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Home My WebLink About20031786.tiff RESOLUTION RE: GRANT PERMIT FOR TEMPORARY ASSEMBLY TO RONALD MCDONALD HOUSE CHARITIES OF DENVER, INC. - JULY 19 AND 20, 2003 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, Ronald McDonald House Charities of Denver, Inc., 1300 East 21st Avenue, Denver,Colorado 80205,has presented to the Board of County Commissioners 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 11:00 a.m. until 8:00 p.m.on July 19,2003,and from 11:00 a.m. until 7:00 p.m. on July 20, 2003, on property described as follows: W1/2 of the NW 1/4 of Section 7, Township 3 North, Range 68 West of the 6th P.M., Weld County, Colorado WHEREAS, said applicant has paid to the 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 Ronald McDonald House Charities of Denver, Inc., 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 conformityto 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 July 19 and 20,2003, be, and hereby is, granted to Ronald McDonald House Charities of Denver, Inc., to conduct a temporary assemblage at the hereinabove described location. 2003-1786 LC0022 PERMIT FOR TEMPORARY ASSEMBLY - RONALD MCDONALD HOUSE CHARITIES OF DENVER, INC. PAGE 2 The above and foregoing Resolution was,on motion duly made and seconded,adopted by the following vote on the 14th day of July, A.D., 2003. BOARD OF COUNTY COMMISSIONERS _�®/,,/`l W ELCOU TY, COLORADO ATTEST: "et/1 /,D� / tL)\� vid E. Lo g, C it Weld County Clerk to the Board Robert D. Masden, Pro-Tem BY: Deputy Clerk to the Board EXCUSED M. J. Geile �•�S T : EXCUSED Willis . Jerke /' ,1861I / J Of• l/// J Glenn Vaad en Rh �1p1` . Date of signature: '7/9` 2003-1786 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 substitUled,for the verbal description of plans for the assembly site. All required information must be furnished before the application will be processed. I r /� NAiME:kor I Crc'I ticti f act �Y Arh0�1C;.cf house of. CitahliO3 AGE: SI rocief RESIDENCE: a S4 u,S2[ . ('3 C2 MAILING ADDRESS: fIt. 00 faS1 ZI`d /4u-t riPntut NCO O2QS NAME:e3Q(`t'.PS l ( C , --SrA5e. VOJrigun \ta, Pg0S ttpf11ros.AGE: RESIDENCE: I h) f3 S - 044' n )-CJvu Y✓t� • C'U gf7S0 MAILING ADDRESS: ( O7% S. Ccr-itn4t . �� mo CD CisDk 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 off all fproperty upon which the assembly is to be held: �.QQ nottIOF ck d- 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 r owners.) NAME: io LC LLC' - \J pC c !kccO( a:UPqC5 RESIDENCE: /f)). S to�� N l j gnlbh: �Vr(U, S'O..TOI S. MAILING ADDRESS:/079 Ce4 ntq� fc��2(a-71c ( ) Kea NAME: K RESIDENCE: MAILING ADDRESS: i 2003-1786 2. Nature or purposes of the assembly: S.Ce al]£ c 4fl3(Lc r .Sked 3. Dates and hours during which the assembly is to be held: (1410(1(1 an.sct t SLQP - 4. Maximum numper pf persons to be allowed at ass,mbly at any one time: CP.C c 4-/c r Led ortw-Qr S/ 5. The maximum number of tickets to be sold, if any: &&7ccl\L1a1 6. Identi�fjplan to li it number of persons to thq�/maxi um identified above: Sal affnd J aUI sCLAP{ CLe 7. Identify plans for supplying potable (drinking) water, including the source, number, and location of facili ies, -and type and means of dispo>�g of waste deposited: ciEe Gtaicj a43(Lep 1 8. Identify nn the plans for h2ldi g, collecting, and dispos'n4 g of solid waste materials: 9. Identify the plans for providing separate toilet facilities for males and females, including the source, number, and to do , type and the means of d s osing of wastes deposited: 2 • 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 techn,ic�i fnsan/�n sesandprovisionsforemgrge yambulanceservice: S- u l t et 1-E c 4 el S cf.LP r S LQDt 11. Identify the plans, if any,to illuminate the location of the asseptly, including the source and amount of power,and the locatio9 of lamps: tPp ar^ ..o 12. Identify the plans for parking vehicles, including size and location of lots, points of highway access and interior ads, incl ding routes between highway acc ss and parking lots: SQI� a c,c Ato «e�PF 3dL 13. Identify the plans for communications with hospital, police, and fire services, including the sour arr}ount/and location of communicati n equ• ment SQQ a_ t±Prl Ler 14. Identify the plans for camping facilities, if any: S alL(Gr ri grm4 _116.19d 3 15. Identify the pl ns for fire protection: 41416414 { Q vattor 0Q� 16. Identify the plans for security, including the number of guards, their deployment, their names, addresses, credentials ayll ho r�s Pf availability and descrip}on o peer group control, if any: �.Q CQ P/ 40S(L&C -3G QQ 17. Identify the plans for sound control and sound amplification, if ary inclu ng umber, location, and power of amplifies and speakers: P 4r'4- aviS(Fa..Q I 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: A/74 19. Identify the plans, if any, fo an lectrical system: „aP cif aeh1 cc. 4 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, prevention, and p,yeserye ti)e scenic attributes; 1prt5 to and the p ate du on the site: a 'f CCI4d a'ris?CE'r 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. 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 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 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. 5 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. Ap icant's signature • rCit l r Applicant's printed na even/ ri/ P,r^.fzi" r Applicant's position SUBSCRIBED AND SWORN to before me this day of 20 Witness my hand and official seal. Notary Public My commission expires: 6 M:\CTB\cTBFORMS\FOASMBLY WELD COUNTY PERMIT FOR TEMPORARY ASSEMBLY By action of the Board of County Commissioners of the County of Weld,State of Colorado, taken this 14th day of July, 2003, 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 on the 19th day of July. 2003, through the 20th day of July, 2003, on property described as: W1/2 of the NW 1/4 of Section 7,Township 3 North, Range 68 West of the 6th P.M., Weld County, Colorado This permit authorizes McDonald House Charities of Denver, Inc., 1300 East 21st Avenue, Denver, Colorado 80205,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 as Exhibit "A." PERMIT APPROVED this 14th day of July, 2003. BOARD OF COUNTY COMMISSIONERS ATTEST: LI W D COUNTY, COLORADO r C Weld County Clerk to th o ,y , , O a David E. Long, Chair ( /1 2003) BY: a ' . Deputy Clerk to the =..r- Robert D. Masden, Chair Pro-Tem EXCUSED M. J. Geile EXCUSED William H. Jer e lenn agae4- NOTE: THIS PERMIT MAY BE REVOKED AND THE BOND FORFEITED FOR FAILING TO MEET THE CONDITIONS SET FORTH HEREIN. APPLICATION FOR TEMPORARY ASSEMBLY (Answers) 1. The west one-half of the northwest one-quarter of section7, township 3 north Range 68 west of the 6th principal media, County of Weld, state of Colorado, less the county road right-of-way according to the document recorded at book 86, page 273. 2. Hosting La Ley 1170 AM 5th Year Anniversary Celebration and donating the proceeds to The Ronald McDonald House of Charities. 3. Sat. July 19, 2003 from 11 AM till 8 PM and Sun. July 20, 2003 from 11 AM till 7 PM. 4.2000 People are to be allowed on at assembly at one time. 5. No tickets will be sold. Event is open to the public. About 300 tickets will be given away on the radio for event. 6. Orosco Security Agency will be in charge of crowd control and to limit the number of persons to the maximum, security guards will not let any more people in to the event and traffic will be redirected. However we expect this not to happen we planned ahead and we will fence off an area large enough to accommodate people if we were to surpass the number of people expected. 7. Tubs of bottled water will be placed on property to benefit our guest. Bottled water will be sold as well as other drinking beverages like soda and juice. Please see attached drawing for tub locations. 8 cubic-yard dumpsters will be placed in locations that are beneficial to the event for dumping. Waste Management will provide the service for disposing the waste. (Waste Management 500 E. Vine Dr. Ft. Collins, CO 80524 970- 416-3552) The measures of the dumpsters are 6'/ ft. tall x 6ft. wide. Also sinks will be provided by Super Bowl Portable Restrooms Incorporated (3263 Oakland St. Aurora, CO 80010 303-341-6828) Attached is a letter stating that Super Bowl Restrooms Incorporated will provide this service. 8. Waste Management will provide 8 cubic dumpsters to accommodate the disposing of garbage. They will also service and dispose of any waste collected at the event. (Waste Management 500 E. Vine Dr. Ft. Collins, CO 80524 970-416-3552) 9. Super Bowl Portable Restrooms Incorporated (3263 Oakland St. Aurora, CO 80010 303-341-6828) will provide toilet facilities for males and females. They clean and service all portable restrooms and also provide sinks and portable restrooms to accommodate any handicap people attending the event. Attached is a letter stating that Super Bowl Restrooms Incorporated will provide the portable restrooms and service for the event. 10. An application has been submitted to the Mountain View Fire Protection District so that they can provide any paramedic service or emergency service for the event. 11. The property will not need to be illuminated because the event will be taking place outside and during daylight hours. Sat. July 19, 2003 from 11 AM till 8 PM and Sun. July 20, 2003 from 11 AM till 7 PM. 12. The parking lot will be 300 ft. x 500 ft. in size and a second parking lot for performers or vendors that is 200 ft. x 100ft in size. There are 5 roads leading to the event from County Line Rd. 1 and County Rd. 36. There 3 emergency roads that are 20 ft wide for emergency vehicles only. 4 roads lead to County Line Rd. 1. Two of them are for the general public the other two roads are for emergency use. 1 road leading to County Rd. 36 is for emergency Rd. use only. See sketch attached for any more information. 13. Cell phones will available for emergency use to communicate any accident or any emergency service needed. Orozco Security Agency will also have cell phone communication available for any emergency that needs to be reported. The Mountain View fire Protection District will also be present upon review of application. 14. N/A 15. Plans for fire protection include having certified fire extinguishers on the property, no smoking on property, the Mountain View Fire Protection District to be present upon review of application. Also the tent being put up by Rental City is fire proof (Certificate of Flame Resistance is attached). 16. Orozco Security Agency (3601 Magnolia St. Evans CO 80620) will provide security for this event. Attached is a letter of verification by Orozco Security Firm, insurance certificate, license, and a bond. 17. Attached is a sketch and set up plans for stage and sound to be used. Professional engineers will monitor and work equipment. 18. N/A 19.Power generators will be used to power sound and any other electrical equipment used for this event. 20. The assembly of the event will be completed by R&M Drain and Waterproofing. Attached is a statement of work being provided by R&M. R&M will fence out the assembly with an orange safety barricade fence. A copy of the type of fence is attached. 21. Bond statement is attached. 22. A Certificate of Insurance is attached. 23. Attached is a check for the amount of$100.00 K O 3b La, Le�y Stk Anr�vivtvsary • Ron aUd McDowatd House of Civavity Etrent �, I--_Evv,er ¢nC.5 500' Ex' EX,+ ay PARKINg 300' 6J+vo,1C.e a Exit ® lea r_4441.11 s lariwzi.ail ® • Or booth&re /2s02-' ►:� _� ■.Green- Dumpsite % c ' 6 ► a° ►ZI •= Blue- Gb,-kerAtera 141A UICICI REO - Beer Loden SCALE: I"= ioo' L 1201 kaY beer . ,.• Caardeal' ••' S+a• •_._ I L. VIP ioo" le PARKItJG I I -LD" 10I11-41Department of the Treasury Interral Revenua Service P . O . 'Box 9941 In reply refer to : 2916820108 Ogden UT 84409 Dec . 19 , 1997 LTR 1224C 84-0728926 000000 00 000 03317 RONALD MCDONALD HOUSE CHARITIES OF DENVER INC 1000 E 16TH AVE DENVER CO 80218 Taxpayer Identification Number : 84-0728926 Dear Taxpayer : Thank you for your correspondence dated Nov . 17 , 1997 . Cur records show your organization is exempt from income -_x under Section 501 ( c ) ( 3 ) of the Internal Revenue Code . If you have any questions about this letter , please write to us at the address shown at the top of the first page of this le :ter . If you prefer , you may call the IRS telephone number listed in yc_ ^ local directory . An employee there may be able to help You , bu : the office at the address shown on this letter is most familiar with your case . Whenever you write , please include this letter and , in the spaces below , give us your telephone number with the hours we can reach you . Keep a copy of this letter for your records . pp Telephone Number ( -..3 ) Ov7-//SSA _..� pp Hours , f-!-LL 0,2.n - 57.7ir1 • Internal Revenue Service Department of the Treasury • P. O. Box 2508 Cincinnati, OH 45201 Person to Contact: Date: February 5, 2001 Paul Perry 31-07423 • Customer Service Representative Ronald McDonald House Charities of Denver Inc Toll Froo ee o llep hpone Number: T 1300 E. 21st Avenue 877-829-5500 Denver, CO 80205 Fax Number: 513-263-3756 Federal Identification Number: 84072892E Dear Sir or Madam: This letter is in response to ycur request for a copy cf your organization's determination letter. This letter will take the place of tine copy you requested. Our records indicate that a determination letter issued in May of 1977 granted your organization exemption from federal income tax under section 501(c)(3) of the Internal Revenue Code. That letter is still in effect. Eased on information subsequently submitted, we classified ycur organization as one that is not a private fourcation within the meaning of section 509(a) of the Code because it is an organization described in sections 509(a)(1) and 170(b)(1)(A)(vi). This ciassification was based on the assumption that your organization's operations would continue as stated in the application. If your organization's sources of support, or its character, method of operations, or purposes have changed, please let us know so we can consider the effect of the change on the exempt status and foundation status of your organization. Your organization is required to file Form 990, Return of Organization Exempt from Income Tax, only if its gross receipts each year are normally more than 525,000. If a return is required, it must be flied by the 15th day ual ounting . The law ses a n it the fifth a month, ufter p toota the mum of 5110,000, when aend of the organization's n return is filed late, unless there iisnreasonable penalty of 520 a day, up cause for the delay. All exempt organizations (unless specifically excluded) are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of 5100 or more paid to each employee oin nduring Act calendar year. Your organization is not liable for the tax imposed under the Federal Unemployment nemp y (FUTA). Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the Code. However, these organizations are not automatically exempt from other federal excise taxes. Donors may deduct contributions to your organization as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to your organization or for its use are deductible for federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. £0'd X1101 -2- • Ronald McDonald House Charities of Denver Inc 84-0728926 Your organization is not required to file federal income tax returns unless it is subject to the tax on unrelated business income under section 511 of the Code. If your organization is subject to this tax, it must file an tion Business Income Tx s letter, we income tax rem whether an yof your organization's apesent or proposed activ t the Form 90-T, xempt urn. In tiesae unrelated' r trade or are not determiningning Y business as defined in section 513 of the Code. The law requires you to make your organization's annual return available for public inspection without charge for three years after the due date of the return. If your organization had a copy of its application for r a copy of recognition of exemption on ny isupporting docum7, it is ents an`d the° make exempton'lable lettter tor public any individual who requests the such app s oh documents costs tor therson in The law. You ndoe charge of require you to provide for copies of public inspection ction and actual postage tern cn the Internet (World Woe Web). You may documents that are widely available, such as by posting ..•', be liable for a penalty of $20 a day for each day you do not make these documents available for public inspection (up to a maximum of $10,000 in the case of an annual return). Because this letter could help resolve any questions about your organization's exempt status and foundation status, you should keep it with the organization's permanent records. If you have any questions, please call us at the telephone number shown in the heading of ;his letter. This letter affirms your organization's exempt status. Sincerely, cy John E. Ricketts, Director, TEJGE Customer Account Services JUN-18-03 WED 11 03 RONALD MCDONALD 10USE FAX NO, 3038323802 p, 02 Page lot l immaiMINIIIIS STATE OF COLORADO DEPARTMENT OF STATE CERTIFICATE DOVE"rA DAVIDSON.Sc.re:,::; u(&,ac La ?ic Sink,or C'ulrrrrdc. ht•.chv Cc nifu t}ri1,<u:ca;dim �a the rtc,+rd<orai;.La i e, RONALD MCDON AILD}1Ol'Sc C'H.\Mil liti OF DENVER INC'. C.„I,radh NONPROFIT crrr;°(,1 ;fir ION I .....as :9S7:3] I97 sc ..•:ili.{in thin�,il'liet,m Nmr.nbcr 2. :,1;r,;utd has complied with the app icablc prLA.19:ans tlx Env;;:i Lind of t<H. cL 1 al nn 1.171' ''tc is in good ctundirp and and-Jai/2d:;ad Cttnpe.cnt to imnsect bu+.ncss or to condo t +ui[airs within thla ERZ% k t:ucc }chn:n:c 7.2iaa? Par I tWotan; CertMeate ID 635789 'e va6:atc t-:.eerCn w.Nell the bAawm5 S.&t'.A:tin.ht err it,seer4 to;ON cna r"avuution.GaJeyuu WWW.fOS.it■tC.00.11■JVBItl�SOCRRI�IC8r0 ' _—......._....._.. _. .:..__..�L._ _�..__ http:ilwww.sos.state.co.us/forte/co rporati on/images/doestmp/OS_19871317197.9 if 2/24/200 06/18/2003 18:38 9703((393725 EPEWAtPDATPGTWAGINAIA: PAGE 01 S ACA Pv1,LC' E1 I (CIAOf acjc CCw to( J 1 �� ' oJ, ;, \ \)S c.wo` 1;ik ✓E, lx%' ,S\ (x -. G r. ,°.A` 2 ""`b6'`raieeSeeurigeicy 3601 Magnolia St. - Evans, CO 80620 Phone (970) 339-3725 June 18,2003 To Whom It May Concern: This is to verify that Orozco Security /matey will be pervading security (corrnucrot AGREEMENT)for La Lay Radio and Fiesta-2003. On July 19 and 20, 2003 ,uties of Guard 1. 12 Properly equipped and uniformed security guards. 2. General Security Services including physical protection of the Property; prevention of vandalism, crowd control &monitoring of I.D. & minors, and parking lots. 3. Guard shall comply with all Federal, State and local laws, Ordinances,Rules and regulations set by Orozco Security Agency. I'm pervading copies of: • Workers' compensation Insurance; • Liability Insurance • bond • business license If you have any questions or concerned feel free to call me.(970)339-3725 Sincerely, olanda Orozco-O CO/.1.a[tld3 14:51 97633393725 EPEWAEPDATPGTWAGDMAW PAGE 61 Orozce Security Wan 3801 Magnolia St. -- Evans, CO 80820 Phone (970) 3394725 June 17,2003 To Whom It May Concern: This is to verift that(hozco Security Agency will be pervading security (specific purpose of crowd central) for La Lay Radio and Fiesta-2001. on July 19 and 20 ,2003 I'm pervading copy of: • Workers' compensaton insurance; • liability insurance • bond • business license If you have any questions or concerned feel free to call me.(970)339-3725 Sincerely, • CZ) Yol zco-Chr tt st OLD REPUBLIC SURETY COMPANY %MI : P O BOX 1976 CONTINUATION CERTIFICATE DES MOINES, IA 50306 eao....E. mm weewrTior+ EFFEcT-€ware EXPIRATI0NDATE RLI- 312224 SECURITY GUARD 12/31/2002 12/31/2003 OROZCO, YOLANDA OROZCO SECURITY GUARD AGENCY 3601 MAGNOLIA STREET EVANS, CO 80620 fgz 0V L. Ab Ffs'�i a�{ 'ZC4 At StireWW4 MU>��9�> ,Q�'p j j�( s i,F, n` J J Fz,'3Cb+3 oJ`S.1.Yr,�buL�i;�� x�IX� �4wYvY'�`%'�,3�"Sz[DSY.��``.s.�� .. �� .�.x_4'�.„�.��e��,�'�,Z..S�v.�' `t�. a�k�a cF:v2.. F � '�G'�`. CITY OF GREELEY CITY HALL 701 10TH AVENUE GREELEY, CO 80631 eaX4 .`..cigsMOR'xuz}WWWIMESa `.o ssMY�...,u�S^ ageitainSgatThiW ,.x.4 THIS BOND CONTINUES IN FORCE TO THE ABOVE EXPIRATION DATE CONDITIONED AND PROVIDED THAT THE LOSSES OR RECOVERIES ON 11 a IT AND ANY AND ALL ENDORSEMENTS SHALL NEVER EXCEED THE PENALTY SET FORTH IN THE BOND AND WHETHER THE LOSSES OR y RECOVERIES ARE WITHIN THE FIRST AND/OR SUBSEQUENT OR WITHIN ANY EXTENSION OR RENEWAL PERIOD.PRESENT,PAST OR FUTURE. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. .4 a fYs SIGNED AND DATED THIS ELEVENTH DAY OF AUGUST, 2002 I k Al AA '•; 40-4216 - , LINDEN/BARTELS & NOE o� P O BOX 336640 OLD REPUBLICS j�JTR,ETY COMPANY Yg GREELEY, CO 80633 i ::: wW`auunllrq F £ �a��1G SURfry r,'' BY +�A.S3T RE ARV . AV Cp ' y ` , t S .ti q Z i:. t�z ,J:Y '�Y ...a . e V , �.SX§{Px Y£ii4.1"l''≥ MMMM4ii w�$'a"��F ..a WZ : � % � • 1981 • ,,,, nl uyiriaN��W```` �rr ` 1 • —" . CITY OF GREELEY LICENSE 013073 OWNER 13073 BLO3RENEWAL 0560-00014 :: OROZCO SECURITY GUARD AGENCY 3601 MAGNOLIA ST EVANS. CO 80620-0000 CERTIFICATION SITE 3601 MAGNOLIA ST AIE., AT£> 0 2/07/2003 EVANS. CO 80620-0000 EXPIRATION!' DATE : 12130/2003 sir LIL,£IVS;E ,Ref 25.00 InlYNt' N Se 25.00 DUEO1'=30-03 .00 CODE TYPE OF CERTIFICATION I' ELSECURB SECURITY PATROL. BUSINESS 2003 BUSINESS LICENSE RENEWAL This license is issued subject to all the terms and provisions of all of the ordinances of the City of Greeley in force and effect relating hereto and is subject to revocation and upon , these terms is so accepted by the licensee herein named. Dlr8CtO(of Finance POST IN CONSPICUOUS PLACE �1 CORD CERTIFICATE OF LIABILITY INSURANCE DATE IMWDONYYY) PRODUCER 3-12-2003 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Union Colony Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1218 8th Ave, HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Greeley, CO 80631 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER U„ ' - nn 1 Fi*�—� Ma_ --Izas_ OrOZCO Security INSURER Et • 3601 Magnolia St. INSURERc: i;'- g �I. Evans, CO 80620 • .INSU :RD: 1 COVERAGES -'-+' INSURERS --- THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED.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 OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR A0O LTR NSRI TYPE OF INSURANCE POLICY NUMBER DATF(EFFECTWE'I;IDATE(MXPIRATON '— DATF(MWDD/1'YI 1'.DAIE/MMyppryp UNITS A 9ENERAL LIABILITY lL COM'.NERCAL GENERAL LLIBIUTY 72LP149670 ACACHOCCiU CE 51,000,000 9/18/02 9/1A/02 PREMISES(Eaoa * $100,000 -:!AIMS MADE }( OCCUR t , MED EXP(Any One Peroor,l 55,000 PERSONAL&ADV INJURY 51,000,000 GENT.AGGREGATE1JMIT APPLIES PER GENERAL AGGREGATE 51 .000.000 POLICY PRO- JECTL� PRODUCTS-CDMP/OPAGG $) ,000,000 AUTOMOBILE LIABILTT-Y .AUTOMOBILE AlYALITO • COMBINED SINCE F LIMIT S (Eaa¢Eant) ALL OWNED AUTOS S/.HEDULED AUTOS B0OLYINJIAiY •$ " (Per Fella,) Hi REO AUTOS NON-OWNED AUTOS BODILY INJURY S (Par accident) PROPERTY MAGE S (PeOPracrJOerE)DA T GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S _ ANY AUTO OTHERTHAN EA ACC S AUTOONLY: AGO $ EXCESS/UMBREUA LIABILITY EACH OCCURRENCE ' OCCUR Li CLAIMS MADE - -- AGGREGATE ,5$ f S DEDUCTIBLE I 1--__- - - .--- -' RETENTION $ S .. WORKERS COMPENSATION AND $ EMPLOYERS'LIABILITY WC STATU- OTH- TORYUMITS I ER ANY PROPWETOWPARTNERIEXECUTIVE OFRCER/MEMBER EXCLUDED? EL EACH ACCIDENT S Il,_deccMaurldar EL DISEASE-EA EMPLOYEE S SPECIAL PROVISIONS below OTHER EL EMCEESE-POLICY OMIT S DESCRIPTION OF OPERATIONS/LOCATIONSI VEHICLES/EXCLUSXJNS ADDED BY ENDORSEMENT,SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION OatS 1�_` SHOOED ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION `." DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ DAYS WRITTEN 9"--1-134 CO M NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL • IMPOSE NO DOC)SATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR REPRESENTATIVES. AUTIIORIZEO REPRESENTATIVE ,- ; I_ _-?'C-e-t j ///p�:(_, ACORD 25(2001/08) G / ©ACORD CORPORATION 1988 r FROM : SUPER BOW PORTABLE RESTROCMS FAX NO. : 303341682E Jun. 11 2003 03:43P9 P1 Super Bowl Portable Restrooms,Inc. 3263 Oakland St. Aurora,CO 80010 303-341-6800 Fax 303-341-6828 June 11, 2003 Re: La Ley 1170 A M Anniversary TO Whom It May Concern: This letter is to confirm that Ismael Aldana is ordering portable restrooms and sinks for their event in July. Sincerely, Connie Solo. 06/03/2003 13: 52 5052564831 STRIKING PAGE 02 SPARX/LORENZO ANTONIO - STAGE PLOT [-114.1 gill vp 1s A0 6 tAs..e i L4 i( flu /0(44o - I Eden ' t ban Quitu Amp 6 PERCUSSION Amo DRUM Pisen RISER on TOWS _on roller. ,. ., 8'x 8'x2' high Percussion © 3 a l 1 Voc 8'x 8'x 2' high 15 l Q Keyboards O C$ Cs e ��* 0 Saxophone . 7 O Trumpet CAA Lead Vocal Mice, and Monitors O Trombone 0 0 0 0 et* .0 -,:f Sparxl Sparx2 Sparx3 Spanc4 ^ ^ 0 • Lorenzo Antonio 1 1 1 1 1 r4 FRONT OF STAGE MONITOR MIXES ; t 1 • Front Vocals 2 Keyboard 3 Guitar 4 Drums 5 Bass 6 Percussion 7 Saxophone&Trumpet B Trombone h1°1Q- LA mill n0 -1 L .iycesseey . �w' Y LereL� J6 .( J ;s 10 icL L� - ifyin. Any- Lire ld."<th , s 06/03/2003 13:52 5052564831 STRIKING PAGE 03 SOUND & LIGHTING REQUIREMENTS - LORENZO ANI0NIO. SPARX FRONT OF HOUSE SPECIFICATIONS 1 32 X 8 HOUSE CONSOLE (YAMAHA, SOUNOCRAFT, CREST, ETC.) 1 DUAL 32 BAND E.Q. (BSS, K.T., ARX, ETC.) 2 DIGITAL REVERBS (LEXICON, YAMAHA) 1 ROLAND SDE-3000 DIGITAL DELAY 2 DBX-172 SUPERGATES(OR EQUIVALENT)(4-CHANNELS NOISE GATES) 5 DUAL CHANNEL COMPRESSOR/EXPANDER HOUSE SPEAKER SYSTEM SYSTEM TO BE CAPABLE OF PROVIDING MINIMUM OF 110 db THROUGHOUT VENUE AND AT LEAST 3-WAY ELECTRONICALLY CROSSED-OVER. SYSTEM TO BE WIRED IN STEREO. MEYERS, MARTIN, E.V., E.A.W. MONITOR SPECIFICATIONS CONSOLE: Mvwmum 32 channels, 8 descreet mixes. No less than 10 Primped wedges, 15 Inch speaker with 2 Inch horn. Each mix (8) should have a dedicated 31 band EQ and should be crossed over electronically. 1 CLEAR-COM SYSTEM SET UP BETWEEN F.O. H. CONSOLE & MONITOR CONSOLE • MICROPHONES & DIRg'OT BOXES 1 AKG-D-112, SHURE B-52 4 AKG-451, SHURE SM-81 12 SHURE SM-57 4 E.V.408 9 SHURE BETA 58, SM-58, AUDIX OM-6 4 ACTIVE DIRECT BOXES 5 WIRELESS MICROPHONES (THESE ARE MINIMUM REQUIREMENTS, SUBSTT(UTIONS MAY BE MADE FOR HORN MICS, ETC.; DEPENDING ON AVAILABILITY) SOUND COMPANY PROVIDING SYSTEM TO SUPPLY TWO SYSTEM ENGINEERS DURING SOUNDCHECK AND DURING SHOW. SYSTEM TO BE COMPLETELY WIRED, TESTED, AND HAVE A BASIC 'STARTING POINT' FLAT E.Q. SETTING WHEN SPARX & LORENZO'S SOUND CREW& BAND ARRIVE AT VENUE... LIGHTING 60K LIGHTING FRONT& BACK TRUSSING. 2 SPOTS WTTH OPERATORS INITIALS _ t • 96/03/2093 13:52 5952564831 STRIKING PAGE 95 INPUT ASSIGNMENT 1,IST - LORENZO ANTONIO. SPARK CONSOL F CHANNEL/ INPUT INSERT PHA TOM POWER 1 . KICK - 2. SNARF 3. N.N. * 4. TOM-1 GATE 5. TOM-2 GATE 6. TOM-3 GATE 7. O.H. 8. O.H. • 9. MINI DISK (D.I.) - - 10. BASS (0.1) COMPRESSOR 11 . GUITAR 12. XFY-1 ID.I.) 13. tFY-2 (DI) t 14. TIMBALES pATF 15. CONGA 16. CONGA 17. WNGOS 18. PERCUSSION O.H. 19. $AX COMPRESSOR/EXPANDER OR INSERT 20. TRUMPET COMPRESSOR/EXPANDER ALL 3 HORNS 21 . TROMBONE I\ COMPRESSOR/EXPANDER IN SU8-GROUP 22. VOCAL (LORENZO) cOmpREssoR/EXPANDFR 23. yOCAL (FEMALE-1) COMPRESSOR/EXPANDER OR IFISERT 24. VOCAL (FEMALE-2) COMPRESSORLEXPANDER ALL 5 STAR 25. VOCAL (FEMALE-3) COMPRESSOR/EXPANDER VOCALS IN 26. VOCAL (FEMALE-4) COMPRESSOR/EXPANDER SUB-GROUP 27. astreialeffer 28. VOCAL IPERCUSSION),t 29. V 1- 30. REVERE 1 $ETURN 31. SEVERS 7 RETURN 32. RELAY RETURN EFFECTS RETURNS TO BE IN STEREO IF POSSIBLE • .. 06/03/2003 13:52 5052564831 STRIKING PAGE 04 BACKLINE EQUIPMENT RIDER - SPARX & LORENZO ANTONIO GUITAR RIG; ONE (1) FENDER TWIN AMP WITH TILT LEGS OR SEPARATE ADJUSTABLE AMP STAND clank 50 peavey BASS RIG; ANY BASS AMP AND CABINET WITH AT LEAST 200 WATTS KEYBOARD RIG; OPE DUAL TER KEYBOARD STAND (QUICKLOK, ETC.) ONE (1)ALESSIS QS8.1(or KURZWEIL PC-88, or ROLAND RDB00) PERCUSSION RiQj PREFERENCE: LATIN PERCUSSION TWO QUINTO TWO CONGA TWO SET OF TIMBALES ONE CYMBAL STAND ALL STANDS FOR CONGAS,BONGOS&TIMBALES TO BE INCLUDED DRUM KIT; PREFERENCE: YAMAHA RECORDING SERIES OR MAPLE CUSTOM; DW; PEARL; PREMIER ONE 22" BASS DRUM ONE 10" TOM ONE 1Z" TOM "n Oa 14' OR 18" FLOOR TOM SIX BOOM CYMBAL STANDS • ONE SNARE STAND ONE HI-HAT STAND ONE DRUM THRONE TWO 14" SNARE DRUMS ONE YAMAHA DOUBLE BASS DRUM PEDAL MISCELLANEOUS EQUIPMENT; EIGHT MUSIC STANDS W/STAND LIGHTS INITIALS gititiormastvitnemramamordiatamtatmoragitiipowcANT if o e t)) IA E N T '_ L REGISTI-3IED , ISSUED BY APPLICATION 1'� Date o1 Men-adore NUMBER \I A INf%ATRFS INC! !AM o . ,y r .fa' NumberNumberEVANSVILLE,INDIANA 47711 Older Number ,� co P140.1 st ' +•� 334419 �7r,�J� MANUFACTURERS OF THE FINISHED a r^- TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated a (or are inherently noninflammable} and were supplied to: CO 692330 {.1 RENTAL CITY _ 6330 GUNPARK DR - • co .r .y BOULDER CO 80301 h-- H Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire L., Marshal Code, equal to exceeds NFPA 701, CPA' 84, ULC 109. t0 The method of the FR chemical application is: Serial 0: 8131110(2) Description of item certified: r ff 1 CENT MID 60WX30SNY I0'SPACE E Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric � T-Aemu __ S'N YDER All• NEW PHILADELPHIA,OH _^ Signed: z Name of Applicator of Flame Resistant Fli Italy TENT DEPARTMENT—ANCHOR INDUSTRIES INC. - I I'`? 7 C A- 2 j' u dingo cJOE(riP_ rr3hr.3 data anar le71' in -0 Jun 19 03 10: 31a Maria 303 iim-cu-a,us IUt u1:Ui YM CUWtsf INSUR, ADVISORS FM N0, 3036838004 P• 3 P. 10 Co West Insurance Group Attention: John L. Anna 703 Wilcox Street Castle Rock, CO 80104 303-663-9457 x112 e-mall:johnannaca cowcst coin REQUEST FOR CERTIFICATE OF INSURANCE • FAX TO: 303-663-8004 X s jYeeded Date of Request £URGENT Time 3 �Yc Normal Your Business Name: ?d in �ro.Ir d t Requested By: Certificate For: 11 e±yj' C'cx r,-t Attu: Address: Q1S \I a'� 1 `7.. ( City,State,Zip Additional Insured Required:_Yes No Project or Job Reference: FAX Number for Certificate Holder: Mail to Certificate Holder:iC Comments/Special Requests: b 6 Jun 19 03 10: 30a Maria 303 p. 1 A & M Drain and Waterproofing Inc. • 7156 Birch St., Commerce City, CO 80022 (305) 516-9121 Fax (505) 551-8700 TO: Weld County FROM: Maria F. Olvera Vice President DATE:. 6/19/03 • RE: Property of section 7, township 3 R&, M Drain and Waterproofing Inc. is responsible for the work performed' at the address on west one-half of the northwest one-quarter of section. 7, township 3 north range 68 west of the 6th principal median, County of Weld, state of Colorado, To be completed on or before July le 2003 for a special event going on July 19th and 20'h 2003. And to maintain property in good condition before and after the event. If you need more information regarding this letter, please fill free to give me a call at (303) 316-9126. Thank you, —)P\ Maria Olvera Vice President Jun 19 03 10: 31a Maria 303 p. 2 �pp0y , - nce w:..4 x » Barricade Fence '.. .` , ` ` , ; '4• Z..w >3 Orange Safety �MMj� `littty�m , ` Highly visible orange safety fence Ilea 4 �, *q.�.�gp��a�r�m� UV Stabilized. 4 X 100 ft. rolls log Ir ga r�r�allium �a: 7-7 �.y;.a��aierr®arrr�®mow . Conwed VI51® Fence ysrltiy'igl..o:r III00 rc�S�r�, X05229-004 Utility Pence fi ih;y*ih4eb� �r10*A~80as y ''c.ageerte�itil*r�talet"r��Olb tiQifirrorrrrelligh 001011,ea Tenax Beacon Plus }• r b SIED e�piOpasteQ� 89903004 Utility Fence rr rs %�0 t Mt 440 ,,:, iti titan Fence Poles & M , . ,, Ties is ¢c+ a > Tenax Holes and Poles System r�+ consist x ` r Black plastic ties for utility fence applic boundaries 30113609 60 in. Holes and Poles.. ........ .. .... 30010201 7 in. black plastic Ties 1000/pk T—flAxlia ...................... DATE(MM/DDNY) ACIUtIL CERTIFICATE OF INSURANCE ,/03/03 PRODUCER RISKPLAN INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 659 4TH AVENUE AHOLDER.LIS TATE DOES ERT LI, EXTEND OR LOBELOW. LONGMONT CO 80501 THE COVERAGE AFFORDED BY THE POLICIES _ .�, r. _' ` COMPANIES AFFORDING COVERAGE COMPANY PENN-STAR INSURANCE COMPANY A INSURED JACXESS, LLC 11. ' COMPANY B 10"18 SOUTH COFFNAN - LONGMONT CO 80501 COMPANY C rCOMPANY D I COVERAGES 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. T POLICY EFFECTIVE POLICY EXPIRATION CO POLICY NUMBER LIMITS LTR TYPE OF INSURANCE DATE EFFECTIVE DATE(M EXPIRATION ) GENERAL AGGREGATE 1$ 2,000,000 A GENE RAL LIABILITY �X PRODUCTS-COMP/OP AGG $ COMMERCIAL GENERAL LIABILITY - 1 1 CLAIMS MADE [J11 OCCUR BINDER-061803-01/01389-1 7/19/03 7/20/03 PERSONAL&ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 1,000,000 E-OWNER'S&CONTRACTOR'S PROT FIRE DAMAGE(Any one fire) i$ 100,000 r - - _ MED EXP(Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 4.__{ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) -1 SC ED TOS HIRED AUTOS BODILY INJURY 4 $ (Per accitlentJ NON-OWNED AUTOS HPROPERTY DAMAGE $ 6GA AUTO ONLY-EA ACCIDENT $ GARAGE LIABILITY — -- - -- OTHER THAN AUTO ONLY. ANY AUTO EACH ACCIDENT $ -H _ AGGREGATE $ EACH OCCURRENCE j$ EXCESS LIABILITY AGGREGATE $ .. UMBRELLA FORM S OTHER THAN UMBRELLA FORM STATUTORY LIMITS WORKERS COMPENSATION AND EACH ACCIDENT $ EMPLOYERS'LIABILITY - DISEASE-POLICY LIMIT $ THE PROPRIETOR INCL PARTNERS/EXECUTIVE EXCL _ DISEASE EACH EMPLOYEE $ OFFICERS ARE'. OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS 2-DAY SPECIAL EVENT - RONALD MACDONALD CHARITY HOUSE FOR 2-DAY EVENT ; JULY 19TH AND JULY 20TH ADDITIONALLY INSURED: WELD COUNTY PER TERMS AND CONDITIONS OF POLICY CERTIFICATE HOLDER CANCELLATION --- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, WELD COUNTY BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 915 10TH STREET OF ANY KIND UP N. THE COMPANY, ITS AGENTS OR flEPflESENTATIVE5. P O BOX 758 AUTHORIZEDREFRES ATIVE GREELEY CO 80631 � _ ( OACORD CORPORATION 993 ACORD25-S'{37931 Him—mien Him-mien rilmul ralenn I iIlL',unt-tn menuLPZI�LL illr1U� LLL!LVI LPL [!„F_ifin JJUFL"'T Jfi Rin [ e '. .Ii, `! '—,, PIONEER GENERAL INSURANCE COMPANY rrJ LICENSE AND/OR PERMIT BOND L� l BOND NUMBER P62864 [Li f El: KNOW ALL MEN BY THESE PRESENTS: '�._ LTTI 1l That we, Jackass.LLC as Principal, rc— HI and PIONEER GENERAL INSURANCE COMPANY,incorporated and under the laws of the State of Colorado,with principal C [7 offices at Denver,Colorado,as Surety am held and firmly bound unto Board of Weld County Commissioners H in penal sum of THREE THOUSAND AND NO/100 Dollars,( $3,000.00 ) t lawful money of the United States for which payment, well and truly to be made, we bind ourselves, our heirs, executors, administrators,successors and assigns,jointly and severally,firmly by these presents. e WHEREAS,the said Principal has applied to said Obligee for a license to ASSEMBLY PERMIT 7 NOW, THEREFORE,THE CONDITIONS OF THIS OBLIGATION IS SUCH,That if the said Principal shall indemnify said 7 Obligee against all loss to it caused by said Principal's breach of any ordinance,mle or regulation relating thereto,then the above ,_ (t,, obligation shall be void,otherwise to be and remain in full force and effect until the 11TH day ofJUNE - iI [_' 20 04 ,unless renewed by continuation certificate. ITff- ':! THIS BOND MAY BE TERMINATED at any time by the Surety upon sending notice in writing,by certified mail,to the Clerk ! l rr' of the Political Subdivision with whom this bond is filed,and at the expiration of thirty(30)days from the receipt of said notice, l' this bond shall ipso facto terminate and the Surety shall thereupon be released from any liability for any acts or omissions of the ! Principal subsequent to said date. l 5. Hn rl Signed,sealed and dated the 11TH day of JUNE ,20 03 Iii; 1 rI Lum Jacke LC, I el I-5 ,E='; / ,al,1 'ICC?e t ert9 iliVill 7 hTii 2 Principal : J 6 Ili PIONEER GENERAL SU CO ANY �, Tr,-I By �V�.c2 \ OJ By #�� Resident Agent Sharon K. Pond Attorney-In-Fact IL- P-1217/90 , tl [' [Li IC I 71 i� [7' [[7 i,,. i li -I -.r;L�LrLf 1. .�ILL.......... .....LirL.....Lr....riL11111 um LLI mill 1 ffl l 'Ii fl l_r_u U .r .r.Li-.nom jfl rn1`rn,. PIONEER GENERAL INSURANCE COMPANY Denver, Colorado P 62864 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the PIONEER GENERAL INSURANCE COMPANY,a corporation of the State of Colorado has its principal office in the City of Denver,Colorado pursuant to the following By-law,which was adopted by the Board of Directors of the said Company in 1990,to wit: 'Article VI-Section 2-RESIDENT OFFICERS AND ATTORNEYS-IN-FACT.The President or any Vice-President,acting with any Secretary or Assistant Secretary,shall have the authority to appoint Resident Vice-Presidents and Attorneys-In-Fact,with the power and authority to sign,execute,acknowledge and deliver on its behalf,as Surety: Any and all undertakings of suretyship and to affix thereto the corporate seal of the corporation.The President or any Vice-President,acting with any Secretary or Assistant Secretary,shall also have the authority to remove and revoke the authority of any such appointee at any time,does hereby make,constitute and appoint *** MICHAEL D. PIERCE, RAE L. CAMPBELL, JOAN DELAUDER *** *** LAWRENCE E. LUTGEN, SHARON K. POND *** OF FORT COLLINS, COLORADO its true and lawful Attorney(s)-In-Fact,to make,execute,seal and deliver for and on its behalf,as Surety: And any and all undertakings of suretyship And the execution of such bonds or undertakings in pursuance of these presents,shall be as binding upon said Company,as fully and amply,to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the Company at its offices in Denver,Colorado,in their own persons. The following Resolution was adopted at the Regular Meeting of the Board of Directors of the Pioneer General Insurance Company,held on June 1,1990. 'RESOLVED,That the signatures of officers of the Company and the seal of the Company may be affixed by facsimile to any Power of Attorney executed in accordance with Article VI-'Section 2 of the Company By-laws;and that any such Power of Attorney bearing such facsimile signatures,including the facsimile signature of a certifying Assistant Secretary and facsimile seal shall be valid and binding upon the Company with respect to any bond,undertaking or contract of suretyship to which it is attached.' Ali authority hereby conferred shall remain in full force and effect until terminated by the Company. IN WITNESS WHEREOF,PIONEER GENERAL INSURANCE COMPANY has caused these presents to be signed by its President and its corporate seal to be hereunto affixed this 1st day of January 2003 PIONEER GENERAL INSURANCE COMPANY N.S U4,,hh SecretarySCI State of Colorado ) �F�ia!!/�— F' County of Arapahoe ) ss By PRESIDENT di_S I': A I. ' i ht.�0l0R�0�_s On this 1st day of January 2003.before me personally came Bruce H. Lowdermilk to me known,who being by me duly sworn,did depose and say that(s)he resides in the County of Adams,State of Colorado;that(s)he Is the President of the PIONEER GENERAL INSURANCE COMPANY,the corporation described in which executed the above instrument;that(s)he knows the seal of the said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so affixed by order of the Board of Directors of said corporation;that(s)he signed(his)(her)name by like order;and that By-law,Article VI-Section 2,adopted by the Board of Directors of said County,referred to in the preceding instrument,is now in force. 0 \ oTA4 4�F� • My Commission Expires 1/18/2007 • Moh rry P Notary Public �/�� LJ f11 +� - FOF co`o foregoing M.J. Frick Secretary of PIONEER GENERAL INSURANCE COMPANY, do hereby certify that the above and is a true and correct copy of a Power of Attorney executed by said PIONEER GENERAL INSURANCE COMPANY,which is still in full force and effect. Signed and sealed at the City of Denver,Colorado this 1 1 t h day of June 2_001, P133 Secretary 19 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, 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. 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 charding@co.weld.co.us DOCKET NUMBER: #2003-58 DATE: July 14, 2003 TIME: 9:00 a.m. APPLICANT: Ronald McDonald House Charities of Denver, Inc. do Kori Orsinger 1300 East 21st Avenue Denver, Colorado 80205 REQUEST: Application for a temporary assembly of more than 350 persons on July 19 and 20, 2003 - La Ley 1170 AM KJJD 5th Anniversary Celebration LEGAL DESCRIPTION:W1/2 of the NW 1/4 of Section 7,Township 3 North, Range 68 West of the 6th P.M., Weld County, Colorado LOCATION: East of and adjacent to Weld County Road 1, and south of and adjacent to Weld County Road 36 (See Legal Description for precise location.) BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO DATED: June 27, 2003 PUBLISHED: July 3, 2003, in the South Weld Sun t N OTICE OF APPLICATIONFOR TEMPORARY ASSEMBLY Pursuant to the Weld Canty Code, • public hewing will be held in the Chambers of the Board of STATE OF COLORADO) Casey Commissioners of We Canty. Colorado. )S.S. Weld County CreemW COUNTY OF WELD Cane, 915 Street First- Floor,oaime soared, at the time spaded. Ruth Pelton-Roby, as manager of Peltoncad water Publishing Company LLC, being duly deed pesoD w the ee sworn, states that it is publisher of the Clear to the Goad, n wrihB,rest five days South Weld Sun, a weekly newspaper prior a M,leanly. the court published in Keenesburg in said County wader shall• r be°boa re by the °^ es� hey. In State; that said newspaper has a accorded! with the general circulation in said County and has Americans with Disabilities been continuously and uninterruptedly ado if special accommodations in od for Sr. published therein, during a period of at participate in required in order"b you to hearing least fifty-two consecutive weeks prior to please contact+a t the Clerk to the first publication of the annexed notice; 336-the 7215,Denial ion 1226 that said newspaper is a newspaper prior to M. day of M. within the meaning of the act of the Mnle complete casefiN General Assembly of the State of b..aininedin the ffwa Colorado, entitled "An Act to regulate the Ce to the Board a County myCentennial Commissioners. printing of legal notices and Rand Cagy ant.a r advertisements" and amendments Third Floor,Greeley, thereto; that the notice of which the Colorado. E-Mail messages sent to an annexed is a printed copy taken from said ind4bal Cammisionr newspaper, was • yreben.ludednthe published in said case file. To ensure newspaper, and in the regular and entire Inclusion of your Had! domsM^denoe Ines the issue of every number thereof, once a ease Me,pee send a week for 1 successive weeks; that copy to said notice was so published in said fine dlaS9ee.waes.°e.es newspaper proper and not in any DOCKET NUMBER: supplement thereof, and that the first publication of said notice as aforesaid, DATE:July 14'200' was \on the _3_day of TINE: e:DD..m. ,II--k\'-- 2003, and the last APPLICANT: Ronald McDonald House on th adoKm"'asinger of Denver.n" 003. 1300 East 21st theme On,Colorado 90205 REQUEST:Application for PELTON PUBLISHING COMPANY LLC a temporary assembly of /� /� more Men 350 persons a, By , / - r � Ly 1170 M KJJD2003 Lth Il/J, d) t' Lay era C KJJD 5th Anniversary Celebration Ruth Pelton-Roby LEGAL DESCRIPTION: W12 a the NW1M of Its: Manager Section 7. Township3 Nat,Range as West of Mesh P.M..Weld Cagy, Cobweb Subscribed and sworn to before me this LOCATION: East a end _ 1'Y,11frl rbp4,,,y adjacent to Weld Gayety day of C 2003.,.•` 6 �1/' �,,. Road 1,and iced of and 7 Gi�� •.,KhrT Road• m38es (See Legal Description for pees .-r2,,�t zi ,f 17f,ii%% NnTAfl y . locate.) otary Publ ' ° BOARD OF My Commi'n expires:,c..7, : ., nA. PUP'. ., WELD COUNTY, COLORADO ; -7 • '"'- , L1.r•C`` DATED:Jbw,2T,2003 4 �• }41.•x*"'< PUNLMIfED: 3,2003, "'Itt,111!t1^° m e South Weld Fe Hello