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Home My WebLink About20140916.tiff RESOLUTION RE: GRANT PERMIT FOR TEMPORARY ASSEMBLY ON APRIL 19 AND 20, 2014 (ALTERNATE DATES ARE APRIL 26 AND 27, 2014, IN THE EVENT OF POOR WEATHER) - MARTIN AND BERTA GUTIERREZ 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, Martin and Berta Gutierrez, 7717 County Road 31, Fort Lupton, Colorado 80621, have 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 5:00 p.m., on April 19 and 20, 2014 (alternate dates April 26 and 27, 2014 in the event of poor weather), on property described as follows: 7717 County Road 31, Fort Lupton, Colorado, 80621; being further described as Lot B of Recorded Exemption #3375; being part of the E1/2 of Section 28, Township 2 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 Martin and Berta Gutierrez, 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 the Weld County Code, 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 April 19 and 20, 2014 (alternate dates April 26 and 27, 2014 in the event of poor weather), be, and hereby is, granted to Martin and Berta Gutierrez to conduct a temporary assemblage at the hereinabove described location. Gel 5O 3a7 2014-0916 LC0022 PERMIT FOR TEMPORARY ASSEMBLY— MARTIN AND BERTA GUTIERREZ PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 24th day of March, A.D., 2014. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: dimeti , . /o;44 �Cl� Doug Rademacher Chair Weld County Clerk to the Board ,, � /� 0 °G f(, ��; ara Kirkmey roiem BYCDeSAL t Clerk to the Board {* l �� • 1861 ��-,� �=n P. Conway APPRCREDAS ORM: �r ,� ., /7 � Fc� Y - ®� ' 1 D�� ike1ree ounty Attorney William F. Garcia Date of signature: 3-O97'/11 2014-0916 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 10th day of March, 2014, 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 11:00 a.m., until 5:00 p.m., on April 19 and 20, 2014 (alternate dates April 26 and 27, 2014, in the event of poor weather), on property described as: 7717 County Road 31, Fort Lupton, Colorado, 80621; being further described as Lot B of Recorded Exemption #3375; being part of the E1/2 of Section 28, Township 2 North, Range 66 West of the 6th P.M., Weld County, Colorado This permit authorizes Martin and Berta Gutierrez 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 10th day of March, 2014. BOARD OF COUNTY COMMISSIONERS ��,,// WELD COUNTY, COLORADO ((��(( t ATTEST: C/ to;tk. K enic dic Dougl s ade acher, Chair Weld County Clerk to the Board Bar ara Kirkmeyer Pro-T et BYQQQ 9Q Deputy' Clerk to the Board . Sean P. Conway __I--- Mike Free ��;��P gliirI William F. Garcia NI- ref NOTE: THIS PERMIT MAY BE REVOKED AND THE BOND FORFEITED FOR FAILING TO MEET THE CONDITIONS SET FORTH HEREIN. 2014-0916 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. 11 NAME: toe— — ytiL /Itc .`fpbb QLg4errez AGE: RESIDENCE: 71/7 &Z 31 El.1,4-ton -�'1. Ketoa 1 ILING ADDRESS: a. e, ac a karma 303) 41,03-4,5155- 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: 77/7 L' 2 / f¢. l /t�' e� r e0(.77/ rl?{ b cc cenfiroy, G1 / fa��h�tip norK. r'rinre. 610 wick O.f 6,11,- f'IU L&lirt1) Cow.irX rolo'rd eth 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: 2014-0916 0,000e0000000nUDDDD00.000000 2. Nature or purposes of the assembly: itor,3e- {� aLjt n r! G u21L-� Purr v is 4 an-tis -JffvocU t y '"e food, vtt 9n-fe iaime e 4' �'V1 i food, L ici luu^ .4- Zotk. 3. Dates and hours during which the assembly is to be held: ?r't I la t*' cl /3'1`.1 aU1 it iiatan. -I-D &to sp.e,, ((II-iern fe_. die its (Levi / 14m ckAO* olOfY- (toet�y-Aei' p Q./nu-14;1_5 ) gig, 2'7 HA- I 4. M imum number of persons to be allowed at assembly at any one time: ( M&1 Pr praxi ma_Tell /),5'60 (neerr �r'eld) oppttcA, arhai rert t) 5. The maximum number of tickets to be sold, if any: Al/4 6. Identify plans to limit number of persons to the maximum identified above: &o.-tAli4y 1tort,r<.K r..0)(I lir )ng rIAQ- 4 -it aloce en c�fcs once. HAe maxi mum has hero Inn do Ac en-)-v -Fycef t_di lI (be issurrt onn G.44-Fen n5' 5 +here �atc j do pr nj +r1 c-k n-' narnh 6) -1-: petyk oi' etle et+. ' 7. Identify plans for supplying potable (drinking) water, including the source, number, and Igq,cation of facilities, and type and means of disposing of waste deposited: bCY4-)ed< i._VQ:1-er' Wi (I be pr nu ; deb_ +itrou5hnu - arem, . "'iate LJiI) Le. pkn1y e ; +ra hea nS ac well cs eJ co r\An �y,r c i tom... a LA-nn *ye -Cc( 3riposr rid' a-P -1-Y1AA rL,nci. 8. Identify the plans for holding, collecting, and disposing of solid waste materials: I v'ashc'ans "-I-h roach aux euert$ at et. . Ditr r to 11 be. if esfionsihL. w 'corn-plat a Dear, l;,0 4UPv• cupid-. 9. Identify the plans for providing separate toilet facilities for males and females, including the sources number, and location, type and the means of disposing of wastes deposited: (jn /1 r/.Q Site. eeY0ocef toil! be 0 mo/diri ' 1-he cr. 5evVS≤- i�ie. ;A31 II he unisex ( poi-I•- t- Inc) (rri-pcc r\ 16 +1) et-A- -VI\c.vh t±ia GeiVL iL Deck. +ft e-nt up . “ 6nn eliLA() -1-bikf• 4-a(ultI-ie5 t_)111' be iuuelct.61 asLo d riec<a Sc�. cc-Htet .In mce.,r--' -* O=0 0:V100 boo 00000'00000000.000000 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: p 1P45e Ste. c" an m. 9# 0 11. Identify the plans, if any,to illuminate the location of he assembly, including the source and amount of power,and the location of lamps: 4 A Evert - 'Jo he h4 d du ri n Cray /4(%a; //is" /w{6- 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: p6ca --C vn -*Kg) 13. Identify the plans for communications with hospital, police, and fire services, including the sour,Ge,amount,and location of communication equipment: CtnL-netc�6_ li.y _ 9e(_ga r i4/ �f.uv. (DYninw i na(J on. t vApVnl�J�L..Y' (1Oice 14. Identify the plans for camping facilities, if any: id/it 0.`000`00000000`00000000.000000 15. Identify the plans for fire protection: V+ • �Ix,P4°n Fi re. IJ) 1 C+ �S . t A miles -r(tom euemo site_ will kr_ no Oj2eM 42ire, cI- c wj%imc. 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: ,S J ie tscar-i• camel Seeder; E� &ase See c H-a_. ck m ce÷± 4# 17. Identify the plans for sound control and sound amplification, if any, including number, location, and power of amplifiers and speakers: n9//,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 theirlicense permit numbers: Oil -kod aerncLoIrs corn he rte$L red. be. iicsrlc ei. 19. Identify the plans, if any, for an electrical system: Al�1 0:`0001]0000000100000000.000000 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, preve„"ntt�erosion,and preserve the scenic attributes; and the plans to abate dust on the site: /V/9 open 4'e d 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 the applicant of each of the terms and conditions of the temporary assemblage permit. A-T" Ac mak/I (p 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. -7---i-Ac4,4-FYI ,t L 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. 0:`000'0000000 0'00 000 000.000000 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. AfraC 4. t -,Q13Irc0, � n� ufe Applicant's signature .May Lt-t-f�Y y r 6e r1 g . C�u e r)/c2- ppi;64_4 'spy- ¢met n a_me Applicant's printed name os:-1 oh Applicant's position PP SUBSCRIBED AND SWORN to before me this 3/sue day of JGL tail, 20 19 0 Witness my hand and official seal. &064- � �o. Notary Public My commission expires: 9_a., /7 ESTHER E. Gi5SICK NOTARY PUBLIC STATE OF COLORADO NOTARY ID 19974016478 MY COMMISSION EXPIRES SEPT. 29, 2017 M:1CTB\CTBFORMSIFOASMBLY.DOCdoc Jan. 20, 2014 10:24AM No. 2306 P. 1/1 rte. O •_ Page: 1 , i,:.:( 1 ,:1 Vsim . ,•, Di M ;: Customer ID DEN-09637 United Site N_..._i- t ..1� Inc. 11.' �r _ _ I Rt . 0-494005 Site Se vices o Colorado, In \ rims s Order Igo. 1 SITE SERVICES�d $';', Ordor Date: 01/17/14 1" ' T:rr;;a. Due Upor,r ecelp: Customer Service: 1-800-864-5387 ORDER P.D.No. Sere s,en9on RRFTT L.ANf ri L Cust.Serv.Rep.: Bill RANCHO CAPORAL Ship HORSE EVENT To: MARTIN GUTIERREZ To: MARTIN GUTIERREZ 7717CR31 7717CR31 FORT LUPTON, CO 80621 FORT LUPTON, CO 80621 (Items Rented Item I Description Quantity Rental Term From/Thru Unit Price Total Price DXR 10 04/111/4 75.00 750,00 Deluxe Rectrnnm Each 04/14/14 DELIVER BETWEENN"3 PM-5 PM**FRIDAY *CALL MARTIN ON SITE TO CONFIRM SPOTS* PICKUP ANY TIME MONDAY r n IJV, 10 04111/14 100.000 +100.00 I vu Damage Waiver Each 04/14/14 ADA 2 04/11/14 116.00 230.00 ADA Wheelchair Accessible Each 04/14/14 DWP 2 04/11/14 10.00 20.00 Damage Waiver Each 04114/14 2SS 3 04/11/14 75.00 225.00 2 Station Sink Each 04/14/14 OW 3 04/11/14 10.00 30.00 Damage Waiver Each 04/14114 SPC-ALL 15 04/13/14 21.95 329.25 Event Service Sun(6-gam) Each 04/14/14 Rama To:United olio Sidi/Ms,PO Oex 63207,Phoenix,AZ 860724207 • Subtotal: 1,684.25 Total: 1,584.25 • Signature —.. Date; 01-19-2014 23:05 BERTA A GUTIERREZ 3038578587 PACE1 - �(j • N _ e p • • > :trimo • oloi•m: . i Yt40i K— --- --ovl�Ct..aN(•i • a•••• D Q? • :.1.:. --.igc,,.....) aa►�s ac� ieaua�� a Wz l...ta t :- ' !1!/T � Y'80'-£ x'12.31' • . .•:•: .. . •.•. • •••••••:.-.:•:" ••-••• -.•••- - -...*.•',AA:::•#-•. •-, . . 4-- 4.... : . , -..•:„..,...:;•:::•._•••••:. •:.....'. a (e�3 4Q4 / - pp C� a -k�. : •••....-.---:::::::. ',,.-,.:.-...:••;:-.:.. .... ...:::-....,.:..,...,• n - :: . _ O tl fil.2 _ .........' ..f..1.;;:i...i...:..,.....'....'..i 1••. :...:-...:1-::,1%..1...i.'..:...:........-'' ..:.'::::::.•:• - _ `v+�{ X11. l4 ,. • �2 x 7 °AEl ) oe- 5r..-.......'_[......-:;4.-.-.....•:.:••••::..'.'...7..-...-/ . -. . , . . . ...' ... - -fiF - °.° 1 - I : . . , .._ . . . . tt a .r. I 200.0r s. . Z �� • • : . . - -1 A 1 _ lipi y r __ „=,; 44t.c.:== ts44 �— d: Js•r own • S H WY 85 — — _ __ m m .1 y g7, i p 30 CC"" 4qZ A3 Az y m zo - , zA m 77 b X 0 'd" R2 '" "r�. A A 2 C m � D • C��7 �"A D 0 D • m rip = --< D T z • > O Der Q --I O al o m w Z A n Cam] o �SI I'O G E T jam, m y O V ,, m A z • . . O X COW co C=J = Cn - D C n z G D D T m 2 cn • O --I-I m y •• D < n 2 D —I r o � m m C — Z (ii C7 —{ ', W. - IN (Is) J C R...X31. 0 • 0 6 ••r]_• z a { z 0 a _ .. . a a O o a • W `m z O a g r ll P, D m 0 T n 01/16/2@14 1.3:03 303306543E JJESCORT PAGE 01 ` 'Ll • Sj . ...--I10)-21*..-" , J.J. ESCORTilk SECURITY, INC !(7•:4: ) 6475 South Cody Street 303-933-4544 a' � 1.itt1eton. Colorado 80123 720-922-.,904 fax / January 1S 2014 Ref Event April 12 and 13 2014 Mr.Martin Gutierrez,J.1.k scox t c Security Inc.will provide Security for your event on April 12 13 2014 And rain date of April 19,20 2014.Our company will provide ten armed officers with radios and.:ell phones.Pour officers speak Spanish.Oa o ica s have Riot Aid,CPR staining.1 have been in co luta with the Weld County Sheriff Office about the number of officers we will have at the event.Please pot t the No Firearms or Alcohol allowed signs at the gates.We are Lice se,Bonded and Insured.A deposit h:s 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 303 933 4544 JJ Escort&Security Inc. James A.Sweep.CEO • • • • b1-lb-bt31t4 b1:.:5 bLK II H H (L I ltil#2bZ .SVJ3b�rizitAi( F'H(at1 6dJDd Lt gag9L 0� LddrJdLLI IJ t1 H1rJdd bt7.✓t 1 11 -0d-ta -6L'� DRWiin(e111a/12) STATE OF COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT I lr'ENQQII Trl rrOIDATE A RETAIL c�OD ESTAI2I ISHMEI►IT s.P%_ I as I Ii I.. r► III a� rl lw I rr�a.a�I+.�I I7VI�.0 I ACCOUNT NUMBER LIABILITY INFORMATION ISSUE DATE LICENSE VALID TO use for all references cn:,nty p all, I Indust lyre' vab i1y ci.ie month I day I NM: DECEMBER 31 014 6636500 62 3289 4/15/20111 1/17/2014 2014 THIS LICENSE MUST 9E POS I EV AT THE Foil OWING LOCATION: This certifies that ricensee sho•.^.T hereon TACOS JUNIOR is authorized and licensed to engage MOBILE UNIT in business in accordance with the WELD COUNTY,CO 806 I provisions of the law and regulations of the Colorado Department of Public Health (finer: TACOS JUNIOR INC and Environment. Any alterations made on this l;cersse autemellCca11y riisake it LICENSING AGENCY: WELD COUNTY DEPART.MEt'T OF PUBLIC HEALTH AND ENVIRONMENT nuf and void. POSTINA i12EJU1iSin1'�'.EK,M.f� -;i._uli�hC;TOI'� CONSPICUOUS ENVIRONMENTAL HEALTH SERVICES • PLACE A Detach Here A 'd 968tib£6£0£ ONI SOOV1 d17L:ZL bL 0£Uef 01/'ZJ/14 08 : 13AM MST David Simon Agency —> Martin �-.. 3O3Ub'/8b8'f pg 1/ 1 (�I�na DATE{MM DDIvwY) CigETrRTIFI*. A E dF LIABILITY I SUR_A CE f ui/29/210i4 i This CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THls CERTIFICATE DOES NOT APPIRMATIVcLY OR NEGATIVELY AMEND. EXTEND On ALTER THE VUIERAGE AvroRDED SY THE POLICIES I 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(lea) 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 cell!!!cgs Retest In Seti Cr soft endnriereene(e). PRODUCER ('uNIE:ui NAM DAVID SIMON INSURANCE PHON eituao£�i; r 303" 659-9066 !INC,L o);(80O)726-3179 420 Court Place ADDRESS:ADiz6rigf.ton@gmail.com Brighton, CO 80601 PRODUCER 7 CU$TCIMER Ott! INSURER(S) AFFORDING COVERAGE NAICS INSURED INSURER A: Scottsdale..Insurance Company_.,,.,_, Martin Gutierrez INSURER B: 7717 County Road 31 INSURER C: Fort Lupton, CO.80621 INSURER D: INSURER E: INSURER F: I 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 1 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, E CLUS!ONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE SEEN REDUCED BY PALO CLAIMS. 11485 ADDL BURR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE SIM MITI POLICY NUMBER (MMIDDfYYYY) ,a0MCD/YYTYi LIMITS GENERAL LIABILITY I$ 1,nnn,nnn (;At_:H raC:r:IIRRFIUf:P , UAMRt I'. P(N I CY 7 COMMERCIAL GENERAL LIABILITY PREMISES(Es oee rlenca) $ 100,000 I CLAIMB•MADE in OCCUR . Il MED EXP(Any e,erersen) '$ 5,000 AT __ I CPS1934428 04/1212014 104/14/2014 PERSONAL!LADY INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 OEM L AOG EBATE LIMIT APPLIES PER: PRODUCTS-COMP/OP 400 $2,000,000PRO- , j POLICY ■ JECT ■ LOC $ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ Ms I ANVAt1T0 BODILY INJURY(Per person) $ I HALLOWNPA AUTOS BODILY INJURY(Per acclG )ent $ SGHEOt1LED AUTOS PROPERTY DAMAGE I HIRED AUTOS trer nualieni) $ { NON.OWNED AUTOS I I I $ !II ! I$ UMBRELLA LIAR F OCCUR I EACH OCCURRENCE 1$ EXCESS LIAS CLA" 'Lnpe ArroceAr; i$ I DEDUCTIBLE I ` 4 i,,..1RETer.mc , 4 I WORKERS COMPENSATION yyyfi STATU- ! nl H. AND EMPLOYERS'LIAa1LRY YIN 17081'LIMITS ` ER ANY PHUPH161UWPAiINEHIEX61;U1rVN r--, u E,L.EACH ACCIDENT $ (Mandatary In ri EXCLUDED? ""' EL,DISEASE•EA EMPLOYEE r $ {Mandatary In NH) If yen,desuribu under .DESCRIPTION OF OPERATIONS BOW E.L.OISEASE•POLICY LIMIT $ _ I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Atteen ADORO 101,Ad ellorlel Rer118rRaScnetlule,ll MoreepaCe Si require°) Special Events Policy TT e o Gay Horse Racre,.event 1T ,! d to be held nd 12 201 d 04 13 201 Weather Permitting �i1 ,'l�lI , �,.4G 1191-1 on 04 I,) ') a 41i Mir- ., '>044 Weather or it will be held on 04-19-2014 and 04-20-2014 at 7717 County Road 31 Fort Lupton,CO.80621 CERTIFICATE HOLDER CANCELLATION Weld County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1150 0 Street THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Greeley, CO.80632 AUTHORIZED REPRESENTATIVE UdVlU .�In1Ot >t 91988.2009 ACORD CORPORATION.All rights reserved. ACORD26(2009/09) The ACORD name and logo are registered marks of ACORD 01-28-2014 20:58 BERTA A GUTIERREZ 3038578587 PAGE1 139dd L8S8LS8£0£ Z3aa3I1f19 d UTa38 62:20 6102-0£-10 NCI I H DENVER. AllirtikkL CLINIC - - - - -- 7150 LAFAYt i I t ST. DENVER,CO 80220 303-288.8200 ..t.- -Saar! -_-- !r 7,s. _ !r / -'c✓ —/ J e_ /U �Lce '7 r Id/ y 4ce1r4 ^ J ? I It / G✓ 1 7/ 2 7 4a 04- Cc. // +/ //erer'/✓Itrr!&,a p i9 t / .r / ft /Wa re I-4 e a--t a r nr s f i Urcir . .F.. 'laL#e _ l99- learH "5 �er- 4&r Oter^ a0 w,-,c - = n 1 4 7-4e race arts are Aril 12 4n1 13 r gat,' atres re Apr; / It ter 20 4 d ieee 4rra - .fde a' .1.. r d- . , ffiai S/.nef.re(+r+ ,, I0/10 39t1d 1tiWINV a3AN3Q NINON L0Eb88ZE0E 1E:E1 blOZ/0E/I0 • 1861> MEMORANDUM 1111 = � ' Er J TO: Rafaela Martinez, Clerk to the Board DATE: 03/19/14 U� coUNTYI FROM: Janet Lundquist, Public Works SUBJECT: Temporary Assembly Gutierrez Horse Racing Event 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 1,500 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). 4. The applicant submitted an acceptable Traffic Control Plan (TCP) prepared by a certified Traffic Control Supervisor (TCS) 5. Please submit an Incident Action Plan for the Office of Emergency Management. Page- 1 -of l March 19,2014 C:\Users\ramartinez\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BBCGBZMY\Temp Assembly Gutierrez Horse Race 031914.DOC Rafaela Martinez From: Frank Piacentino Sent: Thursday, February 06, 2014 4:04 PM To: Rafaela Martinez Subject: RE: attachment Rafaela, Weld County Building Inspection have no concerns, appears no building will be used for contestants or public,all events to take place outdoors. If you have any question,please call or write Frank Piacentino Building Official Weld County Building Inspection 970-353-6100 Ext 3531. 1 2-S.1866 en- NIA 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: Rafaela Martinez Sent: Thursday, February 06, 2014 3:55 PM To: Dan Joseph; Bethany Salzman; Lisa Aguirre; Mark Geyer; Janet Lundquist; Roy Rudisill; Brad Yatabe; Frank Piacentino Subject: attachment It would help to attach the document. Thank you Rafaela.4. Martinez Deputy Clerk to the Board 1150 O Street)P.O. Box 758IGreeley, CO 80632 tel: (970)336-7215 X5226 Pi r-r s t 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. 1 MEMORANDUM 1 °, To: Rafaela Martinez, Deputy Clerk to the Board February 7, 2014 � �)�g+ ,,� f ' ' n From: Bethany Pascoe, 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 and Location of Event: Berta &Martin Gutierrez 7717 County Road 31 Fort Lupton, Co 80621 Zone District: A(Agricultural) Dates of Events: April 12, 2014 &April 13, 2014 or April 19, 2014 and April 20, 2014 (weather permitting) My records indicate that Mr. & Mrs. Gutierrez own 2 (two) separate adjacent properties: 1309-28-1-00-058 (consists of approximately 10 acres) 1309-28-1-00-059 (consists of approximately 36.19 acres) Therefore, total number of LIVESTOCK(i.e. horses, cattle, etc) could not exceed 184(46 acres x 4= 184). Again, their application states APPROXIMATELY 1500 people which does not set an exact attendance limit. No active violations were noted. SERVICE,TEAMWORK,INTEGRITY,QUALITY �861 Memorandum TO: Rafaela Martinez G o uN 2 From: Dan Joseph DATE: February 15, 2014 SUBJECT: Martin Gutierrez Temporary Assembly Request In response to your request, Environmental Health Services has reviewed the Temporary Assembly Permit,LC0022, for Martin Gutierrez, located at 7717 WCR 31, in Fort Lupton, Colorado. After reviewing the application, the following is the recommendation made by this Department: 1) 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. Based on number of toilets being provided (10)we recommend having 5 hand washing stations. The 3 dual sinks being provided may meet this requirement provided that portable toilets are located within close proximity to one another. In addition, the Department reviewed our complaint database and did not find any complaints filed for that address or for the applicant. Should you have any questions regarding this matter, please contact me at extension 2206 or via e-mail at djoseph(a,co.weld.co.us. Thank you. cc: Cindy Salazar, Environmental Health Services Deb Adamson, Environmental Health Services To: Weld County Board of Commissioners From: Deputy Lisa Carpenter Date: February 24, 2014 RE: Martin Gutierrez/Horse Racing Event Dear Commissioners, I have researched and found no reported calls for service to 7717 WCR 31, Fort Lupton, CO 80621 for the Calendar year of 2013 to present day. I find no grounds for disapproval for the Temporary Assembly Permit. Respectfully Submitted, Deputy Lisa Carpenter Community Resource Officer Weld County Sheriff's Office 1950 "O" Street Greeley, CO 80631 DEDICATED AMBULANCE SERVICES AGREEMENT (#0314-03-42381) THIS DEDICATED AMBULANCE SERVICES AGREEMENT (this "Agreement") is made and entered into as of the signature dates set forth below, to be effective as of April 12, 2014 (the "Effective Date"), by and between Banner Health, an Arizona nonprofit corporation, d/b/a North Colorado Medical Center ("Banner") and Martin Gutierrez, an individual ("Client"), RECITALS: 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 12 and 13, 2014 (the "Event"), with alternate bad weather reschedule dates of April 19 and 20, 2014 (the "Rescheduled 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 12, 2014 and shall terminate at 11:59 PM on April 13, 2014, or in the event of a Rescheduled Event, shall commence at 12:01 am on April 19, 2014 and shall terminate at 11:59 PM on April 20, 2014, 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 Y:\BCC\shslegal\WR\Colorado Region Facility Contracts&Matters\NCMC\Ambulance Service\Martin Gutierrez Ambulance Services Agt.Race.2014.agl.doc ($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 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 ail 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 to ees subcontractors or agents engaged in the work under this Agreement at the time em 9 employees, 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. 20OO(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 all 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:\BCCIshslegaRWR\Colorado Region Facility Contracts&Matters\NCMC\Ambulance Service\Martin Gutierrez Ambulance Services Agt.Race.2014.ag1.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:\BCC\shslegal\WR\Colorado Region Facility Contracts& Matters\NCMC\Ambulance ServicelMartin Gutierrez Ambulance Services Agt.Race.2014.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: Martin Gutierrez 7717 WCR 31 Fort Lupton, Colorado 80621 4 Y:\BCC\shslegal\WR\Colorado Region Facility Contracts & Matters\NCMC\Ambulance Service\Martin Gutierrez Ambulance Services Agt.Race.2014.ag1.doc r If to Banner: Banner Health d/b/a North Colorado Medical Center 1801 16th Street Greeley, Colorado 80631 Attn: Chief Executive Officer with a copy to: 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 an 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 Martin Gutierrez, Individual North Colorado Medical Center CBy: / '/ SID Name:rry l Name: Rick Sutton Title: C W. ,V 61 Title: Chief Executive Officer 11 Date: Iv Date: odijd0-1 FEIN: Pccr, 44-1 EE-`? `' (cllo\ 5g(-zs 2- 5 V:\BCC\shslegal\WR\Colorado Region Facility Contracts & Matters\NCMC\Ambulance Service\Martin Gutierrez Ambulance Services Agt.Race.2014.ag1.doc y $ EXHIBIT A DEDICATED AMBULANCE SERVICES AND RATES Dedicated Ambulance Services: Banner shall provide the Dedicated Ambulance Services during the Event. Rates: Client shall compensate Banner at the rate of One Hundred Fifty and No/1OOths 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 treatmentls) 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:\BCC\shslegal\WR\Colorado Region Facility Contracts&Matters\NCMC\Ambulance Service\Martin Gutierrez Ambulance Services Agt.Race.2014.ag1.doc 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, Assembly Room, 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 In accordance with the Americans with Disabilities Act, if special q 9 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 5226, 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 ramartinez@co.weld.co.us DOCKET #: 2014-28 DATE: March 24, 2014 TIME: 9:00 a.m. APPLICANT: Berta and Martin Gutierrez 7717 County Road 31 Fort Lupton, CO 80621 REQUEST: Application for a temporary assembly of more than 350 persons on April 19 and 20, 2014 (alternate dates April 26 and 27, 2014 in the event of poor weather) LEGAL DESCRIPTION: Lot B of the Recorded Exemption #3375, being part of the E1/2 of Section 28, Township 2 North, Range 66, West of the 6th P.M., Weld County, Colorado LOCATION: 7717 County Road 31, Fort Lupton, Colorado 80621 (See Legal Description for precise location.) BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO DATED: March 10, 2014 PUBLISHED: March 14, 2014, in the Greeley Tribune Affidavit of Publication STATE OF COLORADO ss. County of Weld, I Desirea Larson of said County of Weld, being duly sworn, say that I am an advertising clerk of NOTICE FOR TEMPORARY ASSEMBLY '. THE GREELEY TRIBUNE,Pursuant to the Weld n the Chambersf the Board of CounCode.a ty Comm ssioners of Wetd will be held that the same is a daily newspaper of general Courty,Colorado,Weld County Administration Building,1150e0 Street,Assembly Room,Greeley,Colorado 80631,at the time circulation and printed and published in the City of specified. (f a court reporters desired,please advise the Clerk to the - Greeley, in said county and state;that the notice or Board,in writing,at react five halls prior of the the hearing. The cost-,r advertisement, of which the annexed is a true copy, of engaging a court reporter shall be borne by the requesting party. In accordance with the americans with Disabilities.act,if I has been published in said daily newspaper for special accommodations are required in order fot you to partici-pate in this hearing,please contact the Clerk to the Boards Of- consecutive(days):that the notice was published in fine et 1970)336-7215,Extension 5226,prior to the day of the hearing. The complete case fi'e may be examined'n the office of the the regular and entire issue of every number of said Clerk to the Board of County Commissioners,weld county Ad---;i newspaper during the period and time of ministration Building,11500 Street,Greeley,Colorado 8O631. Ee dames gessenttoanindividualCommisslorermay-nott�:: publication of said notice, and in the newspaper case file. To ensure inclusion of your E-Mail correspondence into the case file.please send a copy to rams- proper and not in a supplement thereof; that the rtinez.@co.weld.co.us DOCKET u: 2014-28 first publication of said notice was contained in the DATE: March 24,2014 • Fourteenth day of March A.D. 2014 and the last TIh1E: 9:00 a.m: APPLICANT: • publication thereof: in the issue of said newspaper Berta and Martin Gutierrez"7._ • ''`' bearing the date of the 7717 County Road 31 Fort Lupton,co 80621 • -'' Fourteenth day of March A.D. 2014 that said The REQUEST:Application for e temporary assembly of more than Greeley Tribune has been published continuously 350 persons on Apr,19 and 242014(alternate dates April 26 and uninterruptedly during the period of at least six and 27,2014 in the event of poor weather) • LEGAL DESCRIPTION: Lot B of the Recorded Exemption months next prior to the first issue thereof Range 66,inWest ofart f the 6th P.M,,E112 of Section County,Colorado North, contained said notice or advertisement above n,Colorado;:a • referred to; that said newspaper has been admitted LOCATION: 7717 County Read 31,Fort Lupton 80621(See Legal Description for precise location.) - - to the United States mails as second-class matter BOARD OF COUNTY COMMiSSIONERS under the provisions of the Act of March 3 1879,or WELD COUNTY,COLORADO , DATED: March 10,2014..._. a:'`` "°'" '' " ' `- any amendments thereof; and that said newspaper The Tribune • : _' is a daily newspaper duly qualified for publishing March 14,201A:...,•..::_.�,.` '.x;`c'_:'';`,..'•` _ _ • legal notices and advertisements within the meaning of the laws of the State of Colorado. March 14,2014 Total Charges: $10.80 14th day of 1 arc L 14 V My Commission Expires 6/14/2017 • • 4-1/( Sr- Notary Public ROBERT LITTLE NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20014016494 MY COMMISSION EXPIRES JUNE 14,2017 RECEIPT DATE /-3/- 2Ory NO 87387 t ° ro "' RECEIVED FROM ti d wta �,J O 0 o AD RESS O� CO //'iP jYLtIL.�/V G/l IF- (Vac , $ / .(7Q 8 o o = FOR , -i-rt caicvi,y a_vdd k PAbra J'`- "O t2 co D (/ m O a: HOW PAID Oa. O if; CASH ; � 1/66 -a(4 CHECK �e® BY a ' \r' MONEY \' ORDER U.S. Postal.ServiceTM a CERTIFIED MAILTM RECEIPT m (Domestic Mall Only;No Insurance Coverage Provided) ED For delivery Information visit our anisette at www.eepe.00me 1T' a L Postage Y'm a�,l 3.,97. 12-1 Certified Fee O Foci hark Q Return Hecept Fee Ht (Endwsernent Required) a Ace I n,YCd❑oi,vetY FCe I D— (Er-du rsemer t Reequed, TnM WM. CI I rt.i RE, 1 K FC I S I �� y�/�� /)I M ,f- (] I I f bee Apt No.r n�t ^� /� .PO2 No T I ill/ CA 31 co 8o�al irttermeLBtt ) l w+on, • SEN'E•: C•M•LETE TH/S SECTI•N C•M•LETE THIS SECn•N •N•ELIVE•Y • Complete items 1,2,and 3.Also complete A Signature item 4 if Restricted Delivery is desired. 17. ,v-� / t ■ gent ■ Print your name and address on the reverse / ■ Addressee so that we can return the card to you. R. Received by(R• -d Name) C. Date of Delivery • Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? O Yes 1. Article Addressed to: If YES,enter delivery address below: O No .-4 '1an-�t, M6V-iLL0 GDS '7'7Ir7 CR. 31 It. l.u.pi-an, CO 0o(-Pal 3. Service Type IN Certified Mail O Express Mail ❑Registered 0 Return Receipt for Merchandise ❑Insured Mail O C.O.D. 4. Restricted Delivery?(Extra Fee) O Yes z. Article Number 7004 2890 0003 5709 0321 (Transfer from service labe° PS Form 3811,February 2004 Domestic Return Receipt 102595.02-M-1540 Hello