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HomeMy WebLinkAboutItem #03 Special Event Permit - Request for Road and Boat Ramp Closure for Access-Life, Inc. Sre c of Good L , <r,c AGENDA ITEM COVER SHEET Meeting Date: October 16, 2012 Item # Reviewed By." > Contact Name: James F. Washington Department Director: G Contact Number: 407 - 905 -3104 / City Manager :`'t ", Subject: Special Event Permit — Request for Road and Boat Ramp Closure for Access -Life, Inc. Special Event. Background Summary: In order to temporarily close a public street and boat ramp, the approval of the Honorable Mayor and City Commission is required. Access -Life, Inc. has made application to the City for a Special Events Permit for Community outreach for families living with disabilities that would require the temporary closing of City owned streets and Starke Lake Boat Ramp. It would also require the use of the Bill Breeze Park, Gazebo and Fishing Pier. The set up start on Friday, November 9, 2012 from 8:00 AM — 5:00 PM. The event will be held on Saturday, November 10, 2012 from 10:00 AM — 2:00 PM. The streets to be closed are a portion of N. Lakeshore Drive to intersection with Oakland Ave., Boat Ramp, & Dock. Issue: Should the Honorable Mayor and City Commission approve the temporary closing of public streets, Boat Ramp, & Dock for the purpose of a Community outreach for families living with disabilities? Recommendations Staff respectfully recommends approval with the following requirements: 1) All residents that will be affected by the road closure must be notified in advance; 2) An emergency lane must be maintained at all times; 3) Roads must be blocked with proper barricades; 4) Signs to be posted at the boat ramp in advance to notify the public of the closure; 5) Temporary power hook -ups and generators shall be inspected by the Building Division prior to energizing; 6) Fire Department to provide EMS personnel with equipment; 7) Risk Management approval is contingent on proper insurance coverage prior to the event. Attachments: Special Event Application and location map Financial Impact: 1) Public Works cost for barricade setup and breakdown to close off Lakeshore Dr. is $420.00 due prior to the event; 2) Fire Department will have, EMS standby on rotation bases with on -duty personnel as available at no cost; 3) Parks and Recreation Department will require use fees totaling $1,850.00 and an additional $250.00 refundable security deposit. The amount due for this event will be $2,520 Including deposit. Type of Item: (please mark with an x') Public Hearing For Clerk's Dept Use: Ordinance First Reading ✓ Consent Agenda Ordinance Second Reading Public Hearing Resolution Regular Agenda X Commission Approval Discussion & Direction Original Document/Contract Attached for Execution by City Clerk X Original Document/Contract Held by Department for Execution Reviewed by City Attorney N/A Reviewed by Finance Dept. N/A Center of Good L h Sre I vl �<? CO tr , ORGANIZATION HEADQUARTERS Name: Access -Life, Inc. Address: PO Box 99 City: Altoona State: FL Zip Code: 32702 Phone Number: 32702 REPRESENTATIVE Name: Doug and Leanne Goddard Address: PO Box 99 City: Altoona State: FL Zip Code: 32702 214 -893 -9056 Phone Number: APPLICANT (if different) Name: Address: City: State: Zip Code: Phone Number: Type of Event: Parade Ceremony Exhibition Show Concert Demonstration Other Date (s) and time (s) scheduled: Set -Up on November 9th from 8am -5pm; Expo on November 10th From 10am -2pm with early set -up at 7am and teardown from 2pm -6Pm Name and types of activities: Bank fishing, archery, boat rides, kayaking, arts & crafts, games, food, petting zoo. Approximate number of spectators and participants: 500 Community outreach event for individuals and families living with disabilities to connect them to churches, organizations and people in their area Purpose of Special Event: Exact Location of Event: Bill Breeze park & gazebo, lake side park, boat ramp & dock and fishing pier. Designation of Public Facilities or Equipment to be Used: In addition to the above areas we would like to request that the road between Bill Breeze and lake side park be closed for the duration of our event. Number of Temporary Directional Signs: x $5.00 per sign = City of Ocoee • 150 N Lakeshore Drive • Ocoee, Florida 34761 Phone: 407. 905.3104 • Fax: 407. 905.3155 • www.ocoee.org Copy of State Permit if State Roadway is used: yes no FOR PARADE: Exact Location of Marshalling and Staging Area: Time at which units of Parade will begin to arrive: Time at which units of parade will be dispersed: Exact Route to be traveled shown on Attached Map: yes nno Please attach approximate number of persons, animals, and vehicles participating with description of types of animals and vehicles. Parade will occupy all of the width of the street, roadway or sidewalk: yes no FOR FIREWORKS: The following shall be attached to this application: 1) A detailed listing of the type & quantity of fireworks to be used. 2) A detailed written statement outlining all appropriate safety procedures which will be used at fireworks display in order to protect the safety of the public and all surrounding property. 3) A detailed written statement describing what facilities and containers will be used to store fireworks. 4) If applicable, applicants Federal License number for transporting fireworks across state line. 5) A detailed list of names, addresses, occupations, and backgrounds of all individuals who will be responsible for the actual display, use or explosion of any fireworks. The backgrounds statement should include a complete history of the experience of the individuals involved with respect to their use of fireworks, including a detailed list and explanation of each and every accident resulting from the use of fireworks which the individual has been responsible for, or involved in. 6) A map showing exact launch point and area of fallout. Applicant Signature: (/ AI.LO L f Date: Approved by Police Chief ATTPC.BeD Date: Approved by Public Works Director Crime. ATTACtIED Date: Approved by Fire Chief P D Date: Approved by Risk Management AITACHED Date: Approved by Building Official s %! L ' - Date: /t *Any and its conditions should be in memorandum form. City of Ocoee • 150 N Lakeshore Drive • Ocoee, Florida 34761 Phone: 407. 905.3104 • Fax: 407. 905.3155 • www.ocoee.org Copy of State Permit if State Roadway is used: yes [-no FOR PARADE: Exact Location of Marshalling and Staging Area: Time at which units of Parade will begin to arrive: Time at which units of parade will be dispersed: Exact Route to be traveled shown on Attached Map: yes (aino Please attach approximate number of persons, animals, an vehicles participating with description of types of animals and vehicles. Parade will occupy all of the width of the street, roadway or sidewalk: [ 1 yes no FOR FIREWORKS: The following shall be attached to this application: 1) A detailed listing of the type 84 quantity of fireworks to be used. 2) A detailed written statement outlining all appropriate safety procedures which will be used at fireworks display in order to protect the safety of the public and all surrounding property. 3) A detailed written statement describing what facilities and containers will be used to store fireworks. 4) If applicable, applicants Federal License number for transporting f across state line. 5) A detailed list of names, addresses, occupations, and backgiouncls of all individuals who will be responsible for the actual display, use or explosion of any fireworks. The backgrounds statement should include a complete history of the experience of the individuals involved with respect to their use of fireworks, including a detailed list and explanation of each and every accident resulting from the use of fireworks which the individual has been responsible for, or involved in. 6) A map showing exact launch point and area of fallout. r Applicant Signature: I � i, _._ f` , r- t_ ' Yi r (.)` Date: + Approved by Police Chief . Date: 9 Approved by Public Works Director Date: Approved by Fire ChieT Date: Approved by Risk Management Date: Approved by Building Official Date: *Any denial and its conditions should be in memorandum form. City of Ocoee • 150 N Lakeshore Drive • Ocoee, Florida 34761 Phone: 407. 905.3104 • Fax: 407. 905.3155 • www.ocoee.org Pierce, Ad riana From: Krug, Stephen Sent: Friday, October 05, 2012 3:53 PM To: Pierce, Adriana; Dreasher, Brad; McNeil, Pete; Hayes, Jeff; Brown, Charlie; Washington, Jim; Williford, V. Gene Cc: McDonald, Debbie Subject: RE: ACCESS -LIFE 1 Approvals & Agenda Item PW is approved. Stephen C. Krug Director of Public Works City of Ocoee 301 Maguire Road Ocoee, Florida 34761 407 - 905 -3170 407- 905 -3176 (fax) From: Pierce, Adriana Sent: Friday, October 05, 2012 3:51 PM To: Dreasher, Brad; McNeil, Pete; Hayes, Jeff; Brown, Charlie; Krug, Stephen; Washington, Jim; Williford, V. Gene Cc: McDonald, Debbie Subject: RE: ACCESS -LIFE 1 Approvals & Agenda Item While all of this information is necessary and important. 1 am confirming via this e -mail that all of you have approved this event without conditions other than the additional information requested by Risk Management to be added on the certificate of insurance froin the Zoo. Additionally, since Mr. Goddard did not speak at the last commission meeting 1 will also need to include the information to waive Park & Public Works fees on the Agenda Item. Please forward your recommendations no later than 9:00 AM on Monday October 8, 2012 Thank You, Adriana Pierce From: Dreasher, Brad Sent: Friday, October 05, 2012 1:56 PM To: McNeil, Pete; Hayes, Jeff; Brown, Charlie; Goclon, Steve; Krug, Stephen; Washington, Jim Cc: Pierce, Adriana; Fire Battalion Chiefs; Hoover, Tim; Bryant, Michael Subject: Re: ACCESS -LIFE 1 City of Ocoee REC DEPT (CFL AL EXPO ZOO /HAYRIDE) We can handle the hay ride. I will be at the event and assist in coordinating the hay ride. Sent from Blackberry From: McNeil, Pete Sent: Friday, October 05, 2012 01:49 PM To: Hayes, Jeff; Brown, Charlie; Goclon, Steve; Dreasher, Brad; Krug, Stephen; Washington, Jim Cc: Pierce, Adriana; Fire Battalion Chiefs; Hoover, Tim 1 Pierce, Adriana From: McNeil, Pete Sent: Friday, October 05, 2012 4:18 PM To: Pierce, Adriana; Dreasher, Brad; Hayes, Jeff; Brown, Charlie; Krug, Stephen; Washington, Jim; Williford, V. Gene Cc: McDonald, Debbie Subject: RE: ACCESS -LIFE Approvals & Agenda Item FD has approved without conditions. We will have PR and EMS at event for no cost. Pete McNeil, Fire Chief Ocoee Fire Department 563 S. Bluford Ave. Ocoee, FL 34761 Office: 407 - 905 -3140 pmcneil us From: Pierce, Adriana Sent: Friday, October 05, 2012 3:51 PM To: Dreasher, Brad; McNeil, Pete; Hayes, Jeff; Brown, Charlie; Krug, Stephen; Washington, Jim; Williford, V. Gene Cc: McDonald, Debbie Subject: RE: ACCESS -LIFE 1 Approvals & Agenda Item While all of this information is necessary and important, I ain confirming via this e -mail that all of you have approved this event without conditions other than the additional information requested by Risk Management to be added on the certificate of insurance from the Zoo. Additionally, since Mr. Goddard did not speak at the last commission meeting I will also need to include the information to waive Park & Public Works fees on the Agenda Item. Please forward your recommendations no later than 9:00 AM on Monday October 8, 2012 Thank You, Adriana Pierce fro n Dreastier, Brad Sent: Friday, October 05, 2012 1:56 PM To: McNeil, Pete; Hayes, Jeff; Brown, Charlie; Goclon, Steve; Krug, Stephen; Washington, Jim Cc: Pierce, Adriana; Fire Battalion Chiefs; Hoover, Tim; Bryant, Michael Subject: Re: ACCESS -LIFE 1 City of Ocoee REC DEPT (CFL AL EXPO ZOO /HAYRIDE) We can handle the hay ride. I will be at the event and assist in coordinating the hay ride. Sent from Blackberry From: McNeil, Pete Sent: Friday, October 05, 2012 01:49 PM To: Hayes, Jeff; Brown, Charlie; Goclon, Steve; Dreasher, Brad; Krug, Stephen; Washington, Jim Cc: Pierce, Adriana; Fire Battalion Chiefs; Hoover, Tim 1 Pierce, Adriana From: McDonald, Debbie Sent: Tuesday, October 09, 2012 11:09 AM To: Doug Goddard Cc: 'Leanne Goddard'; Pierce, Adriana; Hall, Krista Subject: RE: ACCESS -LIFE 1 COO Risk Management (CFL AL EXPO) Hello There, This completes the Certificate requirements. Thanks so much, Debbie From: Doug Goddard jmailto:dg3sCflajh.netj Sent: Tuesday, October 09, 2012 9:13 AM To: McDonald, Debbie Cc: 'Leanne Goddard'; 'Doug Goddard'; Pierce, Adriana; Hall, Krista Subject: ACCESS -LIFE 1 COO Risk Management (CFL AL EXPO) Debbie, Attached is the revised COI from the zoo. Let me know if you need anything else. © Doug Goddard (214) 336 -1188 4i+{tv www.fishingwithfriends.org 1 Pierce, Adriana From: McDonald, Debbie Sent: Thursday, October 04, 2012 3:17 PM To: Doug Goddard Cc: Williford, V. Gene; Pierce, Adriana; Hall, Krista Subject: RE: ACCESS -LIFE l City of Ocoee Buildings DEPT (CFL AL EXPO PERMIT) Thanks so much! Original Message From: Doug Goddard [mailto:dg3 @flash.net] Sent: Thursday, October 04, 2012 2:16 PM To: McDonald, Debbie Cc: Williford, V. Gene; Pierce, Adriana; Hall, Krista Subject: RE: ACCESS -LIFE 1 City of Ocoee Buildings DEPT (CFL AL EXPO PERMIT) Got it I'll get with the zoo folks and get back to you thanks. :) Doug Goddard (214) 336 -1188 www.access- life.org www.fishingwithfriends.org Original Message From: McDonald, Debbie [ mailto :dmcdonald @ci.ocoee.fl.us] Sent: Thursday, October 04, 2012 1:50 PM To: Doug Goddard Cc: Williford, V. Gene Subject: RE: ACCESS -LIFE 1 City of Ocoee Buildings DEPT (CFL AL EXPO) Hello Doug, We have reviewed the Certificate, and have one request: Please reference the Name of the Event, Date & Location, this can be added to the description of operations /locations /vehicles section. The insurance limits are acceptable. Thank you for your attention to this matter. Have a great day, Debbie Debbie McDonald HR Analyst City of Ocoee 150 N. Lakeshore Drive Ocoee, FL 34761 407 - 905 -3100 ext. 1050 1 Page 1 of 2 Hall, Krista From: McDonald, Debbie Sent: Tuesday, September 11, 2012 3:33 PM To: Hall, Krista Cc: 'Doug Goddard'; leanne @access - life.org; Leanne Goddard Subject: RE: Access -Life 1 City of Ocoee /Krista Hall (Permit & Insurance Requirements) Hello Leanne, The City requires a Certificate of Liability Insurance Form naming "The City of Ocoee As An Additional Insured" with general liability limits to be $1,000,000/$2,000,000 general aggregate. $1,000,000 automobile liability, hired & non -owned autos & $500,000 Workers Compensation . If I can be of any further assistance, please do not hesitate to contact our office. Thank you, Debbie Debbie McDonald PPP City of Ocoee HR Analyst 150 N. Lakeshore Drive Ocoee, FL 34761 407 - 905 -3154 From: Hall, Krista Sent: Monday, September 10, 2012 6:30 PM To: McDonald, Debbie Cc: 'Doug Goddard'; leanne @access - life.org; Leanne Goddard Subject: RE: Access -Life 1 City of Ocoee /Krista Hall (Permit & Insurance Requirements) Debbie, Could you please respond to this email to let her know exactly what you guys need. I have her application waiting to be routed to everyone once she get the Location May and Insurance to us. Thanks, Krista From: Leanne Goddard f mailto:leanne goddard@vahoo.coml Sent: Friday, September 07, 2012 2:35 PM To: Hall, Krista Cc: 'Doug Goddard'; leanne @access - life.orq Subject: Access -Life 1 City of Ocoee /Krista Hall (Permit & Insurance Requirements) Hi Krista — 9/11/2012 Pierce, Adriana From: Hayes, Jeff Sent: Wednesday, September 26, 2012 3:29 PM To: Doug Goddard Cc: Brown, Charlie; McNeil, Pete; Krug, Stephen; Washington, Jim; Williford, V. Gene; Dreasher, Brad; McDonald, Debbie; Pierce, Adriana Subject: RE: Discussion regarding Access Life event 11/10/12 Doug, There were just a couple items that came out of the meeting that you will need to address, these are: 1. The Public Works Department will be charging a fee for the barricade setup and breakdown to close off Lakeshore Drive, that fee will be $420.00. 2. The Police Department and the Parks & Recreation Department will need to know what animals will be brought into the park as part of the petting zoo or zoo display. 3. The Parks and Recreation Department will require facility use fees for this event, which we have previously discussed, totaling $1,580. In addition to these fees there will be a $250 security deposit, which is refundable. Please let me know if you have any questions regarding the Parks and Recreation fees. If you have any additional questions on the other items or your special event permit, you should direct them to Adriana Pierce in the Permitting Division at APierce@ci.ocoee.fl.us. Jeffrey Hayes Parks and Recreation Director 125 N. Lakeshore Drive Ocoee, Florida 34761 407 - 877 -5803 From: Doug Goddard jmailto:dg3@flash.net1 Sent: Wednesday, September 26, 2012 11:08 AM To: Hayes, Jeff; Brown, Charlie; McNeil, Pete; Krug, Stephen; Washington, Jim; Williford, V. Gene Subject: RE: Discussion regarding Access Life event 11/10/12 lust checking in to see _how the meeting went let me know if there are any questions and-if we are on the 10/2 commissioner's meeting docket. Doug Goddard (214) 336 -1188 www.access- Iife.org www.fishingwithfriends.org Original Appointment From: Hayes, Jeff On Behalf Of Hayes, Jeff Sent: Friday, September 21, 2012 2:46 PM To: Hayes, Jeff; dg3(aflash.net; Brown, Charlie; McNeil, Pete; Krug, Stephen; Washington, Jim; Williford, V. Gene Subject: Discussion regarding Access Life event 11/10/12 1 Ce vtet of Good Li_ Aii1V(ki 1 )g t ou1m ?h li;tic'1'D �+. SCi?i i . , 1 luo(1. (ait i \1i111 ig _er iiUtit <ltthiltlll, i1i.ti1i`It't :i 1 1�ulrz�i`i ri: „lu .�. � � :fu<<1 la'. iia Ihs1,�i�•, MEMORANDUM TO: Special Event Sponsor FROM: Jim Washington, Building Official RE: Conditions of Permit from Ocoee Building Division Conditions of Special Event permit as regulated by the Building Division: SPECIAL EVENT NAME: Access Life Community Outreach DATES: November 9, 2012 # OF PARTICIPANTS 500 # OF MALE FACILITIES REQUIRED* three # OF FEMALE FACILITIES REQUIRED* three • Sponsor shall provide a minimum of 1 male restroom (water closet) per 100 estimated participants and 1 female restroom (water closet) per 65 estimated participants. The distribution is based on the participants being composed of 50% of each sex. Existing facilities may be counted. Placement of facilities should be so that a participant shall not have a path of travel greater than 500 feet to reach a facility. In addition, accessible facilities must be provided and relatively central in location. *Regardless of how few participants are expected, there should be 1 male and 1 female facility provided as a minimum. Existing facilities open to the public on or within the 500 foot travel distance are counted in meeting this requirement. • Temporary power hook -ups and generators shall be inspected by the Building Division prior to energizing. If inspections are required after normal working hours, the event sponsor shall assume the city's cost which is S50.00 per hour per inspector with a minimum charge of 3 hours. NOTE: A special event permit may include temporary directional signs and tent signs only. Directional signs and tent signs shall conform to the requirements of the Ocoee Land Development Code. A special event permit does not automatically authorize streamers, cold -air balloons, flashing or search lights, etc. The City of Ocoee • 150 N Lakeshore Driye • Ocoee, Florida 34761 Phone: (407) 905 -3104 • Fax: (407) 9(15.3155 • wtt-w.ocoee.org A l COR� DATE (MM /DD /YYYY) CERTIFLATE OF LIABILITY INSURANCE 9/10/2012 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 CONTACI NAME. Christi S. HAYDEN R PITTMAN INS AGENCY PHONE FAX (A/c, N Ext). (214) 369 -7433 (NC 987 -4767 7015 Snider Plaza #209 ADoless: hrpittmanins @aol.com Dallas, TX 75205 INSURER(S) AFFORDING COVERAGE NAICH INSURER A: Scottsdale Insurance Company INSURED ACCESS -LIFE, INC. INSURER B. INSURER C : 5200 WATERVISTA DRIVE INSURER D: ORLANDO, FL 32821 INSURER E : 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 LTR TYPE OF INSURANCE INSR VD POLICY NUMBER (MM /DDS) (MM /DDY/YWY W ) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES O (Ea t ccurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 A X Includes CPS1416823 8/16/2012 8/16/2013 PERSONAL &ADV INJURY $ 1, 000 , 000 Watercraft GENERAL AGGREGATE $ 2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 1 , 000,000 POLICY PRO- LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ _ ANYAUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED - AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED PROPERTY DAMAGE $ AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY r/N TORY LIMITS ER ANY PROPRIETOR/PARTNER /EXECUTIVE E L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS !VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The policies include a blanket automatic additional insured endorsement or policy terms that -- - - - - -- - - - -- - provide additional insured status and a blanket automatic waiver of subrogation endorsement that provides a waiver of subrogation to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status subject to policy terms and conditions. The policy includes an endorsement providing that 30 CERTIFICATE HOLDER CANCELLATION CITY OF OCOEE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 150 NORTH LAKESHORE DRIVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN OCOEE, FLORIDA 34761 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORFED REPRESENTATIVE e L) F I �jE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD , , ® A ° DATE (MM /DDIWW) ` °R CERTIFICATE OF LIABILITY INSURANCE 10/2/2012 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 Barbara Flora NAME: - - -- - -- - - - - - George Eidson Agency Inc dba Eidson Insurance Rialt Wit); (407) 849 -0333 - FAX No): (407)425 -5694 P.O. Box 540209 E -MAIL ADDRESS: barbaraf @eidsoninsurance . corn PRODUCER 00009761 2807 Edgewater Dr oUSTOMERIDP: Orlando FL 32854 INSURER(S) AFFORDING COVERAGE NAIC # -- _ INSURED INsuRERA:National Casualty Company 11991 INSURER B Ins Co 1070 Central Florida Zoological Society, Inc. INSURER C: P. O. Box 470309 INSURER D: _ - INSURER E : Lake Monroe FL 32747 -0309 INSURERF: COVERAGES CERTIFICATE NUMBER:12 / Master 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. INSRM ADDLISUBR' POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 300 , 000 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) - A j CLAIMS -MADE X OCCUR X 0000002514700 3/12/2012 3/12/2013 MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ NONE GE 'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 5,000,000 X POLICY PRO JECT r LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY (Per person) $ A A LL OWNED AUTOS 0000002514700 3/12/2012 3/12/2013 - - BODILY INJURY (Per accident) $ _ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON -OWNED AUTOS -- - _ -- - -- 1$ -- -- $ I UMBRELLA LIAB X OCCUR EACH OCCURRENCE - $ 2,000,000 X EXCESS LIAB C LAIMS - MA DE AGGREGATE - - - $ 2,000,000 DEDUCTIBLE - - - ---- --$$ - A RETENTION $ k O 0000002514700 3/12/2012 3/12/2013 $ B WORKERS COMPENSATION X l TORY I IM WC STATIUT- S LOTH- AND EMPLOYERS' LIABILITY Y / N - _ER - ANY PROPRIETOR /PARTNER /EXECUTIVE N E L EACH ACCIDENT $ - 500,000 OFFICER /MEMBEREXCLUDED? 830 -36655 7/15/2012 7/15/2013 (Mandatory in NH) E L DISEASE - EAEMPLOYEE $ 500,000 If yes, descnbe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Ocoee is listed as additional insured as respects General Liability coverage. Access -Life November 10, 2012 @Bill Breeze Park 125 N. Lakeshore Drive Ocoee, FL 34761 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ocoee 150 N Lakeshore Dr Ocoee, FL 34761 AUTHORIZED REPRESENTATIVE / L J Mariany CPCU /BCF ` - ACORD 25 (2009 /09) II� gqII © 1988-2009 ACORD CORPORATION. All rights reserved. F with pdfFactory trial version"www paTTactorY C011led marks of ACORD y4 ti 4, *.t s `° ""''' .1 "1"`; '. ■ g ; dam - -- „t< 3 - h r r "' 1r g as N BIUIorI ! , dr �` 3n a }5 • . �' < $ - :' PARKING TENT . & 4."- "" 't, ENTRANCE ..� " 4 ; , ' ". .:ARCHERY AREA 1, - 1/4 ` ^ • `` ;' V OLUNTEER ` . . µ , < ., 44. " :,; : ; ` VOLUNTEER v - " 4 ' ' P ARKING PARKING , iw :-,1 .'-',,, i r rr, s 3 I VIC13_ , a Z •fir 1- PHOTOGRAPHY V t w f t ' » .rr�.: 2 ORANGE COUNTY REST 12 oc • ROOM S It a a ` ;� ATHLETICS V, , _ 7 , ,,,,.. a n. - • Y , l ' 'I 1 3 CANINE � t, .- COMPANIONS Z W } „1 4 - FACEPAINTING & a 7 , V Z . a ”: X it' > y 1 BALLOON ART • • h- Z STORYTELLING 1 i ° ° - - . _ '',. RTICIPAN k. oc °c ri w .. w. PARTICIPANT a a EL S HOPE °-+� 5 NATHANIEL'S # AREA a a PARKING PARKING � ' �+ BOAT TRAILERRARK 6 - GOSPEL BRACELET '4 .. '' ill . s BUDDY '- ,, CRAFT +i 4 f�� • ' "I?' * 6 i f_ ry ti .. W ELCOME _. 7 - CFL PEDIATRIC _ , ' - VOL & PART *n y m' «fit . ; - "'� ._ THERAPY ' ,.. - °''' o. REGISTRATION k , , r Lakewoo• Avenue x -;:„4,' to �` • 8 - PICTURE FRAME ' 5 , CRAFT >, ,: ; : 1 4 BAIT STATION #1 co 9 - OCPS .1 c ® > • ;ri 10 GAMES ' m 4 _ I 11 MOOD FLAGS t I `,: 9 4 ® BOAT RIDES CHECK -IN .- ,, ,� Ka°' PORTALET;'S ®® 1 12 LIFT SPOKES & ` - T -SHIRT & CD SALES STROKES +i T - , ,.; Ir , 4 a , - " FISHING CHECK -IN BAIT STATION #2 BAIT STATION #3} r. POPCORN /SNOW CONES :.:- ---- FISHING PIER KAYAKING CHECK -IN 1 KAYAKING DOCK