APPROVAL If the organization is a tenant and/or renter of the event location, please have the property owner complete the following. Mark all that apply: rI Location is City of South Miami property (street, sidewalk, right~of-Way, park, etc.) o fPplicant/organization owns the requested event location r;I Applicant/Organization will be using private property Comments: _____________________________ _ Property Owners Name: l S T hl~~ , 1 B.,n It. o£ <:50 t.h(...h R,~ vn , Property Address: ,5 7SO ~l..L nse +- Phone: .3 os--fc, G,Cl -.5l{~ ~ b r'''e· j-Obt:L ".J P "I-fU~-eb" PRINT APPLICANT'S NAME r--. I r:.~1?~ .. PROPERTY OWNER SIG~ APPLICANT'S TITLE 3\a61 (0) ? DATE NOTARY SIGNATURE Subscribed and sworn before me, this dB Day 01 mClVLn ,a Notary Public in and lor MI CLm i -Dti cLJJ . Vl de!, Sig .' N BLlC) 2 000001-0 12/03/15 ~.~ II Consu~er's Certificate of Exemption II DEPARTMENT OF REVENUE Issued Pursuant to Chapter 212, Florida Statutes 85-8012600365C-4 01/31/2016 Certificate Number Effective Date This certifies that TEAM FOOTWORKS EDUCATIONAL AND FITNESS CORPORATION 5724 SUNSET DR SOUTH MIAMI FL 33143-5316 01/31/2021 Expiration Date DR-14 R.04/11 is exempt from the payment of Florida sales and use tax on real property rented, transient personal property purchased or rented, or services purchased. Brtjoert\l,g:~Arl tangible Important Information for Exempt Organizations DR-14 R.04/11 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 (FA C.). 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 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 require the revocation of this certificate. 6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Account Management at 800-352-3671. From the available options, select "Registration of Taxes," then "Registration Information," and finally "Exemption Certificates and Nonprofit Entities." The mailing address is PO Box 6480, Tallahassee, FL 32314-6480. POLICE DEPARTMENT Off-duty police officers are required for street closures as determined by the Police Department. You will be required to hire off-duty police officers if your event includes street closures, alcohol sales or large crowds. No o o o Will your event obstruct the normal flow of traffic or sidewalks? Do you expect the total attendance for your event to be over 50 people at anyone given time? Will you be requesting the use of off-duty police officers? If YES, how many T8b (Please note: if you answered NO, to this question off-duty officers can still be assigned to your event at a cost to the applicant 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. STREET, SIDEWALKS AND RIGHT-OF-WAY CLOSURES List detailed closures you are requesting for your event including street, sidewalks and right-of-ways. 5&£ COu es€ HAP Please note: All closures require City Commission approval by resolution and may take up to two (2) months to be approved. All street, sidewalk and right-of-way closures must be identified on the site map. PLANNING AND ZONING No o Will you be hanging any banners over public streets or pole banners? If YES, a separate Banner Application with the City of South Miami Planning & Zoning Department will be required. (Please note: Only SOl(c)(3) organizations may apply for a banner application. All requests for banners over public streets must be reviewed and pre-approved. A SOl(c)(3) certificate, insurance and photos of the banner must be included with the application to the Planning & Zoning Department) o Have you notified the event location neighbors or businesses about your event? 3 CODE ENFORCEMENT o o No o Will you be having any music and/or amplified sounds during your ~ent? 19' Will your event be starting before 8:00 AM. ~Will your event end after 11:00 PM? PARKS AND RECREATION Yes o o o V Will this event take place in any of the South Miami City parks and/or recreation facilities? /(Please note: A rental fee will be applicable if a city park is being used) Q" Will this event require the use of any Department equipment (stage)? ~ Will this event require the use of any Department staff? PARKING DIVISION PUBLIC WORKS No o Will you be renting any City parking meters? If YES, how many __ _ (Please note: All closures or interference on right-of-ways that includes parking meters will be required to pay the daily meter fee) o ./ Do you have enough on-site parking to accommodate your event? Id"" Will your event involve the use of a shuttle and/or alternate parking sites? No o o o Will your event interfere with any public right-of-ways, such as roads, sidewalks, alleys etc.? Will your event require any full and/or partial road closures? (Please note: any right-of-way closures will require at least one off-duty officer per corner) Would you like the City to provide you with barricades for you event, at a cost? If YES, how many /00 . (TYPE 1) Please describe your plans for the cleanup and removal of recyclable good, waste and garage during and after your event. ADDITONAL EVENT FEATURES o Temporary Fencing [!( Signs/Banners Gt;-ents or Canopies [3' jflflatables/Rides !3" Additional Barricades Iir"Electrical Services/ Generators o Live Music o 9pen Flames ~Port-A-Johns o Other: _____________________ _ (Please note: If any of the following apply, a separate narrative description of each additional feature may be required by the City with this application. Additionally tents, open flames and signs/banners may require Building Permits at the cost to the applicant.) FILM/STILL PHOTOGRAPHY )J /A Type of Production: _________ Special Effects or Weapons: _________ _ Base Camp Location: __________________________ _ Cast: _______ _ Crew: ________ _ Extras: _______ _ Total Number: _____ Total Vehicles: ____ _ Type of Vehicle: ______ _ DEPARTMENT DIRECTORY Special Events Division .................................................................. . (305) 668-3873 South Miami Police Department ................................................. . (305) 663-6301 Public Works Department ............................................................ . (305) 403-2067 Parks and Recreation Department ........... , .................................. . (305) 668-3876 Code Enforcement Department ................................................... . (305) 668-7335 Planning and Zoning Department ................................................ . (305) 663-6326 5 INDEMINIFATION AGREEMENT THIS AGREEMENT ("Agreement") is entered into by and between Tearn G::ttbhr ks ("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) . . WOc..I/ft -.::::.tJJ 73C!1 ~t " s NSAIJlttio~I (date(s)) 3,;2018("special Event"); and WHERAS, pursuant to of the City's Code ent Regulations, the Applicant must execute an indemnification and hold harmless agreement protecting the City from 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 ( collectively IflndemniteeslJ ) harmless from and against any and all such claims, suits, actions, damages, or causes of action arising as 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 included in and about the defense or settlement of any clams, and the investigation thereof, except to the extent caused by indemnitees negligence of willful misconduct. 3. No Street shall be closed without approval from the City Commission. 4. 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. 5. Event areas shall be restored to equal or better condition than they were before the event started. 6. Any damage to private property shall be restored to its original condition or better and as accepted by the Owner caused by applicant or any of its agents, servants or employees, invitees and onlookers. 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 and additional incidental fees. 8. Applicant must pay all fees prior to the date of their event(s). 9. Applicants shall notify the City of South Miami Special Event Coordinator at least forty-eight (48) hours prior to start oftheir event of any cancellations to be considered for any refunds. 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. JOh1 ":rP~ {4use ~ PRINT APP Npcr::rnWlC'~ NOTARY SIGNATURE Subs~ribed and sw)l;t before me, this • 1\.d :t6o.1h. day ofud -M,AJ'n, jJ( e, County, State of PL OYj dQ,...o Signature (NOTARY PUBLIC) APPLICANT'S TITLE DATE 6 ROUTE/MAP A map of the event site is required and should indicated the event layout with proposed attractions, recommended street closures, parade or run/walk routes, etc. please draw your map on the space provided below, or attach a m.p to the application upon submittal. The following must be identified and labeled 1. Event site (streets, bldg., etc.) 3. Canopies, tents, stages 5. Fencing/Barricades 7. First aid facilities 2. Routes (races, parades, etc.) 4. Restroom facilities 6. Off duty police officers 8. Parking Area IgIl ~'t- SW 57th. Ct';-, ---f~r"1-"'; D U8 1 Start Detail SW 58th. Ave. Twilight 5k Miami, FL. 5 Red Rd. ,------ z SW 59th. Ave. SW62ndAve. .-I: Start Is 81 ft.11lnchos north of Sanitary sewer at middle of the street at SW 74 Ter and 58 th Ave. r South Miami on 57 ;;::: Court. SW 57th. Ct. 13' 3'" I about:blank 1 mile is on 87 5t just before 60th Ave 2 mile Is on 84 StJust pastS2 CL 3 mile Is 0f1 74 Ter Just past turn off of 58 51 .. 3/28/18, 2A4 PM Course measured by Don Matuuak and David Raybon. 786-52503540, donaldmllltuszak@comcaliit.net Page 1 of 1 NOTIFICATION/PETITION We, the undersigned business 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 disapproved. 8 FINAL CHECK LIST This list is to ensure that all necessary documentation is included and that all required procedures are followed. The Special Event Coordinator will check the application against this checklist to ensure all information was submitted correctly. D APPLICATION: D FEE: All information has been properly filled out on the application with all required documents at least 21 days prior to the proposed event. A $60 application fee and $100 administrative fee must accompany your submission in check or money order form. D SIGNATURES: Application must be signed and notarized. D EVENT NARATIVE: Briefly discuss your Organization/Business, the purpose of your event, the benefits, etc. D NOTIFICATION FORM: The name, signature, address and phone number of each person who is either a property owner or lessee within the requested event area must appear on the sheet. D SITE PLAN: D COPY: A site plan must be submitted with the application that must show intersecting streets, parking areas, tents, stages, routes, barricades, etc. It is strongly recommended that you make a copy of your application for your own records COMPLETED APPLICATIONS: Yvette Valdes, Special Events Coordinator Gibson-Bethel Community Center 5800 SW 66th Street South Miami, FL 33143 Office: 305-668-3873 -Email: vvaldes@southmiamifl.gov Once the application has been approved processed and the date has been reserved the following must be submitted prior to the event date. D INSURANCE: D EVENT FEES: The applicant is required to submit a Certificate of Insurance naming the event and the City of South Miami (6130 Sunset Drive South Miami, FL 33143) as an additional insured, in the amount of $1,000,000. A $500 refundable security deposit, and other applicable chargers such as, but not limited to, street closures, off-duty police officers, etc. will be due and required before any permit can be issued. 9 I r~djti¢'Wotlt$ P~jl"Jj~~Jl;t Event £ostEstimafil ~bgliije4'ri"YvetteValdes, Namedi'li:tIlbJi, 1'WiIi~t R:Ritil. v 'tUm" ,,1\ \ Ii! jI ,J '" 3rdnnl! ,~reu ,~"afil ~~J~ il\i!.un",;,I;Y!."lUUi' .' "~i NWerill'ls,t Da'i'f'::::P'#bl~!1 \¥flrk&"I'I<!~.I'oM!lteria11! E!nUpmene. B_~'t(a~a'FratRate.(:Pet,OJ1de~) v .' :P . d " ".4. ,11! .. ·., .. · .. 1!1.., .•. ,· .. iI.'.l'. 8.· .. ..... ll'f!:L~JlI\!r~ .. ;,-' .""=~_~_~.".-~ Valdes, Yvette From: Sent: To: Cc: Subject: Yvette, Aurelio Carmenates Tuesday, April 03, 2018 2:38 PM Valdes, Yvette Gomez, Nelson; John Reese RE: Cost Estimates Please find below are the fees for the two events per the Fee Schedule: Taco Craft Temporary full road closure= $25 ($0.25 x Approx. lOOLF) = 575LF x .25 = $143.75 The MOT fee for roadway = $100 x 2 directions = $200 Temporary Staging Area = $200 Total = $ 543.75 Twilight Run Temporary full road closure= $25 ($0.25 x Approx. lOOLF) = 7967 LF x .25 = $ 1,991.85 (Note: I deducted the one-way on SW 58th ave totaling 8480.67LF to the total length amount) The MOT fee for roadway = $100 x 4 directions = $400 Total = $ 2,391.85 1 CERTIFICATE OF LIABILITY INSURANCE I 4/4/2018 !f!'.:l_ ... c"" IS ISSUED AS A MATTER OF IIU", ONLY AND : NO RIGHTS UPON THE '"c 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 BElWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMt'UKIAN " If tho_ -, holder is an AUUIIIUNAL , the , must be If· IIUO'l IS .. "I :~w',-".".bj~C~,to the terms; i of the pol~cy, certain . may require an endorsement. A statement on this certificate does not confer rights to the 1 holder in liou of such; PRODUCER I'~" STAR Insurance -Fort Wayne office LFril' (260)467-5689 2130 East Dupont Road . m~.rcr, ret I r.e~_ Nol, (26" '''-" .. com Fort Wayne INSURED IN 46825 Road Runners Club of America/2018 and Its Member Clubs 1501 Lee Highway, Suite 140 Ar1' VA 22209 , .. II _M, INSU~"R B _M, :" INSURERC INSURERD '.'''RE. E , •• ".E., , $2M A.I. ., ro, .11-. ,''', Life Co, NOI"-'1. 111991 I 66869 THIS IS TO CERTIFY THAT THE POLlC(ES OF (NSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED!\BO~E 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 SHOVVN MAY HAVE BEEN REDUCED BY PAID CLA~'M;;:S:,. -----------------1 'rf: lYPEO' on" ~~ LlMIl X GENERAL LIABILITY ~ $ A I CLAIMS-MADE W OCCUR ~ I $ ~ Legal Liability to KR00000007171000 12/31/2017 12/31/2018 MED EXP (Any one person) I $ r-Participant $2,000.000 U:01 AM U:01 AM PFR.<;nNAI R.AnVINJURY 1$ ~N" , n ~~~~ APOPLIES PER: GENERAL I $ ~ POLICY L.....J JECr LaC Abuse &: Molestation -COMP/OP AGG I $ I OTHER $5,000,000 Ab"",,, I' LfABIL.llY j-- A >--ANY AUTO I ALL OWNED r-::-AUTOS r--!--HIRED AUTOS UMBRELLA LlAB t-----EXCESS LlAB OED I I r----SCHEDULED AUTOS rx NON-OWNED t--AUTOS -1 OCCUR I CL I i'LIABILITY ANY ,",I B Excess Medical & Accident ($250 Deductible/Claim) KR00000007171000 SPX0000028554500 I I I '- ~IL Y INJURY (P" p""'1 I' ," ""_ 12/31/2018 LOODILYINJURYIP"",,,,,tll' 12:01 AM 12:01 AM .,!AMAI.:it: 1$ 1'- I. I EL C,nO"T I • I E.L DISEASE -FH"P' nv I. LEL DISEASE 00' IC' I I I. 12/31/2017 12/31/2018 Excess Medical 12:01 AM 12:01 AM AD & Specific Loss DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) 2,000,000 500,000 . '-'-""-"- 2,000,000 nn' ", .• A 2,00~O 500,000 2, OO(), 000 $la.OOO $2.500 CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED AS RESPECTS THEIR INTEREST IN THE OPERATIONS OF THE NAMED INSURED. DATE OF EVENT(S): 06/03/18 Twilight 5k Run/Walk and Post Race Party INSURED RRCA CLUB/EVENT MEMBER: TeamFootworks, Att'n: Karen Plaster, 5724 Sunset Drive, South Miami, FL 33143 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 06/03/18 City of South Miami THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 6130 Sunset Drive ACCORDANCE WITH THE POLICY PROVISIONS. South Miami, FL 33143 AUTHORIZED REPRESENTATIVE Terry Diller/MMA ~ --'~ 'R _ ~J<2Pc..U © 1988-2014 ACORD CORPORATION, All roghts reserved. ACORD 25 (2014101) INS025 (201401) The ACORD name and logo are registered marks of ACORD