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Dubuque Golf & Country Club Fireworks PermitCity of Dubuque City Council Meeting Consent Items # 06. Copyrighted June 20, 2022 ITEM TITLE: Dubuque Golf & Country Club Fireworks Permit SUMMARY: City Manager recommending approval to issue a permit to the Dubuque Golf and County Club for a fireworks display on July 4, 2022. SUGGESTED Suggested Disposition: Receive and File; Approve DISPOSITION: ATTACHMENTS: Description Type Dubuque Golf & Country Club Fireworks Permit-MVM City Manager Memo Memo Staff Memo DGCC Fireworks Permit Application Staff Memo Supporting Documentation THE C DUjIBQTE Masterpiece on the Mississippi TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Dubuque Golf and Country Club Fireworks Permit DATE: June 14, 2022 Dubuque WAWca 914 ii 2007-2012.2013 2017*2019 Fire Marshal Kevin Esser is recommending City Council approval to issue a permit to the Dubuque Golf and County Club for a fireworks display on July 4, 2022. I concur with the recommendation and respectfully request Mayor and City Council approval. v Mic ael C. Van Milligen MCVM:sv Attachment CC' Crenna Brumwell, City Attorney Cori Burbach, Assistant City Manager Amy Scheller, Fire Chief Kevin Esser, Fire Marshal THE CITY OF DUB E-E Masterpiece on the Mississippi TO: Mike Van Milligen, City Manager FROM: Kevin Esser, Fire Marshal DATE: June 1, 2022 RE: Dubuque Golf and Country Club Fireworks Permit INTRODUCTION Dubuque AII•Ameft Cky �I 2007-2012.2013 2017*2019 The Dubuque Golf and Country Club has applied for a permit for fireworks display for July 4, 2022. Aerial Fireworks displays require the approval of City Council prior to permit issuance. BACKGROUND A permit application has been received for a fireworks display on July 4, 2022 at approximately 9.30 p.m. with a rain date of July 5, 2022. The applicant has submitted all require documentation including a certificate of liability insurance and qualification of the pyrotechnics operator. RECOMMENDATION I recommend submittal to the City Council requesting approval to issue a permit to the Dubuque Golf and Country Club for a fireworks display on July 4, 2022. cc: Amy Scheller, Fire Chief 11 WEST 9T". STREET DUBUQUE, IOWA 52001 563-589-4160 FAX 563-589-4209 Permit Application Date of Application: Business, Organization, or Applicant Name: Contact Person: Address: Phone Number: Cell phone: E-Mail address 1:� I a o a Q Type of Permit Requested: (Check one) ❑ Agricultural Land Burn (30 day) ❑ Bon Fire (l day) ❑ Blasting (30 day) R Fireworks / Pyrotechnics (1 day) ❑ Land Clearing Burn (30 day) ❑ Prescribed Burn (30 day) and event location: i All .duly lietaiis regaramg the permit requirements must be tiled when application is made and whenever requested by the Fire Marshal. It is the applicant's responsibility to satisfy all permit requirements, submit applicable fees with application, and ensure that conditions are in acco dance with app ' able State and Local fire regulations. Applicant's Signature FOR DEPARTMENT USE ONLY DATE ISSUED: FEE: $ ❑ PAID FIRE MARSHAL Fireworks Display Permit Information Sponsor Dubuque Golf 8t Country Club 1800 Randall Place Dubuque, Iowa 52003 Lance Marting, GM, 608-346-9578, lance@dubuguegolf.org Tara Dolan, tara@dubuguegolf.org Date: July 4t", 2022 @ about 9:30 pm Rain date: July 51", 2022 @ about 9:30 pm Operator/Supplier AM Displays, Inc. 18064 170t" Avenue Yarmouth, IA 52660 Jesse Speer, Pyrotechnician ,4coR0® CERTIFICATE OF LIABILITY INSURANCE DAT5/3/W2 D/YYYY) 5/3/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Britton Gallagher One Cleveland Center, Floor 30 1375 East 9th Street CONTACT _ NAME: PHONE FAX n/c No Ext : 216-658-7100 A/c No): 216-658-7101 ADDRIESS: INSURERS AFFORDING COVERAGE NAIC # Cleveland OH 44114 INSURER A: Everest Denali Insurance Company 16044 INSURED INSURER B : AXIS Surplus Ins Company 26620 J & M Displays, Inc. 18064 170th Avenue INSURER C: Everest Indemnity Insurance Co. 10851 INSURER D : Yarmouth IA 52660 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 495653285 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. ILN.TR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD POLICY EXP MM/DD LIMITS C GENERAL LIABILITY S18ML00060-221 1/15/2022 1/15/2023 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 CLAIMS -MADE r_X1 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X1 PRO- LOC A AUTOMOBILE LIABILITY S18CA00033-221 1/15/2022 1/15/2023 COMBINED SINGLE LIMIT Ea accident) $1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS Ix BODILY INJURY (Per accident) $ PROPERTY acEciden DAMAGE $ HIRED AUTOS rXAUTOS NED B UMBRELLA LIAB X OCCUR P-001-000063943-04 1/15/2022 1/15/2023 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $ 5,000,000 DED RETENTION $ $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS' LIABILITYER Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑ N / A (Mandatory in NH) E.L. DISEASE - FA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ C Excess Liability #2 S18EX01313-221 1/15/2022 1/15/2023 Each Occ/ Aggregate $4,000,000 Total Limits $10,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. FIREWORKS DISPLAY DATE: July 4, 2022 RAIN DATE: July 5, 2022 LOCATION OF EVENT: Dubuque Golf & Country Club ADD'L INSURED: The City of Dubuque, Iowa, its employees, volunteers, officers, elected officials, partners, subsidiaries, divisions & affiliates, event sponsors & landowners as their interest may appear in relation to this event; Dubuque Golf & Country Club (sponsor) GERTIFIGA I E HULUt=K GANGCLLA I IUN Dubuque Golf & Country Club 1800 Randall Place Dubuque IA 62003 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Dubuque Golf and Country Club Shoot Team Lead Technician — Jesse Speer PH: 563-559-6187 Jesse is AM trained and has been the lead tech on the Dubuque Golf and CC show since 2018. Assistants: (assistants are trained AM employees) Eric Arensdorf Justin Bell Jennifer Hoover