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Item S13
I�`� County of Monroe �y,4 ' '�, "tr, BOARD OF COUNTY COMMISSIONERS County �a� Mayor Michelle Coldiron,District 2 �1 nff `_ll Mayor Pro Tem David Rice,District 4 -Ile Florida.Keys Craig Cates,District 1 Eddie Martinez,District 3 w Mike Forster,District 5 County Commission Meeting June 16, 2021 Agenda Item Number: S.13 Agenda Item Summary #3336 BULK ITEM: Yes DEPARTMENT: Airports TIME APPROXIMATE: STAFF CONTACT: Richard Strickland(305) 809-5200 No AGENDA ITEM WORDING: Approval to sponsor 4th of July Fireworks as an exception to the requirements of Airport promotional sponsorships Resolution No. 123-2021. ITEM BACKGROUND: The Airport wishes to promote goodwill toward the County and the Airport and sponsor 4th of July fireworks events in Key Largo, Marathon, Big Pine/Lower Keys and Key West. As shown in the attached documents, the sponsorships will reach thousands of residents and visitors; those attending the events and by way of advertisement of the Airport's logo on banners posted at the events, media recognition (print and radio), and logo on Chamber of Commerce and Rotary websites and social media. PREVIOUS RELEVANT BOCC ACTION: Approval of Airport promotional sponsorship Resolution No. 123-2021 on March 17, 2021. CONTRACT/AGREEMENT CHANGES: NA STAFF RECOMMENDATION: Approval DOCUMENTATION: Resolution 123-2021 Info & Stats - Rotary Clubs & KL Chamber of Commerce FINANCIAL IMPACT: Effective Date: Expiration Date: Total Dollar Value of Contract: $60,000 ($15,000 for each of the four sponsorships) Total Cost to County: $ -0- Current Year Portion: Budgeted: Source of Funds: Airport Operating Fund 404 CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: N/A If yes, amount: N/A Grant: County Match: Insurance Required: No Additional Details: REVIEWED BY: Beth Leto Completed 06/11/2021 11:40 AM Richard Strickland Completed 06/11/2021 11:46 AM Pedro Mercado Completed 06/11/2021 11:48 AM Purchasing Completed 06/11/2021 12:10 PM Budget and Finance Completed 06/11/2021 12:36 PM Maria Slavik Completed 06/11/2021 12:38 PM Liz Yongue Completed 06/11/2021 3:03 PM Board of County Commissioners Pending 06/16/2021 9:00 AM RESOLUTION NO. 123 —2021 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA DELEGATING AUTHORITY TO THE DIRECTOR OF AIRPORTS AND APPROVING THE USE OF KEY WEST INTERNATIONAL AIRPORT ENTERPRISE REVENUE FUNDS TO BE USED FOR PROMOTIONAL SPONSORSHIPS. WHEREAS, Florida Statute 331.20 grants to the Board of County Commissioners the right,power,and authority to publicize, advertise,and promote the activities of its airport in order to make known the advantages, facilities, resources, products, attractions, and attributes of its airport; and WHEREAS, the Department of Transportation, Federal Aviation Administration has promulgated the Policies and Procedures Concerning the Use of Airport Revenue in the Federal Register at 64 Fed. Reg. 7696, February 16, 1999, and WHEREAS, the Policies and Procedures Concerning the Use of Airport Revenues lists the permitted uses of airport revenue and includes, among other things, the full costs of activities - -&,ected towards promoting public and industry awareness of airport facilities and services; and WHEREAS, Key West International Airport has sponsored community organizations and community events from Key West High School to the Naval Air Station Key West Air Show to the Wounded Warrior Ride; and WHEREAS,community involvement and community outreach through paid sponsorships of community organizations help effectuate the purposes of F.S. 331.20 and promotes and engenders goodwill toward the airport and the county; and WHEREAS, the board desires to set forth a policy permitting the use of airport enterprise revenue funds to support community promotional sponsorships; NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA: Section 1. The Monroe County BOCC (The Board) desires to establish a positive relationship with the community and Key West International Airport. Section 2. The Board finds that promotional sponsorships which raise the goodwill toward the county by making known the advantages, facilities, resources, products, attractions, 1 and attributes of the Key West International Airport and/or the Florida Keys Marathon International Airport serve a public purpose. Section 3. In furtherance of this resolution, the Board incorporates the rationale set forth in the memo attached as Exhibit A as if fully set forth herein. Section 2. The Board hereby delegates to the Director of Airports the authority to publicize, advertise, and promote the activities of its airports; to make known the advantages, facilities,resources,products, attractions, and attributes of its airport;to create a favorable climate of opinion concerning its airport and to cooperate with other agencies, public and private, to accomplish these purposes. Section 4. Expenditure thresholds shall be based on the level of anticipated community outreach(community exposure). "Community exposure" shall be defined as the total number of individuals the outreach activity is estimated to reach. The Board hereby authorizes sponsorship expenditures to publicize, advertise, and promote the activities of its airport in the following amounts: Rate of Community Maximum Director Expense Exposure Up to 5,000 people $5,000.00 5,001 to 10,000 people $10,000.00 Greater than 10,000 $19,999.99 PASSED AND ACCEPTED by the Board of County Commissioners of Monroe County, Florida, at a meeting of said Board held on the 17th day of March, 2021. 3 . w Mayor Michelle Coldiron Yes w in Mayor Pro Tern David Rice �(es Commissioner Craig Cates _ Commissioner Eddie Martinez Yew _ w �s Commissioner Mike Forster Yes w "' r=- r '# L BOARD OF COUNTY COMMISSIONERS IN MADOK, Clerk OF MONRO Byq By As Deputy Cleric Mayor Michelle Coldiron NRQ FAB EY2 P AS NTY ATTORNEY DM4 3/2/21 EXHIBIT A Ivey West International Airport. 3441 South Roosevelt Boulevard Key West,Florida 33040 AIRPORT MEMO From: Erick D'Leon,Asst. Director of Airports To: Richard Strickland; Beth Leto Date: October 30, 2020 Re: Airport Promotion and Community Relations Introduction The Key West International Airport is a substantial component of the Key West community and offers the island's most significant economic engine with a combined annual economic output totaling$856 million.As the Airport continues to exhibit rapid growth trends in every aspect of its operation, it is imperative for the Airport to maintain a positive relationship within its small island community.This is accomplished by strategic community outreach efforts to ensure that all citizens are aware of the Airport and express a favorable opinion of the Airport's successful future.Although generally intangible, maintaining a community relationship that promotes a positive airport outlook ensures that the Airport can continue to prosper efficiently and effectively within the physical and sociological limitations of operating on an island. Background The Federal Aviation Administration(FAA)deems that public use airport's expenditure of funds for the promotion of an airport and marketing of airport services are legitimate costs of an airport's operation. Additionally,the FAA entrusts airport management to assure that the level of expenditures for such —purpnses be reasonable in relation to the airport's specific financial situation. Airport funds may be used to support community activities,or community organizations, if the expenditures are directly and substantially related to the operation of the airport. In addition,the policy provides explicitly that where the amount of the Contribution is minimal,the airport operator may consider the"directly and substantially related to air transportation"standard to be met if the contribution has the intangible benefit of enhancing the airport's acceptance in local communities impacted by the airport. As a point of reference,the Key West international Airport,like many other commercial airports, through a combination of Federal,State,and Airport generated funds,maintains a federally mandated Noise Insulation Program (NIP)for eligible family residences.The NIP has expended substantial funding to lessen the impact,and associated burden,of aircraft noise to single family homes and multi-family condominium facilities in Key West by way of noise insulation efforts.The multi-year program creates a cohesive environment in which the Airport and its numerous operations are an accepted part of the community's daily function. Community Relations Recently the Airport announced plans to pursue a major capital improvement plan combining millions of dollars in development to completely overhaul the manner in which the Airport operates.The improvements,developed to meet air service demand, include a new terminal concourse and significant roadway improvements to streamline and improve the passenger experience. However,as the Airport continues to make significant strides in air service development,which supports the community's tourism based economy,the island of Key West is home to only twenty five thousand permanent residents. In a small town community,such as Key West,the importance of a grass roots effort to establish a positive community relationship cannot be overstated.That relationship is fostered through strategic efforts that focus on hosting community events, public outreach presentations,key marketing efforts,and the encouragement of constant feedback from the community through ad-hoc committees and other public forums. The Airport has historically selected the neighboring Key West High School Athletics Department as a recipient of an annual sponsorship.The sponsorship offers tangible and intangible benefits to the operation of the Airport.While the relationship benefits are intangible,the tangible benefits of hometown marketing are of incredible value to the Airport and a critical focus to all promotional marketing efforts. The local community is vital to the future success of the airport. Utilizing simple marketing efforts such as banner advertisements and other key signage, local event programs and print media,and radio advertisements are all part of a larger effort to continually keep the local community involved with the Airport.Therefore,the participation with local groups such as the Key West High School Athletics Dept., a local non-profit youth athletics dance association,or a wounded warriors ride,the effort ensures the Airport maintains a positive position within the growth and daily life of the community that supports the Airport's operation. State and Federal Guidance As-prevrausly stated,the FAA offers clear guidance on haw revenues used for promotional/marketing efforts,and revenues used for donations to charitable/community service organizations are classified as permitted uses.The guidance can be found in Federal Register/Vol.64,Pgs. 7696-7723,Polity and Procedures Concerning the Use of Airport Revenue. Additionally. Florida Statute 331.20 empowers the BDCC to expend funds to publicize and promote the airport and its related facilities, and to create a favorable climate of opinion in the interest of promoting and engendering goodwill toward its airport. Policy Request We request to clarify that promotional,marketing,and community outreach efforts in addition to charitable donations are,as defined by existing state and federal guidelines, part of the Airport's normal operating expenses. Included in those expenses,the Airport will focus on the following categories to pursue effective community relations: Membership: industry, Economic Development, &Other Associations Partnership: Education, Military,&Other Agencies Sponsorship: Youth Development,Tourism,Economic Development,Government Relations, Community,Leadership, Diversity& Inclusion As with all other operational expenses,as these expenses are defined by the FAA,the Airport Director will be provided with the same liberties that are afforded with tither aspects of the daily duties associated with the operation of the Airports. However,due to the nature of procurement for event specific memberships, partnerships,or sponsorships,as they may occur, it is not feasible to adhere to standard County procurement policies for multiple price quotes. In these cases,the Airport Director will adhere to the Monroe County Purchasing Policy guidelines for purchasing authority with relation to the purchasing levels for total dollar amount requested. Additionally, as defined by the FAA, airport management will assure to the BOCC that the total amount of expenditures for such purposes would be reasonable in relation to the airport's specific financial situation.The specific level of director approved expenditures will be based on the level of exposure the expense will provide. For example, if the expenditure will offer a small amount of exposure, up to five thousand people,for the airport,the expense will be limited to five thousand dollars. If the expense will offer a medium amount of exposure,five thousand to ten thousand people,the expense will be limited to ten thousand dollars. If the expense is expected to offer the Airport a significant amount of exposure, greater than ten thousand people,such as with major events, partnerships,or marketing campaigns for air service,the expense will be limited to nineteen thousand nine hundred ninety nine dollars and ninety nine cents;see below chart. Rate of Exposure Maximum Director Expense UP to 5,000 people $5,000.00 5,000 to 10,000 people $10,000.00 Greater than 10,000 $19,999.99 Additionally,significant exposure expenses over the Director's procurement authority will abide by the policies and procedures already outlined within the County's purchasing policy,with regard to County Manager approval and/or BOCC approval. it s37) V`AV1 Rotary ROTARY CONNECTS THE WORLD The Rotary Club of Key West has hosted the 4th of July Fireworks celebration for over 45 years, bringing thousands from all over the world together to celebrate here in the Florida Keys. The Key West fireworks has between 12,000 and 15,000 visitors in attendance viewing from the beaches, boats, hotels,, restaurants, and many other locations in Key West. In addition, the event is advertised countywide and on social media reaching thousands more! The hotels in the City of Key West and Monroe County are at max ity which shows this event and weekend . s a huge revenue capad generator for our local businesses and economy. This year is especially an 'Important year to generate revenue after the crucial impact the COVID-19 pandemic had on our community. cb,� 1z, June 1 , 2021 James Olive President Rotary Club of Key West Legendary KEY LARGO ® a s o Chamber of Commerce a Key West&Florida Keys Marathon International Airport Key Largo Chamber of Commerce 106000 Overseas Highway Atten: Richard Strickland,CM Atten:Elizabeth Moscynski Key West Florida,33040 Key Largo, FL 33037 305-393-7742 305-451-1414 4th of July Fireworks Show-Key Largo-Free Community Event at Rowell's Presenting Sponsor $15000.00 Sponsor Benefit Package Trustee Level Top Tier Membership with the Key Largo Chamber of Commerce Angle Fish Package: Business logo on home page of chamber website Two premium listings on website Run-of-site banner on website Logo recognition on the cover of the membership directory(welcome packages& online) Logo recognition in the annual visitor and newcomer guide Members Mailing labels 6 times a year Monthly meetings luncheon for 4 Ask a local(business card display) 12,full-page,full color ads in the Legend Monthly Newsletter Dues for 12 months up to Event Benefits: Presenting Sponsor of the Firework Logo on parade awards,banners,sponsor VIP tent,website,social media and poster Company banner in the parade Recognition on all media VIP seating for up to 10 at Parade First float placement in Parade Banner at Fireworks Link on Chamber event day web page Leto-Beth From: Mercado-Pedro Sent: Thursday,June 10,2021 5:05 PM To: Leto-Beth Subject: FW:Sponsorship Proposal with Benefits Attachments: Audience Overview Analytics All Web Site Data Audience Overview 20210101-20210531 (2).pdf,Users per day Analytics All Web Site Data Audience Overview 20210101-20210531 (1).pdf,Monthly Analytics All Web Site Data Audience Overview 20210101-20210S31.pdf RI Pedro Mercado n y ' Assistant County Attorney « 1111 12th Street,Suite 408 Key West, FL 33040 Rp cF � (305) 292-3470 ,,.:,..Ci LC COUNI (305)292-3516(fax) VERN4 ENT l.9A I, From: Dleon-Erick<Dleon-Erick@MonroeCounty-FL.Gov> Sent:Wednesday,June 9,20214:10 PM To: Mercado-Pedro <Mercado-Pedro@ Mon roeCounty-FL.Gov>; Leto-Beth<Leto-Beth@MonroeCounty-FL.Gov> Cc:Strickland-Richard <Strickland-Richard@MonroeCounty-FL.Gov> Subject: RE:Sponsorship Proposal with Benefits Pedro, See attached reports run from Jan 1 to May 31 that cover daily, monthly, and an overall audience overview. Page views (logo views)are around 16K a month and the site has about 4K plus new users a month.The newsletter is placed on the website and is also direct emailed to 650 people each month. Thanks, Erick D'Leon M: (786)647-9416 From: Mercado-Pedro< ercado-Pedro MonroeCounty-FL,Gov> Sent:Tuesday,June 8, 2021 6:15 PM To: Leto-Beth<Leto-Beth onroeCounty-FL,Gov>; Dleon-Erick<Dleon-Erick on roeCounty-FL.Gov> Subject: RE:Sponsorship Proposal with Benefits Erick, the benefits indicate that the airport logo would run on their website.Can you find out how many hits their website gets(daily, monthly) and the circulation for the Monthly Newsletter. d �Q Pedro Mercado � 11 Assistant County Attorney li 1111 12th Street,Suite 408 a� Key West, FL 33040 CfR - (305) 292-3470 CI YLtO NIY uµ (305) 292-3516 (fax) GPNNT LAW, _l From: Leto-Beth<L, Beth MonroeCounty-FL.Gov> Sent:Tuesday,June 8, 20216:09 PM To: Mercado-Pedro< - rcado-Pedro onrggCount -FL. ov> Subject: FW:Sponsorship Proposal with Benefits FYI,attached is a list of benefits for sponsoring the KL Chamber fireworks. From: Dleon-Erick<PDileon-Erick@ Mon roeCount -FL.Gov> Sent: Friday,June 4, 20214:39 PM To: Leto-Beth<Leto-Meth onroeCounty-FL. ;ov> Subject: FW:Sponsorship Proposal with Benefits fyi Erick D'Leon M: (786)647-9416 From: Elizabeth Moscynski<,oresident keyiar oc ar ber.q > Sent: Friday,June 4, 20213:37 PM To: Dleon-Erick<Dleon-Erick MonroeCouty-FL.Cov> Subject: RE:Sponsorship Proposal with Benefits CAUTION:This email originated from outside of the County.Whether you know the sender or not, do not click links or open attachments you were not expecting. Here is the updated proposal. I have included all the perks of the sponsorship. Elizabeth From: Elizabeth Moscynski<president keylar ochar ber,or° > Sent:Wednesday, May 26, 20213:40 PM To:'Dleon-Erick'<Dleon-E rick@ MonroeCo ul nt -FL. op Subject:Sponsorship Proposal Here you go. Let me know if this works President Key Largo Chamber of Commerce 106000 Overseas Highway Key Largo, FI. 33037 TOLL FREE: 800-822-1088 TEL: 305-451-1414 FAX: 305-451-4726 w_ .fla- eys.co / www. e lar ocharnber.or 2 Key Largo,FL Chamber t C1fI II I Data c to report Audiencei All Users Direct Traffic Jan 1,2021 -May 31, 100.00%Users 20.09%Users Organic Traffic Referral Traffic 66.02%Users 6.43%Users Overview All Users: 0 Users New Users Direct Traffic: $T Users New Users Organic Traffic: 0 Users New Users Referral Traffic: 0 Users New Users 6 000 6,000 4 000 4,000 2,000 -2,000' February 2021 March 2021 April 2021 May 2. IS New Visitor IN Returning Visitor Users New Users Sessions All Users Direct Traffic All Users All Users All Users 20,749 20,476 23,850 Direct Traffic Direct Traffic Direct Traffic 5,828 5,766 6,842 Organic Traffic Organic Traffic Organic Traffic 11110 11110 13,701 13,545 15,413 Referral Traffic Referral Traffic Referral Traffic Organic Traffic Referral Traffic 1,334 1,164 1,594 Number of Sessions per User Pageviews Pages/Session All Users All Users All Users 1 .15 82,619 3.46 A Direct Traffic Direct Traffic Direct Traffic 1 .17 41,721 6.10 Organic Traffic Organic Traffic Organic Traffic 1 .12 36,643 2.38 Referral Traffic Referral Traffic Referral Traffic 1 .19 4,254 2.67 Avg.Session Duration Bounce Rate All Users All Users 00:01:27 57.22% Direct Traffic Direct Traffic 00:01:28 56.05% Organic Traffic Organic Traffic 00:01:24 58.20% Referral Traffic Referral Traffic 00:01:52 52.82% Language Users %Users 1. en us All Users 18,089 21111M 86.99% Direct Traffic 4,307 11111M 73.90% Organic Traffic 12,681 MjMMM 92.25% Referral Traffic 1,207 INJIMlM 90.48% 2. en-us,W-8 All Users 1,124 5.41% Direct Traffic 1,124 M 19.29 i, Organic Traffic 0 0.00% Referral Traffic 0 0.00% 3. en All Users 579 2.78% Direct Traffic 121 2.08% Organic Traffic 416 3.03% Referral Traffic 45 3.37% 4. zh-cn All Users 253 1.22% Direct Traffic 116 1.99% Organic Traffic 102 0.74% Referral Traffic 35 2.62% 5. en-cgb All Users 232 1.12% Direct Traffic 37 0.63% Organic Traffic 182 E 1.32% Referral Traffic 15 1.12% 6. en-ca All Users 72 0.35% Direct Traffic 21 0.36% Organic Traffic 44 0.32% Referral Traffic 8 0.60% 7. es-as All Users 51 0.25% Direct Traffic 11 0.19% Organic Traffic 35 0.25% Referral Traffic 5 0.37% 8. en-au All Users 44 0.21% Direct Traffic 14 0.24% Organic Traffic 28 0.20% Referral Traffic 2 $ 0.15% 9. es-es All Users 33 0.16% Direct Traffic 8 0,14% Organic Traffic 23 0.17% Referral Traffic 2 0.15% 10.h'•fr All Users 32 0.15% Direct Traffic 5 0.09% Organic Traffic 27 0.20% Referral Traffic 1 0.07 0 2021 Google Analytics 1,,1,,g.,FL Chamber Go to report All Web Site Data Audience Overview 0 All Users Jan 1,2021 -May 31,2021 100.00%Users Overview 0 Users New Users 600 6,000 4,000 4,000 2 2,000 February 2021 March 2021 April 2021 May 2 III New Visitor 0 Returning Visitor Users New Users Sessions 20,749 20,464 23,850 Number of Sessions per User Pageviews Pages/Session 1 .15 82,619 3.46 Avg.Session Duration Bounce Rate 00:01:27 57.22% Language Users %Users ........ ........ 1. en-us 18,089 1111111= 86.99% 2. en-us ulff-8 1,124 5.41% 3. en 579 2.78% 4. zh-cn 253 1.22% 5. en-gb 232 1.12% 6. en-ca 72 0.35% 7. es.us 51 0.25% 8. en au 44 0.21% 9. es-es 33 0.16% 10.'r-f r 32 0.15% C 2021 Google Key Largo,FL Chamber r�alytl�� II Its at t�report Audience Overview All Users Jan 1,2021 -May 31,2021 100.00%Users Overview Users New Users 60D s{3f1'.. { AGO i February 2021 March 2021 April 2021 May 2021 91 New Visitor 11 Returning Visitor Users New Users Sessions 20,749 20,464 23,850 Number of Sessions per User Pageviews Pages/Session 1 .15 82,619 3.46 Avg.Session Duration Bounce Rate 00:01:27 57.22% Language Users %Users 1. en-us 18,089 86.99% 2. er:-rsS Utf-,8 1,124 5.41% 3. era 579 2.78% 4. sts-ors 253 1.22% 5. ens-gb 232 1.12% 6, en-ca 72 0.35% 7. es-us 51 0.25% 8. eel-au 44 0.21% 9. es-es 33 0.16% 10.fr-fr 32 0.15% 2021 Google APPLICATION MONROE COUNTY PLANNING&ENVIRONMENTAL RESOURCES DEPARTMENT Request for Public Assembly Permit An application must be deemed complete and in compliance with the Monroe County Code by the staff prior to the item being scheduled for review. Application Fee: $150.00 Public assembly means an outdoor gathering in temporary structures such as tents,of individuals that may be attended by members of the general public,with or without an admission charge,when the anticipated daily attendance is expected to exceed 250 persons a day and that occurs on more than one day per calendar month,including flea markets,but excluding: (1)Events or functions,put on by any government agency including athletic events on athletic fields;or (2)Camping activities conducted by charitable organizations devoted to serving young people. An application for a permit to hold a public assembly must be filed with the Planning Director at least 9 days before the day on which the public assembly is to be held. However,if the public assembly is to be held within 9 days after a specific and unanticipated event or announcement of public importance and in response to it,the application may be filed within 24 hours after the event or announcement and at least 36 hours before the public assembly is to be held.The Director may also receive and act on an application even though the application was not filed in time,if necessary to preserve the First Amendment rights of an applicant. Date of Application: 5 / / Lo Q- Month Day Year Applicant/Agent Authorized to Act for Property Owner/Person Sponsoring the Public Assembly: (Agents must provide notarized authorization from all property owners.) re d �i wI, Applicant(NanwO of Person,Business or Organization) Name of Person Submitting this Application :. :.. a, Mailing Address(Street,City,State and Zip Cod ) t 1 Q 14 / . Work Phone Home Phone Cell Phone Email Addressre g Property Owner: (Business/Corp must include documents showing who has legal authorized to sign.) (Name/Entity) Contact Person TM MailingAddress Street,City,State and Zip Code) 'g ww Work Phone Home Phone Cell Phone Email Address Pagel of 4 Last Revised August 2020 APPLICATION Description of property on which the public assembly shall take place: (if in metes and bounds,attach legal description on s-parlte sheet.) A V"j P Block Lot J bdivision Key,", Real Estate(RE) Parcel ID Number Alternate Key Number Street Address_f(_Streei,City,State&Zip Code)' Approximate Mile Marker Name of Event if applicable): Date(s)in which the event is to be held: v Hours in which the event is to be held: Estimated"maximum"number of persons to participate in and/or attend event: Estimated"maximum"number of persons to participate in and/or attend event within a given hour of the event (peak anticipated attendance): 'C' Total number of parking spaces at the property on which the public assembly shall take place: Total number parking spaces ?� aces dedicated to the public assembly at the property on which the event shall take Place, Estimated maximum parking demand during the peak anticipated attendance: Please provide the general nature of the public assembly and the arrangements made to protect the public health and safety during the conduct of the public assembly, including arrangements with respect to traffic direction and control,crowd control and sanitation facilities.Access for fire department and emergency vehicles shall be clearly designated and maintained at all times: UV11r1A_f�1( fflcl n<; CL Acii -6 Please provide a description of the arrangements made to avoid substantial harm to the public health or safety and to minimize or to avoid substantial harm to,or impairment of the normal use of,a public place or to avoid substantial harm to the envirou lent: ILL _U L j 4 4 G 0 6�f 01(A_!5J "'evised August 2020 Eileen Eadie Subject: FW: Rowell's Marina-4th of July Event From: Elizabeth Moscynski<f residen .gyjargpthp it r. r > Sent:Wednesday,June 2,202111:28 AM To: 'Hemeyer-Zully'<H rr +yp',,! it MonroeCo j n - G > Cc: 'Moeller-Mary'< ,lir roe < - L : Lirrsr:r ;_i....Mt ?>; Eileen Eadie < iRrdrI ' _ Ir. brrr.rr> Subject: RE: Rowell's Marina-4th of July Event Thank you for getting this to us. Monroe County is funding the event, and we are the party involved in carrying it out. The Park is Rowell's,Waterfront Park. Since it is a County Park,does the Fire Department have a site plan to identify the water sources? If so, is it possible for me to get a copy? We should have our paperwork(excluding fireworks)to the Fire Dept. in a few days. Once viewed and if approved, how long will it take to get the letter? Thank you for the information on the Fireworks. The Technicians have been doing the shows for several years in the Florida Keys; currently,they are obtaining permits. Thank you for your time. Respectfully, 1/ y� / President Key Largo Chamber of Commerce 106000 Overseas Highway Key Largo, FI. 33037 TOLL FREE: 800-822-1088 TEL: 305-451-1414 FAX: 305-451-4726 .fI - rn tcf- i fs — ,t From: Hemeyer-Zully< em s r r ZU 1 LI,%_ proeCqt nt—� ��> Sent:Tuesday,June 1,20215:38 PM i 41h of July Letter Requirement for Monroe County Fire Department Key Largo Chamber of Commerce Requestor 1. A detailed Scope of Work/Event Plan/Brief Narrative describing the event: ➢ A free Community Event,sponsored by Monroe County Key West International Airport, along with County Commissioner Mike Forester. ➢ Minimal work effort for set up and tear down; Spectators are welcome to bring lawn chairs and blanket for viewing fireworks on Blackwater Sound. (no seating will be provided by event host) ➢ Area provided for vehicle parking. ➢ Marginal set up and tear down. One (1) Food Trailer,Three(3)-pop-up canopies and small sound stage to paly music with Fireworks Show. ➢ Park will open at 6:30 PM for Firework Show at 9:30 PM. Fireworks will be launched off a barge on Blackwater Sound, out of range of land. ➢ Two County Sheriffs on Duty ➢ Parking will be directed by Event Volunteers. ➢ Safety Briefing will take place prior to the event. 2. Identify the location(s)for the event: Monroe County Park—Rowell's Waterfront Park 3. Identify the dates and times of the event,including days for set up and tear down: • July 4th, 2021—6:30 PM to 10:00 PM • Set up—Afternoon of July 4th—Tear down evening July 4th(Food trailer may be moved the next day) 4. Provide an estimated number of attendees, including those who will work at the event: • 500(first time event estimate) and Volunteers 20 5. Provide a proposed site plan indicating event areas,such as food trucks,parking, ingress/egress, and seating, including a North directional arrow: Attached 6. Please quantify any tents,canopies,air supported structures,food carts,rides, booths,games,stages and types be utilized and type(s)and size(s): • Small 10 x 10 stage for sound only • 3—10 x 10 popup canopies (no cooking will take place) • New food trailer owned by Rotary Key Largo. 7. Identify fire extinguishers to be used: Extinguishers set up in 5 areas—See Site-Plan Attached 8. If food trucks or food vendors are proposed,please identify the type of cooking to be performed with details on type of heating,fuel,stand-by power,etc. • Food equipped with propane and gas powered generator • Cooking Hamburgers—Hot Dogs on flat grill and French fries in a safety equipped fryer. • Standby power is a generator—two gas powered 9. Identify/Depict Fire Department Access routes on plan:See Site-Plan Attached 10. Identify/Depict Fire Department water supply location and type or Fire Hydrants on plan: Monroe County Park, water supply and Fire Hydrants are not physically identified in the park. A site plan to identify the area or location from the Fire Department was requested. See attached email request. Mission: Ron DeSantis Governor To protect,promote&improve the health of all people in Florida through integrated v Scott A.Rivkees,MD state,county&community efforts. "� `' State Surgeon General HEALTH Vision:To be the Healthiest State in the Nation May 28, 2021 Key Largo Chamber Of Commerce 106000 Overseas Highway Key Largo, Florida 33037 RE: Key Largo Chamber Of Commerce 41' July Fireworks Rowell's Marina 104550 Overseas Highway Key Largo, Florida 33037 Fireworks will go off in the Florida Bay and be watched from Rowell's Marina The special event is on: July 4, 2021 from 6:30 pm to 10 pm To Whom It May Concern, This serves as approval of the requirements of portable restrooms at the special event under the following conditions per 64E-6.0101 (7) Table PRI Florida Administrative Code: Estimated number of people in attendance: 250/day Duration: Approximately 4 Required number of portable restrooms: 2(two) The portable restrooms will be placed in in a convenient area for the people attending the special event for the duration of the special event. These restrooms shall be serviced as necessary so as not to create unsanitary conditions. This approval is limited to the date(s) and conditions. Failure to comply with these requirements may result in the department pursuing legal redress. Any changes to the number of people at the special event or the duration of the special event will require the re-approval by the Florida Department of Health, Bureau of Environmental Health in Monroe County. Thank you for your cooperation with the Florida Department of Health, Bureau of Environmental Health in Monroe County. Regards, c., Fitima Garcia Environmental Specialist CC: File Florida Department of Health in Monroe County 1100 Simonton Street,Key West,Fl.33040 PHONE:30503-75M -FAX:305/8095629 ° Public Heafth Accredftad6n Monroe.FLHealth.gov _ o CD m m - cm a > y c. r CL 0 E o c tM Q pz "a 10 C w ` 0 w d w K O m 0 �e = Of m 3 0 •� � " a, m � .. o io c Tv c a V H d a a m > E Q � c J O fn to i�i O W V C V W H g C R "� _ 0 N m C CL c d C = rr R CO O OOi 7 V 'a Q R A a Z C� �"' O C 3 W i C. O R H H _ '3 0. > Z .t2"' L. N E O O d � � � E a 'O tom! .�. 3 m 'o w m �. c m .'�. � oaia E3 cc c cc w d F; c vl A V m c c Q O R l06LMd CO) 0 0. ca W Cl) O d' O 1L v O. d C N" 0 'C Q � IL � 3 W � h E l t G £ £ £ I� r I 9 � a I r r ty r t 4 � I - ��s�r� fi,� £r��t�,l�, �.,„l(jt3�s��11>� �����14£££,•?�z� 1;-£ ,�>1�t' s �?t, ����� ,�ut �����7�ri.rSi ���t�� 1� � � �� - 5&�ot - rl�a,lhls�l,��t},�3} ��,1 S� 3;: �1 ,+7>. �t£»tl,,.{ Si„I�r t,.t,uti�hr£}�,��„y1 r;. r;t £� ,�,1�1 ,.f, �, r � t• zs,� t Ck`., � )JL,..,I(,c, ;.}, � t�»-. �II,..t)( - ��, 'I"'AM - c, .� �lSlt - � �s - (,��+t {2;i � ,r�,1s, 11�1 - i�., {��,� �,s11 I�£,; j�I-- 1 rr£ l.tt ��S� �1 .SSA £..4� t £i ( �t,, - _� � � `s �• i t �R4�Mii�4�s CERTIFICATE OF LIABILITY INSURANCE °AT512w mr 05/20/2021 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. N SUBROGA710NIS 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 REGAN INSURANCE AGENCY INC/PHS NAME: 21224589 PHONE (866)467-8730 FAX (888)443-6112 The Hartford Business Service Center (Iuc,N°'Ext): (ac,No): _ ..............� 3600 Wiseman Blvd E-MAIL San Antonio,TX 78251 ADDRESS: INSURER(S)AFFORDING COVERAGE NAICM INSURED INSURER A: Sentinel Insurance Company Ltd. 11000 KEY LARGO CHAMBER OF COMMERCE INSURER B: 106000 OVERSEAS HWY KEY LARGO FL 33037-3116 INSURER C: INSURER D: 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 INDICATEDMOTWITHSTANDING 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. INSF TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTA€ NSR 9W0_ MM/DD Y Y MMIDD/Y YYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000' DAMAGE TO RENTED CLAIMS-MADE�OCCUR $1,000,000 S .ta,wrrence)' X General Liability MED EXP(Any one person) $10,000 X 21 SBM BS8815 04128r2021 04/28/2022PERsoNAL&ADVINJURYA $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000' POLICY❑PRO- LOC PRODUCTS-COMP/OPAGG $2,000,000 JECT .....OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) A ALL OWNED SCHEDULED 21 SBM BS8815 04/28/2021 04/28/2022 BODILY INJURY(Per acdclerd) AUTOS AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAR ' OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- MADE AGGREGATE DED I RETENTION$ E��_ WORKERS COMPENSATION PER ' OTH- AND EMPLOYERS'LIABILITY TATU. R _ ANY YIN E.L.EACH ACCIDENT PROPRIETOR/PARTNER(EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A ErEL. L DISEASE-EA EMPLOYEE (Mandatory in NH) If yes,describe under DISEASE-POLICY LIMIT DESCRIPTION OF OP£ A:TIONsW.icsv A EMPLOYMENT PRACTICES LIABILITY 21 SBM BS8815 04/28/2021 04/28/2022 Each Claim Limit $10,000 Aggregate Limit $10,000 [DESCRIPTIONOF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) hose usualtothe Insured's Operations.Monroe County BOCC&Monroe County TDC are an additional insured per the Business Liability Coverage orm SS0008,attached to this policy in respects to the 4th of July Event at Rowell's Marina. CERTIFICATE HOLDER CANCELLATION _ Monroe County BOCC&Monroe County TDC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED PO BOX 1026 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED KEY WEST FL 33041-1026 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD MONROIE COUNTY SHIERIPPS OFFICE MM d `• Sin m' Y IE 1 May 24,2021 y 1-0 whom it may concern: The Key Largo Chamber of Commerance has inform the Monroe County SherifF s Office of a local special event planed for July 40 2021 from 6:30 pm until 10:00pm at Rowell's Community Park in Key Largo located at the 104 mile marker. The event is a 41h of July fireworks display and as estirnated.to attract approximately 200-250 persons attending t the event. The event coordinator is responsible for securing necessary permits for this event based on the estimated attendance and all pertinent information. Monroe County Sheriff's Office will respond to all emergency situations as needed via the 911 system during this time period as well as any non-emergency request via dispatch. The Key Largo Chamber of Commerance will employ two off duty Monroe County Deputies to serve as security at this event. Please do not hesitate to contact us if you have any questions or concerns regarding this matter. Sincerely, � ', � Capt. Don Fanelli I P .w �._.�100 TAVERMMI,330 0 (305) 5-5;2111:._'_.. 5) 5 -5205 WWW.FrOOONET lip Key Largo Fire Department 1 East Drive Key Largo,Florida 33037 Tel:305-451-2700 dgarrido@keylargofire.com Date:May 27,2021 Event:July 40'Parade Date of event:July 41',2021 Sponsor:Key Largo Chamber of Commerce Location:Key Largo,Florida Dear Mrs.'Ladie Thank you for contacting me and informing the Key Largo Fire Department of your upcoming event.We understand this event is scheduled to be held on July 41.The parade is 10:00 A.M— 11:45 A.M.and the firework show commences at 6:30 P.M.through 10:00 P.M.The Key Largo Fire Department is aware and will respond to all emergencies via the 911 system. If you have any questions,please,don't hesitate to contact me. 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O'-O" 'Sf'a U ❑ i ;4'a13•'; �� - ' X �� a O d $ 0 8SL o ."' 025iaaa Jd)!1+£ Q A H a-I i V,7 N O O N N,.1 1. in w t, to +n +ss ea w n �R r ® aSSa � � � � �� �yttl` t � a a r � \u7 tl1 ��►.b v aN }}N CO "� V M IE n8 8 O 01 0, p mO 1 a .. y .-I 1H 14 M: cn E O7 M M M M'M M OA b m Ln Y M °. O. °.`° f > C a N � d ' a +? ZB N a L L Cl) IDa cu) -CO > U41 (no .2 ei .3 x Ci E CN .2 .0 to r C. 0-0 9 13 aj CD mm 0 O 0 >>m 2 04 co 0 a; LO Y C. 9 u 04 w 00 LO CD CD 0. C, 0 CN CL 0 cli 0) CD 0 00 00 LL LO Cl) CO u II 2 E Mu 0 CL w 0 0) (L C; 2 W-0 10 CL a) U Im 0 a- w E c 0 CL Kb t u 0 w � CL a cl 2 Cc: m > -.—. cwr CD E E 0 > 0 m M 0 0 5. x wr- B, Cc,2� R, 001 Ln E < -C 0 :2-:E t rL ® > C-4 0 m 0 U Cl W 66jz m = 0 u Ot c CL 0 M is V -0 E a E-M" CD -C :3 Q .� OL C', z CL>D CL U) ............ R1 Pedro Mercado Assistant County Attorney 1111 12th Street,Suite 408 Key West, FL 33040 (305)292-3470 C C. (305)292-3516 (fax) CITY CO LINT Y &'LOCAL, GOVERNMENT LAW . ............'4 From:Sam Williams<swi11iarns(@samdwi11iams,com> Sent:Thursday,June 10, 20214:13 PM To: Mercado-Pedro<Mercado-Ped roCcD Mon roeCounty-FL.Gop Subject: RE:4th of July sponsorship CAUTION:This email originated from outside of the County.Whether you know the sender or not, do not click links or open attachments you were not expecting. Pedro, Marathon's Independence Day celebration is our largest community party of the year. More than 3,000 people attend the event on Sombrero Beach each year, and most of them stay until the fireworks — honestly, the best small town fireworks display in America. And the fireworks crowd grows larger, both on land and with the literally hundreds of boats that watch from the water. This year, with July 4th falling on a Sunday, our crowds will be larger than usual. In recognition of our sponsors, our Rotary Club is placing a full two-page spread ad in the Weekly Newspapers. The Marathon issue of this newspaper is home-delivered as well as distributed to nearly every commercial and retail location. They have a print circulation of more than 5,000 copies a week, as well as more than 50,000 unique online visitors per month racking up a half-million page views. Our sponsors will also be recognized on our radio campaign on WWUS-FM radio with heavy rotation of our ads the week before the event. Sam Williams PA Realtor(c) Rotarian(c) 11050 Overseas Highway Marathon Florida 33050 Office: 305-289-6559 swilliarns.realestateflor'LdakeXs com Sam's Bio/About Sam<hjtpsjj Jjgp xc Al 7/,�a o Z !L!o io_�� > _Q114 Z. KZ.QA _p1g2�ZftEQ Top Producer Entire Middle Keys 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020 Please note that any negotiation communications included in this email does not constitute a contract until it's in writing and executed by both parties From: Mercado-Pedro<Mercado-Pedro@MonroeCountv-FL.Gov> Sent:Wednesday,June 9, 20212:20 PM To:Sam Williams<swill ia ms@sa mdwi 11 iarns.com> Cc: Leto-Beth<Leto-Beth(@Monrqge�Q�uFL,Coy> Subject:4th of July sponsorship Importance: High REQUEST FOR USE OF COUNTY PROPERTY IN MONROE COUNTY,FLORIDA Date: 05252021 Name of Contact and organization: Lower keys Rotary Heidi Morris Address&Telephone number: 181 Key Deer Blvd Big Pine Key FL 33043 305 414 8347 Email: store6896@theupsstore.com Specific County property or meeting room requested: Big Pine Community Park Intended use: community Independence Day Celebration Date(s)needed: July 3 2021 Time: from 12:01 am to 12:00 pm Official Monroe County Government Use: Yes ❑ No ❑ Number of participants: 900 Alcohol consumption/sales? Yes ❑No ❑ Use of personal BBQ grill: Yes ❑ No ❑ USE OF COUNTY PROPERTY ONLY Clean up provisions, assurances, and state if any improvements are to be to facility: We provide set up and teardown w/volunteers...Please see attched Coordination with: Sheriff Dept: Yes ❑■ No ❑ Fire Dept: Yes ❑ o Security: Yes Q No ❑ Public Works: Yes ❑ No ❑ Previous history of holding similar events: Yes ❑ No ❑ USE OF MEETING ROOMS ONLY Special Audio Visual Equipment needed: Yes ❑ No ❑ Describe: Public Address System: Yes ❑ No ❑ Arrangement of Room: Fees are listed on pages 8, 9, and 10 of the Policy for Public Facilities,Roads,Bridges, & County Meeting Rooms and are NON-REFUNDABLE. Checks or Money Orders are to be made payable to Monroe County Board of County Commissioners. COUNTY USE ONLY Scheduled Date: Insurance/Hold Harmless Requirements: Approved: Yes ❑ No ❑ By: Fees charged or basis for waiver to be approved by County Administrator: Alcohol use or basis for waiver or special conditions to be approved by County Administrator Remarks: 10/17 MEMORANDUM OF REQUEST From: Lower Keys Rotary Club �eys To: Monroe County Public Works Monroe County Attorney-Pedro Mercado �=w• Monroe County Administrator d tE . t to May 24,2021t' , w PURPOSE C ',ra'n d a s This is to request the use of the Big Pine Community Park as a venue of our annual Independence Day Celebration,which includes the only public fireworks display in the Lower Keys. Having the event at the Big Pine Community Park will facilitate the county's involvement in this beloved Independence Day Celebration at the beautiful county park that still doesn't have the following that it should. This will be a showcase for thousands of people to check out this wonderful venue that was always intended for community recreation. This year's event falls on Saturday,July 31 We would need the use of the park for pre-staging of the event July 1,2,3,4 and for teardown on July 51n Staging is accomplished by using Rotary club members and volunteers. We would be using the open field between the ball field and the community center. The event itself begins at 5pm July 3`d and ends after the fireworks,which begin firing shortly after dark,so a concrete time frame is not possible. EVENT DETAILS The Rotary Club does not charge for entrance to this public event. We have vendors come in and sell food, water,and soft drinks for the attendees. Those vendors pay the Rotary Club a fee and we in turn use the funds to help pay for the event. The fireworks display is paid for by funds raised in fundraising activities throughout the course of the year. We host celebrity grocery bagging events on Big Pine and solicit donations and sponsors prior to the event. Our only money-raising activities the day of the event are our sales of beer, wine and a 50/50 raffle.We are also asking permission to continue the sale of alcoholic beverages at the event. We erect a large stage with shade for the band, mount our USA flag and provide access for the event MCs. Attendees often bring lawn chairs or blankets for seating maintain safe social distancing and mask wearing for all non-fully vaccinated attendees will be encouraged per current CDC guidelines.. No coolers are allowed. The club handles parking and event access. We hire MCSO deputies for crowd control.Waste Management provides trash/recycle receptacles and portable facilities will be provided to alleviate pressure on the park's sewer system. We would need access to water but we supply our own generator for power needs. Events include games for kids(with the addition of this venue also the playground), raffle, live music,food, drinks,and vendors and possibly a dunk tank and bounce house. We are planning to shoot the fireworks from a barge on the waters within the park.We plan to notify the neighbors of the impending event as we will be using both the park and adjacent streets for parking of event traffic. Our crews and MCSO will oversee that operation. The fireworks company provides event liability insurance and we will provide the paperwork with the county as a named insured. Monroe County Fire Rescue will be on site for medical emergencies. FUNDING Funding is derived through Rotary Club donations,event sponsors,sales of alcoholic beverages,celebrity bagging,and other events. All funds raised are used to pay for the event/. Estimated event costs: Fireworks $12,000 Food& Beverages $1,000 MCSO $400 Waste Management$1,500 Equipment rental $400 Music $700 Total $16,000 For the last several years,the event has lost small amounts of money. Because of that there is no beneficiary of net proceeds. If net proceeds were to occur,they would be placed in a dedicated account to help pay for the 2021 Independence Day Celebration. The Lower Keys Rotary Club is a non-profit Florida Corporation. REQUESTS 1. Use of the Park from July 1 through July 51n 2. Waiver of closing hours 3. Waiver of event fees 4. Alcoholic beverage sales 5. Waiver of clean-up fees Rotary uses club volunteers and community volunteers for equipment removal and site clean up after the event. � wa e� w I r w° w° u s ® , 0 Oe O O � Ot } u, t, - 7 1 i � G 1. Ao �a w 10 0 os os os - o g o F. Yi t „ U MONROE COUNTY PLANNING&ENVIRONMENTALRESOURCES ENT r ,z�,� -, dk"•- v`kh s Request for Public Assembly Permit An application must be deemed complete and in compliance with the Monroe County Code by the staff prior to the item being scheduled for review. Application Fee: $150.00 Public assembly means an outdoor gathering in temporary structures such as tents,of individuals that may be attended by members of the general public,with or without an admission charge,when the anticipated daily attendance is expected to exceed 250 persons a day and that occurs on more than one day per calendar month,including flea markets,but excluding: (1)Events or functions,put on by any government agency including athletic events on athletic fields;or (2)Camping activities conducted by charitable organizations devoted to serving young people. An application for a permit to hold a public assembly must be filed with the Planning Director at least 9 days before the day on which the public assembly is to be held. However,if the public assembly is to be held within 9 days after a specific and unanticipated event or announcement of public importance and in response to it,the application may be filed within 24 hours after the event or announcement and at least 36 hours before the public assembly is to be held.The Director may also receive and act on an application even though the application was not filed in time,if necessary to preserve the First Amendment rights of an applicant. Date of Application: 1 / Month Day Year Applicant/Agent Authorized to Act for Property Owner/Person Sponsoring the Public Assembly: (Agents must provide notarized authorizatio o all property owners.} Applicant(Name of Person,RJiness or Organization Name of Person Submitting this Application Mailing Address(Street,City,State and Zip Code) l . Work Phone Home Phone Cell Phone Email Ad ess PropertyOwner: (BusinesslCorp must include documents showing who has legal authorized to sign.) (Name/Entity) kontact Person - - - Mailing Ad ress(Street,City,State and Zip Code) T Work Phone Home Phone Cell Phone Email Address Pagel of 4 Last Revised April 2017 Description of property on which the public assembly shall take place: (If in metes and bounds,attach legal descri tion on separate sheet.) rl�na ,na-15 C) Block Lot Subdivision Key Real Estate(RE)Number Alternate Key Number Street ddress(Street,City,State&Zip Cade) Approximate M e Marker Name of Event(if applicable): Date(s)in which the event is to be held: L ®1 Hours in which the event is to be held: � olan - Estimated"maximum"number of persons to participate in and/or attend event: Estimated"maximum"number of persons to participate in and/or attend event within a given hour of the event (peak anticipated attendance): Total number of parking spaces at the property on which the public assembly shall take place: Total number of parking spaces dedicated to the public assembly at the property on which the event shall take place: Estimated maximum parking demand during the peak anticipated attendance: Please provide the general nature of the public assembly and the arrangements made to protect the public health and safety during the conduct of the public assembly, including arrangements with respect to traffic direction and control,crowd control and sanitation facilities.Access for fire department and emergency vehicles shall clearly des° aced and maintain at all times: Please provide a description of the arrangements made to avoid substantial harm to the public health or safety and to minimize or to avoid substantial harm to,or impairment of the normal use of,a public place or to avoid su stantial harm to the environment: , Page 2 of 4 Gast Revised April 2017 All of the following items must be included in order to have a complete application submission: (Please check the box as each required item is attached to the application.) Completed application form Correct flee(check or money order payable to Monroe County Planning&Environmental Resources) FA V rrent Property Record Card(s)from the Monroe County Property Appraiser Location map Site Plan DRAWN TO SCALE, of the event venue, showing ingress and egress paths, parking spaces (# of spaces), emergency vehicle access, location of temporary structures (if any), location of stages (if any), and locations of any other attractions that may be on site. Identify Documentation that the requested use of the designated place has been granted by the person or government having the authority to grant the use of that place(in the case of Monroe County owned property,a completed"County Use Form"from the Public Works Division shall be required) The name,residence address, and telephone number of any principal officer(s)of the applicant and/or any other individual(s)authorized to represent the applicant in applying for the public assembly permit. E Copy of written coordination from the Florida Health Department if portable toilets are to be utilized. F i L.- Written acknowledge of the event from the Monroe County Sheriff's Office. Written acknowledge of the event from the Monroe County Office of the Fire Marshal. If there are temporary structures being used for assembly or seating, a seating chart of the structure shall be provided,including tables,chairs,aisles,egress paths and exits Provide a Crowd Control Manager per every 250 persons(an individual that can provide evidence of completion of the Florida Certified Crowd Manager training course, or have a Current Florida Basic Law Enforcement Officer Certification,or have a Current Florida Fire Safety Inspector Certification). If the event is to take place within the Key Largo Fire District (an independent fire control district established by the Florida legislature), a letter of coordination with the District shall be obtained, and applicant shall be advised that The KLFD may impose additional restrictions/requirements that shall be provided. If deemed necessary to complete a full review of the application,the Planning&Environmental Resources Department reserves the right to request additional information. BIG PINE AND LOWER KEYS ROTARY INC.FIREWORKS ACCOUNT 81-275/829 388 PO BOX 431957 BIG PINE KEY,Fl, 33043 Dare PAY TO_ I Of P; (70 ME ORDER 01' DOLLARS 9 W ...wom MEMO 1:08 2 90 2 7 5 71: 00 010131.4i 3 8 8 The applicant/owner hereby acknowledges and agrees that any staff discussions or negotiations about conditions of approval are preliminary only, and are not final, nor are they the specific conditions or demands required to gain approval of the application,unless the conditions or demands are actually included in writing in the final development order or the final denial determination or order. By signing this application,the owner of the subject property authorizes Monroe County Planning& Environmental Resources staff to conduct all necessary site visits and inspections on the subject property. I,the Applicant,certify that I am familiar with the information contained in this application and,that to the best of my knowledge such information is true,complete and accurate. Signature of Aplica Date: f STATE OF � > COUNTY OF Sworn n to and subscribed before me this day of 20 d7 by � � who is personally known to me OR produced (PRINT NAME OF PERSON MAKING STATEMENT) as identification. (T PE OF ID PRODUCED) pp Signature of Notary Pub4if,State of Florida Print,Type or Stamy Commissioned Name of Notary Public My commission expires:+,, Zq,,2G 7 Notary Public-State of Florida a ;,' Commission#GG 328517 Z: My Commission Expires April 29,202 Send complete application package to: Monroe County Planning& Environmental Resources Department Marathon Government Center 2798 Overseas Highway,Suite 400 Marathon,FL 33050 Page 4 of 4 Last Revised April 2017 MEMORANDUM F REQUEST From: Lower Keys Rotary Club �eys d To: Monroe County Public Works lair Monroe County Attorney-Pedro Mercado :. v Monroe County Administrator January 24, 2020 tflok for PURPOSE I�sff a n.( r This is to request the use of the Big Pine Community Park as a venue of our annual Independence Day Celebration,which includes the only public fireworks display in the Lower Keys. Having the event at the Big Pine Community Park will facilitate the county's involvement in this beloved Independence Day Celebration at the beautiful county park that still doesn't have the following that it should. This will be a showcase for thousands of people to check out this wonderful venue that was always intended for community recreation. This year's event falls on Friday,July 3rd We would need the use of the park for pre-staging of the event maybe Tuesday,June 30,but July 1,2,3,4 and for teardown on July 5`". Staging is accomplished by using Rotary club members and volunteers. We would be using the open field between the ball field and the community center. The event itself begins at 5pm July 3'd and ends after the fireworks,which begin firing shortly after dark,so a concrete time frame is not possible. EVENT DETAILS The Rotary Club does not charge for entrance to this public event. We have vendors come in and sell food, water,and soft drinks for the attendees. Those vendors pay the Rotary Club a fee and we in turn use the funds to help pay for the event. The fireworks display is paid for by funds raised in fundraising activities throughout the course of the year. We host celebrity grocery bagging events on Big Pine and solicit donations and sponsors prior to the event. Our only money-raising activities the day of the event are our sales of beer, wine and a 50/50 raffle.We are also asking permission to continue the sale of alcoholic beverages at the event. We erect a large stage with shade for the band, mount our USA flag and provide access for the event M Cs. Attendees often bring lawn chairs or blankets for seating. No coolers are allowed. The club handles parking and event access. We hire MCSO deputies for crowd control.Waste Management provides trash/recycle receptacles and portable facilities will be provided to alleviate pressure on the park's sewer system. We would need access to water but we supply our own generator for power needs. Events include games for kids(with the addition of this venue also the playground), raffle, live music,food, drinks, and vendors and possibly a dunk tank and bounce house. We are planning to shoot the fireworks from a barge on the waters within the park.We plan to notify the neighbors of the impending event as we will be using both the park and adjacent streets for parking of event traffic. Our crews and MCSO will oversee that operation. The fireworks company provides event liability insurance and we will provide the paperwork with the county as a named insured. Monroe County Fire Rescue will be on site for medical emergencies. FUNDING Funding is derived through Rotary Club donations,event sponsors,sales of alcoholic beverages,celebrity bagging,and other events. All funds raised are used to pay for the event/. Estimated event costs: Fireworks $12,000 Food& Beverages $1,000 MCSO $400 Waste Management$1,500 Equipment rental $400 Music $700 Total $16,000 For the last several years,the event has lost small amounts of money. Because of that there is no beneficiary of net proceeds. If net proceeds were to occur,they would be placed in a dedicated account to help pay for the 2020 Independence Day Celebration. The Lower Keys Rotary Club is a non-profit Florida Corporation. REQUESTS 1. Use of the Park from July 1 through July 5`h 2. Waiver of closing hours 3. Waiver of event fees 4. Alcoholic beverage sales 5. Waiver of clean-up fees Rotary uses club volunteers and community volunteers for equipment removal and site clean up after the event. gPublic.net- Monroe County, FL Pane 1 of 5 f4qPUb11c.neV MonroeCounty, FL Disclaimer The Monroe County Property Appraiser's office maintains data on property within the County safely for the purpose of fulfilling its responsibility to secure a just valuation for ad valorem tax purposes of all property within the County.The Monroe County Property Appraiser's office cannot guarantee its accuracy for any other purpose.Likewise,data provided regarding one tax year may not be applicable in prior or subsequent years.By requesting such data,you hereby understand and agree that the data is intended for ad valorem tax purposes only and should not be relied on for any other purpose. By continuing into this site you assert that you have read and agree to the above statement. Summary Parcel ID 00286360-000000 Account# 1353550 Property ID 1353550 MillageGroup 100H Location 31009ATLANTIS or,B G Pi`I=KEY Address Legal wH'SPER1,NGP,`•I"cSPL',Tn3P8=57 BIG PINE KEvT.ACTAOP585-81 Description OR749 365-CGR7r9-373OR10'2 2nv512-;e- OR 0.2-2.472 2�?3Q C - „.✓.+et,` , CASE:f33-10213-CId-(VT�1OR13^.'?-156t)020P1792.179/21 (Nate:Not to br•used on L•;a. Neighborhood 10051 Property Class COUNTYt36o0' Subdivision WHISPERING PNESNO3 Sec/Tvip/Rng 24/66;29 Affordable NO �` `°� - Housing Owner hIOtiROE COUNTY BOARD Oi COUNTY COM."IISSIONER5 1100SINIONTO JST KEY WEST FL 33040 Valuation 2027 2016 2015 2014 + Nlarkat Irnpro4einent V.i'.ue $929,271 $929,271 $941,852 $956,515 + Market 4I sc Value $754,107 $754,107 $679,575 $639,596 + Mirk;2t Land Va;ut $1,440,23t- $1.44J.238 $1,440,238 $1,545,944 = Just Market Value $3,123,616 $3,123,616 $3,061.665 $3,142,055 = Total Assessed Value $2,399,268 $2.181,153 $1,982,867 $1,802407 Schoc!Enempt Va:ue ($3,123,616) ($3123,616) ($3,061,665) ($3,142,055) School Taxable Value $0 $o $o $0 Land Land Use NutnberofUni-s Unit Type Frontage Depth (8600) 443,15000 Square Foot 0 0 Yard Items Description Year Built Roll Year Quantity Units Grade ASP,iALT PAVING 2003 2009 1 55076 SF 2 ASPHALT PAVING 200E 2309 1 11770SF 3 PATIO 200E 2009 1 28900SF 2 TIKI 200-n 2009 1 2176SF 3 FENCES 2003 2009 1 810 SF 2 FENCES 200B 2009 i 1880SF 1 CH LINK FENCE 2009 2009 1 14009E SF 3 https:Hgpublic.schiteidercorp,com/Application.aspx?AppID=605RLa}-erID=99-1.6&Pa(,eTy... 3/22/20I 8 r � 1 t � nx r w° w _ r F 1 O{ r Q` avhp r 1� I i s si�i,1} [[ttr}r177ti7�7��s �i 1 s r fifi 44 rt r r��� i t iR jj)11 U^ R�la� 9q I tl}a� I j s� w Q U :a : p CL , EL O MQ co J J r �; C (LLL Z W y q U O C .. L7 U q C_ O t° O; CV O tp O � O r 560' G'' o cv CO c� e a CT) ,e Co ° .� Mission: Ron DeSantis Governor To protect,promote&improve the health of all people in Florida through integrated state,county&community efforts. 1`i,Iorida Dr.Scott Rivicees,MD. State Surgeon General Vision:To be the Healthiest State in the Nation February 21, 2020 Heidi Morris, President Lower Keys Rotary Fax: (305) 509-7449 Email: store6896@theupsstore.com Dear Heidi, In response to your letter dated February 18, 2020, please see the table I am sending you regarding the number of portable restrooms required for the Independence Day Celebration event being held July 3, 2020 at the Big Pine Community Park, Big Pine Key. If you don't expect more than 1000 attendees, then 7 portable restrooms is adequate for this 5- hour event. If you should later revise your number upward then please consult the table to determine the number of portable restrooms required. Please let me know what portable restroom company is providing the portable restrooms. If you have any questions, please call me at(305) 676-3910. Yours truly, A&tz�t-4r Brandie Peretz Environmental Specialist 11 Monroe County Health Department brandie.peretz@flhealth.gov ........... STOCK ISLAND ....... ....... . ...... KEY I LARGO ...............S,T,A"T,EW,I,D,E Florida Department of Health Florida Department of Health Monroe County Health Department Monroe County Health Department www.FloridasHealth.com Dept.of Juvenile Justice Bldg. 50 High Point Road. TWITTER:HealthyFLA College Road,Stock Island,FL Tavernier,FL 33070 FACEBOOK:FLDep,rtmentofHealth PHONE:305-676-3941 PHONE:305-676-3941 YOUTUBE:f1doh FAX 305-809-5679 FAX 305-453-8759 TABLE PR I NUMBER OF PORTABLE RESTROOMS REQUIRED FOR SPECIAL EVENTS ASSUMES SERVICING ONCE PER DAY NUMBER OF PEOPLE PER DAY NUMBER OF HOURS FOR EVENT PER DAY 1 2 3 4 5 6 7 8 9 10 250 2 2 2 2 2 3 3 3 3 3 500 2 3 4 4 4 4 4 4 4 4 1,000 4 5 6 7 7 8 8 8 8 8 2,000 6 10 12 13 14 14 14 15 15 15 3,000 9 14 17 19 20 21 21 21 21 22 4,000 12 19 23 25 28 28 28 30 30 30 5,000 15 23 30 32 34 36 36 36 36 36 6,000 17 28 34 38 40 42 42 42 44 44 7,000 20 32 40 44 46 48 50 50 50 50 8,000 23 38 46 50 54 57 57 58 58 58 9,000 26 42 52 56 60 62 62 62 64 64 10,000 30 46 57 63 66 70 70 72 72 72 12,500 36 58 72 80 84 88 88 88 88 92 15,000 44 70 84 96 100 105 105 110 110 110 17,500 50 80 100 110 115 120 125 125 126 126 20,000 57 92 115 125 132 138 138 144 144 150 25,000 72 115 144 154 168 175 175 176 176 184 30,000 88 138 168 192 200 208 208 216 216 216 MONROIE COUNTY I S OFFICE RICHARD A. RAMSAY, SHERIFF �k f 1 To: Whom It May Concern From- Captain Donnie Catala Subject: h of July Fireworks Show Date: February 20, 2020 MonroeThe rifrs Office is workingclosely i the Bigin Rotaryin preparation of the 41hof July event to be heldthe BigiCommunity Park can Friday, July 3, 2020. Considerationsi r control, eventc ri , parking, alongi the arrival and departureroutes to reduce traffic conflict in the adjacent neighborhoods. MCSO will have deputiesassigned to assist the above tin rns. There will be deputieson land and one will be on the water for security. MONROE COUNTY BOARD OF COMMISSIONERS EVENT AND USE OF COUNTY PROPERTY HOLD HARMLESS AND INDEMNITY AGREEMENT For and in consideration of having been granted permission by the Monroe County Board of Commissioners, County Administrator, and/or Assistant County Administrator, or his/her designee to hold an Event within Monroe County limits or on Monroe County property, the Undersigned on behalf of the organization hereby agrees on behalf of the organization, to protect and hold harmless Monroe County, its subsidiaries or affiliates, elected and appointed officials, employees, volunteers, representatives and agents from (i) any claims, actions or causes of action, (ii) any litigation, administrative proceedings, appellate proceedings, or other proceedings relating to any type of injury (including death), loss, damage, fine, penalty or business interruption, and (iii) any costs or expenses that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with, (A) any activity of Undersigned or any of Undersigned employees, agents, contractors or other invitees, (B)the negligence or willful misconduct of Undersigned or any of its employees, agents, sub-contractors or other invitees, or (C) Undersigned's default in respect of any of the obligations that it undertakes under the terms of this Agreement, except to the extent the claims, actions, causes of action, litigation, proceedings, costs or expenses arise from the intentional or sole negligent acts or omissions of the County or any of its employees, agents, contractors or invitees (other than Undersigned) arising out of or occurring in connection with the event or the use of County property described herein. The Undersigned also agrees to protect and hold harmless Monroe County, its subsidiaries or affiliates, elected and appointed officials, employees, volunteers, representatives and agents from any present,past or future claims which may be asserted by this organization, or any member of this organization or any participation or third party arising out of or occurring in connection with this event or the use of County property. That as the consideration of the County entering into this Agreement with the Undersigned, it is agreed and understood that the Undersigned shall indemnify the County against any and all claims or expenses or losses of any type, which are related to or arising from the participation of the Undersigned in this event. The Undersigned agrees and understands that a part of said consideration for this Agreement shall include the Undersigned's promise that any rights to bring suit against the County and any rights to compensation therefrom on any matters arising from or otherwise related to Undersigned's participation in this event have been knowingly and willingly relinquished by the Undersigned under this Agreement. The Undersigned therefore agrees to save harmless, indemnify, and defend the County, including its subsidiaries and affiliates, its consultants, agents, volunteers, elected and appointed officers, and employees from any and all claims, suits, actions, damages, expenses, losses, penalties, interest, demands,judgments, and liabilities claims and related expenses in connection with the loss thereof, and costs of suit, including attorneys' fees, for any expenses, damages, or liability incurred by any of them, whether for bodily or personal injury, death, property damage, direct or consequential damages, or economic loss or use thereof, including environmental impairment, arising directly or indirectly on account of or arising out of the Undersigned's participation in this event or the use of County property. The Undersigned's obligation shall not be limited by, or in any way to, any insurance coverage or by any provision in or exclusion or omission from any policy of insurance. The Undersigned agrees to pay on behalf of Monroe County, as well as provide a legal defense for the County, both of Event and Use of County Property Hold Harmless And Indemnity Agreement which will be done only if and when requested by the County, for all claims made. Such payment on behalf of the County shall be in addition to any and all other legal remedies available to the County and shall not be considered to be the County's exclusive remedy. Or in the case of another Government altency The ' as a state agency or subdivision defined in Section 768.28, Florida Statutes, agrees to be fully responsible to the limits set forth in such statute for its own negligent acts or omissions, or intentional tortious actions, which result in claims or suits against either County or , and agrees to be liable to the statutory limits for any damages proximately caused by said acts or omissions, or intentional tortious acts. The County, as a political sub-division of the State of Florida, as defined in Section 768.28, Florida Statutes,agrees to be fully responsible to the limits set forth in such statute for its own negligent acts or omissions,or intentional tortious acts,which result in claims or suits against either the or County, and agrees to be liable to the statutory limits for any damages proximately caused by said acts or omissions,or intentional tortious acts. Nothing contained in this Section shall be construed to be a waiver by either party of any protections under sovereign immunity, Section 768.28 Florida Statutes, or any other similar provision of law. Nothing contained herein shall be construed to be a consent by either party to be sued by third parties in any matter arising out of this or any other Agreement. Page 2 of 3 Event and Use of County Property Hold Harmless And Indemnity Agreement Those who are hereby released shall not be stopped or otherwise barred from asserting any expressly reserved right to assert any claim or cause of action they may have against the Undersigned or any others. This Agreement shall be interpreted under and its performance governed by the laws of the State of Florida. The parties agree that any action relating to this Agreement shall be instituted and prosecuted in the courts of Monroe County, Florida, and therefore, each party to this Agreement hereby waives the right to any change of venue. By the signature to this document, the undersigned acknowledges that it understands the contents of this document and is voluntarily agreeing to its terms. The undersigned is authorized and holds the actual authority as the Legally Authorized Representative of this organization to enter into this Agreement and the organization has delegated such signatory authority to me. In witness whereof Uwe have hereunto set my/our hand and seal the } ._Day of in the year .. .m. Y NAME OF EVENT tilt101 DATE(S)OF EVENT r .. LOCATION OF EVENT `I r� PURPOSE OF EVENT a Organization/Sponsor's Name Qujeglly Authorized�epresentative Printed Name Title State of Florida County of Monroe SUBSCRIBED AND SWORN to (or affirmed before me) on this 44 day of y , 20 by he/she is personally known to me or has produced, —__(type of identification)as identification. Notary Public _ (SEAL) ®'g—."J® EIL GULLEY, �,p`` cr Notary Public state of Fiorida Page 3 of 3 ?+ Commission GG 328517 r My Commission Expires % ae," April 29,2023 .aiCORL?® CERTIFICATE F LIABILITY INSURANCE DATE(MNUDDtYYYY) 2/20/2020 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 have ADDITIONAL INSURED provisions or 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 endorsements. PRODUCER CONTACT NAME: All Sullta Arthur J.Gallagher Risk Management Services, Inc. PHONE FAX 2850 Golf Road _.1_833 3ROTARY tArc 630-285-4062 Rolling Meadows IL 60008p'RfiSi rotary@ajg.com ®INSURERS AFFORDING COVERAGE NAIC# — ------- - . ___.._._._.._. INSURER A_Lexington Insurance Company 19437 INSURED INSURER B .._......._ —---_._._ _..--.—.— .........--._ _.,,...._..._._._._..__._......}......._._... . ... ......... All Active US Rotary Clubs&Districts INSURERC. Lower Keys Rotary ...--..... _ ..___- __ ......._ ATTN: Risk Management Dept. INSURERD: 1560 Sherman Ave. Evanston, IL 60201-3698 INSURER F: COVERAGES CERTIFICATE NUMBER:899307648 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. 'LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MNU D/YYYY MMtDDIYY P LIMITS A X COMMERCIAL GENERAL LIABILITY 015375594 7/1/2019 7/112020 EACH OCCURRENCE $2,000,000 CLAIMS-MADE �X OCCUR Y DAMAGE TO RENTED PREMISES Ea occurrence $500,000 MED EXP(Any one person) $ X ........................... PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $4,000,000 X POLICY ( ( LOC PRODUCTS-COMP/OP AGG $4,000,000 ........., PRO- JECT (......,7 OTHER: $ 015375594 OMBINED ILETIMIr— A AUTOMOBILE LIABILITY Ea accident $2,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON OWNED PROPERTY DAMAGE AUTOS ONLY X AUTOS ONLY Per accident $ X UMBRELLA LIAR OCCUR NOT APPLICABLE EACH OCCURRENCE $ EXCESS LIAR Id CLAIMS-MADE AGGREGATE _$ DIED I I RETENTION$ $ WORKERS COMPENSATION NOT APPLICABLE PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE 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 1$ DESCRIPTION OF OPERATIONS/LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The Certificate holder is included as additional insured where required by written contract or permit subject to the terms and conditions of the general liability policy, but only to the extent bodily injury or property damage is caused in whole or in part by the acts or omissions of the Insured. CERTIFICATE HOLDER CANCELLATION Monroe County and The Lower Keys Rotary SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 431957 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Big Pine Key FL 33043 ACCORDANCE WITH THE POLICY PROVISIONS. 25th Annual Independence Day Celebration July 3,2020 AUTHORIZED REPRESENTATIVE PC" ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD REQUEST FOR USE OF COUNTY PROPERTY IN MONROE COUNTY,FLORIDA Date._ Name of Contact and organization: JL Address&Telephone number: Email: 4 Specific County property or meeting room requested: Intended use: Date(s)needed: a Time:from to r"I Official Monroe County Government Use: Yes ❑ N Number of participants: Alcohol consumption/sales? Yes UNo❑ Use of personal BBQ grill: Yes❑ No❑ USE OF COUNTY PROPERTY ONLY Clean up ovisions assurances,and state,i 'an imp ovements are to be to facility: f Coordination with: Sheriff Dept: Yes No❑ Fire Dept: Yes ❑ No❑ Security: Yes No❑ Public Works: Yes No Previous history of holding similar events: YesF No❑ USE OF MEETING ROOMS ONLY Special Audio Visual Equipment needed: Yes❑ N Describe: Public Address System: Yes❑ No❑ Arrangement of Room: Fees are tasted on pages 8,9,and 10 of the Policy for Public Facilities,Roads,Bridges,& County Meeting Rooms and are NON-REFUNDABLE. Checks or Money Orders are to be made payable to Monroe County Board of County Commissioners COUNTY USE ONLY Scheduled Date: Insurance/Hold Harmless Requirements: Approved: Yes❑ No❑ By: Fees charged or basis for waiver to be approved by County Administrator: Alcohol use or basis for waiver or special conditions to be approved by County Administrator: Remarks: 10/17 x P TO U C H E NTE R PR ISE S FIREWORKS DISPLAY SERVICE CONTRACT Contract#: 0086 Sponsor: -Big44ne-& Lower Keys Rotary Club Contact/Client: -Steve-E `G�--- MOCC%'S Date of Display: July 3rd, 2020 Location: To be displayed from barges near Big Pine Community Park Time: 9:®OPM Duration: 15-minutes Show Price: $10,800.00 (All-inclusive) Deposit Required: $10,800.00 by January 31st, 2020 (special pricing offer) Other details: Company will secure all permitting Scope of Work: 15-Minute 1.3G Aerial Fireworks Display(s)on July 3rd,2020. Display will have an opener, body and grand finale utilizing 1.3G Fireworks All Fireworks will be fired 100% electronically. Initials Vero Beach, FL I Phone: 772-924-0940 1 info 9 explosivetouch.com I v9/2018 Page 1 X P I V .7W7 TOUCH ENTERPRISES We the undersigned, being Interested in a fireworks display for July 3rd,2020 agree to pay a total price of$ 10,800-00 for the display agreed upon,and the display will be produced by Angry Unicorn Displays, LLC a division of Explosive Touch Enterprises,LLC. TERMS AND CONDITIONS: The undersigned,intending to be legally bound,agree as follows• 1. Sponsor to make g deposit payment of 50%of the contract price upon signing of contract,but no late than 30 days prior to display.If the display Is being contracted within 30 days of display date,deposi payment is due immediately to anaurn enough time to acquire permits,PERMITS WILLNOT CURFrs FOR THIS EVENT WITHOUT DEPOSIT PAYMENT BEING RECEIVED,Balance Payment due 14 days prior. 2. In the event Sponsor shall fall to pay any sum when due under the terms of this contract,Sponsor shall pay,in addition to such amount,interest at the rate of 1.5%per month on the unpaid amount from the original due date.Sponsor does further agree that It shall pay Angry Unicorn Display's reasonable attorney fees and court costs in the event Angry Unicorn Displays shall commence suit or incur fees to compel Sponsor to pay any sums due hereunder or otherwise as a result of Sponsor's default of any of the terms and provisions herein contained. 3. If event is on land,sponsor to furnish police and/or crowd security personnel,provide proper parking supervision,and Insure adequate patrol of the safety zone as marked and secured by the sponsor until Angry Unicorn Displays,LLC advises that it is no longer required.Angry Unicorn Displays,LLC is not responsible for clean-up of extended range debris for land-based shows other than company equipment, supplies and packing materials.A land based fireworks display will produce an extended range debris field depending on wind speed.Sponsor shall be responsible for the clean-up of any such debris. 4. If event is over the water,Angry Unicorn Displays,LLC will be responsible for marine event permit,and for the control of safety zone. 5. Angry Unicorn Displays,LLC reserves the right to stop the display in the event persons,vehicles or animals enter the secured safety zone and security is unable or unwilling to remove them and enforce the safety regulations. 6. Angry Unicorn Displays,LLC will obtain and furnish at its expense all applicable licenses,permits and a minimum of$5,000,000.00 liability insurance for your electronically fired display.Angry Unicorn Displays,LLC.will obtain all necessary government approvals for the display. 7. In accordance with local regulations and ordinances,fireworks displays shall not take place later than 10:30pm unless approval is obtained from the governing authority.The restrictions shall not be applicable with regards to holidays such as December 31,January 1,or other national holidays.If for some reason,shoot time does not occur before the allotted time and shoot is cancelled due to local authority or expiration of permit,Sponsor is liable for full payment of display. 8. Sponsor holds Harmless Angry Unicorn Displays,LLC from any claims that do not directly relate to damages produced by Angry Unicorn Displays,LLC's staff,equipment or pyrotechnic material.The Sponsors agree to give Angry Unicorn Displays,LLC prompt notice of any claims or demands and to cooperate with Angry Unicorn Displays,LLC or its successors in Interest or assigns,If any,In the defense of any such claims and/or demands.The Sponsors agree to Indemnify,and hold Angry Unicorn Displays,LLC.&its parent company harmless against any and all liability claims,damages,losses, expenses and costs,including attorney fees that arise out of the display(s)which is subject of this contract except for liability which is due solely to negligence on the part of Angry Unicorn Displays or its staff or equipment or pyrotechnic material provided by Angry Unicorn Displays,LLC.or its staff. 9. CREDITS:As a material inducement to Angry Unicorn Displays agreeing to enter into this agreement, Sponsor shall give Angry Unicorn Displays program credit as sole fireworks supplier and producer in all press releases,advertising and any other program announcements,printed or otherwise. , \ In Itials Vero Beach, FL I Phone: 772-924-0940 1 info@explosivetouch.com I v9/2018 Page 2 10.If show is canceled due to actions unrelated to the actions or inactions of Angry Unicorn Displays,LLC or its staff,equipment or pyrotechnic material,sponsor is responsible for any permit,fire watch or bargettug fees,if applicable.Additionally,if the aforementioned cancellation occurs,sponsor will be responsible for load in/load out expenses not to exceed 50%of budget.If show is stopped while in progress for any reason,Sponsor will still be responsible for contract amount minus the cost of material not discharged,unless the stoppage is due to the actions of Angry Unicorn Displays,LLC or its staff or due to problems with the equipment or pyrotechnic material of,or provided by Angry Unicorn Displays,LLC or its staff,in which case Angry Unicorn Displays,LLC shall be in default under this agreement. 11.If wind exceeds 20mph,fireworks display will be postponed to an agreed date between sponsor and Angry Unicorn Displays,LLC. 12,Inclement Weather:Angry Unicorn Displays,LLC.will make every attempt to execute all fireworks displays as scheduled.Angry Unicorn Displays,LLC.reserves the right to postpone a display for safety hazards caused by inclement weather.The Sponsors shall cover the additional costs reasonably incurred by shooting the display on a mutually agreed upon alternate date.The additional cost for shooting the display on an alternate date shall not exceed 100%of the display budget. 13.Rain Date policy is as follows:Postponement time is 11:59am on the day of display. 14.If the delivery and/or exhibition of the fireworks are postponed by reason of inclement weather,it shall be re-scheduled to the Inclement Weather Date set forth by Sponsor. 15.In the event a reschedule occurs and is unrelated to the actions or inactions of Angry Unicorn Displays, LLC or its staff,and additional fees are incurred by Angry Unicorn Displays,LLC such as permitting,fire watch,police,barge,etc,Sponsor will be responsible for these fees as they are automatically charged to US. 16.Sponsor agrees to notify Angry Unicorn Displays,LLC of any unknown changes of said fireworks display such as change of venue,change of time or any other unknown change a minimum of 14 days prior to display date.If for any reason an unknown change does not allow for the setup and execution of fireworks display,sponsor is responsible for 50°/®deposit. 17.Client agrees to provide Angry Unicorn Displays,LLC with an adequate firing area that is necessary to produce a safe fireworks program.if for any reason on the day of display the firing area is considered unsafe(Ex:Flood I ng/Stand ing water is present,muddy terrain or other hazards)to execute the fireworks display,Sponsor is still liable for 50%of Show Budget. 18.If Sponsor has accepted a pre-payment discount offer at signing of contract,sponsor understands that if for any reason sponsor cancels fireworks display,that 50%of the pre-payment amount is forfeited. 19.Marketing:Angry Unicorn Displays,LLC may use public displays for promotional use,including but not limited to videotaping and providing Invitations to current and/or potential customers to view the display setup site and the fireworks display.For private displays,Angry Unicorn Displays,LLC will seek approval from Sponsors before making such invitations.In return for marketing privileges,Angry Unicorn Displays may donate products and services to enhance the display. 20.Force Maieure:Angry Unicorn Displays,LLC will take all reasonable steps to complete its obligations under this contract.However,Angry Unicorn Displays,LLC shall not be held responsible for failure to perform its obligations under this contract if such failure is a result of an act of God including extreme weather,natural disaster,terrorism,war,or any extraordinary circumstance beyond its control. 21.Default:if Sponsor fails to timely perform any of its obligations under this Agreement,Sponsor shall be in default and Angry Unicorn Displays,LLC shall be entitled to pursue all remedies available under Florida law or equity.However,not-withstanding the foregoing,if the display is canceled by Sponsor due to acts of force majeure referenced in Paragraph 20 above,or any other reason unrelated to the actions or inactions of Angry Unicorn Displays,LLC,or its staff or due to the equipment or pyrotechnic material of or provided by Angry Unicorn Displays,LLC or its staff,Angry Unicorn Displays shall be entitled to retain the 50%deposit as its liquidated damages due to the difficulty of determining Angry Unicorn Displays damages arising from such a cancellation.If Angry Unicorn Displays,LLC fails to timely perform any of its obligations under this agreement Angry Unicorn Displays,LLC shall be in default and Sponsor shall be entitled to withhold any future payment due hereunder and pursue all remedies available to Sponsor under Florida law or equity. 22.Terms&Conditions:This agreement shall be governed by and construed in accordance with the laws of the state of Florida.This agreement is non-binding irrespective of endorsement until the 50%deposit has been satisfied and notice presented by Angry Unicorn Displays,LLC. 23.Venue Guarantee:Sponsor agrees to forfeiture of the 500%deposit and all other incurred fees In the event the venue does not make proper arrangements and display must be canceled.Any required changes,moves or special instructions for display site will be provided in written format at time of permitting.This would include but not limited to moving boats,yachts,vehicles or other necessary Items in the fallout zone. W Ij"4litials Vero Beach, FL I Phone: 772-924-0940 1 info@explosivetouch.com I v9/2018 Page 3 24.IMPORTANT NOTE:Items listed for this fireworks display require a firing area that conforms to NFPA 1123,which states that there must be at least 70 feet per inch of shell diameter between firing site and any spectators,cars or buildings.This program requires a safety zone that has aradius of FT because of the inclusion of_-inch shells.Adjustments will be made to the content of the program if necessary to conform to NFPA 1123. 25.DISPUTES:The prevailing party in any legal dispute between the parties to this agreement shall be entitled to recover its reasonable attorney's fees,expert witness fees and court and litigation costs relating to the dispute,including appellate proceedings. X SIV Display Coordination Contact DCC Please provide information for a primary contact person who can be reached on the date of your event.This will help to ensure smooth and accurate execution of your display: Name: I 1` \(Y-ut) Title. �� �'` l_1)'� )r 4 4 1� i�4t.��tiy Work Phone: ✓' �, r` L�` . 1 '�t� . 1l Cell Phone: 2)u' � l�! �`� '� �► r i E-mail Ad ress: �k `% i�i? 1 �' fc,C�D lc kv_Vi,r> C c:��'•.L�:._G.c.`3�• f`kc:j NOTE 1:The DCC information provided above is transferred to the Shooter In Charge(SIC)for the day of display.Please make sure that all information provided is accurate and correct so that there are no setbacks or communication errors for successful operations. NOTE 2: Golf Courses,Hotels&Any other venues with Automatic Sprinkler systems,please make sure to notify your operational or maintenance staff to deactivate outdoor sprinkler systems in the immediate area of the display site. Initials Vero Beach, FL I Phone: 772-924-09401 info 9explosivetou ch.cam 1 v912018 Page S I V XPL.1 TOUCH ENTERPRISES Angry Unicorn Displays,LLC.a division of Explosive Touch Enterprises,LLC_upon acceptance of this contract in writing,agrees to fulfill the contract In a workmanlike and professional manner. \ I . I I Date Y' Sponsor or Client Name 6.4( - Sponsor or Client Title Signature Angry Unicorn Displays, LLC. Display Company President/Owner Title Signature Please e-mail signed contract to info@explosi)/-etQuch.com and make payment of $10,800.00to officially bind this contract for your fireworks display. Thank you for choosing to produce your fireworks spectacular! Initials Vero Beach, FL I Phone: 772-924-0940 1 info@explosiy-elQuch.com I v9/2018 Page 5 ,'r Explosive Enterprises P L I V l.�lj` 4260 Amelia Plantation Court Vero Beach, FL 32967 Phone Number:772-924-0940 Email address:info@explosivetouch.com Please make all checks payable to:Explosive Touch Enterprises,LLC. Big Pine&Lower Keys Rotary Club INVOICE /`® I Client name:Steve Estes Address: P.O. Box 431957 Big Pine Key, FL 33043 Invoice Number Invoice Date Phone: 303-501-0233 E-mail: b' 21__=;'`!_;'ilt�l_con) 179 115/20 CUSTOMER REGION VALID UNTIL Big Pine Key, FL DUE NOW FWD $10,800.00 1 $10,800.00 $0.00 1 $0.00 $0.00 1 $0.00 $0.00 1 $0.00 $0.00 1 $0.00 Subtotal: $10,800.00 DISCOUNT Payment Methods:s Check Credit Gard r 1 BIG PINE AND LOWER KEYS ROTARY INC. 81-275/829 387 FIREWORKS ACCOUNT PO BOX 431957 BIG PM KEY,FL 33043 DATE 2nZAC) 7PA7y To--E lRlf4l m oayAnd o!5n4- lCo 4 nAA-1 l----doLLAR5 area MEMGj/r A,Xat ,:0E1290275 ?I: 001 TRANSMISSION VERIFICATION REPORT TIME : 02/28/2020 13:16 NAME : THE UPS STORE 6896 FAX 3055097449 TEL : 3054148347 SER.# SROE7J640182 DATE,TIME 02/28 13:13 FAX NO./NAME 3052896336 DURATION 00:02:40 PAGE(S) 09 RESULT OK MODE STANDARD ECM Adak or Udft The Uor"S Stum F1 UP!. 181 Key Deer Blvd Big Pine Key, FL 33043 305.414.8347 Tel 305.509.7449Fax store6896@theupsstore.com theupsstorelocal.com/6896 Fax T � From Company Phone number Fax number Fax number 1 - Date _ 'Qi- 4'1 --- Total pages 4 C-,Cj� job number Copyright Q 2015 The UPS Store,Inc. 5109031315 t County of Monroe Emergency Services Division OFFICE OF FIRE MARSHAL BOARD OF COUNTY COMMISSIONERS Monroe County Fire Rescue Mayor Sylvia J. Murphy, District 5 490 63rd Street,Ocean Mayor Pro Tern Danny L.Kolhage, District 1 Marathon,FL 33050 Michelle Coldiron, District 2 (305)289-6005-Phone Heather Carruthers, District 3 "(305)289-6336-Fax David Rice,District 4 FIREWORKS PERMIT APPLICATION APPLICATION SHALL BE SUBMITTED TO THE FIRE MARSHAL`S OFFICE NO LESS THAN 30 DAYS PRIOR TO THE EVENT SPONSORING ORGANIZATION RESPONSIBLE ORGANIZATION Business Name: ° Business Name: C k` Address Address: City/State/Zip: City/state/Zips Phone: Phone: W i ) Fax: Fax: � a DATE OF DISPLAY: 3 TIME OF DISPLA c A PM Approximate Duration of Display: - Location of Property and Display: Distance from Shore/Nearest Buildings:_) — ` Name of Area Fire Department: l , ATTACHSITEMAP TO INCLUDE BARYVLAUNCH LOCATION F DISPLAY* *A diagram of the grounds on which the display is to be held,showing the point at which the fireworks are to be launched, the location of all buildings, highways, the line behind which the audience will be restrained,and the location of nearby trees, telephone lines, and any other overhead obstructions. (Site map must show the distance of nearest share/buildings and the distance from the audience) DATE OF APPLICATION: '�1'1 �a� Revised:May,2017 Fireworks Permit Application Page 1 of 4 EVIDENCE OF INSURANCE The ORIGINAL Certificate of Insurance,per event,must be approved by the Monroe County Risk Management Office prior to issuance of the fireworks permit. Copies are not acceptable for insurance q1212rovaL 1. The&8mwmOsCOUNTY BOARD OF COUNTY COMMISSIONERS MUST be: e. Named eoen Additional Insured party AND ALSO. b. Listed as a Certificate Holder on o Commercial General Liability insurance policy covering the fireworks display. 2. Both the"sponsoring"and"responsible"entities/organizations must be named as insured parties. 3. The Commercial General Liability insurance policy must have limits of not less than$1,000,000.00 per occurrence and $3.000.000.00 annual aggregate claims. 4. Statutory Workers'Compensation a. Employers Liability coverage with minimum limits cf$500.000 5. Watercraft Liability with minimum limits of*1.00O.00U. This coverage is necessar because a barge will be used eo the"firing stage"for the fireworks. a. Jones Act coverage with minimum limits of $1.OU0.UOU. This coverage is necessary because any ofthe fireworks company's employees that work off the barge will bo eligible for Jones Act benefits. REGULATIONS FOR THE DISPLAY OF FIREWORKS The applicant shall read and comply with the following regulations as evidenced by signature below: 1. |o the location of this fireworks display in a publicpark oronproperty ownedby Monroe County? Check One: YES 0 G V 5 \ O (If"YES", attach a copy of the resolution or other authorization or permit of the Board of County Commissioners of Monroe County or County Administrator authorizing said display and use of the County property.) 2. List the number,size and type of each fireworks shell hobedischarged: (Use attachment page Jnecessary) Quantity Size Type—Description 3. Site selection of fireworks disp|ays, the transportation and ground discharge of finymmorhe shall conform to NFPA 1123 and NFPA 1124. Off-shmra discharge of fireworks must obtain a marine event permit issued by the U.S' Coast Gmard, and shall conform to USCG negmUadimme. 7lde 40\ CFR. Hnowmrku shall NOT be displayed within one hundred (100) feet of any building uf any sort, or where the dimcharge/fai|umbo fire/faulty Dring/orfm||out of any fireworks or other objects would endanger any pemona, buildings, structures,forests or brush, or fifty(5O)feet from the nearest above ground electric or telephone lines, tmae, or other overhead obstruction. In no case shall e display be fined within one half(1/2) mile of any honpi1a|, nursing home, or nursing care center. 4. Spectators at a display of fireworks shall be restrained behind lines or barriers as designated by local authorities and as specified in NFPA 1123, Table 3-1.3; but in no case less than two hundred (2OO)feet from the point at which the fireworks are to be discharged.Only authorized persons and those in actual charge of the display shall be allowed inside these lines or barriers during the unloading,preparation,or firing of fireworks. 5. All hnmwmrkm that fire a projectile shall be so set up that the projectile will go into the air as nearly as possible in e vertical dinection, provided that where such fireworks are to be fired beside a lake or other large body of water,they may be directed in such a manner that the failing residue from the deflagration will fall into said body of water. Revised: May,2017 Fireworks Permit Application Page 2mf 4 6. Any fireworks that remain unfired after the display is concluded shall be immediately disposed of or removed in a manner safe for the particular type of fireworks. The debris from the discharged fireworks shall be properly disposed of by the operator prior to departure from the premises. The operator, upon conclusion of the display, shall make a complete and thorough search for any unfired fireworks or pieces which have failed to fire or function, and shall dispose of the material in a safe manner. Such search shall be instituted at the earliest possible time following the conclusion of the display, but in no event later than the first period of daylight which follows the event. 7. No fireworks display shall be held, or firing of shells must cease, when the wind velocity exceeds twenty(20)miles per hour. 8. QUALIFICATIONS OF OPERATORS: A certified, experienced, competent operator with the knowledge of NFPA 1123 "Code for Fireworks Display" and NFPA 1124 "Standard Code for Outdoor Display of Fireworks" is required. Fireworks display companies are responsible for the current certification of the operators employed by the company. (Attach copies of operator certifications when utilizing free-lance operators.) 9. There shall be, at all times, a competent and certified operator of the display constantly on duty during the discharge of the fireworks, with a sufficient number of trained assistants available for safe conduct of the display. Assistants shall be fully trained and educated in regard to safety hazards. Please provide operator/assistant information requested below: OPERATOR: Name: Address: -JJ Phone: Certification Expiration Date: TRAINED DISPLAY ASSISTANT(S): (Use attachment Rage if needed) Name: Address: Phone: Certification Expiration Date: Name: Address: Phone: Certification Expiration Date: Name: Address: Phone: Certification Expiration Date: 10. All fireworks articles and items at places of display shall be stored in a manner and in a place secure from fire, accidental discharge and theft;and in a manner recommended by the manufacturer. 11. The sponsor of the display shall make provisions for adequate fire protection for the display. The sponsor shall consult with the authority having jurisdiction and the operator to determine the level of fire protection required. 12. Any fireworks display over open water must be permitted by the U.S. Coast Guard and shall conform to USCG regulations, Title 46, CFR. Contact the Commanding Officer, USCG Marine Safety Office, Waterways Branch, PO Box 01-6940, Miami, FL at (305) 535-8751, Fax (305) 535-8740 for USCG marine event planning information. 1, THE UNDERSIGNED, HEREBY CERTIFY THAT I HAVE READ THE ABOVE REGULATIONS AND SHALL COMPLY FULLY WITH ALL OF THE REQUIREMENTS HEREIN AND HAVE AUTHORITY TO ENTER INTO THIS AGREEMENT ON BEHALF OF THE ABOVE LISTED ORGANIZATION. SIGNATURE: DATE: 0-ai-06aAZ) PRINTED NAME: TITLE: Revised:May,2017 Fireworks Permit Application Page 3 of 4 DEFENSE, INDEMNITYAND HOLD HARMLESS AGREEMEENT THIS AGREEMENT made as of thec96' day of 2020 by and between MONROE COUNTY, ("County"),and rX VVI Q_ hereinafter referred to as("Sponsor"): WITNESSETH: That for and in consideration of the mutual covenants and conditions set forth hereinafter, the parties agree as follows: I. That for and in consideration of permission to conduct a fireworks display in Monroe County,Florida, by the Sponsor to performed to be held at the location �F e t "�)�YA A — , �,Vu the Sponsor does hereby agree and� will have issued a Commercial General Liability insurance policy in accordance with Monroe County Ordinance Nos. 29-1983;30-1985; 34-1985;005-1986;and 001-1991, and Ch. 13, Art. 1, Sec. 13-3 of the Monroe County Code of Ordinances wherein the Monroe County Board of County Commissioners shall be named an Additional Insured of the Sponsor; with limits of not less than$1,000,000.00 per occurrence and$2,000,000.00 annual aggregate.Additionally,the Sponsor shall provide: a. Statutory Workers'Compensation-Employers Liability coverage with minimum limits of$500,000. b. Merchant Marine Act of 1920 also known as the "Jones Act", Watercraft Liability with minimum limits of $1,000,000. 2. That an original of said insurance policies, per event, shall be delivered to the Monroe County Fire Marshal's Office prior to the issuance of the Fireworks Permit. 3. That for and in consideration of the permission to have the fireworks display, the Sponsor does hereby agree to indemnify Monroe County for any and all claims, suits,causes of action,loss, damage, costs, expenses and liabilities that may result or arise out of the fireworks display, including but not limited to any and all claims, suits, causes of action, judgments or damages sustained by Monroe County for bodily injury or for injury to or loss of property resulting from,caused by,or arising out of the fireworks display. 4. That in addition to the indemnification referred to in paragraph 43, the Sponsor does hereby agree to hold Monroe County harmless concerning the fireworks display activities, and will defend any and all lawsuits, causes of action and claims, and will further, pay all costs and attorney's fees for Monroe County BOCC resulting from, caused by, or arising out of the fireworks display. IN WITNESS WHEREOF,I hereto affix my hand and seal on this c-2-Y day oi�_f 202-6 . 0 NATURE, 6A�TA TITLE PRINT NAME U_ ORG IZATION State of Florida County of_ZA%9u_1_ _ Swom to(or affirmed)and subscribed before me this '21R, day of 120A5 by NEIL GU q Name of person signing above LLEY k," Notp4o"iS&qte of Florida Commission#GG 328517 my commission Expires Si ture of NotarV Pdglic—State of Florida April 29,2023 Name of Notary PAM(Typed,Printed,or Stamped) Personally Known: Or Produced Identification: Type of Identification Produced: Revised:May,2017 Fireworks Permit Application Page 4 of 4 rS, . I � ��,� , , � �' � � • ` c +mod t r - �� 'h � �` �� �� i+ �.,. �, is r:� — �, tk'" y�� w® �, d ��� I � ✓ ,,® a° • �o ,� w qa ,�.a o • .- ��k , s �' 4 t .� ®� Ot Ot- �� �� ° 11� O� ::a � � �t � �, i r�1 �'�c '� 5 SK �� t ,51 ��, tf ,_ �i �. � c t � � �� ��'' t� �j �'� �°,, � �" m'� � 13 � T €.�, �. � '��� y , 'fir,. N "" ��4 - � �a� �y �,�: ,. � � �.� ���. �� tw `�a �t��� k�� F�����C f''+��lkk�k�i�f�13 � Y4� l�l uBs}�PLC k�l,„` .�My�����i� i" _ a4� 4�` a4� ��k �JEr� � e; r� Cip�g 9il� � k, r �� , ,t �� �a�, $,, � t¢ ` j aU (D o fl = v .-:; fY u o a- n C 4 -� C'4 +� s4 Dt ' ,G 4 Q X N m fL O < L) v Z mCL ~` q a a U p y cp 1 � d Q Q C_ V) C ccCD O e cD O Ln S O )5 560' G" O v CO ss� Cl- — � A A p re e r I UNITED STATES DEPARTMENT OF COMMERCE * National Oceanic and Atmospheric Administration NATIONAL OCEAN SERVICE �o 4�ArEs ov Florida Keys National Marine Sanctuary 33 East Quay Road Key West,Florida 33040 FLORIDA KEYS NATIONAL MARINE SANCTUARY SPECIAL USE PERMIT Permittee: Permit Number: FKNMS-2018-087 Mr. EJ Weppel Effective Date: July 1,2018 Creative Pyrotechnics, LLC Expiration Date: December 31, 2021 14747 Baltusrol Drive Orlando,FL 32828 Project Title: Fireworks Displays in the Florida Keys This permit is issued for activities in accordance with the National Marine Sanctuaries Act (NMSA), 16 USC §§ 1431 et seg., and regulations thereunder (15 CFR Part 922). All activities must be conducted in accordance with those regulations and law. No activity prohibited in 15 CFR Part 922 is allowed except as specified in the activity description below. Subject to the terms and conditions of this permit, the National Oceanic and Atmospheric Administration (NOAA), Office of National Marine Sanctuaries (OHMS) hereby authorizes the permittee listed above to conduct activities within Florida Keys National Marine Sanctuary (FKNMS or sanctuary). All activities are to be conducted in accordance with this permit and the permit application received June 15, 2018. The permit application is incorporated into this permit and made a part hereof; provided, however, that if there are any conflicts between the permit application and the terms and conditions of this permit, the terms and conditions of this permit shall be controlling. Permitted Activity Description: The following activities are authorized by this permit: 1. Discharge of debris into waters of the sanctuary that results from pyrotechnic displays. No further activities prohibited by sanctuary regulations are allowed. Permitted Activity Location: The permitted activity is allowed in Bogie Channel, Big Pine Key, within a 500-foot radius of the central coordinate 24.6795194°, -81.3449138°. Weppel Permit#FKNMS-2018-087 Page 2 of 5 Special Terms and Conditions 1. A maximum of four(4) discrete fireworks displays are authorized while this permit is in effect, one display per year on or around July 4. FKNMS approval is required for additional displays. Special Use Permit fees associated with this activity may also change if additional displays are authorized. Contact Joanne Delaney, FKNMS Permit Coordinator, at Joanne.Delaney@noaa.gov or(305) 809-4714 for assistance. 2. The permittee must provide a copy of current comprehensive liability insurance to FKNMS by May 1 annually. The insurance certificate shall be forwarded to Joanne Delaney(Joanne.Delaney@noaa.gov). 3. If fireworks displays are proposed for sites other than that listed in the Permitted Activity Location section, above, the permittee must contact FKNMS (Joanne.Delaneygnoaa.goov) a minimum of 30 days prior to the event with the launch coordinates to review the activity and its proximity to sensitive resources. 4. No additional materials are authorized for discharge under this permit. 5. All non-biodegradable labels and wrappings shall be removed from pyrotechnic shells before they are fired. Wrappers and any other waste shall be contained on-board the launch vessel and then disposed of on-shore. 6. The permittee must clean up all debris resulting from pyrotechnics immediately following each fireworks display. Any debris that is apparent in marine waters of the sanctuary, terrestrial/upland areas adjacent to the sanctuary, and on any vessels must be removed and contained for disposal on-shore. The permittee may be liable for costs of clean-up activities should debris remain after events conclude. 7. The launch vessel must not anchor or spud on or above coral or coral reefs. Anchoring and spudding on hardbottom and seagrass habitat shall also be avoided. Preferred anchoring/spudding is over sand bottom. Please consult Florida Keys benthic habitat maps to locate appropriate sandy areas for anchoring: http://flkeysbenthicmaps.no aa.govl. 8. The launch vessel operator shall be informed of FKNMS regulations related to vessel operation and anchoring, prior to each event,as follows: a. "Operating a vessel in such a manner as to strike or otherwise injure coral, seagrass, or any other immobile organisms attached to the sea bed" is prohibited throughout the sanctuary(15 CFR922.163(a)(5)(i)); b. "Having a vessel anchored on living coral other than hardbottom in water depths less than 40 feet when visibility is such that the seabed can be seen" is prohibited throughout the sanctuary(15 CFR922.163(a)(5)(ii)); C. Any party found responsible for injury to sanctuary resources may be subject to penalties under the National Marine Sanctuaries Act(NMSA), 16 USC § 1431 et seq. 4, FW INSTRUCTIONS FOR COMPLETING P T-6003 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION E Y PERMIT OR SPECIAL SALES LICENSE If you have any questions or need assistance in completing this application,please contact the Division of Alcoholic Beverages& Tobacco's(AB&T)local district office. Please submit your completed application to your local district office at least seven(7) days prior to the first date of the event to insure the permit is issued by the event date. This application may be submitted by mail, through appointment, or it can be dropped off. A District Office Address and Contact Information Sheet can be found on AB&T's page of the DBPR web site at the link provided below. Local A T Licensing Offices This application is used for obtaining a One,Two,Three Day Permit to sell alcoholic beverages for consumption on the reported premises only. A special sales license may also be obtained by the use of this application for the sale of alcoholic beverages for a period of up to three days.This license does not permit the sale of alcoholic beverages for consumption on the premises and only allows package sales in the manufacturer's original sealed containers. GENERAL INSTRUCTIONS Submitting Your Application The Division of Alcoholic Beverages and Tobacco, Bureau of Licensing,accepts applications for one,two,and three day events and special sales licenses. Please complete all required information.All questions must be answered fully and truthfully.You must provide an original application and supporting documentation that may be required by the local authorities. All signatures must be original. Contact Person All communications regarding your application will be sent to the applicant at the mailing or email address provided. However, if you would like for us to communicate with someone other than the applicant regarding your application, please provide the name and contact information for that person in the"Permit or License Information"section. Your named contact person will be permitted to make changes to the application paperwork on your behalf and we will communicate directly with them regarding any application issues or deficiencies. You will not be copied by the division with the correspondence. APPLICATION REQUIREMENTS AND INSTRUCTIONS FOR COMPLETING THIS APPLICATION Florida Law for One/Twoffhree Day Permit Per Florida Statute 561.422, upon the filing of an application and payment of a fee of$25 per permit,the division may issue a permit authorizing a bona-fide non-profit civic organization to sell alcoholic beverages for consumption on premises only for a period not to exceed 3 days for a single event,subject to any state law or municipal or county ordinance regulating the time for selling such beverages.Any such civic organization may be issued only three such permits per calendar year except in those counties or cities with special acts governing the number of permits allowed.Any bona-fide non-profit civic organization permitted under this section may purchase alcoholic beverages from a distributor or vendor licensed under the beverage law. The applicable statute can be found at:;Temporary Permit(ODP)Special Acts The following cities have special acts which permit the issuance of more than three permits per calendar year if the event is held in a specific geographical area: City of St. Petersburg; City of Tallahassee; City of Leesburg; City of Eustis; City of Tavares; City of Mount Dora; City of Clearwater. The special acts may be viewed at: Temporary Permit Special Act Information All sections of the application must be completed except the section titled Affidavit for Special Sales License. Registration of Legal Entity or Proof of Non-Profit Status All corporations,domestic or foreign and limited liability companies seeking this permit are required to be registered with the Florida Secretary of State, Division of Corporations, as"non-profit"and the status of the registered entity must be"active." Organizations NOT incorporated must submit one of the following: a letter Auth: 61A-5.0013,FAC 1 outlining the purpose and the goals of the event and who will benefit from the event's profits; organization's National,State,or Local charter; organization's by-laws, 501(c)3 registration, or Minutes of Meeting. If you have not already registered, you will need to contact the Department of State at(850)488-9000 or www.sunbiz.or_q for further information. Your application will be considered incomplete without this active registration or proof of non- profit status. Sales Tax Certification to be completed by the Florida Department of Revenue. Please take this application form to the Department of Revenue for their approval. The address for the office serving your area of interest can be found at Local AABT Licensing Offices. Applications must be submitted within 90 days of receiving this approval. Zoning Approval This section only applies to applications for a One,Two,Three Day Permit. The city or county zoning authority in which the event or special sale will be held executes zoning approval. Please check with your local authority for their requirements. The address for the zoning office serving your area of interest can be found at Local AST ices Offices_. Applications must be submitted within 180 days of receiving this approval. Sketch of Premises A complete sketch of the premises, drawn in ink or computer generated (letter size)which includes all permanent walls, doors, windows,counters, labeling each room and area. Include any outside areas where alcoholic beverages will be sold, consumed,or served. Due to the difficulty of scanning,no blueprints are accepted. When the event of the non profit organization is being held at a location that is already licensed for the sale of alcoholic beverages,a sketch of the entire premises must be submitted. If the event does not include the entire premises,the sketch must identify the area of the licensed premises where the event is to be held and must be a separate room or enclosure.The attestation included with this application must have the original signature of the permanent license holder and must be submitted by the non-profit group as part of the completed application. Affidavit of Applicant for One,Two,Three Day Permit Read and sign in the presence of a notary. The affidavit must be signed by an officer of the Non-Profit Civic Organization; or in the case of a church,synagogue, school, or fraternity/sorority,the signature of an authorized representative of the church,synagogue, school,or fraternity/sorority. There are several important points you should be aware of: 1. The legal drinking age is 21. Please ensure that no one under 21 years of age is served an alcoholic beverage or allowed to consume alcoholic beverages. 2. The purpose of this permit is to provide your non-profit organization with a permit to sell alcoholic beverages to generate funds for your civic or charitable cause. 3. Your organization,as the permit holder,is the ONLY entity that may receive any of the profits from the sale of alcoholic beverages on this permit.You must have responsible members of your organization at the alcoholic beverage sales location at all times.Your event CANNOT involve the SHARING OF ANY PROFITS OR RECEIPTS,or a"DONATION"to your cause if you obtain a temporary permit.Participation in this practice subjects your organization to jeopardy and denial of future alcoholic beverage permits. 4. All records of alcoholic beverage purchases and sales must be retained for examination by the Division of Alcoholic Beverages and Tobacco personnel. 5. No One,Two,Three Day Permit will be issued to any organization in connection with any type of gambling activity, i.e. Casino Night, Las Vegas Night, Monte Carlo Night,etc. 6. If your event is cancelled due to acts of nature, and you plan to reschedule,you need to notify the division within 14 days of the cancellation so that you will be eligible for re-issuance of the permit at no fee to you. 7. The Division of Alcoholic Beverages and Tobacco will issue One,Two,Three Day Permits to College fraternities and sororities only when the following conditions are met: a) The permit is being requested for an event that clearly has a designated charitable or civic purpose, such as a charity fundraiser. b) The Division must have written approval for the holding of such event from a designated Auth: 61A-5.0013,FAC 2 school official with responsibility over fraternity or sorority activities, such as the organization's advisor, or the director of student activities or his/her designee. c) The Division must receive a specific written outline from the fraternity or sorority as to where the event will be held, how entry into the event will be controlled so as to prevent the attendance of minors,and how control of the event will be maintained by the fraternity or sorority to prevent such matters as excess consumption,improper distribution of alcoholic beverages and the like. Florida Law for Special Sales License Florida Statute 561.20(12)(a), upon the filing of an application and payment of a fee of$25 per permit,the division may issue a license authorizing the sale of alcoholic beverages in sealed containers only,for a period not to exceed 3 days. This license is issued only for the purpose of authorizing a sale pursuant to: levy and execution; bankruptcy sale; a sale by an insurance company in possession of alcoholic beverages; a sale resulting from a license suspension or revocation; a sale of damaged goods by a common carrier;a sale by a bona fide wine collector; or a sale pursuant to part V of chapter 679 Florida Law for Special Sales License Registration of Legal Entity All corporations, domestic or foreign;general partnerships; limited liability companies; limited liability partnerships; and limited partnerships are required to be registered with the Florida Department of State, Division of Corporations. If you have not already registered, you will need to contact the Department of State at(850)488- 9000 or www.sunbiz.org for further information.Your application will be considered incomplete without this active registration. Sales Tax Certification to be completed by the Florida Department of Revenue. Please take this application form to the Department of Revenue for their approval. The address for the office serving your area of interest can be found at Local ABT Licensin C)fices Applications must be submitted within 90 days of receiving this approval. Affidavit of Applicant for Special Sales License Read and sign in the presence of a notary. The affidavit must be signed by the individual applicant, each partnei of a general partnership, a general partner of a general partnership of a limited partnership, a managing member manager,or officer of a limited liability company, each partner of a limited liability partnership,or one of the officers of a corporate applicant. All signatures must be original. APPLICATION CHECKLIST TRANSACTION PLICTION REQUIREMENTS ❑ Complete DBPR ABT-6003 Division of Alcoholic Beverages and Tobacco Application for One/Two/Three Day Permit or Special Sales License. You may apply for multiple event dates. One/Two/Three Day Permit ❑ Pay$25 fee for each event(make check payable to the Division of Alcoholic Beverages and Tobacco). ❑ College fraternities and sororities must meet certain conditions which are outlined in the application instructions and requirements. ❑ Complete DBPR ABT-6003 Division of Alcoholic Beverages and Tobacco Application for One/Two/Three Day Permits or Special Special Sales License Sales License. ❑ Pay$25 fee(make check payable to the Division of Alcoholic Beverages and Tobacco). Auth: 61A-5.0013,FAC 3 DBPR ABT-6003—Division of Alcoholic Beverages and Tobacco Application for Onerrwo/Three Day Permit or Special Sales License STATE OF FLORIDA DBPR Form DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ABT-6003 Revised 08/2013 If you have any questions or need assistance in completing this application, please contact the Division of Alcoholic Beverages& Tobacco's(AB&7)local district office. Please submit your completed application to your local district office at least(7)days prior to the first date of the event to insure the permit is issued by the event date. This application may be submitted by mail, or it can be dropped off. A District Office Address and Contact Information Sheet can be found on AB&T's page of the DBPR web site at the link provided below. Local ABT Licensin 0 ices SECTION 1 --CHECK TRANSACTION REQUESTED Transaction Type: IX One/Two/Three Day Permit El Special Sales License SECTION 2—PERMIT or LICENSE INFORMATION If the applicant is a corporation or other legal entity,enter the name and the document number as registered with the Florida Department of State Division of Corporations on the line below. FEI um e Busine s Tele hone Number I E-Mail Address(Optional) -I t�j qvna4l -(-,Wyl IINameof Ap licant(s): (Th is the name the permit or license will be issuedDepartment1 e Document# 364 TLA-0 (AA =siness Natne(D/B/A)o ame of Event Locatio of Ev Unt(Stketa d Nu mb b, County State Zip Code in FL ailin! ddres,s(Street or Box)A7 A211210—+_ ate Zip Cori-, Contact Per on-This section is optional,see application instructions for details Contac .W7W on 7Telephone Number "Y Z L ext. Email dress(Op t' I dr al) iCL YA+P_ anock'A U)cn Mailing Address et or P.O ox) k% City to Zip Code )4S Date(s) Pgphiit Desired mnliellizzi 1� ABT District Office Received Date Stamp Auth: 61A-5.0013,FAC SECTION 3-'SALES TAX TO BE COMPLETED BY THE DEPARTMENT OF REVENUE Full Name of Applicant Organization Error! Reference source not found. 1 The named applicant for a license/permit has com lied with the Florida Statutes concerning regisWation for Sales and Use Tax and has agreed to pay any applicable taxes due. Signed Date Title Department of Revenue Stamp: SECTION 4-ZONING TO BE COMPLETED BY THE ZONING AUTHORITY GOVERNING THE EVENT LOCATION Location of Event(Street and Number) City County The location complies with zoning requirements for the temporary sale of alcoholic beverages pursuant to this application for a One/Two/Three Day Permit. Signed Date Title Note: College fraternities and sororities must meet certain additional conditions which can be found in the application instructions and requirements. Auth: 61A-5.0013,FAc 2 SECTION 5-"DESCRIPTION OF PREMISES TO BE LICENSED AB&T AUTHORIZED SIGNATURE REQUIRED Business Name(D/B/A)or Name of Event A rl A-0 Q Neatly draw a floor plan of the premises in ink,irtcluding sidewalks and other-06wde areas which are contiguous to the premises, walls,doors, counters,sales areas,storage areas,restrooms, bar locations and any other specific areas which are part of the premises where the event will be held. A multi-story building where the entire building is to be licensed must show the details of each floor. Auth: 61A-5.0013,FAC 3 MEMORANDUM F REQUEST From: Lower Keys Rotary Club Ke of , r To: Monroe County Public Works Monroe County Attorney-Pedro Mercado i Monroe County Administrator January 24,2020 t e &�fw nfA ro Sou hsPCiY PURPOSE o This is to request the use of the Big Pine Community Park as a venue of our annual Independence Day Celebration,which includes the only public fireworks display in the Lower Keys. Having the event at the Big Pine Community Park will facilitate the county's involvement in this beloved Independence Day Celebration at the beautiful county park that still doesn't have the following that it should. This will be a showcase for thousands of people to check out this wonderful venue that was always intended for community recreation. This year's event falls on Friday,July 3`d We would need the use of the park for pre-staging of the event maybe Tuesday,June 30, but July 1,2,3,4 and for teardown on July 5`h. Staging is accomplished by using Rotary club members and volunteers. We would be using the open field between the ball field and the community center. The event itself begins at 5pm July 3rd and ends after the fireworks,which begin firing shortly after dark,so a concrete time frame is not possible. EVENT DETAILS The Rotary Club does not charge for entrance to this public event. We have vendors come in and sell food, water,and soft drinks for the attendees. Those vendors pay the Rotary Club a fee and we in turn use the funds to help pay for the event. The fireworks display is paid for by funds raised in fundraising activities throughout the course of the year. We host celebrity grocery bagging events on Big Pine and solicit donations and sponsors prior to the event. Our only money-raising activities the day of the event are our sales of beer, wine and a 50/50 raffle.We are also asking permission to continue the sale of alcoholic beverages at the event. We erect a large stage with shade for the band,mount our USA flag and provide access for the event MCs. Attendees often bring lawn chairs or blankets for seating.No coolers are allowed. The club handles parking and event access. We hire MCSO deputies for crowd control.Waste Management provides trash/recycle receptacles and portable facilities will be provided to alleviate pressure on the park's sewer system. We would need access to water but we supply our own generator for power needs. Events include games for kids(with the addition of this venue also the playground), raffle, live music,food, drinks,and vendors and possibly a dunk tank and bounce house. We are planning to shoot the fireworks from a barge on the waters within the park.We plan to notify the neighbors of the impending event as we will be using both the park and adjacent streets for parking of event traffic. Our crews and k8C5O will oversee that operation. The fireworks company provides event liability insurance and we will provide the paperwork with the county as a named insured. Monroe County Fire Rescue will be on site for medical emergencies. FUNDING Funding is derived through Rotary Club donations,event sponsors, sales of alcoholic beverages,celebrity bagging,and other events. All funds raised are used to pay for the event/. Estimated event costs: Fireworks $12,000 Food 6kBeverages $1,000 MCSO $400 Waste Management$l,SDA Equipment rental $400 Music $700 Total $16,000 For the last several years,the event has lost small amounts ofmoney. Because of that there isnobeneficiary of net proceeds. if net proceeds were to occur,they would be placed in a dedicated account to help pay for the 2020 Independence Day Celebration. The Lower Keys Rotary Club is e non-profit Florida Corporation. REQUESTS 1. Use mfthe Park from July 1 through July 5m. 2. Waiver of closing hours 3. Waiver of event fees 4. Alcoholic beverage sales 5. Waiver of clean-up fees Rotary uses club volunteers and community volunteers for equipment removal and site clean up after the event. IZA S ° i mm as 1� e Ot O� t_ ,r r a i! '�'- �Y yam.+ ��...,.. �. r �•v� - SECTION 6-AFFIDAVIT OF APPLICANT FOR NON-PROFIT CIVIC ORGANIZATION ALCOHOLIC BEVERAGE PERMIT NOTARIZATION REQUIRED FW Mk�a e of Applic t Org iz ion 'AnL vVk 7111 NV "This is to certify that the applicant requesting the permit in the above and foreg6ing application is a non-profit civic organization and that the permit,if used,will be used only by the organization making application,on the date(s) requested and at the location stated. By acceptance of this permit,we agree that the applicant organization,as the permit holder, is the ONLY entity that will receive any of the profits from the sale of alcoholic beverages on this permit. This is to further certify that the applicant organization has not received more than three(3)permits within the calendar year, unless otherwise authorized by law,and acknowledge that the location may be inspected and searched during the time that the permit is issued and business is being conducted without a search warrant by authorized agents or employees of the Division of Alcoholic Beverages and Tobacco,the Sheriff, his Deputies, and Police Officers for purposes of determining compliance with the alcoholic beverage laws. 1,the undersigned individual, hereby swear or affirm that I am an officer or authorized representative and am duly authorized to make the above and foregoing statements on behalf of the applicant organization. Furthermore, I swear under oath or affirmation under penalty of perjury as provided for in Sections 559.791, 562.45, and 837.06, Florida Statutes,that the foregoing information is true to the best of my knowledge." STATE OF COUNTY OF llee f- 1-4 C T/AUTHORIZED REPRESENTATIVE NAME \4EELJaANT/AUTHORIZED REPRESENTATIVE SIGNATURE The foregoing was O Sworn to and Subscribed before me this 41_8 Day Of 20 9, 0 Bylley�Ji who is personally known to me (print name(s)of person making statement) OR who produced as identification. Commission Expires: Ao,11 4,7,;Z0,-5 Notary Public NEIL GULLEY *Q State of 4o- ry u -W'.-sNotery Public-State of Florida Commission#GG 328517 My Commission Expires y C m 0 mission Up A pril 0 pril 29, 2023 Auth: 61A-5.0013,FAC 4 SECTION 7'=AFFIDAVIT OF APPLICANT FOR SPECIAL'SALES LICENSE NOTARIZATION REQUIRED Name of Apip' antOrgan*z tion "I,the undersign d individual, or if a corporation, its authorized represent6fivi,hereby swear or affirm that I am duly authorized to make the above and foregoing application for a special sales license which authorizes the sale of alcoholic beverages for period of up to three(3)days. I understand this license does not permit the sale of alcoholic beverages for consumption on the premises and only allows package sales in sealed containers and acknowledge that the location may be inspected and searched during the hours that the special sale is being conducted without a search warrant by authorized agents or employees of the Division of Alcoholic Beverages and Tobacco,the Sheriff, his Deputies, and Police Officers for purposes of determining compliance with the beverages laws. swear under oath or affirmation under penalty of perjury as provided for in Sections 559.791, 562.45, and 837.06, that the foregoing information is true to the best of my knowledge and that no other person or entity except as indicated herein has an interest in the special sales license and that all of the above listed persons or entities meet the qualifications necessary to hold this special sales license." STATE OF V!oil- COUNTY OF a t � r%l/�' AUTHORIZ,ED REPRESENTATIVE NAME AP,PLIC THO EPRESENTATIVE SIGNATURE The foregoing was( )Sworn to and Subscribed before me this Day of , 20 X0 By A,, Ae e s - ___ _____ who is(>6 personally known to me (print name(s)of person making statement) OR( )who produced as identification. Commission Expires: Notary Publi Notary Public-State of Plori e : *= Commission# 2 517 y Commission Expires April 2 ,223 Auth: 61A-5.0013,FAC 5 ATTESTATION This form is to be completed by the alcoholic beverage license holder Q=when the event of the non profit organization is being held at a location that is licensed by the Division of Alcoholic Beverages&Tobacco for the sale of alcoholic verages.es. Note:This afte ation must have the original signature of the alcoholic beverage license holder(only persons on file with the divisi n may sign)and must be submitted by the non-profit group along with the application for the One/Two/Three D Permit. licensee: Business Name(DBA): License Series of Permanent License: Type: Contact Person Telephone Number ext. E-Mail Address(Optional) Name of Non-Profit Group: Date(s)of Event I V I IMPOR ANT 0 R A \ N f A One/Two/Three Day permit is being requested for an event to b held on your licensed premises. During the event, no sales or service of alcoholic beverages maybe made rider your alcoholic beverage license in the area identified for use by the non-profit organization.Failure\toco ply will result in administrative charges being filed against your license. Signature of Licensee: Date: Authe 61A-5.0013,FAC 6