Use of Parks Bundle

Procedures for Use of Parks

Any park event or use of sidewalks/trails through any park requires
Use of Parks forms, insurance requirements, and Park Board approval.

1. Application for Park Use for an Event Form must be filled out and sent to Paula Garis,

321 E. Walter St., South Bend, IN 46614, 30 days prior to the next scheduled Park Board

meeting.

2. A letter on letterhead or an e-mail must be submitted no less than 30 days prior to the

scheduled Park Board meeting. (3rd Monday of the month at 5:00 p.m. at the O’Brien

Recreation Center). This is also sent to Paula Garis by email at

[email protected]. The 2016 Park Board Meeting dates are listed below:

a. Tuesday, January 19 g. Monday, July 18

b. Monday, February 15 h. Monday, August 15

c. Monday, March 21 i. Monday, Sept. 19

d. Monday, April 18 j. Monday, Oct. 17

e. Monday, May 16 k. Monday, Nov. 21

f. Monday, June 20 l. Monday, Dec. 12

3. If this is a new event, a formal presentation by the applicant must be made to the Park
Board. We do not require returning events to present to the Park Board again unless
there have been problems or changes to your event.

4. If the event is approved, a one million dollar liability insurance certificate must be
produced two weeks or more prior to the event. The certificate must list the City of
South Bend, South Bend Parks and Recreation, and the Board of Park Commissioners as
additional insured’s. A sample insurance certificate is included in the packet. If
Certificate of insurance is not made out correctly, it will be refused and returned.

5. No alcohol is allowed without an Alcohol Exemption Form (beer and wine only,
purchased through the O’Brien Center). You must show the actual alcohol permit
purchased from the Indiana State Excise Department before purchasing your Alcohol
Exemption Form at the O’Brien Center.

South Bend Parks & Recreation 321 E. Walter Street South Bend, IN 46614 574.299.4765

6. The sponsor/promoter is responsible for supplying a list of food vendors and paying for
the food vendor permits.

7. A list of all equipment being brought in and the company providing them is also
required. For inflatables/bounce houses, South Bend Parks & Recreation has first right
of refusal. Contact Mike Bueno of South Bend Parks and Recreation at 574-235-9373.

8. Any stage set-up needs to have an Amusement Entertainment Permit from Homeland
Security.

9. No equipment or electric is provided.
10. All cleanups are the group’s responsibility. All equipment (rentals of tents, stages,

portable restroom, etc.) must be removed within 48 hours.
11. All forms in this packet may not pertain to your event, i.e. Vendor information/forms.
Firms providing liability insurance include Laven, State Farm, and Gibson. Those are some of
the more popular.

South Bend Parks & Recreation 321 E. Walter Street South Bend, IN 46614 574.299.4765

APPLICATION FOR PARK USE FOR
AN EVENT FORM

APPLICANT INFORMATION

Must be completed FOUR (4) weeks prior to event. Incomplete request forms will be returned to Applicant.

Applicant (Contact) Name: Organization Name:

Date of Application: Event Name:
Is this a return event? ___ Yes ____ No

Applicant Phone: Email Address:
City/State/Zip
Cell Phone:
Address:

Type of Event (mark one): _____ Private (specific guest list and know who is attending)

_____ Public (open to the public)

Are you giving/selling/serving food items of any kind at your public Event? ____ Yes ____ No (If yes, explain. See
Equipment/Set-up below.)

Name of Park: EVENT DESCRIPTION

Site in Park:

Date(s) Requested (including set-up dates & time. Type of Event
Insurance certificate to include all dates):

Start Time: End Time: Anticipated Expected Attendance:

(Please note: all set-up and clean-up needs to be done
within scheduled hours)
Brief Description of Event:

EQUIPEMENT/SET-UP

Electricity is not available in any park. Water is turned off October thru April. Water turn-on
is dependent upon the weather. Before any staking of a tent, inflatables, or portable
restrooms, it is the responsibility of the event organizer to contact the local utilities for
locates.

Are you having a company (caterer) prepared and/or serve food in the park? ___ Yes ___ No If yes, a complete list of
Vendors is to be provided. Food Vendor Permit are required through South Bend Parks & Recreation. Fee: $30.00 PER
10’x10’ BOOTH, $60.00 PER FOOD TRUCK. Health Department Permit and South Bend Parks & Recreation
Food/Merchandise permit are to be visibly displayed.

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Are you having someone or a company provide entertainment, games, or inflatables? ___ Yes ___ No If yes, a list must
be provided in the space below. Use separate sheet of paper if necessary. Inflatables/Bounce Houses MUST first go
through South Bend Parks & Recreation. Contact Mike Bueno at 574-235-9373. If South Bend Parks & Recreation
Bounce Houses are not available, use of any outside company must be approved by Mike Bueno. Once approved, the
company MUST provide us a certificate of insurance naming the City of South Bend, South Bend Parks & Recreation, and
the Park Board of Commissioners as Certificate Holder.

Are you having a company provide equipment i.e. tables, chairs, generators, portable restrooms, bleachers, staging, etc…?
___ Yes ___ No. If yes, a list of equipment and the company providing it must be provided in the space below. Use
separate sheet of paper if necessary. All stage set-up MUST have a Homeland Security Amusement & Entertainment
Permit.

Are you having a tent/canopy? ___ Yes ___ No ___ Pop-up tent ___ Stake tent Tent Size___________________________________
(Utility locates are the responsibility of the applicant. Proof of locates (locate number) are to be provided to South Bend
Parks & Recreation 2 weeks before your event. The name of the rental company MUST be provided for approval before
the company can rent or deliver your items. This is to ensure all parties have gone through the proper steps to use any
park property.

Will your event be contained within the Park or will you need use of Public Streets or sidewalks: (If using public streets
and/or sidewalks, an Application for use of Public Right of Way for Processions MUST be filled out FOUR (4) weeks
prior to notice of event through the:
Board of Public Works
1316 County City Building
227 West Jefferson Blvd.
South Bend, IN 46601

ATHLETIC FIELD USE

Field/Facility Requested: Contact Ray Comer, Athletic Supervisor, for availability and rental cost: 574-299-4775

INSURANCE

A Certificate of Insurance(General Liability and Automobile Liability for $1,000,000.00 each), naming each of the

following MUST be received 2 week prior to your event (a sample Certificate of Insurance is provided in this packet):

The City of South Bend South Bend Parks & Recreation Board of Park Commissioners
227 W. Jefferson Blvd. 321 E. Walter St. 321 E. Walter St.

South Bend, IN 46601 South Bend, IN 46614 South Bend, IN 46614

SECURITY

If alcohol is served, the number of security officers depends upon the number of people attending.

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The following procedures are those which must be followed to request the use of a city park for
an event that is open to the public. This does not include reserving a picnic site or renting a
pavilion. Please call 299-4765 to inquire for picnic reservations or use of a pavilion.

1. A letter on your group's letterhead and flyer must be submitted. The letter must describe
the type of event you wish to hold, the requested date and the park. This must be
submitted four (4) weeks before the scheduled park board meeting.

2. In addition, proof of liability insurance must be provided. The city requires a $1,000,000
per event policy naming South Bend Parks & Recreation, the Board of Park
Commissioners and the City of South Bend as additionally insured. Sample attached.

3. A formal presentation must be made in front of the Park Board. (The board meets the
third Monday of the month at 321 Walter Street, which is the old O'Brien School, at 5:00
p.m.). Applicant must specify which Board Meeting they will attend. Returning events do
not need to appear before the Park Board unless there are changes (such as routes or park)
or if there were problems with your event.

4. Your request should be addressed to the Board of Park Commissioners, 321 East Walter
St., South Bend, IN 46614.

5. No alcohol is allowed without an Alcohol Exemption Form and/or Park Board Approval.
(beer and wine only, purchased through the O’Brien Center). You must show the actual
alcohol permit purchased from the Indiana State Excise Department before
purchasing your Alcohol Exemption Form at the O’Brien Center.

6. No equipment or electric is provided (i.e. stage, tables, extra picnic tables, sound, etc.)
7. Applicant assumes full responsibility of assuring the area will be cleaned up upon

conclusion of the event. A post-event evaluation form will be completed and focused on
items such as clean-up, any damages, and/or security concerns.
8. The City of South Bend Noise Ordinance is in effect at all hours. Between the hours of
11:00 p.m. and 7:00 a.m. certain noises are particularly prohibited. These include
operating radio receiving sets, musical instruments, phonographs and other sound
reproduction devices if audible fifty (50) feet away, as well as shouting, yelling, hooting,
whistling, or singing in the streets in a manner to disturb the peace (Municipal Code 13-
57).
9. Notification of approval/denial of this request will be issued by return of this form, upon
signed authorization by the Board of Park Commissioners.
10. If your event is not carried out in the manner in which you represent it to the Board of
Park Commissioners, the event can be shut down immediately and can terminate any
future events held in South Bend Parks.
11. Applicant agrees to indemnify, defend and hold harmless the Civil City of South Bend,
Indiana, from any liability, loss, costs, damages or expenses, including attorney fees,
which the Civil City of South Bend, may suffer or incur as a result of any claims or
actions which may be made by any person, including a participant in the event/activity,
arising out of the approval of this request by the Board of Park Commissioners.

I have read and agree to the above rules and regulations and that this request may be denied
based on any false or incomplete information. I have also received and read the pamphlet with
the City of South Bend Park Ordinances.

Applicant Signature ______________________________________________ Date __________

Printed Name ___________________________________________________

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DEPARTMENTAL USE ONLY

Presented to Park Board on ________________________ Approved: ____ Yes ____ No

Copies to (when applicable):

Paula Garis, South Bend Parks & Recreation Approval ____________________

Cynthia Fish , South Bend Parks & Recreation Approval ____________________

Steve Orlowski, Park Ranger Approval ____________________

Jim Byers, Operations Manager Approval ____________________

Ray Comer, Athletics Dept. Approval ____________________

Maurice Scott, MLK Center Approval ____________________

Cynthia Taylor, CBL Center Approval ____________________

Rose Kauffman, HP Senior Center Approval ____________________

Garry Harrington, Rum Village Nature Center Approval ____________________

Randy Nowacki, Golf Approval ____________________

Marcia Qualls, Public Works Approval _____________________

Marcy Dean, Potawatomi Zoo Approval _____________________

Heidi Gray, Potawatomi Conservatory Approval _____________________

Joe Hart – Four Winds Field Approval _____________________

Comments or Recommendations (before or after event):

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City of South Bend Parks and Recreation Department Contract
Indemnity & Hold Harmless Agreement

Event Name ______________________________________ Date __________________

Name of group requesting use of Park: ________________________________________

Contact Name: ___________________________________________________________

Address: ____________________________ State: Indiana Zip: ______________

Telephone: ________________________ Cell: _____________ Fax: ______________

Park Location of Event: ___________________________________________________

Date: _______________________________________

Duration: _______________________________________________________________

Insurance Amount: 1 million dollars – one day insurance rider naming City of
South Bend, Board of Park Commissioners and South Bend Parks & Recreation.

Waiver:
Organization Name: _________________________________________________________________ will
release and discharge the City of South Bend and the Board of Park Commissioners, Park Department and
all __________________________________________ volunteers from any and all liabilities due to any
damage, injury or loss of property. I agree to this written contract and will abide by the rules set forth.

______________________________________ _____________________________________
Signature of authorized member Printed name of authorized member

Signed on this date ___________________________________ 20_____

______________________________________ _____________________________________
Authorized Organizer Signature Printed name and title

Should you have any further questions, please contact: Paula Garis with the South Bend Park Department at
574-299-4778. Please return the contract signed via fax to 574-299-1784 or e-mail to
[email protected] or [email protected] . Please keep a copy of this contract for your records.

Insurance Requirements

The City of South Bend requires vendors to submit evidence of adequate insurance prior to
performance of work or services on City property.

Insurance Requirements

An insurance certificate must be prepared pursuant to the requirements listed. Failure to comply
with these requirements in a timely manner may jeopardize the renewal and/or continuation of a
contract. CERTIFICATE OF INSURANCE MUST BE RECEIVED AT LEAST TWO
WEEKS PRIOR TO EVENT.

1. The City of South Bend, Board of Park Commissioners, and South Bend Parks &
Recreation must be named as additional insured on Commercial General Liability
and automobile Liability coverage. An ACORD certificate shall be submitted, reflecting
that the City of South Bend, Indiana, its respective elected officials, officers, employees,
agents and representatives” are additional insured’s.

2. Certificate holder information must read as follows:

City of South Bend, Indiana Board of Park Commissioners
227 W. Jefferson Blvd. 321 E. Walter St.
South Bend, IN 46601 South Bend, IN 46614

South Bend Parks & Recreation
321 E. Walter St.
South Bend, IN 46614

INSURANCE CERTIFICATE MUST BE RECEIVED UPON BOARD APPROVAL OF
YOUR EVENT!

Sample of Certificate of Insurance attached.



South bend park rangers
Want you

To remember to have

Fun in the parks

FIRST AND ALWAYS FOLLOW THE RULES OF THE PARKS
USE THE PARKING LOTS DON’T PARK ON THE GRASS
NO ALCOHOL ALLOWED IN THE PARKS WITHOUT PERMITS

FROM INDIANA STATE EXCISE POLICE AND THE PARKS DEPARTMENT

IN OUR PARKS DON’T DAMAGE OR DESTROY ANYTHING
NO SMOKING OR STARTING FIRES IN THE PARKS

THE PARKS ARE FOR EVERYONE. BE CONSIDERATE
HELP KEEP OUR PARKS CLEAN PUT YOUR TRASH IN A CAN
EVENTS HELD IN A PARKS MUST HAVE PRIOR AUTHORIZATION

PARKS ARE OPENED FROM 6:00 A.M. TILL 11:00 P.M.
AMPLIFIED SOUNDS MUST BE KEPT TO 20 FEET FROM DEVICE
REMEMBER FIREWORKS ARE NOT PERMITTED IN THE PARKS
KEEP YOUR PETS ON A LEASH AND PICK UP THEIR WASTE
SETTING UP A TENT IN THE PARK NEEDS PRIOR APPROVAL

A list of the South Bend Park Ordinances can be found on the South Bend Park Department web site at sbpark.org and
always remember to have FUN IN THE PARKS