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Special Event Application

  1. The City of Waukee would like to thank you for considering our community as a host site for your Special Event. Please submit this application and other required materials to the Waukee Parks and Recreation Department at least 60 days prior to the date of the event, with proof of insurance and/or other certificates, permits, and/or licenses listed below if needed at least 30 days prior to the date of the event. All events will be approved by Waukee City Staff and/or the Waukee City Council, if a resolution is required. The Special Event Application states which conditions need to be met for the event to be approved.

    City approval of a Special Event Application does not preclude responsibility for any additional permits, approvals, or state and federal regulations. The City may cancel the event with notice, impose special guidelines and/or restrictions; included but not limited to: the nature of the proposed event, its attendant circumstances, weather forecasts, the event being deemed hazardous to public safety and/or public or private property. If the applicant or the City of Waukee cancels the event after approval for any circumstances, the application fee will not be refunded.

    The City of Waukee Special Event Application is necessary for: the use of public property and/or park property that requires right-of-way usage or temporary street closures (excluding block parties), parades, runs/walks, fairs/festivals, outdoor concerts/amplified sounds, athletic events, fundraisers, farmer’s markets, fireworks/pyrotechnics, temporary structures (tents, canopies, stages, inflatables). The City of Waukee will determine whether an event is classified as a Special Event if outside of the description stated above. If your event will be using any part of the Raccoon River Valley Trail please fill out the application at www.dallascountyiowa.gov/conservation prior to applying with the City of Waukee. You must provide proof of approval from the Dallas County Conservation Board before the City of Waukee can accept this application.

  2. 1. Completed Special Event Application, $75 non-refundable application fee and shelter/facility payment due. Application will not be reviewed until payment is received.

  3. 1. Proof of insurance noting City of Waukee as additional insured for event.
    2. Proof of barricade confirmation if applicable.
    3. Proof of temporary structure flame resistant certificate if applicable.
    4. Proof of liquor license if applicable.

  4. Event Type*

  5. Pending approval. Call 515-978-0007 to check availability.

  6. **Please include time frame for delivery of amenities such as sanitation, temporary structures, vendors, etc.

  7. Requires City Council approval by resolution.

  8. If your event requires street closures, you will be required to contract barricades and signage.

  9. **Any volunteers/event staff along a race route or road will be required to wear a reflective yellow vest on the outermost part of their clothing.

  10. If approved by City Staff.

  11. Vehicles are NOT allowed to drive or park randomly on the turf of City park grounds due to extensive, underground irrigation systems that sustain damage when vehicles drive across control boxes and heads.

  12. May require City Council approval by resolution.

  13. Trash and portable toilets.

  14. Clean up of the event area, including trash removal, is the responsibility of the event sponsors immediately following the event.

  15. Requirements for additional portable toilets: *For events with alcohol, one portable toilet for every 150 attendees. *For events without alcohol, one portable toilet for every 250 attendees.

  16. Limited water and electrical power are available at some City parks. Additional generator power or water supply is the responsibility of the applicant and may be subject to the approval of city staff.

  17. Limited water and electrical power are available at some City parks. Additional generator power or water supply is the responsibility of the applicant and may be subject to the approval of city staff.

  18. If approved by City staff.

  19. Emergency shelter plan must be submitted by applicant with written approval from emergency shelter host site.

  20. If approved by City staff.

  21. Structure type

  22. All tents or canopies need to provide a flame resistant certificate from contractor. The use of ground stakes for temporary structures must be pre-approved by City staff and utility locate companies. Staking requests must be received five business days before the event. Supporting guides, wires, or ropes will not be allowed to be tied to or anchored to trees, buildings, bridge railings, City signage, or light poles. Temporary structures must be removed immediately following the event. Please call 8-1-1 before you dig or stake.

  23. The use of ground stakes for temporary structures must be pre-approved by City staff and utility locate companies. Staking requests must be received five business days before the event. Supporting guides, wires, or ropes will not be allowed to be tied to or anchored to trees, buildings, bridge railings, City signage, or light poles. Temporary structures must be removed immediately following the event. Please call 8-1-1 before you dig or stake.

  24. The use of ground stakes for temporary structures must be pre-approved by City staff and utility locate companies. Staking requests must be received five business days before the event. Supporting guides, wires, or ropes will not be allowed to be tied to or anchored to trees, buildings, bridge railings, City signage, or light poles. Temporary structures must be removed immediately following the event. Please call 8-1-1 before you dig or stake.

  25. **It is the responsibility of the event organizer to have a completed inspection of the temporary structure with the Waukee Fire Department while the listed contractor is still on-site. Failure to do so may result in fines or closing of the structure.

  26. Requires City Council approval by resolution.

  27. Waukee Municipal code 622.1(1)b defines a “competent operator” as a person 21 years of age or older who states in the application that he/she has the necessary knowledge and experience to explode fireworks. See code 622.1(2) for insurance coverage.

  28. Food and non-food. Liquor license requires City Council approval by resolution.

  29. Individual food vendors, as well as the event organizer, are required to obtain a Temporary Food License from the Iowa Department of Inspections & Appeals. Contact 515-281-6538 to obtain such licenses.

  30. Additional permits and fees for food and/or alcohol may be required by the City and/or the State. These permits will need to be submitted 30 days prior to the date of the event. If selling alcohol, see the Iowa Alcoholic Beverages Division website at www.iowaabd.com. If alcohol is sold the applicant must comply with the recommendations of the Waukee Police Department and additional security may be required.

  31. Special Event Application required (non-refundable): $75

  32. Shelter/Facility if applicable: Varies

  33. Liquor license required if applicable: Payable to the State of Iowa (Iowa Alcoholic Beverages Division)

  34. Payable to Waukee Parks and Recreation Department.

  35. Applicant hereby agrees to indemnify, defend, protect, and hold harmless, the City, its agents, employees, representatives, and elected officials, from and against any and all claims, losses, demands, liability, lawsuits, damages, or expenses (including, without limitation, reasonable attorney's fees), relating to, resulting from, or arising out of, directly or indirectly, the promotion and/or conduct in any way related to the activities in connection with that event, including but not limited to the activities of applicants, employees, volunteers, contractors, vendors, attendees or participants in the event which is the subject of the application.

  36. Electronic Signature*

    By checking this box, I agree that all of the information in this application is accurate to the best of my knowledge.

  37. Provide a detailed map of the event site including the locations of: street closures, event parking, additional dumpsters, portable toilets, water, or electricity, overnight stay areas, temporary structures (including interior layouts), fireworks demonstration area, and vendor booths. Attach additional maps if needed.

    Please use the following legend when labeling the map:
    Label street names, etc.
    Routes for races, parades, etc.---->
    Fencing (_ _ _ _)
    Restrooms/Portable toilets (R)
    Temporary Structures (TS)
    First aid facilities (1stA)
    Alcohol serving/consuming area (A)
    Street Barricades (B)
    Dumpsters (D)
    Admission/registration fee collection (F)
    Parking (P)
    Vendors (V)
    Fireworks/Pyrotechnics (FP)

  38. PERMIT HOLDER, at its own expense, shall procure and maintain insurance as to cover all risk which shall arise directly or indirectly from the Special Event for which the City provides a permit. At a minimum the following insurance is required and the requirement level will be determined based on the number of participants and attendees, nature of the event’s activities and type of City property or other resources involved:

    General Liability Insurance
    1. Low Risk Event– minimum liability limit $500,000
    A. Events with little or no impact on the public.
    B. Events in City parks or on public property without alcohol.
    C. Large picnics in parks exceeding shelter occupancy and using other park areas.

    2. Medium Risk Event– minimum liability limit $1,000,000 (Additional insured and governmental immunities endorsement is required. *)
    A. Fundraising walks and/or runs without street closures.
    B. Sport contests in City parks.

    3. High Risk Event– minimum liability limit $2,000,000 (Additional insured and governmental immunities endorsement is required. *)
    A. Firework/Pyrotechnic displays.
    B. Parades.
    C. Events requiring street closures.
    D. Events that expect large crowds on public property.
    E. Large events taking place for more than one day.
    F. Large events that include alcohol on public property.

    *Endorsements when required must read:

    1. Additional Insured Endorsement:
    Except for Workers’ Compensation and Professional Liability, the policies shall include the City Additional Insured Endorsement of: The City of Waukee, Iowa, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions and /or authorities and their board members, employees, and volunteers, are included as additional insureds with respect to liability arising out of the Insured’s work and/or Services performed for the City of Waukee, Iowa. This coverage shall be primary to the additional insureds, and not contributing with any other insurance or similar protection available to the additional insureds, whether available coverage be primary, contributing, or excess.

    2. Governmental Immunities Endorsement:
    A. Non-waiver of Government Immunity The insurance carrier expressly agrees and states that the purchase of this policy and the including of the City of Waukee, Iowa, as an Additional Insured does not waive any of the defenses of governmental immunity available to the City of Waukee, Iowa, under Code of Iowa Section 670.4 as it now exists and as it may be amended from time to time.
    B. Claims Coverage The insurance carrier further agrees that this policy of insurance shall cover only those claims not subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as may be amended from time to time.
    C. Assertion of Government Immunity The City of Waukee, Iowa, shall be responsible for asserting any defense of governmental immunity, and may do so at any time and shall do so upon the timely written request of the insurance carrier. Nothing contained in this endorsement shall prevent the carrier from asserting the defense of governmental immunity asserted by the City of Waukee, Iowa.
    D. Non-Denial of Coverage The insurance carrier shall not deny coverage under this policy and the insurance carrier shall not deny any of the rights and benefits accruing to the City of Waukee, Iowa , under this policy for reasons of governmental immunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s) of governmental immunity asserted by the City of Waukee, Iowa.
    E. No Other Change in Policy The insurance carrier and the City of Waukee, Iowa, agree that the above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy.

    Certificate of Insurance Requirements

    A Certificate of Insurance is required evidencing all required insurance coverage as provided above with any required endorsements attached so as to evidence their inclusion in the coverage. The Certificate of Insurance is due 30+ days before the Special Event. The following format is required:

    1. List the name of the Event and Date in the Description of Operations section.
    2. The following address must appear in the Certificate Holder section: City of Waukee, Iowa Special Event Application 805 University Avenue Waukee, Iowa 50263
    3. The Producer’s contact person’s name, phone number and e-mail address is required.
    4. Endorsements, as required, shall be included with the Certificate of Insurance to evidence that the policy has been endorsed.

  39. Waukee Parks & Recreation Department: 515-978-0007 or www.waukee.org/parksandrec

  40. Iowa Alcoholic Beverages Division: 515-281-7400 or www.iowaabd.com

  41. Iowa One-Call: 8-1-1 or www.iowaonecall.com

  42. Dallas County Public Health Department: 515-993-3750 or www.co.dallas.ia.us

  43. Leave This Blank:

  44. This field is not part of the form submission.