SPECIAL EVENT APPLICATION - ASA GOLF WELCOME RECEPTIONSpecial Event Application
This application is to be completed by the individual or authorized representative of the organization regulating the event and requesting
permit. Submission of an application does not guarantee the event will be approved. Do not publicize or promote your event until your
notification of acceptance has been issued.
EVENT INFORMATION
ASA GOLD Welcome Reception Opening Ceremony for the ASA Girls' 18 -Under Fast
Name of Event: Purpose: Pitch GOLD Nationship Championship
Date(s) of Event: Sunday, July 21, 2013
7:OOpm - 10:OOpm
Official Start /End time:
Location (Facility /Park /Road):
(Parks - include Park Name
& Shelter Number)
Set up: 7/16, Break down: 7/23
Setup Date/Time & Final Wrap -Up:
Rain or Shine Event: Yes ❑ No
;A
Expected Attendance (include Crew, Participants, Spectators)
Sheraton Sand Key Resort/
Sand Key Park
Facility or Shelter Reserved: Yes ❑ No
Choose Public or Private Event:
Overall:
2500
Public ❑ Private
At any One Time: 2500
N/A ❑
APPLICAN
(complete one of the following sections)
Name: Brian Craig
INDIVIDUAL
(This section is for use by individuals only)
Email: brian.craig @myclearwater.com
Address: 706 North Missouri Avenue City: Clearwater
Daytime Phone: (727) 562 -4839 Cell: (727) 224 -7577
Event Point of Contact: Brian Craig
POC: Phone # (727) 224 -7577
State /Zip Code:
FU33755
Fax No: (727) 562 -4813
COMPANY /ORGANIZATION
(This section is for use by organizations registered with the State of Florida both "For Profit and "Non Profit ")
City of Clearwater Parks & Rec Department
Company /Organization Name: Charity Organization: Yes ❑ No
Address: 706 North Missouri Avenue
Email: Brian Craig @myclearwater com
(Copy of 501(c)3 Required)
Tax Exempt: Yes 0 No ❑
(Florida Exemption Certificate Required)
Clearwater FU33755
City: State /Zip Code:
tt
Organization Website: hp: / /www.myclearwater.com/
Authorized Representative
Name: Brian Craig
Daytime Phone: (727) 562 -4839
Point of Contact Name
(if different):
Cell No: (727) 224 -7577
Fax No:
(727) 562 -4813
Special Event Application v9.13.12
1
EVENT ACTIVITIES
Has this event been held previously? Yes ❑ No
Gil
If yes, Date /Place /Attendance:
Please select all applicable activities and /or known services for this event from the choices below:
0000 00000000000
0000 00000000000
CLASS II
Aerobics /Exercise Class
Animal Acts /Show
Animal Petting Zoo
Baseball
Basketball
Bicycled Riding Events
Block Party
Camping (Adults)
Catering (On -Site Prep)
Craft Show
Dance
Demonstration
Easter Egg Hunt
Electrical Usage
Equipment Rentals
Equipment Testing
Event Planner
Football (non - contact)
Fundraising
Generator Usage
Lighting (external)
Other Public Entity Usage
Photography (active, not still)
Picket (Organized)
Rally
Soccer
Softball
Tent Usage (> 10X10)
Track /Field (NO A- Thons)
Volleyball
000000000000000
O
0
0
O
o
CLASS III
Amusement Device
Beverage /Catering ( with alcohol)
Bicycle Racing Event
Boating Event
Camping (Minors)
Canoe /Kayak Event
Entertainment -Music Band
Fair (Art/Craft /Other)
Fishing Event/Tournament
Media Attendance
Motorsport Event
Parade
Pyrotechnics
Regatta
Sales -
Beverage /Food /Merchandise
Skateboarding Event
Sporting Event (Organized)
Stage /Risers
Use of Road /Right of Way
Water Parade
Other Activity (not mentioned above): No activities on county property. Only overflow parking in the Sand Key
Park lot.
2
Section 1
Please complete the following section of this application. Provide as much detail as possible for activities applicable
to your event. If any of the following sections do not apply to activities, services, or needs for your event, please
write N/A (for not applicable).
3
N/A - none on county property
Describe your plans for Entertainment.
All entertainment located at Sheraton Sand Key Resort
Please name all vendors who will provide
entertainment and the type of entertainment
provided. Entertainment locations must be
shown on the site map.
See attachment.
Describe your plans for parking.
Expected attendance 1500 -2500, overflow parking in Sand Key Park
parking lot
Include parking plan for disabled, vendors,
spectators, participants, media, etc. A visual of
parking must be shown on site map.
Request waiver of parking fees for event attendees
Event located at the Sheraton Sand Key Resort
Directional signage and auxiliary lighting guiding participants
Describe your plans for all signage, and /or
decorations for the event.
toward Sheraton property
Please include type of signage to be used, and
description of verbiage being posted on the
signage.
Signage must also be marked on site map.
3
4
N/A
Describe your plans for Waste Management.
Please include plans for disposal of vendor
waste, as well as all other accumulated waste
product.
Name the company selected for waste
management.
Provide the number of persons your Event
Coordinator has designated for disposal of
waste at the event.
City of Clearwater 2 portable Tight towers
Describe your plans for physical amenities.
Name all vendors being contracted for physical
amenity services. Please include number of
water stations, number of port-o -lets, hand
washing stations, or any other amenities used to
keep attendees comfortable.
Standard 911 response
Describe your plans for emergency services.
Please include the agency name and contact
information for each emergency service (EMS
and Fire) you have requested.
4
Section 2
Provide as much detail as possible for activities applicable to your event.
5
See site map
Describe your plans for Controlling Ingress /
Directional signage and auxillary lighting guiding participants
Egress .
toward Sheraton property
Ingress /Egress is entry and exit of persons,
vehicles, equipment. Please mark locations on
the site map.
N/A
Describe your plans for Vendor /Caterer food
preparation.
Include type of food and how it will be prepared
on site. If smoking, or barbecuing describe
method for disposal of flammable materials.
Verify the caterer /vendor has a valid
food /beverage license. Furnish a copy of vendor
current food /beverage licenses with this
application.
N/A for Sand Key Park property
Describe your Security /Law Enforcement Plan.
Please provide contact information for off -duty
law enforcement agencies used for the event.
Include officer count and attendance times.
Place marks on the site map where security will
be stationed. If funds will be collected on -site,
explain the process securing the money
collected. If equipment will be on -site
overnight, provide details for personal property
safety and security of site.
5
Describe any other Public - Entity access that
may occur during the event.
N/A
Include usage of Street /Road /Park, etc. If
other municipalities will be accessed, provide
proof of permit application or approved permit
from each such entity. Approval permits from
all other municipalities will need to be furnished
to the County no later than 30 days prior to the
event.
Describe in full detail the purpose of your
Welcome Party for ASA GOLD Nationals (18 + U Softball), estimated
demonstration /rally /assembly.
economic impact 8 -10K room nights.
76 teams will be able to relax and enjoy Clearwater Beach. A beach
Provide information on times and locations and
party dinner will be from 7:00 PM to 8:00 PM. The official program
expected attendance. If any type of
demonstration other than signs will be used,
please describe in full detail.
begins at 8:00 PM and goes until 9:00 PM. In addition there will be a
fireworks show on the beach at 9:15 PM.
Describe in full detail any other activities not
previously addressed.
N/A
Please include the use of any external lighting
sources, electrical /generator usage, (both
vendor and applicant), athletic activity (non -
organized), and /or tent usage.
6
Section 3
Provide as much detail as possible for activities applicable to your event.
7
N/A
Describe Staging / Start- Finish Area /Bleachers
/ Equipment /Amusements being used.
Include band, vendor, supplier, setup and tear -
down information, media staging, etc. Please
provide dimensions and locations on the site
map.
N/A
Describe your need for Road /Street / Alley
closure and use of same.
Please include the exact section requested for
closure by naming streets /roads /avenue, etc.
from north to south, then east to west. Then
provide visual on the site map.
N/A
Describe in detail your organized athletic
activity.
Provide information on all activities, who is
overseeing each activity, who will receive the
proceeds from the activity and why.
7
Describe the purpose of your request for
the use of alcohol on County property.
NIA
Please include the type of beverage(s), and
name of the local distributor. Name the
organization who will be serving the
beverage(s), and if a bartending service is
contracted, name the individual bartender.
Describe the method of distribution (walkup
tap, closed cans purchase, bar service, etc.)
Provide the start and official close times of
distribution, as well as announcement time of
"last call ".
All permits for events involving alcoholic beverages
must be posted and visible during the entire event.
The Applicant Name on the Special Event /Special use
form must be the same as all other applied permits.
No exceptions will be allowed.
NIA
Describe in full detail any other activities not
previously addressed.
Reminder:
Attach the following documents and submit with your application (Plans #1 -3 can be provided on the same plan):
1. SITE PLAN
2. PARKING PLAN
3. WASTE MANAGEMENT PLAN
4. INSURANCE - CERTIFICATE (FOR APPLICANT AND ALL COMMERCIAL VENDORS)
5. REQUIRED PERMITS IF CURRENTLY APPROVED
6. IF ADDITIONAL PAGES ARE NECESSARY TO EXPLAIN THE EVENT, PLEASE PROVIDE IN ADDITION TO THIS APPLICATION.
Thank you for completing the Pinellas County Special Event Application. Pinellas County will review the application and
contact you with our response, or request additional information. Please proceed to the Terms of Agreement.
8
TERMS OF AGREEMENT
As the applicant, I hereby accept and understand the responsibility to oversee all contractors, vendors or parties affiliated with
the event and to ensure compliance with all policies, rules and regulations, and guidelines of Pinellas County Government;
including the rules and regulations of each individual department as posted at www.pinellascountv.org. I understand that any
violations may result in immediate cancellation of the reservation and /or revocation of the permit. I understand the permit is
non - transferable and non - refundable. Failure to provide all requirements and payment by the due date will result in no
issuance of a permit for the event. There are parking fees in place at Fred Howard, Fort De Soto, and Sand Key Parks. Parking
fees are also in place at boat ramp locations governed by Pinellas County Parks & Conservation Resources. These fees cannot
be waived.
Based upon details of the event, insurance requirements may change from the below stated requirements. You will be notified
of any change in these requirements. A certificate of insurance as proof of insurance shall be submitted with this application.
Minimum insurance requirements are as follows:
Commercial General Liability insurance including, but not limited to, Bodily Injury, Property Damage, and Personal Injury.
Limits
General Aggregate $1,000,000
Personal Injury and Adv Injury $1,000,000
Each Occurrence $1,000,000
• The term "County" or "Pinellas County" shall include all Authorities, Boards, Bureaus, Commissions, Divisions, Departments and
Constitutional offices of County and individual members, employees thereof in their official capacities, and /or while acting on
behalf of Pinellas County.
• Pinellas County Board of County Commissioners shall be endorsed to the required policy or policies as an Additional) Insured.
Copy of the Additional Insured endorsement must be provided with the certificate of insurance as proof of coverage.
• All policies shall be written on a primary, non - contributory basis.
• Pinellas County reserves the right to request a copy of all insurance policies.
In consideration of this agreement to allow use of the County's property, the applicant shall and does agree to indemnify,
defend, pay the cost of defense, including attorney's fees and hold harmless PINELLAS COUNTY and all of its officers, agents,
and employees from all suits, actions or claims of any character, including all costs, attorney's fees, expenses, damages,
judgments, or decrees, brought on account of any injuries or damages received or sustained by any person, persons,
participants, spectators, or property arising out of or in any way attributable to the holding, performance, operation or
maintenance of the event herein permitted. This duty of defense and indemnification specifically includes any and all alleged
negligence by Pinellas County as related to the event, including but not limited to the issuance of this permit, supervision of
the event, conditions at or adjacent to the site, road, sidewalk, traffic signs /signal conditions.
I agree to the TERMS OF AGREEMENT as set forth in this application, and I agree to abide by all rules and regulations as
provided by separate document with this applications response. Incomplete, illegible and or unsigned applications will NOT be
accepted and will be returned.
Applicant /Authorized Representative:
Signature:
Printed Name:
Date:
See Attached Signature Sheet
9
Countersigned:
George N. Cretekos
Mayor
Approved as to form:
4
Laura Lipowski Mahony
Assistant City Attorney
CITY OF CLEARWATER, FLORIDA
By: W (!K1 , 'U 44-1.
William B. Horne, II
City Manager
Attest:
Oci..te
Rosemarie CaII
City Clerk