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Agenda 01/14/2014 Item # 16A12 1/14/2014 16.A.12. EXECUTIVE SUMMARY Recommendation to approve a permit to conduct the annual Ziggy Dicks Barbeque, Musical Festival, and Carnival on January 17th, 18th and 19th, 2014 located at the Golden Gate Community Center, and to recommend waiver of the Surety Bond in the amount of$2,500 for the event. OBJECTIVE: Recommendation that the Board of County Commissioners (BCC) approves a permit to conduct the annual Ziggy Dicks Barbeque, Musical Festival, and Carnival on January 17th, 18th and 19th, 2014 and waives the Surety Bond in the amount of$2,500. CONSIDERATIONS: Jeffrey Siegal, President of The Rotary Club of Naples Bay Foundation, has made application to the BCC for a permit to conduct their annual carnival. The carnival will be held at the Golden Gate Community Center and will include mechanical rides, food & beverage booths to include popcorn, assorted soft drinks, cotton candy, candy apples, funnel cakes, snow cones and pizza, as well as beer and wine. A County Parks and Recreation Beer and Wine Permit has been received and approved by the Parks and Recreation Department. The Rotary Club of Naples Bay Foundation has presented sufficient evidence that all criteria has been met for the issuance of a carnival permit. The required insurance amount of$1,000,000 has been purchased and Collier County is included as an additional insured. The Rotary Club of Naples Bay Foundation is a not-for-profit entity. In keeping with past practice, the County has waived the Surety Bond requirement for other not-for-profit agencies applying for carnival permits. FISCAL IMPACT: The application fee of $375.00 has been paid by the applicant. This fee includes $100.00 for Fire Plan review and $275.00 for Zoning. A facility rental fee in the amount of$2,160 has been paid to the Golden Gate Community Center by the Rotary Club of Naples Bay Foundation. GROWTH MANAGEMENT PLAN IMPACT: There is no growth management plan associated with this Executive Summary. LEGAL CONSIDERATIONS: This item has been approved as to form and legality and requires majority vote for approval. —CMG RECOMMENDATION: Staff recommends that the BCC approve this permit for the Rotary Club of Naples Bay Foundation to conduct the annual Ziggy Dicks Barbeque, Musical Festival, and Carnival and waive the Surety Bond requirement in the amount of$2,500 for this not-for- profit entity. Prepared By: Claudine Auclair, Business Center Manager Growth Management Division, Planning& Regulation Operations & Regulatory Management Attachments: 1) Application; 2) Site Plan; 3) Letter from The Rotary Club of Naples Bay Foundation requesting Waiver of Surety Bond; 4) Letter from Sheriff's office 5) Letter from the East Naples/Golden Gate Fire Control; 6) Waste Management Backup; 7) Insurance Certificates and Certificate of Exemption 8) List of rides, food and beverages 9) Alcohol Beverage approval stipulation 10) Ron Jons Port-a-Potty invoice 11) GGCC Agreement Packet Page -542- 1/14/2014 16.A.12. COLLIER COUNTY Board of County Commissioners Item Number: 16.16.A.16.A.12. Item Summary: Recommendation to approve a permit to conduct the annual Ziggy Dicks Barbeque, Musical Festival, and Carnival on January 17th, 18th and 19th, 2014 located at the Golden Gate Community Center, and to recommend waiver of the Surety Bond in the amount of$2,500 for the event. Meeting Date: 1/14/2014 Prepared By Name: PuigJudy Title: Operations Analyst,GMD P&R 12/19/2013 9:43:42 AM Submitted by Title: Planner,Principal,Transportation Planning Name: AuclairClaudine 12/19/2013 9:43:44 AM Approved By Name: PuigJudy Title: Operations Analyst,GMD P&R Date: 12/19/2013 1:12:01 PM Name: BosiMichael Title: Manager-Planning,Comprehensive Planning Date: 12/19/2013 1:17:46 PM Name: FrenchJames Title: Director Date: 12/19/2013 1:52:30 PM Name: BellowsRay Title: Manager-Planning, Comprehensive Planning Date: 12/19/2013 4:53:31 PM Packet Page -543- 1/14/2014 16.A.12. Name: AuclairClaudine Title: Planner,Principal,Transportation Planning Date: 12/20/2013 10:33:07 AM Name: GreeneColleen Title: Assistant County Attorney,County Attorney Date: 12/20/2013 11:26:05 AM Name: MarcellaJeanne Title: Executive Secretary,Transportation Planning Date: 12/26/2013 1:36:48 PM Name: KlatzkowJeff Title: County Attorney Date: 12/26/2013 2:44:01 PM Name: FinnEd Title: Senior Budget Analyst, OMB Date: 12/30/2013 5:16:34 PM Name: OchsLeo Title: County Manager Date: 1/6/2014 10:02:53 AM Packet Page-544- 1/14/2014 16.A.12. CiAtier County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION/ NAPLES, FLORIDA 34104 PLANNING AND REGULATION (239)252-2400 FAX (239) 252-6358 www.colliergov.net CARNIVAL OPERATION PETITION PROJECT NUMBER Ziggy Dicks BBQ, Music Festival & Carnival PROJECT NAME CARNY - PL20130002571 DATE PROCESSED Date: 12-09-2013 Due: 1-13-2014 APPLICANT/OWNER INFORMATION ' PETITIONER'S NAME: 0 /31"/ (71 / (t7 7 1/111( PETITIONER'S ADDRESS: kit)Ufi is-6 3 o 6 TELEPHONE: - L( - s C4.-1 FAX: PETITIONER"S E-MAIL: ____ 67'4, f 99( PROPERTY OWNER'S NAME: ' c C; r". \rim_0-1', \j 1Ir PROPERTY OWNER'S ADDRESS: 4fl . TELEPHONE: ):: F-1 - 251 - SC,„ FAX: -' - 1 OWNERS'S E-MAIL ADDRESS: (j2 t t-ooL4 oc9c) PROPERTY IN:FORMATION , — LEGAL DESCRIPTION OF SUBJECT PROPERTY H - GENERAL LOCATION: L471A 1Th C."-n CURRENT ZONING: L/"-- v1) e NATURE OF PETITION: L1 I UL „LA,ALCIAA C.-.(711-14 6\10 KA- a46‘, i - ioI October 13,2010 Packet Page -545- 1/14/2014 16.A.12. Coiber County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION! NAPLES, FLORIDA 34104 PLANNING AND REGULATION (239)252-2400 FAX (239)252-6358 www.coliiergov.net EVENT INFORMATION HAS THIS EVENT BEEN HELD IN COLLIER COUNTY IN THE PAST? C Yes No IF YES, WHEN? WHERE? WAS THIS EVENT PREVIOUSLY HELD IN THIS SAME LOCATION? ❑ Yes No THE FOLLOWING INFORMATION IS INCLUDED IN THIS PETITION. (FOR EXPLANATION, SEE NEXT PAGE.) E 3.a. n 3.c. ❑ 3.e.1) fl 3.e.3) ❑ 3.e.5) ❑ 3.e.7) ❑ 3.e.9) ❑ 3.b. ❑ 3.d. ❑ 3.e.2) ❑ 3.e.4) ❑ 3.e.6) ❑ 3.e.8) Comments: t r Signature of 'e =e ,, 1 Approved: ❑ Not Approved: ❑ Date: Conditions of Approval, if any: SIGNATURE OF COUNTY MANAGER DESIGNEE k October 13,2010 Packet Page-546- eY County 1/14/2014 16.A.12. Co COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION/ NAPLES, FLORIDA 34104 PLANNING AND REGULATION (239) 252-2400 FAX(239) 252-6358 www.colliergov.net I INDIVIDUAL BOOTH NOTIFICATION FORM FOR TEMPORARY EVENTS I , Name of Event: 1(-- )\-1 ‘_J k� .i \ .,_ vu ., ( Name of Booth: SI .'" t • .:',C'k S -- t Lt i,ur € igSe C I . A'C.f Person in Charge of Booth: $v an Mc C i C Types .f Food or Beverage to be Served: ":�)C 1-.) i ;µ. . tc e' . :;' ., ct / , ( 1, .L' C - Florida Administrative Code, Chapter 10D-13 requires all food to come from an approved source. All food storage, preparation and utensil cleaning for this event shall not be done in private homes. Location of advanced food preparation: ( '. (CO- t_i'`1' cq -Ern , t ?r_s How will food be transported to event location? So!; (cal t t t �--f-,-c. ,i a Method of keeping food hot and/or cold at event site ," ( ' j e..s-r ; it I11 Method of cooking food at the location. ``- .- - .tt Food must be protected from dust, insects, flies, coughs, sneezes. How will you provide this protection? Describe type of structure: (- :r ; Cr ;"') t.t It t I. Adequate facilities and supplies shall be provided for m loyee handwashing. How will you provide this? 0 , �`i -. (k ( - (1 °°'4 I � 0. Y.. For Information and Assistance contact: Environmental Health & Engineering Department- (239) 252-2499 Failure to comply with applicable food service requirements in accordance with Chapter 10D-13, Florida Administrative Code, may result in enforcement action. Do you understand this completely? YES 35,_ NO ❑ I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith. I understand that these regulations include food intended for service to the public regardless of whether there is a charge for the food. I agree to assume responsibility for this estalishment and I certify that said business will be conducted in compliance with t Florida Administrative Code, Chapter 10D-13. ( :11C :;// '2 Signature •. ijcant Date - October 13,2010 e Packet Page-547- 1/14/2014 16.A.12. Corner Co dtnty COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION/ NAPLES, FLORIDA 34104 PLANNING AND REGULATION (239) 252-2400 FAX(239) 252-6358 www.colliergov.net SPONSOR NOTIFICATION FORM FOR TEMPORARY EVENTS I 2( Cy Di( Name of Event: .� I c 'c s yr t ( Address of Event: "7OI 6cl4enc--v t C.v-ku„•0 . Date(s) of Event:, Cv) - \ 19 1 204 I Hours of Operation: - - ,-,1-1i > Sots 14;h1(f' 2 1 rcau� -K�r ry Sponsor of Event. ' c.� x C-.a (1_ '‘ ' i S . IC (�'C°} [ `-/ Address of Sponsor: 1+7C-)( 6 614 en Gn 'Fe (�C`cc k{�< i Person in Charge of Food Service: "!CA.1. Mc y 1st Phone: -72(4) " S , - Gt - Number of Food and Beverage Booths: IC, Estimated number of attendees expected at the event at one time? r) Number of toilets to be provided: Portable: Male X Females . Permanent: Male Female Method of toilet waste disposal: -,', Describe method of liquid kitchen waste disposal: t ,_:('<)-C c�;ACI-S.E\14,t0 Describe containers and method of solid waste disposal (garbage): ...1-.,y c ci S,w Number of solid waste disposal containers provided: Describe facilities and method of hand-washing: . :x:,q` trite i. ; Describe facilities and method of utensil washing, rinsing and sanitizing: Iv*,i ,*r ,1s- ,G Source of potable water: ' i s(46) For Information and Assistance, contact: Environmental Health & Engineering Department— (239) 252-2499 As the sponsor of this event you are responsible to notify all food vendors of the temporary food service requirements. Failure to comply may subject the booths to be closed for public health reasons. Do you understand this completely? YES - NO ❑ P I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith. I understand that these regulations include food intended for service to the public regardless of whether there is a charge for the food. I agree to assume responsibility for this establishment and I certify that said business will be conducted in compliance with the lorida Administrative Code, Chapter 10D-13. I/ i j , Signature of�A i.ant Date ' ? October 13,2010 --- Packet Page -548- - 1/14/2014 16.A.12. I � �. � � � °„ �`n � � ;� �+. � �1 r *3 'fir �. �` 1 r s Full Name of Applicant Organization The named applicant for a license/permit has complied with the Florida Statutes concerning registration for Sales and Use Tax and has agreed to pay any applicable taxes due. Date Signed Title Department of Revenue Stamp: / „' .� 'd a t».gs:xs. fig $.. rs s & a Y "-: xc # %7777 7""4;4 y, , ". g� .�' ,6,5 ""`s :�d a r° '' �°f ti p . )6� � .. . �i ,,5:7 'p` , Location of Event(Street and Number} 4701 Golden Gate Parkway City County Naples Collier The location complies with zoning requirements for the temporary sale of alcoholic beverages pursuant to this applytion for a One/Two hre Day Permit. Si ne Date f�- q I 1 Title(US�rJ ' rs erp,-�1 Msszf•.E;1� 41 1 F TltG EVE.)'C i S A -1 r � p,Y `iif E & coos,�,ST Y ecc on c SS f 5 p`t!I r te/,E 2.M e GU1 Lt- S S E UC?r D iI. Note: College fraternities and sororities must meet certain additional conditions which can be found in the application instructions and requirements. Auth: 61A-5.9013,FAC Packet Page-549- 1/14/2014 16.A.12. -iei County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION/ NAPLES, FLORIDA 34104 PLANNING AND REGULATION (239)252-2400 FAX (239)252-6358 www.colliergov.net Excerpt from Ordinance No. 2006-016 3. Application and Fee for Permit. A minimum of thirty (30) days before occupying the carnival or exhibition site, an application for a permit shall be submitted to the County Manager or his designee in four(4)copies accompanied by: a) A surety bond in the penal sum of $2,500, issued by a company authorized to issue such bonds in Florida, conditioned upon the operator complying with each provision of this Ordinance and subject to forfeiture under the terms provided in Paragraph 10 herein below. b) Evidence of current public liability insurance coverage, issued by a company authorized to do business in the State of Florida, in the minimum amount of$100,000 for any one person and $300,000 for any one incident. c) A non-refundable fee in accordance with the current adopted fee schedule for the following: 1) Permit Processing 2) Fire and Safety inspections; and 3) Electrical and Structural Inspections A000. d) A current occupational license issued by the Collier County Tax Collector, and e) including the following information: 1) The name and headquarters address(es) of the carnival or exhibition company(ies) with a direct or indirect financial interest; name(s) and address(es) of any sponsoring organization(s), and the name and local address of the applicant representing the carnival or exhibition company(ies); 2) A description of every activity to be conducted such as but not limited to, menageries; circus and side-show performances; amusement, merry-go-round and other ride activities; food and drink dispensing facilities; booths for conduct of games of skill or chance not prohibited by State law to be open to the public for an admission or participation fee and number of persons to operate the activities; 3) Name and identification of each person accountable for the operation of each activity; 4) A description and sketch of the site showing the location of each activity proposed, the location and number of sanitary facilities; parking facilities, and provision for lighting and public water; 5) Application for Food Establishment Operating Permit from the County Health -' Department as required by Ordinance No. 74-45. October 13,2010 Packet Page-550- 1/14/2014 16.A.12. ier County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION{ NAPLES,FLORIDA 34104 PLANNING AND REGULATION (239)252-2400 FAX(239)282-6358 www.coIliergov.net 6) The plan for refuse, garbage, debris, and sewage disposal during and after operation of the circus or exhibition; 7) Provisions for traffic control,fire safety and security precautions; 8) The date and time each activity is to be conducted and concluded; 9) Written approval from the owner of the property authorizing the use of his premises for such carnival activity; October 13,2010 Packet Page-551- 1/14/2014 16.A.12. jeffrey Siegal From: BMorri9495 @aol.com Sent: Friday, December 06, 2013 11:23 AM To: jeffrey1991 @embarqmail.com Subject: Re:application Hi Jeffrey, The following is a list of rides we anticipate bringing: Hurricane, Rok'N Rol, Sizzler, Raiders, Dizzy Dragon, Spider, Giant Slide, Hy-5 Ferris Wheel, Beach Party, 1001 Nacts, Flying Elephants, Yo-Yo, Tea Cups and Scooter. Due to your food booths, we are planning to bring only popcorn/cotton candy/candy apple/sno-cone trailer and funnel cake/ice cream trailer. We could also provide a pizza trailer if needed Brian Modern Midways In a message dated 12/6/2013 8:26:41 A.M. Eastern Standard Time, leffrev1991 4embaramail.com writes: Good day to you. I am in the midst of filing an application to Collier County. It is a carnival operations application. Some answers I need are: list of potential mechanical rides and list of potential food concessioners. Please respond soonest as I need to go to zoning on Monday. Jeffrey Siegal AWN 1 Packet Page-552- 1/14/2014 16.A.12. \ _ _ — ----- — — — — 50711 SWEET SW { 1 + , r r ■ , { { + 1 f { l { / / .----- r x I li r r , I 4 i ".� SSiN 7oxAa VW I / /-0 ... ,,,.. 4,44:t4t,e.:. .,,, if r lrrrr Z��.1 :`., I it}. /i ft, ter,`v,� r' ] / f // Z` \i i ��,�: its ` \ f '\��/i�a A 5 `,\J ,a ttt�i i t\ ♦ iii 7 �,J``a f > \ ,`, 0� at /ice )n i ,t :e�� .lr!Y�'�f'a / l/ {4,. ii:, ,,,, E . i'i , ▪ 4.. ' , )‘ ..., 6.,N ec 4,..,d.:11 rifo:" oiN IF ., v, a, a ,.. , ,a ,a , rF.sJ. t>w ■ \� • , ,,"... i s , /� i �3„ ,,, , ,” so, s ,„., ...,ate,, - .‘• • .. ,;:,i,,,, ,, .. -, ,i.e(? -. "■. •`‘ .'‘,./;:A '‘i''',41414.Vie'yo-.‘, d ` 7 lam ,` \\ `�` \ XI 0 .\„,,,,., ,00 2,,,,,,,,,,,..., „,,\\ ,„.1,..„.7,..,:,,,, ,,„ - . \ _ >ai - 1‘,,,• „o ,$) ..,\ ,,ii,si,44,..,. .roct; >'" • ' 1‘ ' \ \ \ VP",..;14.....:,,.. ,,ft.to 1Q \t\\t ttt. t`t t`\tea 6:,,.._ _„i�'�� ~' r- --? cn Packet Page-553- k 3 1/14/2014 16.A.12. I > ) Z L---- t --"----,..,.„..„,, / �. / : \ N. 1 Jz - - ;r I/ y ` i \ N / z ° CI C71-1...,./ - \\e',\ ‘,//' \ C\ s110‘\\ \\ ,.;;;,,„,. . . `1. le.\ ,''' / s N'O'\ \- 1/4-\\ N �iA \\\ rl \\ `� \\ �/ \\ \ .,,,.\ ,067 %/ \\� r_ !I- L WATER MANAGEMENT '/'' mA \\ Ili L i i \\`47-) "8-'7 \\ \ 1-- . l'), 194 it t.\\ ,e,.., v.,..m , ,. ... „ ....\\ . . , \,,,,,.....,„ ... ,,,......\\ ... . E --9 k 1s, 4' ,,,;('/7"ir. .\. \ / \ J } � i"....,r \-,1 \, , ,„..,e.'" \, \ \\ \\ � s \\>,„\„,\ ,, ...,, , „ , .\ d pl \ r M'• .),,.\\/> \ \\'-,,,.\ _\) \\\\,,,,,-x/V\--. .- ) 7 7 .. . . .---------_,„\( '0> • \\/7 \\ `\\` '\\:.\\ " \\\e"--,) \\\ '�^�\\` \\\ '�'` \•\'\) \ Packet Pale-554- l L�--- �r- 1/14/2014 16.A.12. Rotary Club of Naples Bay Foundation P.O. Box 1852 Naples, FL 34106 A 501c3 Foundation 239-404-9300 Naplesbayrotary.org December 6, 2013 Paula J. Brethauer Business Center Project Coordinator Collier County Government Growth Management Division/Planning and Regulation 2800 North Horseshoe Drive Naples, FL 34104 Re: Ziggy Dicks BBQ and Music Festival,January 17-19/ 2014 Dear Ms. Brethauer: The Rotary Club of Naples Bay Foundation a 501c3 Foundation is seeking a waiver for the above mentioned event and ordinance regarding the surety bond. We are in the process of completing the carnival application. Thanking you in advance for your help and attention to this important matter. Than in,_ ou i r, t i gi esident Packet Page-555- 1/14/2014 16.A.12. .'""' SHERIFF KEVIN J. RAMISOSK "'C'Vvr lrf.fiRTfil f FY December 3, 2013 Rotary Club of Naples Bay Foundation 35 Hastings Place Naples,Florida 34104 Attn: Jeffrey Siegal, President RE: Security for upcoming events To Whom It May Concern: This is to advise you that the Collier County Sheriffs Office is prepared to provide security for the following upcoming event: 1. Ziggy Dicks BBQ and Music Festival Golden Gate Community Center—4701 Golden Gate Parkway Naples, Florida 34116 January 17, 2014 1600-2300 2 Deputies for Security January 18, 2014 1000-2300 2 Deputies for Security January 19, 2014 1000-2300 2 Deputies for Security If you have any questions,please contact me at (239) 252-0016. Sincerely, Commander Bill McDonald Patrol Division Collier County Sheriff's Office MLJ/eeb Packet Page -556- 1/14/2014 16.A.12. A P44.0 EAST NAPLES - GOLDEN GATE nor 44rollai,t, FIRE CONTROL AND RESCUE DISTRICTS FIRE AND LIFE SAFETY HEADQUARTERS .�+ e_ 4798 Davis Boulevard• Naples,FL 34104 r'' {' Phone: (239)774-2800 Fax: (239)774-3116 Sloe Hem nnn.Chairman Kingman S.trn`ilt,.Fire Chief David Stedman, Chairman ran December 4,2013 Rotary Club of Naples Bay Foundation 35 Hastings P1 Naples,FL 34104 Attn: Jeffrey Siegel Dear President Siegal, Golden Gate Fire and Rescue District has received your date of your event,January 17-19, 2014, located at 4701 Golden Gate Parkway, Golden Gate Community Center. In order to provide a proper fire safety inspection, all vendors and rides shall be placed per the approved layout;you must provide the layout to be approved by GGFD and must allow sufficient time to conduct the fire safety inspection and for you to make any necessary corrections prior to the opening of the event to the public. All inspections that are required by other agencies shall be conducted prior to your fire inspection and documentation of compliance shall be provided. Examples of other agencies include Department of Agriculture, electrical inspections (Collier County) and any other inspections that are required for your event. All violations that are marked by the fire inspector must be corrected before a notice of fire compliance can be issued. Please note that a notice of fire compliance is required in order for your event to take place. The inspector will use the Florida Fire Prevention Code Book 2010 edition and any relevant National Fire Protection Association(NFPA)codes adopted by the state of Florida. You must pass the inspection in order to open to the public. It is your responsibility to organize a date and time for the fire safety inspection. Our inspection business hours are Monday thru Friday 7:00 am to 5:00 pm. A time requested before or after hours will result in overtime fees. Re-inspections resulting from failure to correct violations will result in the assessment of re-inspection fees. All fees shall be paid before a notice of fire compliance can be issued. If you have any questions, please contact me at you leisure. Thank you in advance for your cooperation. Sincerely, Barb Sibley Fire Inspector Packet Page-557- 1/14/2014 16.A.12.VI .it¢Y TEMPORARY ROLL-OFF AGREEMENT %MAIM" .«,� • I ACCT# 1 NBT 033- Waste Management Inc of Florida 4500 Exchange Avenue Naples,FL 34104 Phone(239)253.6350 Fax(566)233-5275 m DELIVERY DATE COMPLETION DATE ACCT.NAME Naples Bay Rotary Club 1103/13 Thursday Monday SERV.ADDR 4701 Golden Gate Pkwy. 1, i 1 CITY,ST ZIP ! Naples, FL 34116 TYPE OF WASTE Clean Up COUNTY Collier TEL 5 239-571-3504 ' FAX ; 239-643-0550 BILL TO ACCT#033 LIBRARY CONTACT ! Bill Jones PAYMENT TYPE:$1,000 CREDIT 'aw' '' FF:FSC/EV FEE: EXP FREQ:0 f OPEN SIC CODE:15 DISP SITE:$C1 MUNI:NNFhIC BILL NAME No MIP or MNT. The Rotary Club of Naples BILL,ADDR1 3500 Radio Rd. Deliver to Golden Gate Park. Call ahead to Blll 571.3504 to meet 1 i CITY,ST ZIP Naples,FL 34104 for placement. IIEZJIIIIII 239-643-$100 CONTACT Bill Jones _ Qty Size I Haul Rate/Flat Rate •I Delivery i Rent Charge Daily Disposal Charge Tonnage Cap j Overage Charge MIN Haul 3 j F20 $130.00 Waived N/A $57.66/Ton ( N/A N/A i ' ! Exempt I 1 I I Blocked Container Fee:$90.00 Unsafe to Haul Charge:$90.00 Subject to fuel surcharge&environmental fees,Contaminated C&O Loads:$302 24 Haul plus Applicable Disposal Charge. TERMS AND CONDITIONS Chemise and Payment. Customer shall pay Contractor for the collection Eeutament. A) Responsibility. The equipment furnished hereunder by and disposal provided by Contractor including any dugout. respot, blocked Contractor shall remain the property of Contractor, however. Customer container and/or excess disposal charges levied, but not prepaid by acknowledges that it has care,custody and control of the equipment while at Customer In accordance to the schedule of charges shown on the top the Customer's location and accepts responsibility for all loss for damage to portion of this agreement.For all amounts billed.payment shall be made by the equipment (except for normal wear and tear or for loss or damage Customer within ten (10) days after receipt of an invoice from Contractor. resulting from Contractor's handling of the equipment)and for its contents. Contractor may impose,and Customer agrees to pay.a late tee of 1e%per Customer agrees not to overload (by weight or volume). move or alter the annum or. it less, the maximum rate allowed by applicable law on all past equipment. and shall use the equipment only for its proper and intended due payments. In the event that any payment is not made when due, purpose. Customer agrees to Indemnify, defend and hold harmless Contractor may,at his sole option,terminate services,recover all past due Contractor against all claims.damages,suits.penalties,fines and liabilities payments and recover any equipment from the premises. for injury or death to persons or loss or damage to property arising out of Waste Material. Customer represents and warrants that the materials Customer's use,operation or possession of the equipment. placed in the equipment shall be'Waste material"as defined herein anti shall B)Access.Customer agrees to provide unobstructed access contain no other substances, The term "waste material" as used in these to the equipment on the scheduled collection day if the equipment is Terms and Conditions shall mean solid waste generated by Customer inaccessible to that the regularly scheduled pick up cannot be made excluding radioactive. volatite, highly flammable. explosive, biomedical, Contractor will promptly notify the Customer and afford the Customer a Infectious `___"` °^d^„e material'shall reasonable opportunity to provide the access and reschedule the service, include b tied as however. Contractor will charge an additional fee as provided for In the hazardor. '1 / or any schedule of charges as shown on the top portion of this agreement, for statestate a tidd .1 Z�6'/f 3 /Ac to Customer's failure to provide initial access. mi title to Attorney Fees.In the event of breach of the Agreement by either party,the breaching party shall pay all reasonable attorney's fees and costs of the and liabi o= net and , any q Agreement.In the Custom(' 3 v k t-N a�i s 41rmleas other party incident to en action brow.ht to enforce this Contract , and event Customer fails to pay Contractor all amounts which become due under Contract this Agreement.Customer agrees to pay,In addition to the amount due,any Drivew if.- -r* bt ice¢/Yh 'right of and all costs incurred by Contractor as a result of such failure to pay, way pro _ to bear including to the extent permitted by law,reasonable attorney fees. tea. gaited to gxcused Performance.Neither party hereto shall be liable for its failure perform 3 _-- "�� W :sibte for to perform or delay performance hereunder due to contingencies beyond its damaw ----"- Ing sub- reasonable control including,but not Smiled to strikes.riots,compliance with surface e herein laws or government orders, Inability to access container, fires, and acts of contras t e driving god and such failure shall not constitute a default under this Agreement. surface L. :site. r v.Gust Waste Management Representative_____ Date Date 12/03/12 Name Print Sena Van Ness#203 MARGINALS Packet Page -558- #3391-002 RECEIVED FROM: [00- 1:117t= :1‘0?1:1 (I:• ,N11.1:):121 t 0 i:I 1:107.•90; I 055ut:r.wo 1/14/2014 16.A.12. RON'S JONS PORTA POTTY RENTALS 2525 70th St. SW r 0 S Invoice r:n Naples. FL 34105 4, Rent-A-Potty Nip-r, n K;\ (239) 352-4700 \,. Fax# 239-793-6723 Date 12/6/2013 E-mail: ronsjonsportapolty .:orricatitet Invoice# 18325 Bill To Job Location Rotary Club of Naples Bay GC:. Community Center Golden Gate Community Park Naples, Fl 33916 Terms Due on Receipt PG Number Quantity Description I Price Each Amount 12;Spezial Event l'orta Lt L nit 40 Of) 480 K1 Service 1.'13- l'20 2 Handicap unit:ery ice on time a..ve21.; 55 CO 110141 Ser.ice Dale : 21Free Standing Sink 55 00 I 10 00 •Servic::Da:es: 14 Service Per 1:ni! 20 00 ')ItO 00 Service DateN: • • IThank you for your business! Total S980.00 Service Area Marco Island to Tampa Cover-All dba Rcns Jon's .:;rta Poly Rent as CZ:Z.9-C6L-6CL' Packet Page -559- 2L9£616£Z 299: Cl 90 1/14/201416Al2. Ac �...-,,, CERTIFICATE OF LIABILITY INSURANCE � 12/05/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS I CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES I BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED Rte, I REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 1-425-454-3386 CONTACT Joanne Manion __ _ Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX .LA!C No,Ext)_425-454-3386 LiAUC,No): 4 4 P.O. Box 367 E-MAIL ADDRESS* .._. .... _._....._...___........ .... ..... ..... .. ... Bellevue, WA 98009-0367 �_____INSURER(S)AFFORDING COVERAGE NAIL# INSURER A: T•H•E. Insurance Company ;INSURED INSURER B: ............... ... .._......... .... .. . ........ .... ;Briggs Transport, Inc. Modern Midways, Inc. INSURER C: 22901 Sherman Road INSURER D: __Y Steger, IL 60475 INSURERE. INSURER F COVERAGES CERTIFICATE NUMBER: 37203.021 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MSR—._______._._..,__ "ADOLISUBR'_._._—_ . .............................. .........POLICY EFF POLICY EXP I LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMJDD/YYYY1 (MMIDDIYYYY) { A GENERAL LIABILITY CPP010090203 04/03/13 04/03/141 EACH OCCURRENCE . $ 1,000,000 ^ DAMAGE."f('7 RENTLO –.— .._. j X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 100 000 X n) $so MED EXP(Any one person) CLAIMS-MADE OCCUR PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000 000 GEP I AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG :$ 1,000,000 �' POLcCY 7F-,-_,‘-;_ ',or;. $ A AUTOMOBILE LIABILITY ;CPP010090203 04/03/13 04/03/14. COMBINED SINGLE LIMIT 1,000,000 I oPPBR ANY AUTO BODILY INJURY(Per person) S ALL OWNED ' SCHEDULED BODILY INJURY(Per accident) $ i AUTOS ,. I AUTOS NON-OWNED ' PROPERTY DAMAGE $ (Dgr ancutePt!.. _ HIRED AUTOS 1 AUTOS 1 $ A UMBRELLA LIAB SIX OCCUR ELP001021004 04/03/13 04/03/14 EACHOCURRENCE 54,000,000 X EXCESS LIAB CLAIM S-MADE', :AGGREGATE s 4,000,000 000,000 .�-�DED ! 1 RETENTIONS 0 _..__ $ WORKERS COMPENSATION '.WC134324 10/29/13 10/29/14, XI W STATU [ LOTH• A AND EMPLOYERS'LIABILITY YIN t ..... TL)R.Y L!N T$ _..._ER ____. ._._. ...._.. ANY PROPRIETOR/PARTNER/EXECUTIVE I N f A . E.L EACH ACCIDENT 5 1,000,000 OFFICER/MEMBER EXCLUDED?(Mandatory in NH) E L DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under ......._ ........__._ _..__ .. .... DESCRIPTION OF OPERATIONS oeiow : E DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS(LOCATIONS I VEHICLES (Attach ACORD 10/,Additional Remarks Schedule,it more space is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Collier County Growth Management Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12800 N. Horse Shoe Drive AUTHORIZED REPRESENTATIVE %Naples, FL 34104 , % G' ;-ft'1 USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name anrt Inn arm renistered marks of ACORD j°manion Packet Page -560- 1/14/201416Al2. Ac D CERTIFICATE OF LIABILITY INSURANCE t THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES -LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED L PRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME_.,.,._ Lockion Companies LLC r ._.�. LOCKTON COMPANIES,LLC-K CHICAGO PHONE 1-800-921-3172 ja,_)fo) 1-312-681-6769 SArc,-N2 Ertl 525 W.Monroe,Suite 600 E-MAIL Rotarvialockion com CHICAGO,IL 60661 a>?anESS..... (312)669-6900 _ INSURER(S)AFFORDING COVERAGE NAIC If INSURER ACE American Insurance Company 22667 INSURED INSURER e__... ACE Property&Casualty Insurance Co 20694 All Active US Rotary Clubs&Districts Attn:Risk Management Division INSURER c• 1560 Sherman Ave. INSURER 0 —_— .._...._ Evanston,IL 60201-3698 INSURER E........___._.. INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INDICATED CERTIFY NOTWITHSTANDING ANY IREQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOLWHICH PERIOD 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 ,.. -.,_... ..--....._......__............._.._.._..._._....._ ....POLICYEFF pOL)CYEXP iiLTR _.- �IADDL WLeD POLICY NUMBER (MMIDD/YYYY)I(MM/DD/YYYY) LIMITS LTR I TYPE OF INSURANCE !INSR WVD A I GENERAL UABIUTY N PMI G23861355 005 7/1/2013 7/1/2014 EACH OCCURRENCE Is 2,000,000 f OAFAA�€TiSREN'I`ED � 5....._500 000._.. X COMMERCIAL GENERAL LIABILITY PREMISES(Es occurrenpel .---f CLAIMS-MADE X OCCUR `MED EXP(Any one person) $ XXXXXXX ;X Liquor Liability PERSONAL&ADV INJURY $ 2,000.000 Included GENERAL AGGREGATE i$ l0000.000 GEN'L AGGREGATE LIMIT APPLIES PER i PRODUCTS-COMP/OP AGG '$ 4.000.000 -� POLICY ! .PirRr r t.00 COMBINED SINGLE LIMIT $ 1.000,000 AUTOMOBILE LIABILITY N PMI G23861355 005 7/1/2013 7/1/2014 a a d DDnc)...____E_._.. .._ BODILY INJURY(Per person) $XXXXXXX ALL ANY AUTO '� " • AUTOS AUTOS BODILY BODILY INJURY(Per accident) $ XXXXXXX. ... ` NON-OWNED PROPERTY DAMAGE $ XXXXXXX(Per accident) I X HIRED AUTOS AUTOS i $ XXXXXXX B X ,UMBRELLA UAB X I OCCUR N M00534092 003 7/1/2013 7/1/2014 EACH OCCURRENCE '$ 5,000,000 I AGGREGATE 1$ 10,000,000 EXCESS LIAR ! CLAIMS MADE '— DED I I RETENTION$ !$ XXXXXXX WORKERS COMPENSATION NC , OTH- NOT APPLICABLE TORY..LIMITS._ .....:_ER._.... AND EMPLOYERS'LIABILITY E.L..EACH ACCIDENT $ XXXXXXX Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE :NIA ' � � OFFICER/MEMBER EXCLUDED' E L DISEASE-EA EMPLOYEE $ XXXXXXX■ (Mandatory in NH) --._ If yes.describe under ` DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ XXXXXXX I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) The Certificate Holder is included as Additional Insured where required by written and signed contract or permit subject to the terms and conditions of the General Liability policy,but only to the extent bodily injury or property damage is caused in whole or in part by the acts or omissions of the insured. CERTIFICATE HOLDER CANCELLATION Collier County Growth Management Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2800 N.Horseshoe Drive THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Naples,FL 34104 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and Irmo are registered marks of ACORD Packet Page -561- 1/14/2014 16.A.12. . • , 000(tOdS iiilt./). tOtc,19A DR-14 Consumer's Certificate of Exemption i R.04/11 Issued Pursuant to Chapter 212 Florida Statutes DIVARImtF4T CIF REVI NIUE e5-sa15765B4CC-9 11/04/2011 11/3012016 501(C)(3)ORGANIZATION Certificate Number :fiec,!;ve tlate Expiration Date Exemption Category This certifies that ROTARY CLUB OF NAPLES BAY FOUNDATION CORPORATION 720 GOODLETTE RD N STE 203 NAPLES FL 34102-5656 is exempt from the payment of Florida sales and use tax on real property rented,transient rental property rented,tangible personal property purchased or rented,or services purchased. • LeKi ' DR-14, Important Information for Exempt Organizations R.04111 lIE 1. Ycx..;must provide all vendors and supplreis welt an exemption certificate before making tax-exempt putchases, See Rula 12A-1.030,Florida Adrrfnistrative Code(FIA.C.). 2. Your Consumers Certificate of Exemption is to be used solely by your organization for your organization's customary nonprofit activities. 3. Purchases made by an individual on behalf of the organization are taxable,even if the individual will be reimbursed by the organization. 4. This exemption applies only to purchases your organization makes. The sale or lease to others of tangible personal property,sleeping accorrmodatior.s.or other rea!property is taxable. Your organization must register, and collect and rem sales and use.lax an such taxable transactions, Note: Churches are exernct frarn this requirement except when they are the lessor of real property(Rule 12A-1.070,F.A.C.). It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for payment of the sales tax plus a penalty of 200%of the tax,and may be subject to conviction of a third-degree felony. Any violation will require the revocation of this certificate. 6. if you have queztions regarding your exems:tion certificate. please contact;the Exerrption Unit ci Account Managumen;at 800-352-3671, Fton-,tee available options,select'Registration of Taxes,"then"Registratlon Information,"and Imally"Exemption Certificates and Nonprofit Entities," The mailing address is PC) E3o),,6'480, Tallahassee,FL 32314-6480. Packet Page -562- 1/14/2014 16.A.12. f. H / p U .rte i n,a, W 1 tt�` 0.4%., `YA \\\ +\\f (\ i` V\ \\y am \\\`�,\\ 4t N d /A I/ \ ,�\ r u \ ' \ ^ \\ \ r � i,5 ill IZiii F. .4.""ir ./,0; '''. %, %, ''', (:4<1.\) ,:>"4, +'' '`. % #•;,"9"CO , \ \ \ .-... ..1,'• i ter';', ":, .....N. V.:\' ' , N 7 1 of .cti AN,":„;11,N '....,„9 0,s" ,,L„::\f A/ \ C ivy \ \\ \\ iii / \\...41!"),rr d�,'\i Zaooewr �r ',,,..:1;0‘,\ 5 y// / \ 0:,..r....:,,,,,,,,,,,,,,,,, �♦ l,, / ER \\ / th;i: / / ii% , „eetorf,:elikivo .......,�'� - „ ,,,.,"0....,:,,, .0. 'mot✓i __ ^' , 1 , s j----q,- 1 --, -- ,,, / \ 4, per'' .> ..” / ,,,,, e / j 1 JJ I - —z-- 1 v J G { t I 1 I r , i _ _ L \ 1 ‘ ( XS — — -----. — -- ---- — — \ Packet Page-563- =='--- \`'° `� \\\ L\ ;�,\%`,(�`\ 1/14/2014 16.A.12. ,`; \ \\ , \ f \ �\ -\ , ° r�A \ A \ \Z\.,;' W\ " AAAA\ �� '��'�' /r` \\ \'t-\�1 \ \\ / ,�� ^ \„ )s „r \\ \>✓ \\ \\ \\\ C \\ �� it \ ` , , , , , :/ :\:\.'"' , \c';e\..). Ns\\ \ , A\A' \- ct-, \ 1 1111WW. ,/ Of V ".' ', "..I \ < \)y V ! � \\ „.. \ ,.., 'ilf- -#• 1/ c-x, , C - , , , \,, >ii ,/,'%.,, 66 for a I r i \ / \ \ ' i '\/ \ \ \\''IA ifrO '- \ ev N's, \ \ i tilii \ /'w �/. / \ \ / E .� \', �� �i f L1N3H3JNNbW a31NM� \ I / , \\ fr y \ • it' \ few'' \.\\ / 7fry \ \ rte \\\ \\ ��\\` Lam\ / \\\� f 7 /////J/ V\ , \ \\, /,p VA \Cl'�� lJ \` . .\\\ ll \ • \•• \\•\\\ // \_�, , �\t, q a r „ \, ,\ \\.,, \ f' a �\ ' r - t \ / 4._,...., ,,, --_-mil i'\\\�\ \, J """�3 \, ).... N tom, �•: NLL �r ,\ ' / i N, * s-'''---,:--''' ''' ''''''' ''''''''''''''''-''''' 1 - ` Fl f 1 \ `. . , / 1 Packet Page -564- 1/14/2014 16.A.12. Rotary Club of Naples Bay Foundation P.O. Box 1852 Naples, FL 34106 A 501c3 Foundation 239-404-9300 Naplesbayrotary.org December 6, 2013 Paula J. Brethauer Business Center Project Coordinator Collier County Government Growth Management Division/Planning and Regulation 2800 North Horseshoe Drive Naples, FL 34104 Re: Ziggy Dicks BBQ and Music Festival,January 17-19/2014 Dear Ms. Brethauer: The Rotary Club of Naples Bay Foundation a 501c3 Foundation is seeking a waiver for the above mentioned event and ordinance regarding the surety bond. We are in the process of completing the carnival application. Thanking you in advance for your help and attention to this important matter. Than in. au rJ'4Ft.g l esident Packet Page -565- 1/14/2014 16.A.12. SHERIFF KEVIN j. RAMBOSK Nclor December 3, 2013 Rotary Club of Naples Bay Foundation 35 Hastings Place Naples, Florida 34104 Attn: Jeffrey Siegal,President RE: Security for upcoming events To Whom It May Concern: This is to advise you that the Collier County Sheriffs Office is prepared to provide security for the following upcoming event: 1. Ziggy Dicks BBQ and Music Festival Golden Gate Community Center—4701 Golden Gate Parkway Naples, Florida 34116 January 17, 2014 1600-2300 2 Deputies for Security January 18, 2014 1000-2300 2 Deputies for Security January 19, 2014 1000-2300 2 Deputies for Security If you have any questions, please contact me at(239) 252-0016. Sincerely, r ..__. Commander Bill McDonald Patrol Division Collier County Sheriffs Office MLJ/eeb Packet Page -566- 1/14/2014 16.A.12. ..... ...... .... 4,1 i'i EAST NAPLES - GOLDEN GATE nfir 4 FIRE CONTROL AND RESCUE DISTRICTS FIRE AND LIFE SAFETY HEADQUARTERS fi ' 4798 Davis Boulevard•Naples, FL 34104 REeSG Phone: (239)774-2800 Fax: (239)774-3116 Steve Hemping, Chairman Kingman Schad!,Fire Chief David Stedman,Chairman December 4, 2013 Rotary Club of Naples Bay Foundation 35 Hastings P1 Naples, FL 34104 Attn: Jeffrey Siegel Dear President Siegal, Golden Gate Fire and Rescue District has received your date of your event, January 17-19, 2014, located at 4701 Golden Gate Parkway, Golden Gate Community Center. In order to provide a proper fire safety inspection, all vendors and rides shall be placed per the approved layout; you must provide the layout to be approved by GGFD and must allow sufficient time to conduct the fire safety inspection and for you to make any necessary corrections prior to the opening of the event to the public. All inspections that are required by other agencies shall be conducted prior to your fire inspection and documentation of compliance shall be provided. Examples of other agencies include Department of Agriculture, electrical inspections (Collier County)and any other inspections that are required for your event. All violations that are marked by the fire inspector must be corrected before a notice of fire compliance can be issued. Please note that a notice of fire compliance is required in order for your event to take place. The inspector will use the Florida Fire Prevention Code Book 2010 edition and any relevant National Fire Protection Association(NFPA)codes adopted by the state of Florida. You must pass the inspection in order to open to the public. It is your responsibility to organize a date and time for the fire safety inspection. Our inspection business hours are Monday thru Friday 7:00 am to 5:00 pm. A time requested before or after hours will result in overtime fees. Re-inspections resulting from failure to correct violations will result in the assessment of re-inspection fees. All fees shall be paid before a notice of fire compliance can be issued. If you have any questions, please contact me at you leisure. Thank you in advance for your cooperation. Sincerely, Jett I Barb Sibley Fire Inspector Packet Page -567- __ _ _ 1/14/2014 16.A.12. ��� r: 1 wM TEMPORARY ROLL-OFF AGREEMENT xxi M Ot.....0 I ACCT# NET 033- Waste Management Inc of Florida 4500 Exchange Avenue Naples,FL 34104 Phone(239)253.6350 Fax(B66)233-5275 ,<-. DELIVERY DATE COMPLETION DATE ACCT.NAME Naples Bay Rotary Club 1/03/13 Thursday 1/07/13 MOnday SERV.ADDR 4701 Golden Gate Pkwy. _) I ( j CITY,ST ZIP Naples, FL 3411 S ' COUNTY TYPE OF WASTE Clean Up Collier TEL# 239-571-3504 FAX 239-643-0550 BILL TO ACCT#033 LIBRARY CONTACT Bill Jones PAYMENT TYPE:51,000 CREDIT w.u. 11"1"1"...".11' FF:FSC/EV FEE: EXP FREQ:0I OPEN "0.0.'0.~ SIC CODE:1S DISP SITE:SCI MUNI:NNFHC 1 BILL NAME No MIP or MNT. The Rotary Club of Naples BILL.ADDR1 3500 Radio Rd. Deliver to Golden Gate Park. Call ahead to Bill 571-3504 to meet 4 CITY,ST ZIP Naples, FL 34104 for placement ) TEL# 239-643-5100 CONTACT Bill Jones Qty Size Haul Rate/Flat Rate • 'Delivery Rent Charge Daily Disposal Charge Tonnage Cap Overage Charge MIN Haul 3 F20 $130.00 Waived N/A 1 $57.66/Tpn NIA • N/A j Exempt f � I l Blocked Container Fee,$90,00 Unsafe to Haul Charge:#30.00 Subject to fuel surcharge a environmental fees,Contaminated C&C)Loads;$302.24 Mau plus Applicable Disposal Charge, TERMS AND CONDITIONS Charges and Payment. Customer shalt pay Corrector for the collection Eauioment A) Responsibility. The equipment furnished hereunder by and disposal provided by Contractor including any digout_repot, blocked Contractor shall remain the property of Contractor, however. Customer container and/or excess disposal charges levied, but not prepaid by acknowledges that it has care.custody and control of the equipment white at Customer in accordance to the schedule of charges shown on the top the Customers location and accepts responsibility for all loss for damage to portion of this agreement.For all amounts billed,payment shall be made by the equipment (except for normal wear and tear or for loss or damage Customer within ten (10) days after receipt of an invoice from Contractor. resulting from Contractor's handling of the equipment)and for its contents. Contractor may impose,and Customer agrees to pay,a late tee of 18%per Customer agrees not to overload (by weight or volume),move or after the annum or. if less. the maximum rate allowed by applicable law an all past equipment, and shalt use the equipment only for its proper and intended due payments. in the event that any payment is not made when due, purpose. Customer agrees to Indemnify, defend and hold harmless Contractor may. at Ms sole option,terminate services. recover an pad due Contractor against Act claims,damages, suits,penalties, ernes and liabilities payments and recover any equipment from the premises. for trtury or death to persons or loss or damage to property arising out of Waste Material Customer represents and warrants that the materials Customers use,operation or possession of the equipment, placed in the equipment shat be'waste material"as defined herein and shall 8)Access, Customer agrees to provide unobstructed access contain no other substances, The term 'baste material" as used in these to the equipment on the scheduled collection day, if the equipment is Terms and Conditions shall mean solid waste generated by Customer inaccessible so that the regularly scheduled pick up cannot be made excluding radioactive, volatile, highly flammable, explosive, biomedical, Contractor will promptly notify the Customer and afford the Customer a infectious •----"A•++e.in„c material'that reasonable opportunity to provide the access and rescheorule the service, include b tied a$ however, Contractor will charge an additional fee as provided for In the hazatdoe state agt 7, ��, - j or any schedule of charges as shown on the top portion of this agreement, for ;ii°s i I Z. r /) S /Act of Customers fallure to provide initial access. 1976, am ra title to Attorney Fees,in the event of breach of the Agreement by either party,the coMtumi J Title to breathing party shall pay all reasonable attorney's fees and casts of the and Ilabl nor and Custom eL:, t*, , , her a"tess and other party incident to any action brought to enforce this Aggreement. In the Contract , and event Customer fails to pay Contractor all amounts which become due under liabilities this Agreement.Customer agrees to pay,in addition to the amount due,any Ciriy_v 1 -r b't5y:+,fSt?'c. right of And at costs incurred by Contractor as a result of such failure to pay, way pro - to bear including to the extent permitted by law,reasonable attorney fees, the we>£ t z, Excused Performance.Neither party hereto shall be liable for its failure .. 3 ."r puitt!d to p ny perform d ;sibie for to perform or delay performance hereunder due to contingencies beyond Its damage mg sub- reasonable control including,but not limited to strikes.riote,compliance with surface - e herein taws Or government orders, inability to access container,fires. and acts of contrac i+ ii "' `"°"0 e driving god and such fsihrre shall not constitute a default under this Agreement, v surface :site. J Oust Waste Management Representative, Date Date 12/03/12 Name Print � C , — _Sena Van Ness#203_ MARGINALS Packet Page-568- 2:33643v,,,, RECEIVED FROM #3391-002 1/14/201-4 16 A 12 If tort A f DR-14 Consumer's Certificate of Exemption R.04/11 Issued Pursuant to Chapter 212,Florida Statutes VtNi „-. 8,6-601576534C C-9 11/Cf-412011 11/30/2016 501(C)(3)ORGANIZATION 1 Certificate Number Effective Date Expiration nate Exemption Category This certifies that .• • ROTARY CLUB OF NAPLES BAY FOUNDATION CORPORATION 720 GOODLETTE RD N STE 203 NAPLES FL 34102-5656 is exempt from the payment of Florida sales and use tax on real property rented,transient rental property rented,tangible personal property purchased or rented, or services purchased. • DR-14 • Important Information for Exempt Organizations 1 FL 04/11 --" VIr41 1. You must provide all vendors and suppliers with an exemption certificate before making lax-exempt purchases. See Ruiz:12A-1.038,Florida AdmInistrativo Code(F.A..C.. 2. Your Consumer's'Cerificate ori Exemption is to be usted acaely by your organization tot your oroanizationlic customary nonprofit activities. 3. Purchases made by an individual on behalf of the organization are taxable,even if the individual will be reimbursed by the organization. This exemption applies only to purchases your organization makes. The sale or lease to others of tangible personal property,sleeping accommodations,or other real property is taxable. Your organization r11.75t register, and collect and rern't sales arid use tax on such taxable transactions. Note: Churches are exempt from this requirement except when they are the lessor of real property(Rule 12A-1.070,FA.C.), 5. it ts a criminal offense.to'fraudulently present this certificate to evade the payment of sales tax. Under no circumstances should tius cf:nate be used to, mh ersonal ts,enorli of any individunt Violators will he ilrable for payment of the sale,,;::tax plus, penalty cf 2000i. of the tax,and n-!ay be zublect to conviction ol S tliird-depre-c -le-lc:a?. Any violation will require the revocation of this certificate. 6. l you have ouestions regarding your exemption certificate,please contact the Exemption Unit of Account rilanaq.!2rrlunt at t.300-:352•3671. Friona the available ootions,select 'Registration pi Tzotes.'then"i7logist ration Information.,"and finally"Exemption Certificates and Nonprofit Entitien," The mailing address is PO box 6480, Tallahassee,FL 32314-6480. Packet Page -569- 1/14/2014 16.A.12. ACRD CERTIFICATE OF LIABILITY INSURANCE 1 12 /Luis THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poiicy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 1-425-454-3386 CONTACT Joanne Manion PRODUCER NAME: FAX -(Alc..i.o.Exti Arthur J. Gallagher Risk Management Services, Inc. PHONE 425-454 3386 lA(G yaJ 3 425-451-3716 E-MAIL P.O. BOX 367 ADDRESS:_ - ............. ......... ......_ 4NSURER(51 AFFORDING COVERAGE NAIC S __.; Bellevue, WA 98009-0367 _ _----.- INSURERA- T.H.E. Insurance Company ,,,, .. .. INSURED INSURER B:... .. ...... ......... _..... .. ._.._. ...... Briggs Transport, Inc, INSURER _ ....... -' "Modern Midways, Inc. 22901 Sherman Road INSURER INSURER E: Steger, IL 60475 INSURER F: ° COVERAGES CERTIFICATE NUMBER: 37201021 REVISION NUMBER: THIS IS TO NDICATED.CNOTWTHSTAND NOTWITHSTANDING ENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIDTH RESPECT TOLWHICH PERIOD HAVE BEEN ISSUED TO THE INSURED NAMED 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. ............. ......._._�__ ...__POLICY EFF POLICY EXP _....._, ,..._....__._ .....ADOLSUBR..._.._. _ I LIMITS iiLIRI TYPE OF INSURANCE INSR INVD POLICY NUMBER (MWDDIYYYY) (MM/OD/YYYY) LTR A I GENERAL LIABILITY CPP010090203 04/03/13 04/03/141 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 1 PREMISES(Ea occurrence) $...... X _-. COMMERCIAL GENERAL LIABILITY 1 CLAIMS-MADE X OCCUR I ■ MED EXP(Any one person) ;$_ i PERSONAL&ADV INJURY i$ 1,000,000 -_ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: i PRODUCTS-COMP/OP AGG I $ 1,000,000 A AUTOMOBILE LIABILITY LOS 04/03/14 COMBINED SINGLE LIMIT ILRY CPP010090203 I 04/03/13 (Ea accident) ".._.. g1,000,000 BODILY INJURY(Per person) $ ANY AUTO _._ ..-- ,.. .. ALL OWNED rX AUTOS SCHEDULED AUTOS I BODILY INJURY(Per accident)', $ ... ....._ _.. NON-OWNED j ! i _ PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS erodenn _._. A i UMBRELLA LIAB X 4 OCCUR . ELP001021004 04/03/13 04/03/14 EACH OCCURRENCE IS 4,000,000 X I EXCESS LIAB 1 CLAIMSMADE AGGREGATE IS 4,000,000 DED i I RETENTION$0 1 i $ WORKERS COMPENSATION WC STATU- OiH A WC134324 + 10/29/13 10/29/14 XI :TORY OWLS ER._ AND EMPLOYERS'LIABILrrY YIN E.L EACH ACCIDENT ;$ 1,000,000 000 ANY PRO°'RIETQfi:f>RRTNGRfEXcCU71 b'c - `� � .. __ ...�..— I OFFICER/MEMBER EXCLUDED? I 1 N I AEL DISEASE-EA EMPLOYEE$ 1,000,000 (Mandatory in NH) : ._.$ _...._.. ......... If yes,describe under ! DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT s 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Collier County Growth Management Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2800 N. Horse Shoe Drive AUTHORIZED REPRESENTATIVE / ler/PWAO Naples, FL 34104 '- USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name ^'1 1^^^zn°, nic+°red marks of ACORD jomanion Packet Page -570- 1/14/2014 16.A.12. jeffrey siegal crom: BMorri9495 @aol.com Sent: Friday, December 06, 2013 11:23 AM To: jeffrey1991@embarqmail.com Subject: Re: application Hi Jeffrey, The following is a list of rides we anticipate bringing: Hurricane, Rok'N Rol, Sizzler, Raiders, Dizzy Dragon, Spider, Giant Slide, Hy-5 Ferris Wheel, Beach Party, 1001 Nacts, Flying Elephants, Yo-Yo, Tea Cups and Scooter. Due to your food booths, we are planning to bring only popcorn/cotton candy/candy apple/sno-cone trailer and funnel cake/ice cream trailer. We could also provide a pizza trailer if needed Brian Modern Midways In a message dated 12/6/2013 8:26:41 A.M. Eastern Standard Time,jeffrey1991(a embargmail.corn writes: Good day to you. I am in the midst of filing an application to Collier County. It is a carnival operations application. Some answers I need are: list of potential mechanical rides and Iist of potential food concessioners. Please respond soonest as I need to go to zoning on Monday. Jeffrey Siegal 1 Packet Page -571- ---•N , 1/14/2014 16.A.12. ACaRE) CERTIFICATE OF LIABILITY INSURANCE , ITHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME Lockton Companies.LLC ,...__._ __ .._. LOCKTON COMPANIES,LLC-K CHICAGO PHONE 1 800 921-3172 �AtC�NOI1.-312 681 6769 jA/C N ,EFM1 _ . ..._ .. ... �.._.... 525 W.Monroe,Suite 600 E-MAIC Ratar�(ci Itreku�n cc?m CHICAGO,IL 60661 ADDESS.;_ (312)669-6900 INSURER(S)AFFORDING COVERAGE NAIC* �__ _ INSURER A ACE American Insurance Company 22667 / INSURED INSURER a ..,....ACE Property&Casualty Insurance Co_ 20699 All Active US Rotary Clubs&Districts Attn:Risk Management Division INSURER c; ,._ 1560 Sherman Ave. INSURER 13 Evanston,IL 60201-3698 INSURER E INSURER F- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:FOR THE THIS IS TO THAT THE INDICATED CERTIFY NOTWITHSTANDING ANY IREQUIREMENT, TERM OR ELO HAHAVE VE B OF ANY CONTRACT OR OTHER DOCUMENT WIRE RESPECT TO LIWHICH PERIOD S 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 ..POLICY EFF POLICY EXP ...,,,� —_.._..._ �ADDL SURR, UMITS ILIR TYPE OF INSURANCE INSR >HVD POUCY NUMBER I(MM/DD/YYYY) (MM/DO/YYYY)! 1 GENERAL UABIUTY N PMI G23861355 005 7/1/2013 7/1/2014 EACH OCCURRENCE 1$ 2,000,000 A (...—, DA RAGE TO RENTEb ix :GOMMb.RCIAL GENERAL.LIABILITY ! PREMISES(Ea occurrence) ....$ 500 n ....... ... .... —I I 'MED EXP(Any one person) $ _._XXXXXXX CLAIMS-MADE X OCCUR 'X- PERSONAL 8 ADV INJURY ,$ 2,000.000... X Litluor Liability 1.._._____A_ Included ! :.GENERALAGGREGATE j$ 10.000.000, ' GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG 1 $ 4.000.000 PRO $ COMBINED SINGLE LIMIT 1,000,000 A ,.x POLICY )FCT LoC N PMIG23861355005 7/1/2013 7/1/2014 ?Eeaccidenl) —_--s -411*, AUTOMOBILE LIABILITY ! ANY AUTO ,. BODILY INJURY(Per person) $ XXXXXXX,___ ALL OWNED SCHEDULED 1 I_BODILY INJURY(Peracadent) $ XXXXXXX.... AUTOS NON OWNED ROaecdentDAMAGE XXXXXXX '. X HIRED AUTOS IX AUTOS - --$ XXXXXXX. B X . LLA uMBRE LIAS X OCCUR M00534092 005 7/1/2013 7/1/2014 ,EACH OCCURRENCE $ 5.000.000 —.. N M EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,000,000 DED I I RETENTION$ s XXXXXXX WC STATU- ; I OTH ; WORKERS EMPLOYERS' ABIIJT NOT APPLICABLE ! TORY LIMITS _..... ER AND EMPLOYERS'UABIUTY Y/N E L EACH ACCIDENT �$ XXXXXXX I ;ANY?P.OPRic iOr?fpt,RTl`kER JiE CUTVE i—"i' ,_. __ ___, .. _ OFFICER/MEMBER EXCLUDED? N/A! - E L DISEASE-EA EMPLOYEE $ XXXXXXX (Mandatory in NH) If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ XXXXXXX DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) The Certificate Holder is included as Additional Insured where required by written and signed contract or permit subject to the terms and conditions of the General Liability policy, but only to the extent bodily injury or property damage is caused in whole or in part by the acts or omissions of the insured. CERTIFICATE HOLDER CANCELLATION Collier County Growth Management Division SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2800 N.Horseshoe Drive THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Naples,FL 34104 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD nam..m•wt Inn's 2r°.•rar,lstared marks of ACORD Packet Page-572- 1/14/2014 16.A.12. Full Name of Applicant Organization The named applicant for a license/permit has compiled with the Florida Statutes concerning registration for Sales and Use Tax and has agreed to pay any applicable taxes due. Signed Date Title Department of Revenue Stamp: `",'" }"..-,-. : 7, ""`," : l, v¢ >w; 3` �kw Ei,i roses ,L" L,.AS. ".e,�y� 't Location of Event(Street and Number) W 4704 Golden Gate Parkway City County Naples Collier The location complies with zoning requirements for the temporary sale of alcoholic beverages pursuant to this application for a One/Two hre Day Permit. Si ne j?"3 13 g eu Date 1 J--1 q Title JU SLrJE S Q ,S[1 . Am 114E EVEXT t iodfr M> e i `c G &, +o4 Qc S Y COAAW s.S rwvel rN/-S r6,,et,/P2 / A.)/LC_ r3E' vo(0lo. Note: College fraternities and sororities must meet certain additional conditions which can be found in the application instructions and requirements. Auth: 61A-5.0013,FAC Packet Page -573- GGC( 1/14/2014 16.A.12. _ 11 ---1 c_"/ 1 Ct. /11, urdc '‘ / It_ 1 \ !•-) \,— tzzi. GOLDEN GATE COMMUNITY CENTER / , 7--1 ) I , RESERVATION REQUEST a division of 0 r, Collier County Parks & Recreation Department Start iL„,;tn End:4701 Golden Golden Gate Parkway, Naples, FL 34116 Phone: (239)252-4180 Fax: (239)455-9556 L3 Entered ,----„ All sections must be complete . Please print clearly. 4/>47 Al 4 4 co/ ?3 7 IV V(1( ' (4 ,4-- ci-t Group Name: i ,C i/V16.- t,c- C; ( i 7 Contact Name - ./6„ r, .t. • 61 4- Phone. Lti 1 Y- i 3z,•.-& Email:‘,) 6-gly/Frfe- —6'44-1"1 Other: i ......,,,\ /. r i fi Mailing Address: , , 0( (...23 ;1 v_<'. / *6.0 .1-. 0.14 6A-1 P°L-- -7 --- --- ,--------- Room Size Requested (circle one): Small (30 max ' Medium (60 max) Large(150 max) OR Outside Facility Type(circle one): Pavilion Amphitheater Field Other: (21'ji fi-;":' , i7 Brief description of function: (4.4,4/C ort., 14- f -.L, -,) 7 I tirli -e-- i Day(s) and Date(s)Requested: '-- ---'‘.. , /1 (-'?— I q ('c)-6)I' Estimated number of people expected to attend this function (including children): ci Os/V A n t PA-/f Times Requested (including Set Up and Clean Up): Start: 7 (HAI End: / The center closes at 9pm lif-F. Closes at 5p.m. Sat Closed all day Sun. Special Requests: Is this function open to the public at no charge? CI Yes No Type of Organization (please check one): Local Non Profit (attach copy of tax exempt certificate) CI Local Civic/Governmental C.1 Other r- - C7 ,.. 4-,:,1 - i I ,-„,,, ,- GGCC Office Use Only \ it -• 1 ' , ,-- ,i---, Cash $ Staff: 'y -rnt'ff,IM 1 . , ck ,....) Check i -, Jr I i - Credit$ Date: i Al , t.:43 Packet Page-574- 1/14/2014 16.A.12. Pane 2 the undersignce, q...ree ,c„ :1-,61,-i-ni, I:, -,::, _lold hESIIS.':, L'ollier County. the Golden ':',F-I- C3fi".1:11,:,:iN, C--nieL Parks& Recreation Depanmern. and any employee of Cci:ier County auainst any and all c,aims by or on behalf of any person or legal entity arising from Applicant's use of the premises, the conduct of Applicant's business or from any activity permitted by the Applicant in or about the premises, and will further indemnify and hold harmless the County, its Departments and employees against performances of any agreements of the Applicant's parts or arising from any act of negligence of the Applicant, or any of the Applicant's party or Applicant's agents, contractors, employees, or licensees, and from and against the cost, attorneys fees, expenses, and liabilities incurred in or about any claim or proceeding brought thereon I, the undersigned, have read and fully understand the Room Rental Policies of the Golden Gate Community Center. I agree to follow those policies, as well as any written or verbal instruction from the GGCC staff. The information I have Flyen i this form is accurate to the best of my knowledge, and I understand that no changes may be m tie 4 ut permission from the Center staff. (‘2(0 Yh Signature of Applicant: Date: __— , , Must be at least 18 years of age /7/// •,---i---;:A.,:,,, Print: ,./ /,', \---) C,,, t \ 7*. \ ‘-''7' 1 ' 1 cli 1 ,,,,<,//1 a 5 li I , -_,,„....., .,-03(/L ,, ,.,„,,,.,,_______ / - - „ ,.., _..,,,,,.._ i.,,, , j.,,,,j E-0-f.)-Ifr SLAF: f \' Packet Page Page -575- 100 I:1 V tit.: 4:7.i 94:6 i 64:7. :1■0?I:1 (1'..(,\111):121 t 0:471 1107., 110 7. 1 004:t9b 1/14/2014 16.A.12. RON'S SONS PORTA POTTY RENTALS / 0j0.17: , Invoice -,525 70th St.SW I ,; -■.- Keg-it-A-Pot ty 'CP 't% ASNIIk Naples. FL 34105 (' , (239)352-4700 I) .,./ Fax# 239-79?-5727) ■.,,,..._... Date 12i6/2013 E-mail: runsjOnspOrtapotty:i.i.iuorricast.ne.1. invoice# 18325 __:„..,.7.-' 801 To Job Location Rotary Club of Naples Bay GG Community Center Golden Gate Community Park Naples, Fl 33916 Terms Due on Receipt PO Number ' Duanti:y 1 —eninn 1 Dry:e Each rc rt I ISpe.:iLii ii.vent Porta:,et 1_nit -I 4i ii, 480 fiCi , Seri.'cc Dine : I'18- I'2 i:i i ' Handicap unit ;e, , i 0 00-v:cc an,:. tirne 2 Wt:A-. 1. 1 Ser.IL:.-Dale,: 2,Free Standing Sink <5 on 110 OG Servic::Die : 1-1 ServiLJ Per I_ni: 280 14,, SriNILL.- Dd.ii.-. St...7,..la:, A',.4 ' . I Thank you for i , your business! ------1-1. Total —.— Service Area Marco Island to Tampa Cover-All Inc dba Ron s Jan's aorta Po:ty Renla s L a CE',L9-C61-5i:J.. Packet Page -576- 0Z.L9 .6L5c2,Z 29S l l el 90 , ,