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Home My WebLink About20132415.tiffRESOLUTION RE: ACTION OF THE BOARD CONCERNING PERMIT FOR TEMPORARY ASSEMBLY TO RUBEN GUARDIOLA - SEPTEMBER 14 AND 15, 2013 WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, Ruben Guardiola, 16526 County Road 53, LaSalle, Colorado 80645, has presented to the Board of County Commissioners an application for Permit for Temporary Assembly on land within the unincorporated portion of the County of Weld, State of Colorado, to be held from 11:00 a.m., until 5:00 p.m., on September 14 and 15, 2013, on property described as follows: 26138 CR 36, LaSalle, Colorado 80645; being further described as Lot D of Recorded Exemption #4518; being part of the W1/2 of Section 9, Township 3 North, Range 64 West of the 6th P.M., Weld County, Colorado WHEREAS, having examined said application, the Board deems it inappropriate to grant to the Application of Ruben Guardiola for a Weld County Permit for Temporary Assembly at this time. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that said application of Ruben Guardiola for a Weld County Permit for Temporary Assembly on September 14 and 15, 2013, be, and hereby is, denied. The above and foregoing Resolution was, on motion duly made and seconded, denied by the following vote on the 26th day of August, 2013. BOARD OF CTY COMMISSIONERS WELD COLORADO ATTEST: C k.... Weld County Clerk to the Board un y Attorney Date of signatureSEP 1 2 2013 William . Garcia; hgr c Dougls $Radem can P. Conway Barbara Kirkmey 2013-2415 fig(« LC0022 APPLICATION FOR TEMPORARY ASSEMBLY INSTRUCTIONS TO APPLICANT: Complete each section and mark "N/A" where not applicable. Additional sheets may be attached and maps, sketches or drawings may be substituted for the verbal description of plans for the assembly site. All required information must be furnished before the application will be processed. NAME:) gO,/Se b/a , AGE: 1.16 RESIDENCE: MAILING ADDRESS: `3an2 e ac abc or (%76Y ud- 3 75 Ce // 3011- NAME: AGE: RESIDENCE: MAILING ADDRESS: NAME: AGE: RESIDENCE: MAILING ADDRESS: NAME: AGE: RESIDENCE: MAILING ADDRESS: (This must list all partners in a partnership, officers of an unincorporated association, society or group, or, if there are no officers, by all members of such association, society or group. IF A CORPORATION, ATTACH A CERTIFIED COPY OF THE ARTICLES OF INCORPORATION.) 1. Address and legal, description of all property upon which the assembly is to be held: 4c0 0,0 -Tess i3Y8 0,e, 3(Q La_Sc0lc (O Xu(o4(S A. Name, residence and mailing address of the record owners of such property (Attach a notarized statement by the record owners of such property consenting to the assembly if application is not made by all of the record owners.) NAME: RESIDENCE: MAILING ADDRESS: NAME: RESIDENCE: MAILING ADDRESS: 2013-2415 M:\CTB\CTBFORMS\Foasm bly.wpd Nature or purposes of the assembly: 0c3c /we in c� jsIA ' l 6u14e2/f �Xti -&f.2fi l r ca -inn / Z C ,S fl7aJx }(A 7 A e/ J�f,✓,C:/ -4,771/Of 8 di" or Kitc A Ar)c/, rtr / e.y1 /-e-e .7. ii7hAe / 3. Dates and hours during which the assembly is to be held:srip/ I L/ f ff/ Z61,/ Pr2>r7 /l,//J to ; 4. Maximum number of persons to be allowed at assembly at any one time: / irr°x 1.4-OO• /-1-fPnc%ncc. (J/7/<noc.-2n (ip n i c HJ 5. The maximum number of tickets to be sold, if any: n A 6. Identify plans to limit number of persons to the maximum identified above: 5-r ar//r eJow rvic r, ; // 6c in 5' 'sr'/c r c/ fa C'.CCLS c P4-2/fig cj '/9n earhhy cJI/f hr 1dCn <//Jrnn e6 /Jc and therr 1JI( kecp ¢nick' a pccplc ra d et/C,--7� 7. Identify plans for supplying potable location of facilities, and type 17' rc/ GJCL/r4/ 60e// 41Ac cc' !-r/� y el- O s &Lt., // G s- ) -)c) s � (drinking) water, including the source, number, and and means of disposing of waste deposited: blcc/ /A7drsghoe. Li lenf 0 ()Itrnp f-ct 1-n1 pck3,:I 8. Identify the plans for holding, collecting, and disposing of solid waste materials: /hrre JA1r/I 4- hi o ICI 541-) Ia..✓25" 41ncl .-6kr rir<Jl r- u) i /r hr. (espz) n b/r� P0/ rnn1 p/e /c c/r,-7-ti r ee 69 lir c/c n 9. Identify the plans for providing separate toilet facilities for males and females, including the source, number, and location, type and the means of disposing of wastes deposited: rf�r, f/<</� T� fc S 5cn,/le- ' w1`%/ hr prdLI (11,0 / r. re cord %LAr5.. oThcir Ai II/ hr of);s e r hel IA<"r_ .1 )ill ri r�C( /hour? . c i /ham Op/ etnc/ p; c r> ikc l-/c.,ncI tai %e I c6 as 6 Laic g, Sac, /71 lhtner) M:\CTB\CTBFORMS\Foasmbly.wpd 10. Identify the plans to provide for medical facilities, including the location and construction of any structures, the names, addresses, and hours of availability of emergency medical techniciaps and nurses and provisions for emergency ambulance service: PAP/ 0,'nn4 gcre✓, /c -Sectie'cs' P/rcrs c sce 1gildrltie a (i. ). 11. Identify the plans, if any, to illuminate the location 9f the assembly, including the source and amount of power, and the location of lamps: 0 i d/,po1; rtz A /r •Gucnl iA, // be 12. Identify the plans for parking vehicles, including size and location of lots, points of highway access and interior roads, including routes between hi hwa access and parking lots: 13. Identify the plans for communications with hospital, police, and fire services, including the source, amount, and location of communication equipment: Paavnh-7ca/c.5 ,S (x)c// G5 C2-2(71-1 /e/ cVftrr/S will I AJ}c C e_ c/ 14. Identify the plans for camping facilities, if any: Jf///� M:\CTB\CTBFORMS\Foasmbly.wpd 15. Identify the plans for fire protection: 'Pk 1yr 1,70 //re/ r O c___i _ 0r f t S//r. ;rr /i;.SIr7c/ 16. Identify the plans for security, including the number of guards, their deployment, their names, addresses, credentials and hours of availability and description of peer group control, if any: ,T $ T ,aSror / axe) (Se r" Let t 17. Identify the plans for sound control and sound amplification, if any, including number, location, and power of amplifiers and speakers: _,///n- 18. p/r;Anicn i-( S ) • 19. Identify the plans, if any, for an electrical system: ,//14 M:\CTB\CTBFORMS\Foasmbly.wpd 20. Identify the plans to ensure that trees, underbrush, large rocks, and other natural features shall be left intact and undisturbed, and natural vegetative cover retained, protected and maintained so as to facilitate drainage, prevent/,erosion, and preserve the sc nic attributes; and the plans to abate dust on the site: PM O9rn 21. Attach a statement by a bonding company licensed to do business in the State of Colorado indicating its intent to furnish a bond required in Section 12-1-30.6.13 of the Weld County Code to ensure performance by the applicant of each of the terms and conditions of the temporary assemblage permit. ONIAC 315-61)Manik) 22. Attach a statement by an insurance company licensed to do business in the State of Colorado stating its intent to provide liability insurance, as required by Section 12-1-30.6.14 of the Weld County Code, to prot ct agpinst injury to persons or property occurring as a result of such an assembly. t ifao 414-qc W 23. Submit $100.00 fee for each event where three -hundred fifty (350) or more people assemble or can reasonably by anticipated to assemble at any one (1) location, unless the location is properly zoned for such assembly, in which case one permit shall be required for the total number of events scheduled for that location for the reminder of the calendar year, not to exceed ten (10) events per year. As used herein, the term event means an assembly or anticipated assembly which is scheduled to last for three (3) consecutive days or less. BY THIS APPLICATION, APPLICANT(S) AGREES TO INDEMNIFY AND HOLD HARMLESS WELD COUNTY OR ANY OF ITS AGENTS, OFFICERS, SERVANTS, AND EMPLOYEES FROM ANY LIABILITY OR CAUSES OF ACTION WHICH MIGHT ARISE BY REASON OF GRANTING OF A TEMPORARY ASSEMBLAGE PERMIT, AND FROM ANY COSTS INCURRED IN DEFENDING AGAINST SUCH ACTIONS OR IN CLEANING UP ANY WASTE MATERIAL PRODUCED OR LEFT BY THE ASSEMBLY. M:\CTB\CTBFORMS\Foasmbly.wpd The applicant, and each of them, swears, (affirms) that, to the best of his knowledge, the statements contained in the application are true and correct. Applicant's signature ,./e4 -CAN 6;4 V' C' I Applicant's printed name Applicant's p'dsition 20 SUBSCRIBED AND SWORN to before me this 1D" day of 7 Witness my hand and official seal. My commission expires: \?'\' X ( TAMMY LEE WATERS NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20124078542 MY COMMISSION EXPIRES DECEMBER 5, 2016 M:1CTB\CTBFORMS\Foasmbly.wpd Aug. 12. 2013 1:37PM No. 6552 P. 1 Page: 1 nited Site Services of Colorado, nc, Customer Service: 1-800.564-5387 Bill RUBEN GORDIOLA To: MARTIN GUTIERREZ 7717 CR 31 FORT LUPTON, CO 80621 I Items Rented _ Item / Description SITE SERVICES ORDER Ship RUBEN GORDIOLA To: HORSE EVENT 16526 CR 53 LA SALLE, CO 80645 Customer ID: •ner 0. Order Date: Terms: P.O. No: Salesperson: Cust. Serv. Rep.: DEN -05631 02/11(13 Due Upon Receipt HORSE EVENT BRETT L. ANGELL Jorge Cervantes DXR Deluxe Restrooms With Hand Sanitizer DEL PER MANUELA 719-208-7370 DW ACCEPTED DW Damage Waiver ADA ADA Restrooms With Hand Sanitizer DWP Damage Waiver 238 2 Station Sink DW Damage Waiver Quantity Rental Term From / Thru Unit Price Total Price 8 Each 8 Each 2 Each 2 Each 2 Each 2 Each 09/13/13 75.00 600-00 09/16/13 09/13/13 10.00 80.00 09/16/13 09/13/13 115.00 230.00 09/16/13 09/13/13 15.00 30.00 09/16/13 09/13/13 75.00 150.00 09/16/13 09/13/13 10.00 20.00 09/16/13 Remit To: United Site SaNices, PO Box 63287, Phoenix, AZ 06812.3281 Subtotal: Total: 1,110.00 1,110.00 Signature Date: 4\ 2 - DEDICATED AMBULANCE SERVICES AGREEMENT (#0314-03-37688) THIS DEDICATED AMBULANCE SERVICES AGREEMENT (this "Agreement") is mad. and entered into as of the signature dates set forth below, to be effective as of ApciLaa,_2(=k6 (the "Effective Date"), by and between BANNER HEALTH, an Arizona nonprofit corporation, d/b/a North Colorado Medical Center ("Banner") and POIVIIIaac, an individual ("Client"). R0.ebeij u fDt()li A -- RECITALS: 9q / (2e 1 WHEREAS, Banner by and through its operation provides ambulance services and Advanced Life Support to residents within the county of Weld and throughout northern Colorado; and WHEREAS, Banner will dedicate ambulances and Advanced Life Support personnel to certain one-time events, when doing so is within Banner's capabilities ("Dedicated Ambulance Services"); and WHEREAS, Client desires to engage Banner to provide Dedicated Ambulance Services at a horse racing event in Fort Lupton, Colorado, on April 13 and 14, 2013 ("the Event"); and WHEREAS Banner desires to be so engaged to provide the Dedicated Ambulance Services in accordance with the terms and conditions set forth herein. NOW, THEREFORE, in consideration of the mutual covenants contained herein, the receipt and sufficiency are hereby acknowledged, it is understood and agreed to by the parties as follows: AGREEMENT: 1. Dedicated Ambulance Services and Rates. Client engages Banner to perform the 'Dedicated Ambulance Services, as more particularly described in Exhibit A, attached hereto and incorporated herein by this reference, at the rates and pricing set forth in Exhibit A, during days and at times as specified herein. If applicable, any conflict between the terms and conditions set forth in Exhibit A and the terms of this Agreement, excluding Exhibit A, the terms and conditions of this Agreement, excluding Exhibit A, shall govern and control. 2. Term and Termination. The Agreement shall commence at 12:01 am on April 13, 2013 and shall terminate at 11:59 PM on April 14, 2013, unless terminated sooner as provided for herein. Client may terminate this Agreement at any time prior to its commencement without penalty. Should Client choose to terminate this Agreement during the event, then Client shall be responsible for payment for the minimum number of hours for which the Dedicated Ambulance Services were scheduled. Banner may terminate this Agreement upon Notice to Client, if, but only if, there is a declared emergency in the County of Weld, or the City of Greeley, which might impair Banner's ability to dedicate Dedicated Ambulance Services solely to Client. Banner would nonetheless, be available to respond to emergency calls at the Event should the need arise. 3. Insurance. Banner has in force at all times and during the term of this Agreement (a) comprehensive general liability insurance, including blanket contractual liability, (b) automobile insurance, and (c) complete operations insurance, all with minimum limits of One Million Dollars ($1,000,000.00) per occurrence and Three Million Dollars ($3,000,000.00) in the annual aggregate, and workers' compensation insurance, as required by law. Banner shall, upon request, provide Client with a certificate(s) of insurance, stating Y:\shslegal\WR\Colorado Region Facility Contracts & Matters\NCMC\Ambulance Service\Martin Gutierrez Ambulance Services Agt 2013.ag1.doc that the above coverages are in force, and shall continue in force, throughout the term of this Agreement. 4. Mutual Indemnification. Each party shall indemnify and save harmless the other party for, from and against all actions, liabilities, losses, damages, claims and demands whatsoever, including costs, expenses and attorneys' fees, resulting, or claimed to have resulted solely from the intentional or negligent acts or omissions of the indemnifying party or its employees, subcontractors or agents engaged in the work under this Agreement at the time of the event or occurrence upon which such actions, claims or demands are based. 5. Compliance with Regulations and Policies. Banner shall comply with all standards applicable to the Dedicated Ambulance Services, including, but not limited to, the standards of (a) any accreditation programs, (b) federal, state and local government laws, rules and regulations, and (c) third party payors. Whenever providing services or goods pursuant to this Agreement on the premises of the Event. 6. Compliance with Employment Laws. Banner agrees to comply with all federal, state, and local laws, regulations, ordinances, and orders governing immigration, equal employment opportunity, and affirmative action that are applicable to Banner, including 42 U.S.C. Sec. 2000(e) et seq., the Civil Rights Act of 1964, the Civil Rights Act of 1991, Sections 503 and 504 of the Rehabilitation Act of 1973, the Vietnam Era Veterans' Readjustment Assistance Act of 1974, the Immigration Reform Act of 1986, the Americans with Disabilities Act, Executive Order 11246 of September 24, 1965, Executive Order 13496 of January 30, 2009, and all amendments and applicable regulations pertaining to any of them, including 41 C.F.R. §§ 60.1.4(a)(7), 60-250.5, 60-300.5 and 60-741.5 (imposing anti- discrimination and affirmative action requirements) and 29 C.F.R. Part 471, appendix A to subpart A. 7. Conflict of Interest Disclosure. Client represents and warrants that none of Client, any affiliate of Client, or any officers, directors, employees, partners, members, owners or shareholders of Client or any affiliate of Client, is related to, affiliated in any way with, or employs (or otherwise has a compensation interest with) any officer, director or employee of Banner. 8. No Federal Exclusion. Banner hereby represents and warrants that Client and ail personnel providing any Dedicated Ambulance Services under this Agreement are not, and at no time have been, excluded from participation in any federally funded health care program, including Medicare and Medicaid and that no such action is pending. 9. Independent Contractor Status. Banner shall at all times be deemed to be an independent contractor of Client. Banner's employees shall not be regarded as employees or agents of Client for the payment of any employer taxes such as FICA, unemployment, and workers' compensation, and Client shall not be responsible for those taxes or any fringe benefits for Client's employees. Further, the employees of Banner shall not be regarded as employees of Client with respect to any intentional or negligent activity in which they may be involved or for any other purpose. 2 Y:\shslegal\WR\Colorado Region Facility Contracts & Matters\NCMC\Ambulance Service\Martin Gutierrez Ambulance Services Agt 2013.ag 1.doc 10. Change in Law. If any new federal or state law, regulation or rule is enacted or if there is a change in any federal or state law, regulation or rule that affects this Agreement, the activities of either party under this Agreement, or either party's performance or ability to perform under this Agreement, or any change in the judicial or administrative interpretation of any such law, regulation, or rule, and either party reasonably believes in good faith that such change shall have a substantial adverse effect on such party's business operations or its rights or obligations under this Agreement, then such party may, upon written notice, require the other party to enter into good faith negotiations to renegotiate the terms of this Agreement. If (a) the parties are unable to reach an agreement concerning the modification of this Agreement within the earlier of (i) forty-five (45) days after the date of the notice seeking renegotiation or (ii) the effective date of the change, or (b) the change is effective immediately, then either party may immediately terminate this Agreement upon written notice of such termination to the other party. 11. Regulatory Termination. If, prior to the expiration of the term of this Agreement, any federal, state or local regulatory body, including, but not limited to, the Centers for Medicare and Medicaid Services, the Department of Health and Human Services ("HHS"), or the Internal Revenue Service determines that this Agreement is illegal or jeopardizes the tax exempt status of Banner or the Hospital, then either party may give the other party such notice as is reasonable in the circumstances and shall make available a reasonable period within which to cure. During such period, the parties shall negotiate in good faith to agree upon an appropriate cure. If no cure is implemented by the parties, then either party, in its discretion, may terminate this Agreement with such notice to the other party as is reasonable under the circumstances. 12. Retention and Inspection of Records. Banner shall keep all records related to this Agreement on file for a period of four (4) years from the date the record is made. Banner shall, upon reasonable notice, give Client or its authorized representative the privilege, at a reasonable time, of inspecting, examining, and auditing, during normal business hours, such of Banners business records that are directly relevant to this Agreement, including, without limitation, the financial arrangement between the parties. The cost of such inspection, examination, and audit shall be at the sole expense of Client, and such inspection, examination, and audit shall be conducted where said records are normally maintained. 13. Access to Records for Government Inspection. Banner agrees, until the expiration of four (4) years after the furnishing of the Dedicated Ambulance Services to be provided under this Agreement, to make available, upon request, to the Secretary of HHS, the Comptroller General of the United States of America, or any of their duly authorized representatives, the contracts, books, documents and records that are necessary to certify the nature and extent of reimbursable costs under the Medicare laws. If Client carries out any of the agreements under this Agreement through a subcontract with a value or cost of Ten Thousand Dollars ($10,000.00) or more over a twelve (12) month period with a related organization, such subcontract shall contain a requirement identical to that set forth in the preceding sentence. 14. Assignment. This Agreement may not be assigned by either party without the prior written consent of the other party. If consent to an assignment if obtained, this Agreement is binding on the successors and assigns of the parties to this Agreement. Notwithstanding any provision of this Agreement to the contrary, Banner shall have the right to assign or otherwise transfer its interest under this Agreement to any "related entity." For the purposes of this Section 14, a related entity shall be deemed to include a parent or subsidiary of Banner, any entity that acquires all or substantially all of Banner's assets or 3 Y:\shslegal\WR\Colorado Region Facility Contracts & Matters\NCMC\Ambulance ServicelMartin Gutierrez Ambulance Services Agt 2013.ag1.doc operations relating to this Agreement, and the surviving entity of any merger or consolidation involving Banner. Any assignment to a related entity shall not require the consent or approval of Client in order to be effective. 15. Corporate Authority. The individual(s) executing this Agreement on behalf of, or as a representative for, a corporation or other person, firm, partnership or entity, represents and warrants that he/she is duly authorized to execute and deliver this Agreement on behalf of such corporation, person, firm, partnership or other entity and that this Agreement is binding upon such entity in accordance with its terms. 16. Waivers. No waiver of the enforcement or breach of any agreement or provision herein contained shall be deemed a waiver of any preceding or succeeding breach thereof or of the enforcement of any other agreement or provision herein contained. No extension of time for performance of any obligations or acts shall be deemed an extension of the time for performance of any other obligations or acts. 17. Severability. If any provision of this Agreement, or any application thereof to any person, shall be invalid or unenforceable to any extent, the remainder of this Agreement, and the application thereof to other persons or circumstances, shall not be impaired, and shall be enforced to the fullest extent permitted by law. 18. Force Majeure. Neither party shall be liable for any delay or failure in performance hereunder caused, in whole or in part, by reason of force majeure, which shall be deemed to include the occurrence of any event beyond the control of the parties, war (whether an actual declaration thereof is made or not), sabotage, insurrection, riot and other acts of civil disobedience, action of a public enemy, laws, regulations or acts of any national, state or local government (or any agency, subdivision or instrumentality thereof), judicial action, labor dispute, accident, fire, explosion, flood, storm or other act of God. 19. Counterparts. This Agreement may be executed in one or more copies or counterparts, each of which when signed shall be an original, but all of which together shall constitute one instrument. 20. Governing Law. This Agreement shall be governed by the internal substantive law of the State of Colorado, without regard for conflicts of laws. 21. Integration and Amendment. This Agreement, including any attachments and documents specifically incorporated herein by reference, contains the entire agreement between the parties. All prior negotiations between the parties are merged in this Agreement, and there are no understandings or agreements other than those incorporated herein. This Agreement may not be modified except by written instrument signed by both parties. 22. Notice. Any notice required to be given under this Agreement shall be in writing, and shall be deemed delivered when personally delivered or three (3) days after the same is sent by certified mail, postage prepaid as follows: If to Client: II20e ' v Dlo (g S - 2 -Co C�c1v�4 Y:\shslegal\WR\Colorado Region Facility Contracts & Matters\NCMC\Ambulance Service\Martin Gutierrez Ambulance Services Agt 2013.ag1.doc If to Banner: if with a copy to: Banner Health d/b/a North Colorado Medical Center 1801 16' Street Greeley, Colorado 80631 Attn: Chief Executive Officer Banner Health 1801 16th Street Greeley, Colorado 80631 Attn: Legal Department 23. No Physician Ownership. Client hereby expressly represents and warrants to Banner that no physician, no physician organization and no member of a physician's immediate family owns or holds an ownership or financial interest in Client, including any affiliated or related entity or person, that is not the subject of art exception or "safe harbor" under applicable law, such as the exception for publicly -traded securities under 42 CFR 411.356(a). IN WITNESS WHEREOF, the parties have executed this Agreement individually or by signature of their duly authorized representative as of the signature dates set forth below, to be effective as of the Effective Date. Banner: CLIENT: BANNER HEALTH d/b/a North Colorado Medical Center By: Name: Rick Sutton Title: Chief Executive Officer Date: 5 ,M itierrez, Individual By: Name: Title: Date: I.,,__� FEIN: Banner Health North Colorado Medical Center Paramedic Services Mitch Wagy Assistant Chief Banner Health NCMC Paramedic Services mitch wagy@bannerhealth.com 1121 M St. Greeley, CO 80631 970-392-2435 970-381-2392 CELL Y:\shsiegal\WR\Colorado Region Facility Contracts & Matters\NCMC\Ambulance Service\Martin Gutierrez Ambulance Services Agt 2013.agl.doc EXHIBIT A DEDICATED AMBULANCE SERVICES AND RATES Dedicated Ambulance Services: Rates: Banner shall provide the Dedicated Ambulance Services during the Event. Client shall compensate Banner at the rate of One Hundred Fifty and No/100ths Dollars ($150.00) per hour/ per "crew" for each hour that Banner provides Dedicated Ambulance Services at said Event (Crew: one (1) ambulance rig and two (2) ambulance personnel). Other Compensation: To the extent Banner provides any medical treatment(s) or transport(s) during the Event, Banner will bill the patient or the patient's insurer, as appropriate for such treatment and transport services. Client is in no way responsible for payment to Banner for said patient transports. Invoicing: Banner shall invoice Client for its services performed during the Event as agreed upon by the Parties. Each invoice shall be itemized and of sufficient detail for Client to verify the validity of the invoice. Client shall remit payment within thirty (30) days of the receipt of such invoice. Client's obligation to pay for services rendered by Banner under this Agreement shall survive expiration or termination of this Agreement. Y:Ishslegal\WR\Colorado Region Facility Contracts & Matters \NCMC\Ambulance Service\Martin Gutierrez Ambulance Services Agt 2013.ag1.doc USDA Farm: 9092 N Tract:5153 �A 9-3-64 United States Department of Agriculture Farm Service Agency 2009 Orthophotography NOT TO SCALE Maps for FSA Programs Only Weld County, CO 2= Cropland 3= Rangeland 10= Other AG Land Disclaimer: Wetland identifiers do not represent the size, shape or specific determination of the area. Refer to your original dermination (CPA -026 and attached maps) for exact wetland boundaries and determinations, or contact NRCS. J.J. ESCO T . h. SECU IITY, INC 6475 South Cody Street Littleton, Colorado 80123 August 08 2013 Mr. Ruben Guardiola 16526 WCR 53 LaSalle ,Colorado 80645 303-933-4544 720-922-2904 fax Ref: Event September 14 and 15 2013 Mr. Ruben Guardiola, J.J. Escort & Security Inc. will provide Security for your event on September 14 ,15 2013. Our company will provide ten armed officers with radios and cell phones .Four officers will speak Spanish Our officers have First Aid CPR training I have been in contact with the Weld County Sheriff Office about the number of officers we will have at the event. Please post the No Firearms or Alcohol allowed signs at the gates. We are License, Bonded and Insured .A deposit has been paid for this event and the balance due at time of service. The Weld County Sheriff Office knows of our company. If you have any questions please contact us at 303 9334544 JJ Escort & Security Inc. Sa.sns„` James A. Swaen CEO 3j2_t' .#-i, L _ CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08-12-2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING •INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER DAVID SIMON INSURANCE 420 Court Place Brighton, CO 80601 CON IACI NAME: PHONE FAX A/C, No, EXI): (303) 659-9065 1(Arc, No (800) 726-3179 A -MAIL ADDRESS: bizbrighton@gmail . com PRODUCER CUSTOMER ID#: INSURER(S) AFFORDING COVERAGE NAIC# INSURED Ruben Guardiola 26138 County Road 36 LaSalle, CO.80645 INSURER A. Burns & Wilcox INSURER B: 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR wvn POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY III OCCUR APP331951166 09/14/2013 09/16/2013 EACH OCCURRENCE $ 1,000,000 1 PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE MED EXP(Anyoneperson) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L LEI GENERAL AGGREGATE $ 2,000,000 AGGREGATE LIMIT APPLIES PER: POLICY n JET [I LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE - LIABILITY ANYAUTO ALLOWNED AUTOS SCHEDULED AUTOS HIRED AUTOS N BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) $ $ $ r UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE S DEDUCTIBLE RETENTION $ $ ' I $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS YIN N IA 'TWC STATU- ORY LIMITS I IOER E.L. EACH ACCIDENT S ❑ E.L. DISEASE- EA EMPLOYEE $ below E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 2 Day Horse Race Located at 26138 County Road 36 LaSalle, CO 80645 CERTIFICATE HOLDER CANCELLATION Weld County Colorado 150 O Street Greeley, CO 80631 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE David Simon © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD25 (2009/09) The ACORD name and logo are registered marks of ACORD ce CERTIFIED FLAGGER U re rn U LL 1U U RUBEN GUARDIOLA CU ClE ao, LEASE AGREEMENT This Lease Agreement, dated March a I , 2006, is between Timothy J. Gittlein, the owner of the real property described below, and Reuben Guardiola. Timothy J. Gittlein will be referred to as "Lessor" and Reuben Guardiola as "Lessee". The Lessor hereby leases that portion of the farm constituting 120 acres, more or less, for construction of equestrian training facilities to be built by the Lessee, and the Lessee hereby leases that portion of the farm constituting 120 acres upon which the facilities are to be constructed, according to the terms and conditions set forth in the following paragraphs: I. DESCRIPTION OF LEASED PREMISES. The Lessee shall lease that portion of the Northwest 1/4, Section 9, Township 3 North, Range 64 West of the 6th Principal Meridian which shall be designated as the subject of this Lease Agreement as Lot A of said section. The property is undeveloped land, previously designated as the center pivot and is referred to in this agreement as the "leased premises". Property lines to be established by survey at a later time. II. TERM OF LEASE. The primary term of this lease is from April 1, 2006 until sale of premises or March 31, 2026. III. RENT. The rent for the term of this lease is $300,000.00, payable to Timothy J. Gittlein in monthly installments of $1,250.00 each, in advance. Each installment of rent is due on the First day of each month, without the requirement of any notice from the Lessor. The Lessee shall be obligated to pay a late charge of ten dollars ($10.00) at the time of paying any installment that is more than nine (9) days late. At any future time during the term of this lease, if all payments have been have made in a timely manner and are current, the parties may negotiate a fair price for the Lessee to purchase the leased premises from the Lessor, taking into account the value of the lease payments made, future oil well rent site income, etc. If for any reason the Lessor shall become incapacitated or not available to receive payments of rent, rent payments shall be paid directly to the trust for Mike John Gittlein, the Lessor's son if he is under 18 years of age, or if 18 or older, directly to Mike John Gittlein. IV. SECURITY DEPOSIT. Not applicable. V. CONDITION OF LEASE PREMISES. The Lessee has inspected the leased premises prior to signing this agreement and accepts the leased premises in their present condition. The Lessor is not obligated to modify the leased premises in any way prior to Lessee's occupancy. VI. REPAIR AND ALTERATIONS OF LEASED PREMISES. The Lessee shall pay for all charges relating to the leased premises. VII. USE OF LEASED PREMISES. The Lessee shall use the leased premises for lawful purposes only and in a quiet, careful and reasonable manner. The parties acknowledge that the Lessee will construct equestrian training facilities on the leased premises. The Lessee, upon termination of this lease for any reason agreed to by both parties in writing, is entitled to remove all of the facilities he constructed so long as the leased premises is returned to the condition in which it was prior to the Lessee entering the leased premises. Should Lessee not remove the facilities within forty five (45) days after termination of the lease, all property remaining on the leased premises shall become the property of the Lessor. VIII. CHARGES FOR UTILITY SERVICES. The Lessee agrees to pay all charges for heat, lighting, telephone service, water and trash pick up, etc. and shall do so before they become past due. IX. RIGHT OF ENTRY. The Lessor and the Lessor's agents shall have the right to enter the leased premises at reasonable times and after giving reasonable notice to the Lessee, or making a good faith effort to do so, for the purpose of inspecting the leased premises for damages or showing the leased premises to prospective purchasers, tenants, mortgage lenders, etc. Subject to this right of entry, the Lessor covenants that the Lessee shall have quiet possession of the leased premises. X. DESTRUCTION OF LEASED PREMISES. If the leased premises are destroyed by fire or other casualty, the Lessee shall have the right, but not the obligation, to repair or restore the leased premises. Whether or not the Lessee elects to repair or restore the leased premises, this lease shall not terminate by reason of the destruction. XI. WAIVER OF CLAIMS. The Lessee shall have no right to make any claim against the Lessor because of any injury or damage to the Lessee or other occupants or visitors or for damage to property belonging to the Lessee or to other occupants or visitors, whether or not the damage is caused by the condition of the leased premises. The Lessee acknowledges that the Lessor's insurance does not provide coverage with respect to the Lessee's property. XII. DUTY TO PROTECT LESSOR FROM CLAIMS. Lessee shall maintain general liability insurance in an amount not less than $500,000.00/$1,000,000.00 naming the Lessor as an additional loss payee and provide the Lessor proof of said insurance annually. If any claim is asserted against the Lessor for damage to person or property arising during the Lessee's occupancy of the leased premises, the Lessee shall be obligated to defend or pay such claim and to reimburse the Lessor for any such claims paid by the Lessor and for reasonable attorney fees and costs that the Lessor may incur in defending any such claim. XIII. LIMITATIONS ON ASSIGNMENT AND SUBLEASING. Without the written consent of the Lessor, the Lessee may not assign this Lease Agreement to a third party in it's entirety. Leesee shall be allowed to partially sublet within the leased premises to third parties as is required and appropriate pertaining to his business plan for the leased premises. Lessee shall retain complete responsiblity for all provisions, obligations and restrictions of this Lease Agreement. XIV. DEFAULT. The Lessee shall be in default under this agreement if the Lessee fails to perform any of the obligations or to honor any of the restrictions imposed on the Lessee by this Lease Agreement. Insofar as non-payment of rent, the Lessee shall be in default ten (10) days after the particular rent installment is due. Insofar as other obligations, including but not limited to the obligation to maintain the leased premises, the default will be considered to take place if the condition causing the default is not corrected within ten (10) days after the Lessor gives a written notice to the Lessee, describing the condition or occurance that constitutes the prospective default. XV. REMEDIES FOR DEFAULT. If this Lease Agreement is in default within the meaning of the previous paragraph the Lessor may, at the Lessor's option, terminate this Lease Agreement. If the Lessor elects to terminate this Lease Agreement, the Lessee shall be obligated to pay all past due rent including rent due for the month in which the default occurs, even if the Lessee vacates or is removed from the leased premises before the end of that month. Similarly, the Lessor shall not be obligated to refund rent paid for the month in which the default occurs, even if the Lessee vacates or is removed from the leased premises before the end of that month. The Lessor shall not be required to terminate this Lease Agreement in the event of the Lessee's default, and if the Lessor elects not to do so, the Lessee's obligation to pay rent shall continue throughout the term of this Lease Agreement and the Lessor may recover all installments of rent as they fall due. Whether or not the Lessor elects to terminate this Lease Agreement because of the Lessee's default, the Lessor shall be entitled to recover from the Lessee an amount equal to the cost of repairing any damage to the leased premises, if the Lessee is responsible for such damage by reason of another provision of this Lease Agreement, and to recover attorney fees and other costs incurred by the Lessor to enforce the Lessee's obligations under this Lease Agreement or to terminate this lease. XVI. ABANDONMENT OF LEASED PREMISES. If the Lessee abandons the leased premises and defaults in the payment of rent, the Lessor may re -rent or re -lease the leased premises without thereby terminating this Lease Agreement, if the Lessor gives written notice or makes a good faith effort to give written notice of that intention. In that case, the Lessee shall continue to be liable for any amount by which the the rent payable under this Lease Agreement exceeds the net rentals recovered by the Lessor through the re -renting or re -leasing. XVII. SURRENDER OF POSSESSION. At such time that the Lessor becomes entitled to possession of the leased premises because of a default by the Lessee, the Lessee shall peacefully surrender possession of the the leased premises in the same condition as they are in at the beginning of this Lease Agreement, not counting ordinary wear and tear. This paragraph shall not, however, require the Lessee to pay for damages to the leased premises that is covered by the Lessor's hazard insurance policy, but the Lessor shall have no obligation to carry hazard insurance on the leased premises. XVIII. SALE OF THE LEASED PREMISES. The selling of the leased premises to a third party must be with mutual consent and agreement of the Lessor and the Lessee, in writing. Lessor and Lessee agree that the proceeds of the sale shall be fairly divided between the parties according to the value assigned to the land and to the improvements and with consideration to past rent payments, oil well site rent, etc. XIX. ADDITIONAL PROVISIONS. The Lessor and the Lessee agree to the following additional provisions: A. Time is of the essence of this agreement. B. The failure or forbearance of the Lessor to enforce any of the Lessee's obligations under this Lease Agreement shall not constitute a waiver of the Lessor's right to take action with respect to any subsequent default, nor shall the Lessor's acceptance of any partial payment of rent affect the Lessor's right to recover the full balance due. C. This Lease Agreement constitutes the entire agreement between the parties and supercedes all discussions and understandings that may have been made prior to the signing of this Lease Agreement. This Lease Agreement may not be amended except by written instrument signed by the Lessor and the Lessee. D. If any of the provisions of this Lease Agreement is contrary to any present or future law of the state of Colorado, the inconsistant provision shall be considered amended or eliminated to conform to such law. E. The Lessor shall mail any notice to which the Lessee is entitled by the terms of this Lease Agreement to the Lessee at: F. All notices to which the Lessor is entitled to shall be mailed to the Lessor at: a9 Q2 __________ ar_e.eteyCi CO SO‘ 31 G. A notice may be delivered personally to the party entitled to the notice, in lieu of mailing. Mailing shall be by certified mail, postage prepaid, return receipt requested. H. If the Lessor needs to provide evidence regarding the status of this Lease Agreement to any mortgage lender, government official, etc. the Lessee shall, at the request of the Lessor, sign affidavits regarding the status of this Lease Agreement and rent. I. This Lease Agreement shall be binding not only upon the parties who have signed as Lessor and Lessee but also upon their successors, personal representatives, executors, heirs, devisees and assigns, (if any are permitted). J.This Lease Agreement is for vacant land only. This Lease Agreement does not entitle the Lessee to aquire any interest in growing crops, minerals, oil well site rent, oil well site damages, or water on the leased premises. K. The Lessee shall maintain the leased premises consistant with any agreements the Lessor has with the Farm Service Agency of the United States Government and the Weld County Soil Conservation District including, but not limited to, noxious weed control, soil erosion, etc. L. At the end of the term of this Lease Agreement, if all obligations and restrictions on the Lessee within this Lease Agreement have been dutifully performed and abided by, the property referred to as the leased premises in this Lease Agreement may become the property of Reuben Guardiola for the purchase price of ten dollars, ($10.00). This Lease Agreement has been signed on the dates indicated below by the Lessor and the Lessee. LESSOR: Timothy J. Gittlein Date of Signing: o / IVOG LESSEE: Reuben Guardiola Date of Signing: 0 "O O 0 m 0 U o 0 0 U PO Box 758 RECEIPT DATE (I ! No.87097 RECEIVED FROM .J ilk r1` C� ecc c� C 6 ADDRESS ()IV u��mck, FOR Tll N 7 HOW PAID CASH 51) . CHECK MONEY ORDER $-- /O7)9-- BY fi� RUBEN GUARDIOLA ESPARZA DBA GUARDIOLA TRAINING 16526 WCR 53 PO BOX 142 Z0,(,, LA SALLE, CO 80645 Date ti. Ce erad O) f LA SALLE, CO 60649 11 BANK & TRUST. For 07 29 729 82.157/1021 Harland ciarke cmawnocumssa CERTIFICATION OF MAILING a, -a a, Y • C_ 0) 0 0. N to v � M C 0 0 N t N aJ `1 a U O O 0 a •bD t2 C 3 v 0 0 4- 0 0 m CU 0 s u *' 4, o a z a, N C C • O v an a) -a • N 4 73. al N s + a O a > a o m U N U o ar a L 0 =C 73 C C C o coro U a L Y Y V m w ro s - '0 C W w al Y C' i 0 N a+ U (11 a) a) v t aJ C by L v C al t H DATED this 12th day of August, 2013 m N N co 13 131 s N O 9 C m 0 3 O ry U' U Qj V C N = U) N N a '3 Jce 1 N 180645 I 184150-3620 N rl to o 0 00 tfl a 1.0 0 0 03 ti m 0 0 03 80632 I 80645 I 80645 Q H O H 0 0 0 0 0 0 CITY ILA SALLE SALT LAKE CITY Z ILA SALLE I GREELEY I GREELEY ILA SALLE LA SALLE 0 LC ADDRESS2 50 E NORTH TEMPLE ST FLOOR 22 _ ADDRESS1 125605 CR 36 I C/O LDS CHURCH TAX DIVISION I PO BOX 517 17442 CR 53 12923 APRICOT AVE I PO BOX 2176 I 116956 COUNTY RD 53 I 126065 CR 36 I NAME BECKER RANCH LLC CORP OF PRESIDING BISHOP OF CHURCH OF FRONT RANGE FEEDLOTS LLC GITTLEIN MICHAEL E GITTLEIN TIMOTHY) GUTTERSEN RANCHES LLC HAMILTON FRED I SUMNER JERRY WELD COUNTY COLORADO LAND RECORDS AFFIDAVIT OF INTERESTED LAND OWNERS SURFACE ESTATE THE UNDERSIGNED, States that to the best of his or her knowledge the attached list is a true and accurate list of the names, addresses, and the corresponding Parcel Identification Number assigned by the Weld County Assessor of the owners of the property (the surface estate) within 500 feet of the property being considered. This list was compiled utilizing the records of the Weld County Assessor available on the Weld County Internet Mapping site, http://www.co.weld.co.us, and has not been modified from the original. The list compiled for the records of the Weld County Assessor was assembled within thirty days of the applications submission date. Signature 75II�'(O�I Date Property Owners Within 500 ft. of Parcel # 121509200010 Account Parcel Owner Mailing Address R7243298 121505000005 BECKER RANCH LLC 25605 CR 36 LASALLE CO 80645 R4964486 121508000011 CORP OF PRESIDING BISHOP OF CHURCH OF C/O LDS CHURCH TAX DIVISION 50 E NORTH TEMPLE ST FLOOR 22 SALT LAKE CITY UT 84150-3620 M0030690 121508000011 CORP OF THE PRESIDING BISHOP CHURCH C/O LDS CHURCH TAX DIVISION 50 E NORTH TEMPLE ST FLOOR 22 SALT LAKE CITY UT 84150-3620 R7780799 121509100023 FRONT RANGE FEEDLOTS LLC PO BOX 517 EATON CO 80615 R7780299 121509300021 FRONT RANGE FEEDLOTS LLC PO BOX 517 EATON CO 80615 R1919802 121504300021 GITTLEIN MICHAEL E 17442 CR 53 LA SALLE CO 80645 R1919902 121504300022 GITTLEIN MICHAEL E 17442 CR 53 LA SALLE CO 80645 R5275108 121509200007 GITTLEIN MIKE JOHN R5275208 121509200008 GITTLEIN MIKE JOHN R5275308 121509200009 GITTLEIN MIKE JOHN R5275408 121509200010 GITTLEIN MIKE JOHN R5275508 121509200011 GITTLEIN MIKE JOHN R5275108 121509200007 GITTLEIN TIMOTHY J 2923 APRICOT AVE GREELEY CO 80631 R5275208 121509200008 GITTLEIN TIMOTHY J 2923 APRICOT AVE GREELEY CO 80631 R5275308 121509200009 GITTLEIN TIMOTHY J 2923 APRICOT AVE GREELEY CO 80631 R5275408 121509200010 GITTLEIN TIMOTHY J 2923 APRICOT AVE GREELEY CO 80631 R5275508 121509200011 GITTLEIN TIMOTHY J 2923 APRICOT AVE GREELEY CO 80631 Account Parcel Owner Mailing Address R7779699 121509200019 GUARDIOLA RUBEN 16526 CR 53 LA SALLE CO 80645 M0232006 121509200019 GUARDIOLA RUBEN 16526 CR 53 LA SALLE CO 80645 R4964686 121509000006 GUTTERSEN RANCHES LLC PO BOX 2176 GREELEY CO 80632 R7779599 121509200018 HAMILTON CONSTANCE R7779599 121509200018 HAMILTON FRED 16956 COUNTY RD 53 LASALLE CO 80645 R4964486 121508000011 JESUS CHRIST OF LATTER DAY SAINTS R1919702 121504300020 SUMNER JERRY 26065 CR 36 LA SALLE CO 80645 R1919702 121504300020 SUMNER LUCILLE Tammy Waters From: Sent: To: Subject: 26138 CR 36 Bethany Salzman Thursday, August 08, 2013 12:30 PM Tammy Waters Guardiola correct TEMPORARY property address Please feel free to contact me with any questions or concerns. bcthany Salzman Zoning. Compliance Officer II 1555 North 17th Avenue Greeley, CO 80631 Office: (970)353-6100 Ext. 3555 f=ax: (970)30++-6498 We6: www.c0.weld.co.us Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. MEMORANDUM To: Tammy Waters, Deputy Clerk to the Board August 9, 2013 From: Bethany Salzman, Zoning Compliance Officer, Dept. of Planning Services Subject: LC0022 Review of the following Temporary Assembly Permit by the Department of Planning Services shows the following: APPLICANT: Ruben Guardiola 16926 County Road 53 LaSalle, Colorado 80645 PROPERTY OWNER: Mike & Timothy Gittlein 2923 Apricot Ave Greeley, CO 80631 DATES & TIMES OF EVENT: September 14, 2013 & September 15, 2013 both from 11:00 a.m. - 5:00 p.m. Approximately 134.46 +/_ Acres in size Zone District: Agriculture No Special Use permits are associated with this property. No existing violations were noted. Please note the application specifically called out "Approx: 1500. Attendance unknown" of people, just an approximate "1500". The number of horses and/or cattle (steers) shall not exceed 4 (four) per acre. Please be advised that over the years, The Weld County Sheriff's Office and Department of Planning Staff have received several complaints of re -occurring rodeo events; however, we have not been able to substantiate continuous events. No overnight camping shall accompany this Temporary Assembly permit or Special Events permit. SERVICE, TEAMWORK, INTEGRITY, QUALITY Tammy Waters From: Sent: To: Cc: Subject: Roy Rudisill Tuesday, August 20, 2013 8:18 AM Tammy Waters; Bethany Salzman; Brad Yatabe; Dan Joseph; Dan Joseph; Deb Adamson; Frank Piacentino; Janet Carter Wagy, Mitch E; bschaefer@plattevalleyfire.org; Roger Ainsworth RE: Ruben Guardiola - Temporary Assembly Permit Tammy, I contacted Platte Valley Fire as this event will be in their district. I'm in the process of coordinating with the Sheriffs Office, the Fire District and the Banner Health Paramedics for this event. I emailed Mitch Wagy yesterday and they are waiting for a signed contract, but looks like they are set for the event. Director Roy Rudisill Weld County Office of Emergency Management 1150 O St. Greeley Co. 80632 970-304-6540 Office 970-381-0417 Cell Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Tammy Waters Sent: Thursday, August 08, 2013 11:07 AM To: Bethany Salzman; Brad Yatabe; Dan Joseph; Dan Joseph; Deb Adamson; Frank Piacentino; Janet Carter; Roy Rudisill Subject: Ruben Guardiola - Temporary Assembly Permit Please review all records on the following property for any associated reports during the last year and return your report to the Weld County Clerk to the Board's Office within seven days. Your report will be used by the Board of County Commissioners in considering issuance of a Temporary Assembly Permit. PLEASE RESPOND NO LATER THAN: August 19, 2013 ESTABLISHMENT: Ruben Guardiola 16526 County Road 53 LaSalle, Colorado 80645 1 HEARING DATE: August 26, 2013 DOCKET NO: 2013-64 Ruben advised that the signed contracts for the emergency services and security would be available in the next few days. He also will be back in to sign his application and have it notarized. Thank you, Tammy Waters Deputy Clerk to the Board 1150 O Street'P.O. Box 758(Greeley, CO 80632 tel: (970) 336-7215 X5226 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. 2 Memorandum TO: Tammy Waters From: Dan Joseph DATE: August 20, 2013 SUBJECT: Temporary Assembly Permit In response to your request, Environmental Health Services has reviewed the Temporary Assembly Permit for Ruben Guardiola, located at 16526 CR 53, LaSalle, Colorado. The following are the recommendations made by this Department: 1) The operator contacts the Department and provides information on which food vendors will be operating at the event. 2) Temporary hand washing stations should be located outside the portable toilets. We recommend that there be one hand washing station for every two portable toilets (provided the toilets are in close proximity to one another). If the portable toilets are spread throughout the facility we recommend one hand washing facility per toilet. Should you have any questions regarding this matter, please contact me at extension 2206 or via e-mail at djosephna,co.weld.co.us. Thank you. CC: Cindy Salazar, Debra Adamson NOTICE FOR TEMPS Pursuant to the Weld County Code Board of County Commissioners of X/Ve Building, 1150 O Street, Greeley, Colorado If a court reporter is desired, please days prior of the hearing. The cost of requesting party. In accordance with accommodations are required in order for Clerk to the Board's Office at (970) 336-72 The complete case file may be exal Commissioners, Weld County Administrati( E -Mail messages sent to an individual Ccl ensure inclusion of your E -Mail corresr egesick@co.weicico.us DOCKET #: 2013-64 DATE: August 26, 2013 TIME: 9:00 a.m. APPLICANT: Ruben Guardiola 16526 County Road 53 LaSalle, Colorado 80645 REQUEST: Application for a temporary and 15, 2013. LEGAL DESCRIPTION: Lot D of Rea Section 9, Township 3 North, Range 641.4 LOCATION: 26138 County Road 36, precise location.) SSW13 1SUId oaw06.1 d BOARD OF COUNTY COMMISSIONERS re WELD COUNTY, COLORADO m DATED: August 8, 2013 w PUBLISHED: August 13, 2013 2 coPr- JO• ®- N w O C) } W J W W C7 VA O ›- ft I CC �I W e, W O U J _I Zeno Qrif— Q ran �NJ atl' Department of Planning Services 1555 N 17th Ave Greeley, CO 80631 (970) 353-6100 Weld County Building Inspection Referral Date: August 20, 2013 Applicant: Ruben Guardilo Address: 16526 CR 53 Project: Temporary Assembly / Special Event/Horse Racing After reviewing the application and documents submitted, the Building Inspection Department has the following comments: The Weld County Building Inspection Department finds conflicts with our interest. Frank Piacentino Weld County Department of Building Inspection To: Weld County Board of Commissioners From: Deputy Lisa Carpenter Date: August 15, 2013 RE: Ruben Guardiola Dear Commissioners, I have researched and found one reported call for service to 16526 WCR 53, LaSalle, CO 80645 for the Calendar year of 2012 to present day. There was an animal call on April 12, 2012 to which the Weld County Animal Control unit responded. There was no information as to what the call was about, nor was there a report taken. I recommend the following documentations to be available before the event. 1. Provide an identified location for the toilet facilities on the map 2. Provide documentation of contract with United Site Services for toilet facilities 3. Provide documentation of contract with J & J Escort and security. 4. Provide documentation of contract with Paramedics 5. Provide documentation of licenses for all food vendors. 6. Provide documentation of a current Certificate of Liability for the insurance 7. Provide documentation of an on call Vet in case any animals are injured 8. Provide an identified location for the Paramedics and a Landing Zone for Air life on the map 9. Water needs to be available for livestock Respectfully ubmitted, Deputy Lisa Carpenter Community Resource Officer Weld County Sheriff's Office 1950 "O" Street Greeley, CO 80631 TEMPORARY ASSEMBLY REVIEW FORM Date: August 8, 2011 TO: Lisa Carpenter FROM: CTB SUBJECT: Temporary Assembly Review Please review all records on the following property for any associated reports during the last year and return your report to the Weld County Clerk to the Board's Office within seven days. Your report will be used by the Board of County Commissioners in considering issuance of a Temporary Assembly Permit. PLEASE RESPOND NO LATER THAN: August 19, 2013 ESTABLISHMENT: HEARING DATE: Ruben Guardiola 16526 County Road 53 LaSalle, Colorado 80645 August 26, 2013 DOCKET NO: 2013-64 No concerns Deputy's Initials The Sheriffs Office had a concern and the deputy has mutually worked with the property owner to correct the concern. (Complete Attached Worksheet) Unresolved concerns exist requiring a Probable Cause Hearing scheduled by the Board of County Commissioners. (Complete Attached Worksheet) Please notify at Extension Board of Commissioner's renewal hearing. of the date and time of the Temporary Assembly Worksheet The following concerns are noted: -)\uAssl. SLEL_ Mcm0ro kul The property owner and the Sheriffs Office have collectively agreed to implement the following to correct concerns noted above: (A time line and corrective action should be listed for each concern) 2 -13 -IS Property Owner, Please Print Date Property Owner Signature Deputy's •nature Use another sheet of paper or attach separate proposal to this packet if needed. Attach copies of all reports associated with this property for the last year. Both the Deputy and the Owner of the establishment will be required to attend the Temporary Assembly Hearing to testify to the above agreement. 0 0 LU 1- 0 < 1 Q CO 0 U o m IX L11 O Ca W O U w C'7 N LU O A. 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W z0 w 'A d� O C z @ O a >F., o w Z O ~ Z U> W v°�'_ o z v w ✓ a ov por cLa vit- co z w co F w -, y E-- Ui x < Gbh?' z xw to vi - O w 3 w c >` U [` -,z ✓ O ♦ Detach Here DR 0010 (01/18/12) STATE OF COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT LICENSE TO OPERATE A RETAIL FOOD ESTABLISHMENT ACCOUNT NUMBER use for all references LIABILITY INFORMATION ISSUE DATE LICENSE VALID TO DECEMBER 31 county I city I Indust. 'typal liability date month I day I year 42729830000 62 3289 6/30/2010 5/2/2013 2013 THIS LICENSE MUST BE POSTED AT THE FOLLOWING LOCATION: TLALTENANGO MOBILE UNIT WELD COUNTY, CO 80631 Owner: ISMAEL HARO RODRIGUEZ LICENSING AGENCY: WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Tatrk: `I REVOR JIRICEK, M.A.E.S., DIRECTOR ENVIRONMENTAL HEALTH SERVICES A Detach Here • This certifies that licensee shown hereon is authorized and licensed to engage in business in accordance with the provisions of the law and regulations of the Colorado Department. of Public Health and Environment. Any alterations made on this license will automatically make it. null and void. POST IN A CONSPICUOUS PLACE i�Vu^Igp, L. INSPECTION REPORT STATE OF COLORADO 9p�;;i9,[IpRi 11111'II0111! ! 1! Overall Result Emissions - Equipment Inspection On D'agnostics Smoke Total Amount Paid PASS PASS PASS N/A PASS . 15.00 ylpi'ilQ I III,- °'1,TION I A 171 Y _a.. i -= 20I3 15.0'_.5 "} E. J)-19 Ems) \._ _ = WW1l TES 7 Cl;: t CI1EVM'l�I— TVFY . . 109? IN 14,.3593327756 06 PLATE: 86TTVD . MOI)f.L: 130 ODOMETER: • 35084 VVFY: 6F7E EMISSIONS TEST INFORf ,TI.Q l S00. [ -1 i; 699 O% 0.13 .117 CO2 % 8.7886 RPM _ 2437 .N/A Dia! nostic Trouble Codes: 9..0549. 1015 4.00 ri UIPMENl' INSp u:!(. c ,i''certer Preseti, 5ystent Paescn xygen Sensor Presence:• Gas Cap Presence:. • Gas Cap Integrity: ARD DIAG . - S=. htCotiimand Sys CONSUMER INFORMATION PASS J Congratulations, your vehicle has.passett the emissions inSpection. 113,OU are renewing 3 our; registration in person, or by mail: the Certificate of Emissions Control, located below, must accompany all supporting documents_. at the tim, e of registration. After 24 hours r to e c retristration lu> Iri' , .,, ,...e,,i1, :,goz/reneovlla 5 �l it �t t.tuissionCotof al ne t ctt me ti atthe owne ��t r questions c t �iM-0-1M contact An r c)' to ar e x. 0. attinent of Rey, e 2 SCJi'U and if located c - '. �4ter !-Wfetro Area. call $\t OU l eta this document in the vehicle as proo of emission compliance. LAND REGISr v)C` NOT STA t L I "C1 RTLIC C IMI L• S CON I I2t > 1im - � ';i `. : 't 11 AND :INCLIUDIIII- 4T OR PAY.MV11V It1- • ! MACKEY VETERINARY SERVICE PO Box 336204 GREELEY, CO 80633 (970) 353-0995 FAX (970) 356-8913 Dr. Lawrence R Mackey Dr. Michael J Mathis To Whom it May Concern, This letter is to confirm that Mackey Veterinary Service will provide on -call services for an equine event held at Ruben Guardiola's Residence on the dates of Sept. 14 and 15, 2013. Sincerely, /2 d)g /974-1//,,/ . L. R. Macke Dr y NOTICE OF APPLICATION FOR TEMPORARY ASSEMBLY Pursuant to the Weld County Code, a public hearing will be held in the Chambers of the Board of County Commissioners of Weld County, Colorado, Weld County Administration Building, 1150 O Street, Greeley, Colorado 80631, at the time specified. If a court reporter is desired, please advise the Clerk to the Board, in writing, at least five days prior of the hearing. The cost of engaging a court reporter shall be borne by the requesting party. In accordance with the Americans with Disabilities Act, if special accommodations are required in order for you to participate in this hearing, please contact the Clerk to the Board's Office at (970) 336-7215, Extension 4226, prior to the day of the hearing. The complete case file may be examined in the office of the Clerk to the Board of County Commissioners, Weld County Administration Building, 1150 O Street, Greeley, Colorado 80631. E -Mail messages sent to an individual Commissioner may not be included in the case file. To ensure inclusion of your E -Mail correspondence into the case file, please send a copy to egesick@co.weld.co.us DOCKET #: 2013-64 DATE: August 26, 2013 TIME: 9:00 a.m. APPLICANT: Ruben Guardiola 16526 County Road 53 LaSalle, Colorado 80645 REQUEST: Application for a temporary assembly of more than 350 persons on September 14 and 15, 2013. LEGAL DESCRIPTION: Lot D of Recorded Exemption #4518; being part of the W1/2 of Section 9, Township 3 North, Range 64 West of the 6th P.M., Weld County, Colorado LOCATION: 26138 County Road 36, LaSalle, Colorado 80645 (See Legal Description for precise location.) BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO DATED: August 8, 2013 PUBLISHED: August 13, 2013 Affidavit of Publication NOTICE OF APPLICATION FOR TEMPORARY ASSEMBLY Pursuant to the Weld County Code, a public hearing will be held in the Chambers of the Board of County Commissioners of Weld County, Colorado Weld County Administration Building, 1150 0 Street, Greeley, Colorado 80631, at the timespecified. If a court reporter is desired, please advise the Clerk to the Board, in writing, at least five days priorof the hearing. The cost of engaging a court reporter shall be borne by therequesting party. In accordance with the Americans with Disabilities Act, if special accommodations are required in order for you to partici- pate in this hearing, please contact the Clerk to the Board's Of- fice at (970) 336-7215, Extension 4226, prior to the day of the hearing. The complete case file may be examined in the office of the Clerk to the Board. of County Commissioners, Weld County Ad- ministration Building, 1150O Street, Greeley, Colorado 80631. E -Mail messages sent to an individual Commissioner may not be included in the case file. To ensure inclusion of your E -Mail cor- respondence into the ease file, please send a copy to egesick@coweld.co.us DOCKET 4: 2013-64 DATE: August 26, 2013 TIME: 9:00a.m. APPLICANT: Ruben Guardiola 16526 County Road 53 LaSalle, Colorado 80645 - REQUEST: Application for a temporary assembly ofmore than 350 persons on September 14 and 15, 2013. LEGAL DESCRIPTION: Lol D of Recorded Exemption 44518; being part of the W1/2 of Section 9, Township 3North, Range 64 West of the. 6th P.M., Weld County, Colorado LOCATION: 26138 County Road 36, LaSalle, Colorado 80645 (See Legal Description for precise location.) BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO DATED: August 8, 2013 The Tribune August 13, 2013 - STATE OF COLORADO County of Weld, I Desirea Larson ss. of said County of Weld, being duly sworn, say that I am an advertising clerk of THE GREELEY TRIBUNE, that the same is a daily newspaper of general circulation and printed and published in the City of Greeley, in said county and state; that the notice or advertisement, of which the annexed is a true copy, has been published in said daily newspaper for consecutive (days): that the notice was published in the regular and entire issue of every number of said newspaper during the period and time of publication of said notice, and in the newspaper proper and not in a supplement thereof; that the first publication of said notice was contained in the Thirteenth day of August A.D. 2013 and the last publication thereof: in the issue of said newspaper bearing the date of the Thirteenth day of August A.D. 2013 that said The Greeley Tribune has been published continuously and uninterruptedly during the period of at least six months next prior to the first issue thereof contained said notice or advertisement above referred to; that said newspaper has been admitted to the United States mails as second-class matter under the provisions of the Act of March 3,1879, or any amendments thereof; and that said newspaper is a daily newspaper duly qualified for publishing legal notices and advertisements within the meaning of the laws of the State of Colorado. August 13, 2013 Total Charges: $58.40 My Commission Expires 6/14/2017 Notary Public ROBERT LITTLE STATE OF COLOLRADO NOTARY ID 20014018494 MY COMMISSION EXPIRES JUNE 14, 2017 Hello