HomeMy WebLinkAboutR-1996-038 Fireworks Permit / 4th of JulyRESOLUTION NO. R-96 18
A RESOLUTION granting a public fireworks display permit to Western Display
Fireworks
WHEREAS, Western Display Fireworks has applied to the City for a public fireworks
display permit to conduct a public fireworks display at Yakima Speedway on July 3, 1996;
and
WHEREAS, Western Display Fireworks has complied with the requirements of
Sections 10.15.040 and 10.15.050 of the City of Yakima Municipal Code in that it has shown
proof of adequate insurance, is the holder of a valid State Fire Marshal Permit for such
display and the Code Administration Manager has investigated and approved the location of
such display, now, therefore
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF YAKIMA:
Pursuant to the provisions of Section 10.15.040 of the City of Yakima Municipal Code,
Western Display Fireworks is hereby granted a permit for public fireworks display according
to the terms and conditions found upon the attached and incorporated permit application.
ADOPTED BY THE CITY COUNCIL this 19th day of MARCH
ATTEST:
CITY CLERK
, 1996.
CERI tl-ICATE OF LNSURANCE
This certifcate is issued as a matter of information only and confers no rights upon the certificate holder.
This certificate does not amend, extend or alter the coverage afforded by the policy(ies) listed below. The
Insurer accepts no responsibility for arry additions or changes rtiade hereon that are not on record with the
Insurer
Name and Address of Insured.
WESTERN DISPLAY FIREWORKS, LTD.
DBA: WESTERN INTERNATIONAL FIREWORKS
P. O 130X 932
CANDY, OR 97013
This is to certify that the po1icy(tes) of uisarance listed below have been issued to the Insured named above
and are in force at this tune.
TYPE OF L'SURAINCE.
and cprationsllocadons
covered thereunder
GEN -I- AL LIABILITY INCLUDING PRODUCTS AND COMPLETED
OPERATIONS fl SURANCE PER POLICY FORM e CGL-EIC844
(CLAIMS MADE) INCLUDING BLANKET VENDORS
NAME OF ENSURER. EVANSTON INSURANCE COMPANY
POLICY IeUtifBER. MC -012707
LD CTS OF LIABILITY AND DEDUCTIBLE COMBS ED SLNGLE LIMIT Bodily Injury and
Property Damage Liability
$2.000,000 each occurrence
$2,000,700 annual aggregate
S 7,500 Deductible each occurrence
Shoid the described policy(les) be cancelled before its (their) expiration date, the undersigned will endeavor
to eive 30 da”s wntten notice to the certificate holder or 10 days written notce in the event the
canccliatron(s) is (art) due to non-payment of premium and/or deductible or retention. Failure to give such
notice shall unposc no obligation or liability of any kind upon the undersigned or upon the Insurer
Name and Address of Certificate Holder• Cover ge under th:s policy is amended to include as additional insured
Yalarna Speedway 1 The fair or etdtibrson association. sponsoring organization or carrsnicse
1600 Pacifi Ave 2. The owner or lessee of any premises used by the named insured
Yamima WA 98901 3 Any public authority granting a permit to the named insured
but only u respect aeti4ents &ruing out of the nesligrnoe of the
named insured or the named utsured's employe= acting in the
course and mope of their emelovment
Show Date: 7/3/96
Show Site. Yakima Speedway
Date. 1/18/96
SM 102-101/85
By
SHAND MORAHAN & COMPANY, INC
Shand Morahan Plaza Evanston, Illinois 60201
Evanston Insurance Company
Evanston, Illinois
Endorsement
Named Insured
WESTERN DISPLAY FIREWORKS, LTD
DBA: WESTERN INTERNATIONAL FIREWORKS
01.6•1.11,1110.11.
Policy No. - MC -012707
Endorsement No : 3
Effective Date : January 16, 1996
•MISIIIIIii91611291MMY.6.1111•1170M.
ADDITIONAL INSURED
Co'erage under this policy is amended to include as an additional insured
1 The fair or exhibition association, sponsoring organization or committee
2 The owner or lessee of any premises used by the Named Insured
3 A.p.‘y public authority granting a permit to the Named Insured
but only as respect accidents arising out of the negligence of the Named Insured or
the Named Insureds employees acting in the course and scope of their employment
1) Yakima Speedway
2) City Of Yakima
3) C.A.R. Promotions, Inc.
4) Pollock Promotions, Inc.
5) Ted Pollock
6) Dennis P. Williams
Page 1 of 1
other terms and condrtions rerrta!n unchanged.
AlAnnzed Represeztal
APPLICATION
FOR FIREWORKS DISPLAY PERMIT
D: Governing body of city, town or county in which display is to be conducted.
DATE OF APP 1CATX)fi
cg- c'163
NAM
a -V �r ' `frui t �)4.s
ADDRESS J
ADI7f'Ep 6�,x 9 3 2-X 14 C c'/O13
1 l( aie Li-fc Alt YaJM lLF i 4 '1
TEL.
5t 3-‘,5"---.
c 1
5A �
t•kt,”tu Staid
i?yROTECHNIC OPERATOR
NAME i kr- cck.QC-ti,
ADDRESS
F® 62,
rot 40.1-44 .:
9,
1 4
UCENSE8
NA;WE$ Of AS51STA.NTS (at least ore spur*ed)
NAME
j1t_(1cL jq- it El 1 .
ADDRESS
24:724:7)( J
PC �^ &Mel,U
tq
l q
AGE
l
ADDRESS
AGENAME
EXACT LOCATION OF PROPOSED DISPLAY
l6,C1C Pi c• t -(-1 c, 4 vcA ► -- 164 01 C-•1421 q 9C ° I
DATE \JI 1 e! '
TIME.1 Z' y Al ; Qc" -10 ; 3 0 �M
NUMBER AND KD 1. DS OF FIREWORKS TO BE DISPLAYED
a. 5 " 51 4.1 s 1 0 7
2" 6,1-v:t ii s n
3c1
; r ,, AL3 21
MMANNE? 8 PLACE 0, S'Oi +AZ_ CC OP TO ✓1: (Lt./
.jr„
SJolec tC Aporova o1 inial Fire R,aa•Jibesi
C 71/1A:: 714 - U-1- ,5 Z;
Synatura dt Apphcan'
F!NANCGAL PESPOONSIB.L'Y
Bonding or ins..,ance Co
Aoo:ess
t;17-4— ( C' '2— C- 1
(Mark One)
✓ Bond or certificate of insurance attached
Bond or certificate of insurance on file with state fire marshal
Bond or certificate of insurance shall provide minimum coverage of
$50 000,$1,000,000 bodily injury liability for each person and event,
respectively, and 525,000 property damage liability
PART I1
PERMIT a
PERMIT
Dale , 19
In accordance with the provisions of RCW 70 77 and applicable local ordinances this permit is granted to conduct a fireworks display as per
the above applIcatton.
Name
(Fun name of person. firm or corporatan grained permit)
Restrictions
Pe --.11 nor valid for conduct of d'sptay
verif;cation of license and
co,,nter•signat.,re of licensing agency
COPY 'A" — Local Authority
(Spnatue of oflcal graneng pe,mn
(Tete)
WA
CTi Town or Only
rPART
Lieetod
FOR
TO: Governing body of city, town or county in
O., 11 s area Dana awsr s r t ..^,,p'
FIREWORKS DISPLAY PERMIT
which display IS t® be conducted.
APPLIGsNy
NAME ,
ADDRESS
lat.
1.•.... -to amt sen a4a e � J
E L� g�y
F
rj -OTECb. C OPER. OA
AME
(� {
oc
pppafgryS
a
.i.r.iEt C>< ASSISTANTS tin asac ov raa9i..e'adr�
04.0E
j�,-iBLp
ADORE
�SI...144 �:tia^y
Sy
[AGE
=-_-_.4.
H61.40_
E3ACT LOCATION OF PROPOSED DISPLAY
D.,E
NuraBEP
tni
}� t.,�
'!'ill ._...—,...,--....L ir '�;J 4i.
_� fz-_ __.....,....�._..._.
AND a l $ OF FI EWOstX$ TO BE DISPLAYED
? t I.3 !113 55
5ii Ila 3c-_
z f
— ..t.. _..2i.___.
OANNER i P•...:E s,,...PRIOR TO D39..v
VS
' r /��.
1 ' -a34.f 2.11%.E I [� Fes •! f !+ti s'h'ams al Apoksam
FiiMANC IAL RESPONSIEWTY
Okra One)
Bond Or Pertefate Of insurance attached
state tie IT,arshal
average of
parson and "rent.j
2,0n0rng Or !rawrawce Cc
�•7 �(' J ^�
7 +�N�r
5 + w ! Y y 7 l �T. c, 1 [ ✓.2Y° (i , t� & r
,o,— Sant or c rafaate of ina;srart 7n !lila with
Bond Or certificate Ot lnsuranCt shat` prOvrda minimum
150.0001$1.000,000 bodily !Nulty ltaadny for each
respective.iy. and $25.000 property Carnage liability
A30:oss
S ii ;,Lf) CI Me, (..(k kft- rs• tPIa:
, t/ a2,
Z•4=^-• i
PERMIT
and applicable local
Data /9
PART II
PE�10rt;T a
In accordance wilt, the provisions of RCW 70.77
the above application.
ordinances his permit rs granted 10 ci0nds,et a tisaworks display as per
Nan.*
;FLA nano or sone, tin d orwrmsr, waxed prow;
Fkalcclions
(Wows of arcs. 9rano% won;
perm not vans for cOrvlucl of Display
w:ihOut ve•:ficaticn Or Act,Ce and
counter-siQnaIi re o1 Itcansi,$ agency
(rao7
WA
CAty toe* w C.txny
PART
VEiNaFicATION OF UCENSE
Dale — q 19 G
May Oils certify that the applica^d-
_ has been Issued a Sprciai Public Display License 10' the date and location Ind•cated�,n the application., or
t�'ftOlds a cirren1 Genera Fub.ic nispiay License arta nas a va:i0 a.>rnd 'iaoi'rty ins,efeK i - , c.p o the State Fire Marsna.
�31� Yr/ .
/.." i�
OFFICE OF STA'£ FIRE MARSHAL
At.rniORCAT1ON TO PURCHASE SPECIAL FIREWORKS
PossesalOn by the applicant Of IRIS Ocmpeled application signed by both the I0C41 Issuing authority and the State Fire Marsha! authorizes the
applicant to purchase the speca! fireworks listed in the application for use at the tOCatlion and Cate shown.
COPY 'C' — Applicant'
aer40n i l' '019rbI $
Fain sF sea • • I