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HomeMy WebLinkAbout20092358.tiffRESOLUTION RE: GRANT PERMIT FOR TEMPORARY ASSEMBLY TO AMERICAN CANCER SOCIETY - SEPTEMBER 19, 2009 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, the American Cancer Society, Attn: Nancy Clark, 8221 West 20th Street, Suite A, Greeley, Colorado 80634, has presented to the Board of County Commissioners with an application for a Permit for Temporary Assembly on land within the unincorporated portion of the County of Weld, State of Colorado, to be held from 5:00 p.m., on September 19, 2009, until 12:00 a.m., September 20, 2009, on property described as follows: Church Barn, LLC, 34283 County Road 33, Greeley, Colorado 80631; being further described as Lot B of Recorded Exemption #3961; being part of the SE1/4 of Section 10, Township 6 North, Range 66 West of the 6th P.M., Weld County, Colorado WHEREAS, said applicant has paid Weld County the sum of ONE -HUNDRED DOLLARS ($100.00) for said Weld County Permit for Temporary Assembly, and WHEREAS, having examined said application, the Board deems it appropriate to grant a Weld County Permit for Temporary Assembly to the American Cancer Society, and WHEREAS, said permit shall be issued subject to compliance with the terms and conditions as set forth in the application materials and upon the express condition and agreement that the temporary assemblage will be conducted in strict conformity to all laws of the State of Colorado, and WHEREAS, any violation to said terms and conditions shall be cause for revocation of said permit and forfeiture of bond. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that said Weld County Permit for Temporary Assembly on September 19, 2009, be, and hereby is, granted to the American Cancer Society to conduct a temporary assemblage at the hereinabove described location. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said Permit. P6 `; /h%L 2009-2358 LC0022 Cl/Bic 9- PERMIT FOR TEMPORARY ASSEMBLY - AMERICAN CANCER SOCIETY PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 2nd day of September, A.D., 2009. ATTEST: Weld County Clerk to the Boa BY Dep APPR u ft h iLaiit (I a MI o the Board my Attorney Date of signature 6(f710,1 David E. Long OARD OF COUNTY COMMISSIONERS LD COUNTY, COLORADO h F. Garcia, Chair ir ouglas R emacher, Pro Tem ra Kirkmeyer 2009-2358 LC0022 WELD COUNTY PERMIT FOR TEMPORARY ASSEMBLY By action of the Board of County Commissioners of the County of Weld, State of Colorado, taken this 2nd day of September, 2009, IT IS HEREBY GRANTED a permit for a temporary assemblage on land within the unincorporated portion of the County of Weld, State of Colorado, to be held from 5:00 p.m. until 12:00 a.m., on September 19, 2009, on property described as: Church Barn, LLC, 34283 County Road 33, Greeley, Colorado 80631; being further described as Lot B of Recorded Exemption #3961; being part of the SE1/4 of Section 10, Township 6 North, Range 66 West of the 6th P.M., Weld County, Colorado This permit authorizes American Cancer Society to hold such an assemblage so long as it is in accordance with Chapter 12 of the Weld County Code and all other applicable State and County statutes and regulations. This permit is subject to compliance with the terms and conditions as set forth in the application materials and to additional conditions set forth by the Board and attached hereto. PERMIT APPROVED this 2nd day of September, 2009. BOARD OF COUNTY COMMISSIONERS wry, COLORADO ATTEST: Weld County Clerk to the Bo Lao _to the Board ounty Attorney David E. Long NOTE: THIS PERMIT MAY BE REVOKED AND THE BOND FORFEITED FOR FAILING TO MEET THE CONDITIONS SET FORTH HEREIN. 2009-2358 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: American Cancer Society RESIDENCE: MAILING ADDRESS: 8221 W. 20th St. Ste A Greeley CO 80634 AGE: 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.) Address and legal description of all property upon which the assembly is to be held: Land is owned by Rick Montera, owner of Church Barn LLC. Event address is: 34283 WCR 33 Greeley CO 80631. Will be held in the southeast corner of Weld County Road 33 and 70 also known as the southeast 1/4 section 10, township 6, Range 66 in Weld County Colorado. 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: Rick & Jimmi Jo Montera RESIDENCE: 34283 WCR 33 Greeley Colorado 80631 MAILING ADDRESS: 134 Oak Ave. Eaton, Co 80615 NAME: RESIDENCE: MAILING ADDRESS: 0:100 '00000000'00 ono 000.000 000 2009-2358 2. Nature or purposes of the assembly: Cattle Barons Ball (Fundraiser for the American Cancer Society) 3. Dates and hours during which the assembly is to be held: September 19, 2009 5pm to Midnight. 4. Maximum number of persons to be allowed at assembly at any one time: 850 guests + vols 5. The maximum number of tickets to be sold, if any: 700 6. Identify plans to limit number of persons to the maximum identified above: -Event is Private- by invitation -No tickets sold at the event - Security is provided to prohibit unauthorized access to land owner's property and to the event. - Volunteers are recruited for specific needs. 7. Identify plans for supplying potable (drinking) water, including the source, number, and location of facilities, and type and means of disposing of waste deposited: Bottled water provided for guests and volunteers. -individual bottles + 5 gallon water jugs provided both in main tent and in other tents etc where guests and volunteers congregate. Curt's Hauling Service is providing. Volunteers will be disposing trash into containers provided by Flexx Production. 8. Identify the plans for holding, collecting, and disposing of solid waste materials: Same plan as for liquid waste. Curt's Hauling Service is providing - 30 cubic yard dumpster Flexx Production- trash containers Volunteers doing the work. 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: United Site Service providing 2 33ft "Comfort Stations" with bathroom valet service. 2 handicap port -a -lets, 2 deluxe port -a -lets. 0:`cOUT DOou OP utoouuuoo.00LIM0 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 technicians and nurses and provisions for emergency ambulance service: Notification of Eaton Fire Department. Including site visit prior to event for inspection. 11. Identify the plans, if any, to illuminate the location of the assembly, including the source and amount of power, and the location of lamps: Power provided by generators. Light towers will illuminate parking areas for guests and volunteers. Light provided for illumination between building and outside restroom areas. 12. Identify the plans for parking vehicles, including size and location of lots, points Of highway access and interior roads, including routes between highway access and parking lots: Vehicles will be parked on the property; one area for guests, other area for contractors and volunteers. Main entrance to property is located on County Rd.33 Most guests and volunteers will be using entrance/exit to the south of the roping arena. Main entrance all weather surface. 13. Identify the plans for communications with hospital, police, and fire services, including the source, amount, and location of communication equipment: Mobile and cellular phones under direction of John Cooke, Weld County Sheriff. 14. Identify the plans for camping facilities, if any: N/A 0:'O00O0000 on 0O0 oo0000.000000 15. Identify the plans for fire protection: Notification of Fire Dept. of Eaton in advance. -Posting of required signage by tent rental company (Fle)o< Productions of Fort Collins) 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: John Cooke, Weld County Sheriff, is coordinating security at site. -Security will be on foot + horse back with vehicles available. -Security for setup Friday night September 18th. - Security Saturday day September 19th and security Saturday evening September 19th and throughout night. 17. Identify the plans for sound control and sound amplification, if any, including number, location, and power of amplifiers and speakers: CEAVCO - See attached contract 18. If applicable, identify plans for meeting County health standards for food concessions and concessionaires who will be allowed to operate on the grounds, including the names and addresses of all concessionaires and their license permit numbers: Food is catered by Kenny's Stampede Steak House: Matt Larson, 3502 W 10th St. Greeley CO 80634 -Primary contact Matt Larson: No Concessions Kenny's Stampede Steak House license permit: 03662770000 exp. 12/31/2009 19. Identify the plans, if any, for an electrical system: - Generators -See contract for CEAVCO 0 :`000'00000 00 0'00 000 000.00 0 000 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 scenic attributes; and the plans to abate dust on the site: - Area will be overseen by landowners. - Plan for use has been approved. -Enviro Tech provided dust control as needed. 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.B.13 of the Weld County Code to ensure performance by he applicant of each of the terms and conditions.of the temporary assemblage perm j( t1ok k .( pray idtd — ChyCk # 11,f 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.B.14 of the Weld County Code, to protect against injury to persons or property occurring as a result of such an assembly. 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 • t3 —properly zoned for such assembly, in which case one permit shall be required for the total hOA- number of events scheduled for that location for the reminder of the calendar year, not to t 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. :11001:10000110 0'00000000.00 OHO 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 sighature SUBSCRIBED AND SWORN 20 C . Witness my hand and official My commission expires: 171k Applicant's printed name i J i k2<j i„"‘5 Applicant's position day of Auffis- Notary I?ublic MY COMMISSION EXPIRES: 0519.2013 M:\CTB\CTBFORMS\FOAS M BLY. DOCdoc AUG-13-2009 THU 10:04 AM HORTON MONTERA CATTLE FAX NO. 9704542432 P. 02 August 12, 2009 American Cancer Society do Nancy Clark 8221 W. 20`s St. Suite A Greeley, CO 80634 RE: Cattle Barons' Ball Dear Nancy: Church Barn LLC 134 Oak Ave Eaton, CO 80615 With regards to your application for permits and licenses for the Cattle Barons' Ball to be held on Saturday, September 19`" 2009, this letter sets forth the position of Church Barn LLC. The land chosen for the event to occur is owned by Rick Montera, owner of Church Barn LLC. The mailing address for Church Barn LLC is 134 Oak Ave. Eaton, CO 80615. The festivities will be held in the southeast corner of Weld County Road 33 and 70 also known as the southeast 'A section of section 10, township 6, Range 66 in Weld County, Colorado. This letter verifies permission Rick Montera has been granted by Church Barn LLC for the event to occur at the location indicated above. Church Barn LLC or Rick Montera will have no role or liability in the activities of the event including the license or permits. If you have any questions, please feel free to call. Sin rely, ,ce>7,7 Rick Montera 1W) Approximate limits of /gravel drive Pre -Engineered Home ^s° Future Church Expansion NEW CHURCH BLDG. Detention Pond Approximate limits of gravel drive Power Pole (try) Cr sack wa Gay Me (In) f .1 Itll• P e. LOT B RE -3961 13.90* AC. (12.91* AC. LESS WCR ROW) 1` a Metal loafing shed (9'x21 ) Metal Barn leaf tam ttr P.m' Poe (1w) Guy Mrs NAP) Cement* pad w �.r I _ I a cma.l. w _ teethed AyMn Oren Cn a a a a - (Iw) Monument PAW)) w111NIQ- \ yp IMed Aghel Deny *M Asphalt Palle Arm liii IIIIIIt s/.ca weyxet tat *z.. Provide! Ill 11111111 I l l l l 11111.111111 1111111 tutu Panne 0 P— P}.(n) 40' RESERVED ROA 80' RESERVED F 30' ROAD ROW 60' ROAD ROW Ymt. N nw al Property Sectc, Phyllis Ar Harvey B Richard 1 WCR 70 cv 58' ;'48'E 648.77' AC, RES ACCESS END 2 1/2 ALUM CAP L5 23501 _ Section la -e-66 POINT OF BE 4 p� ; O a '-_O co 0 - cu O O Q L U 0) O O eciol Llghting Client#: 150499 ACORD. CERTIFICATE OF LIABI AMERCAN LITY INSURANCE DATE (MMIDOIYYYY) PRODUCER Wachovia Insurance Serv-AT, GA 4401 Northside Pkwy, Suite 400 Atlanta, GA 30327-3078 770 850-0050 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURERA: Travelers Property Casualty Co of Am INSURER B: NAIC # 25674 INSURED American Cancer Society, Great West Division, Inc. 2255 South Oneida Denver, CO 80224 INSURER C: INSURER a INSURER E THEPOLICIES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WSR LTR ADM. NNSRT TYPE OF INSURANCE - POLICY NUMBER POLICY EFFECTIVE DATE (MMDDTYY) POLICY EXPIRATION DATE (MMIDD/Yli - LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY TC2JGLSA487D6449TI 09/01/08 09/01/09 `" - EACH OCCURRENCE :1,000,000 X DAMAGE TO TED aEN PREMISES (Fa ANED :100,000 ICL111M: MADE X OCCUR. MED EXP (MY OW person) s2,500 1 PERSONAL & ADV INJURY :1,000,000 GENERAL AGGREGATE :25,000.000 GENL AGGREGATE ATILIMIT APPLIES PER: POLICY' Tf IR& ' L1 LOC PRODUCTS - COMP/OP AGO :2,000,000 . —I A - AUTOMOBRPUABILITY ANY AUTO. ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NONOWNED AUTOS TC2JCAP487D6450TIL 09101/08 .09/01/09 /I��-�- 1 ( l�-1`R L I `'411 ✓ ,i-C 1 CL&h fi CCC- C1 I I e'1Ce COMBINED SINGLE LIMIT (Ea accident) :1,000,000 X t 1 ��('''^^� y d \,t.', I I I �I (.�\I 1 CI 1 61 da],ICe_ \ 'E "tvr I VCI .{T\ o f I ii 1'i IS '> I lJ�c C e t L ` jj (n� (C \-1 X X GARAGE LIABILITY ANY AUTO - - - O . EXCESS/UMBRELLA UABIUTY OCCUR n CLAIMS MADE DEDUCTIBLE RETENTION $ - Ti �j d - $ A A WORKERS riJPLOYFYtSUABIIIY ANY FyFPROPRIETOR/PARTNER/EXECUTIVE SPECIALL coMPENSATIOt4AND - DED? PR VISIONS below TC2JU6487D622808 TRJU8487D643708 - 09/01/08 09/01/08 - - 09/01/09 09/01/09 WC STATU- O X i TORYIIMITSI I Eli ER EL EACH ACCIDENT 6500,000 EL DISEASE- EA EMPLOYEE -:500,000 EL DISEASE - POLICY Will $500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Certificate holder is included as Additional Insured, but only with respect to liability arising from the negligence of American Cancer Society, Great West Division, Inc. during the Cattle Barons Ball 2009 at 34283 WCR 33, Greeley, CO 80631 on September 19, 2009 from 5:00pm to 12:OOmidnight. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL __30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED) TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND IRON THE INSURER, RS AGENTS OR REPRESENTATIVES. • AUTHORIZED REPRESENT TIVE ForWlSby: C'r� ISBe'�- Rick & Jimmi Jo Montera 34283 WCR 33 Greeley, CO 80631 ACORD 25 (2001/08) 1 of 2 #1394030 APB01 e ACORD CORPORATION 1908 NcEnvco Audio Visual RENTAL & STAGING DIVISION 6240 W. 54th Avenue Arvada CO 80002 Phone:303-539-3500 Fax:303-539-3501 IN CASE OF EMERGENCY - 303-539-3599 Reservation No.: Version: Prepared By: DEN25783 1 Joe T Hartman CEAVCO Delivery 09/18/2009 03:08 AM CEAVCO Delivery 09/19/2009 11:00 PM Customer ID# 1678 Terms: Net 30 Order Information Client PO#: Description: JH 1 day Cattle Barons Ball ACS 2009 Site: Contact: NANCY CLARK Client: Phone: Fax: AMERICAN CANCER SOCIETY/GREELEY 8221 W. 20TH STREET: SUITE A Room: Site Ph: GREELEY CO 80634 970-350-5019 Contact: 970-356-9238 Cell Ph: To Be Determined TBD TBD Equipment Qty Item Description Audio System for Band and PA Main PA package for band. Band to bring own Monitor system and consoles Sub Total Band Stage Lighting Upstage Lighting 1 Truss Kit, 12" x 12" x 40' w/ Bolts & Tools 1 2 Chain Motors w/Controller Kit, .5TON / CS800 12 Light, Source 4 Parnel 2 Drape Side Panel, Black Velour w/Tie Line 16' X 27' Downstage Lighting 1 Truss Kit, 12" x 12" x 40' w/ Bolts & Tools 1 2 Chain Motors w/Controller Kit, .5TON / CS800 24 Light, Source 4 Parnel 4 Light, Moving Head MAC -700 Profile* Control and Support 1 Lighting Controller Kit, Road Hog w/Wing Expansion 1 Dimmer Rack, 48 Channel 20A, Sensor 48* 1 Trunk, Cable AC #2 Feeder 5 Wire 1 Cable Kit, DMX Small 1 Trunk, Cable AC 6 CH SOCO 1 Trunk, Ballroom Rigging Hardware / Denver Sub Total Room Decor Lighting 1 Decor lighting package Sub Total Days Unit Price Item Subtotal 4510.00 1.00 100.00 100.00 1.00 225.00 225.00 1.00 15.00 180.00 1.00 75.00 150.00 1.00 100.00 100.00 1.00 225.00 225.00 1.00 15.00 360.00 1.00 175.00 700.00 1.00 650.00 650.00 1.00 500.00 500.00 1.00 200.00 200.00 1.00 15.00 15.00 1.00 150.00 150.00 1.00 75.00 75.00 3630.00 1.00 7000.00 7000.00 7000.00 Pagel of 3 Printed on 05/26/2009 At 03:35 PM Silent Auction Lighting and back half of room Sub Total 2060.00 Video Screens- Power point from computers Screen hung behind the band Sub Total Entrence Band ( C.C. Collier) 1 Audio System/Digital, 4 Speaker Kit 1 Performance Microphone Kit #1 1 Cables for Performance Mic Kit 1 Kit, Tripod Mic Stands 2 AC Outlet Strip Sub Total Sponsor signage auction band 2 LCD Display Kit, w/Pedestal PN-G655U 1 Laptop Computer Kit, 65156 1 Wireless Remote Control, Power Point w/Laser CE2Y-ESP 1 Trunk, VGA Cables 1 DA, VGA 1 x 4 P/2 DA4+ Sub Total 1 Delivery / Pick -Up - Fort Collins - Semi With Trailer* Client to provide security in the building Need single man lift or Rigging and lighting focus Labor 1.00 450.00 1.00 300.00 1.00 0.00 1.00 48.00 1.00 0.00 1.00 950.00 1.00 125.00 1.00 10.00 1.00 0.00 1.00 40.00 1420.00 450.00 300.00 0.00 48.00 0.00 798.00 1900.00 125.00 10.00 0.00 40.00 2075.00 1.00 300.00 300.00 Personnel Monday 14th Possible pre Rig Rigger* Qty RT Rate OT Rate DT Rate RT OT DT Labor Subtotal 2 45.00 67.50 90.00 4.00 360.00 Friday 18th Load in 10am On -Site Coordinator/Manager, 1 600.00 90.00 120.00 1.00 600.00 Day Rate* Audio Operator (Al), Day Rate* 1 500.00 75.00 100.00 1.00 500.00 Lighting Director (LD), Day Rate* 1 500.00 75.00 100.00 1.00 500.00 Lighting Operator, Day Rate* 1 425.00 63.75 85.00 1.00 425.00 Audio -Video Technician, Day 6 425.00 63.75 85.00 1.00 2550.00 Rate* Show and Load Out Sat On -Site Coordinator/Manager* 1 60.00 90.00 120.00 1.00 2.00 Audio Operator (Al), Day Rate* 1 500.00 75.00 100.00 1.00 2.00 Lighting Director (LD), Day Rate* 1 500.00 75.00 100.00 1.00 2.00 Lighting Operator, Day Rate* 1 425.00 63.75 85.00 1.00 2.00 240.00 650.00 650.00 552.50 Strike Sat Midnight? Audio -Video Technician, Day 10 425.00 63.75 85.00 1.00 4250.00 Rate* Page2 of 3 Printed on 05/26/2009 At 03:35 PM Summa Contract Notes IT Shipping Comments Equipment Delivery - Shipping Sales & Expenses Labor Damage Waiver Service Charge Discount Sales Tax TOTAL AMOUNT 21493.00 0.00 300.00 11277.50 0.00 0.00 0.00 0.00 $33,070.50 Your signature below indicates: (1) You have received the above items and (2) You specifically agree to be bound by all the terms and conditions listed on the reverse of this contract. DELIVERY & TERMS ACCEPTED: BY: BY: (Authorized Signer) (Printed Name) Page3 of 3 Printed on 05/26/2009 At 03:35 PM 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 Centennial Center, 915 10th Street, First Floor, 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 Centennial Center, 915 10th Street, Third Floor, 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 #: 2009-55 DATE: September 2, 2009 TIME: 9:00 a.m. APPLICANT: American Cancer Society Attn: Nancy Clark 8221 West 20th Street, Suite A Greeley, Colorado 80634 REQUEST: Application for a temporary assembly of more than 350 persons on September 19, 2009 LEGAL DESCRIPTION: Lot B of Recorded Exemption #3961; being part of the SE1/4 of Section 10, Township 6 North, Range 66 West of the 6th P.M., Weld County, Colorado LOCATION: 32483 County Road 33, Greeley, Colorado 80631 (See Legal Description for precise location.) BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO DATED: August 18, 2009 PUBLISHED: August 20, 2009, in the Windsor Beacon Account #: 346067 Niue Local Newspaper Since 1898 Windsor Beacon 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 Centennial Center, 915 10th Street, First Floor, Greeley, Colorado 80631, at the time specified. If a court reporter is desired, please ad- vise the Clerk to the Board, in writing at least five days prior of the hearing. The cost of en- gaging a court reporter shall be borne by the requesting party. In accordance with the Americans with Disabilities Act, if special ac- commodations 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 exam- ined in the office of the Clerk to the Board of County Commissioners, Weld County Centen- nial Center, 915 10th Street, Third Floor, 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 egesickaco.weld.co.us DOCKET II: 2009-55 DATE: September 2, 2009 TIME: 9:00 a.m. APPLICANT: American Cancer Society Attn: Nancy Clark 8221 West 20th Street, Suite A Greeley, Cobrado 80634 REQUEST: Application for a temporary assem- bly of more the 350 persons on September 19, 2009 LEGAL DESCRIPTION: Lot B of Recorded Ex- emption 53961; being part of the SE1/4 of Sec- tion 10, Township 6 North, Range 66 West of the 6th P.M., Weld County, Colorado LOCATION: 32483 County Road 33, Greeley, Colorado 80631 (See Legal Description for precise location,) BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO DATED: August18, 2009 PUBLISHED: August 20, 2009, in the Windsor Baron 0034140653 Delivered to: STATE OF COLORADO ) ss: AFFIDAVIT OF PUBLICATION COUNTY OF WELD ) Echo Villa , being duly sworn, deposes and says that said is the legal clerk of the Windsor Beacon; that the same is a weekly newspaper of general circulation and printed and published in the town of Windsor, in said county and state; that the notice or advertisement, of which the annexed is a true copy, has been published in said weekly newspaper for 1 Week; 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 issue of said newspaper on Thursday, August 20, 2009 that the last publication thereof was contained in the issue of said newspaper on Thursday, August 20, 2009 that said Windsor Beacon has been published continuously and uninterruptedly during the period of at least six months next prior to the first publication of 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. Legal Clerk Subscribed and sworn to before me, within the County of Weld, State of Colorado this \`\\`owilij urednesday, August 19, 2009 ✓ expires pWo'A-zro U�;'• , 0T,1q ®•4201.• *_ taN • j• °UBL'G rp\ �v1Fl cm. ��P����\ Invoice Text WELD COUNTY CLERK TO THE BOARD, 915 10TH ST GREELEY, CO 80631-1117 f I 4,c.,.., Notary Public Legal No.0034140653 NOTICE OF APPLICATION FOR TEMPORARY AS Affidavit Prepared Wednesday, August 19, 2( 2:39 pm fra*N; WE�Pc COLORADO Memorandum TO: Jenny VanEgdom, CTB From: Dan Joseph, Environmental Health Specialist DATE: 08/26/09 SUBJECT: Temporary Assembly Permit for LC0022 In response to your request, Environmental Health Services has reviewed the Temporary Assembly Permit, LC0022, for the American Cancer Society, located at 34283 County Road 33, Greeley, Colorado. After reviewing the application, the Department has no issues at this time. Should you have any questions regarding this matter, please contact me at extension 2206 or via e-mail at dioscnh(a)co.weld.co.us. Thank you. CC: Cindy Salazar, Environmental Health Services Sara Evans, Environmental Health Services oft. VIIlls From: MEMORANDUM Jenny VanEgdom, Deputy Clerk to the Board August 21, 2009 Ann Siron, Zoning Compliance Officer, Dept. of Planning Services Subject: LC0022 Review of the following request for a Temporary Assembly Permit by the Department of Planning Services shows the following: Applicant: American Cancer Society Attn: Nancy Clark 8221 West 20`h Street, Suite A Greeley, Colorado 80634 Location of Event: 34283 County Road 33 Greeley, Colorado 80631 (Location of Church Barn, LLC/Rick Montera residence) Dates of Event: September 19, 2009, 5:00 p.m. to midnight A hearing before the Board for both the Temporary Assembly Permit and the Special Events Permit will be scheduled for September 2, 2009, at 9:00 a.m. Zone District: A (Agricultural) This use is has been approved by staff on August 21, 2009. Currently there are no active zoning violations on the above mentioned property. It is recommended a referral be sent to the Weld County Department of Public Works for any concerns they may have regarding accesses. SERVICE, TEAMWORK, INTEGRITY, QUALITY MEMORANDUM WUDC COLORADO TO: Jenny VanEgdom, Deputy Clerk to the Board DATE: 08/27/09 FROM: Janet Carter E.I., Public Works ;L SUBJECT: Temporary Assembly American Cancer Society The Weld County Public Works Department has reviewed this proposal. Our requirements are as follows: REQUIREMENTS: 1. No parking will be allowed on Weld County Roadways. 2. Approximately 850 vehicles will require parking on the property 3. This area is not in a Special Flood Hazard Area (SFHA) as determined by the Federal Emergency Management Agency (FEMA). August 27, 2009 Page - 1 - of 1 M:UANIiTADev Review \Temp Assembly American Cancer Society DOC TEMPORARY ASSEMBLY REVIEW FORM Date: August 18, 2009 TO: {DEPUTY} FROM: Ken Poncelow SUBJECT: Temporary Assembly/Special Events Permit Inquiry 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. A copy of the applications will be sent through interoffice mail for your review. PLEASE RESPOND NO LATER THAN: August 28, 2009 APPLICANT: AMERICAN CANCER SOCIETY EVENT LOCATION: 34283 COUNTY ROAD 33 GREELEY, COLORADO 80631 (CHURCH BARN, LLC/RESIDENCE OF RICK MONTERA) EVENT DATE: SEPTEMBER 19, 2009, FROM 5:00 P.M TO MIDNIGHT ,./ No concerns itials 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 Temporary Assembly hearing. of the date and time of the Temporary Assembly Worksheet The following concerns are noted: 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) c727 CI? Property Owner, Please Print Date Property Owner Signature De'puty's Signature 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. MEMORANDUM r�TO: Bruce Barker, County Attorney August 18, 2009 `pC FROM: Jenny VanEgdom, Deputy Clerk to the Board ll COLORADO SUBJECT: Temporary Assembly Permit / Special Events Permit Please find an attached copy of the Temporary Assembly Permit Application and Special Events Permit Application for the following applicant: American Cancer Society 8221 West 20th Street, Suite A Greeley, Colorado 80634 Event Location: 34283 County Road 33 Greeley, Colorado 80631 (Location of Church Barn, LLC/Rick Montera residence) Date of Event: September 19, 2009, 5:00 p.m. to midnight A hearing before the Board for both the Temporary Assembly Permit and the Special Events Permit has been scheduled for September 2, 2009, at 9:00 a.m. A copy of the current insurance document has been provided, however, an updated document will be sent to our office as soon as it is received by the applicant. The applicant has provided a cash bond in the amount of $2,000.00. Please review with comments and return. Thank you. Client#: 150499 AMERCAN ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) PRODUCER Wachovia Insurance Serv-AT, GA 4401 Northside Pkwy, Suite 400 Atlanta, GA 30327-3078 770 850-0050 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC it INSURED American Cancer Society, Great West Division, Inc. 2255 South Oneida Denver, CO 80224 INSURER A: Travelers Property Casualty Co of Am 25674 INSURER B. INSURER C. INSURER D'. INSURER E. COVERAGES 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, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRCDATE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE (MMIDDIYY) POLICY EXPIRATION DATE IMM/DDITY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY TC2JGLSA487D6449TIL09 09/01/09 09/01/10 EACH OCCURRENCE $1,000,000 X DAMAGE RENTED DREAIEMSET (ER occurrence) $100,000 CLAIMS MADE X OCCUR MED EXP (Any one person) s2,500 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $25,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: IiPRO POLICY - I nI LOC PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS TC2JCAP487D6450TIL09 09/01/09 09/01/10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) X BODILY accident) (Per acadenH $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ IOCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ $ A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below TC2JUB487D622809 TRJUB487D643709 09/01/09 09/01/09 09/01/10 09/01/10 X I WCSTATU-I IOER- TORY LIMITS ER E.L. EACH ACCIDENT $500,000 E.L DISEASE- EA EMPLOYEE $500,000 EL. DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is included as Additional Insured, but only with respect to liability arising from the negligence of American Cancer Society, Great West Division, Inc. during the Cattle Barons Ball 2009 at 34283 WCR 33, Greeley, CO 80631 on September 19, 2009 from 5:00pm to 12:00midnight. CERTIFICATE HOLDER CANCELLATION Weld County Government Jenny VanEgdom, Deputy Clerk to Weld County Commissioners Centennial Court House - 915 10th Street 3rd Floor Greeley, CO 80631 ACORD 25 (2001108) 1 of 2 #1394030 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _Sp_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Ju ORIZED REPRESENTATIVE EXHIBIT A 2660 IS by: %d ;#4 14°. APB01 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S (2001/08) 2 of 2 #1394030 Hello