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RESOLUTION NO. 2017-42
RESOLUTION NO. 2017-42 RESOLUTION APPROVING FIREWORKS PERMIT FOR WILLIAM BARRY WHEREAS, the City Council of the City of Fairfax, Iowa, is empowered under the authority of Section 727.2, Code of Iowa, to grant a permit for the display of fireworks by municipalities,fair associations,amusement parks and other organizations or groups of individuals approved by the City Council when such fireworks display will be handled by a competent operator; and WHEREAS, the City Council of the City of Fairfax, Iowa, has received a request for fireworks display permit from William Barry; and WHEREAS, the City Council of the City of Fairfax, Iowa, desires to grant permits only when a competent person will be in charge of the fireworks display to provide for the safety of all concerned. NOW, THEREFORE, BE IT RESOLVED, by the City Council of the City of Fairfax, Iowa, that criteria be prescribed for the issuance of permits for the display of fireworks in the City of Fairfax, Iowa. BE IT FURTHER RESOLVED, that the following definitions be used: Applicant: The person or group, which is applying for the permit. Fireworks: Any explosive composition,or combination of explosive substances,or article prepared for the purpose of producing a visible or audible effect by combination, explosion, deflagration,or detonation, and shall include blank cartridges, firecrackers,torpedoes, sky rockets, roman candles, or other fireworks of like construction and any fireworks containing any explosive or inflammable compound, or other device containing any explosive substance. The term "fireworks" shall not include gold star-producing sparkles on wires which contain no magnesium or chloride or perchlorate, no flitter sparklers in paper tubes that do not exceed one-eighth(1/8) of an inch in diameter, no toy snakes which contain no mercury and no caps used in caps used in cap pistols. Operator: A person trained in fireworks safety who will set up and explode the fireworks. Sponsor: The group paying for or otherwise providing for the fireworks display. Requirements: 1. That the applicant submit an application in writing on the form attached hereto and incorporated herein by reference no later than ten (10) days before a Fairfax City Council Meeting. 2. That no permit be issued until the Chief of the Fairfax Fire Department having jurisdiction over the site of the fireworks display and the City Council, Fairfax, Iowa has approved the location and fire prevention measures. 3. That no permit be issued unless liability and fire insurance coverage is procured to protect the applicant, sponsor, operator and the public in an amount not less than $2,000,000. 4. That the applicant and operator be persons of not less than eighteen (18) years of age on the date of the proposed fireworks display. 5. That the operator must meet the following fireworks safety requirement: a) Possess a current, valid fireworks license issued by a state of the United States which requires formal safety training; or b) Demonstrate an equivalent degree of formal fireworks safety training and experience to the satisfaction of the City Council and the Chief of the Fairfax Fire Department. 6. That any fireworks that remain unexploded after the display shall be immediately disposed of or removed for storage or disposal in a safe manner by the operator who, upon the conclusion of the display, shall make a complete and thorough search for any unexploded fireworks or fuses thereof which have not exploded or functioned. BE IT FURTHER RESOLVED,that the Linn County Sheriff or his or her designee may suspend any permit issued pursuant to this resolution should he or she determine that the health, safety, welfare of the public require the suspension, or should the applicant and/or operator fail to meet or follow the safety qualifications as set out in this resolution. BE IT FURTHER RESOLVED, by the City Council of the City of Fairfax, Iowa, that the Mayor and City Clerk are hereby authorized and directed to execute said Resolution. Passed and approved this 9th day of May, 2017. AYES: Beer, Daly, Kell, Volk, and Wainwright Burnell G. Frieden, Mayor ATTEST: 1 � �l k4M 7s 1 � l a Cynt is Stimson, City Clerk/Treasurer APPLICATION FOR FIREWORKS PERMIT TO: Fairfax City Council,PO Box 337,Fairfax,IA 52228 Applicant ',-` Y _� 1puz Y -- --Phone.---.G�:''- Address .1_to (�+ a', L � OR s FA,:VAkA Date of Birth -2. Sponsor ,,1 Z(<,,.�m lam- C ,, 84 A Y Phone y -ck- 7 Address Date/Time of Display O—Pcq) ^ 6"l ol6 t] t,;t-_ /- c),o 1.`r Location of Display's tee) Operator Phone -62 e? .G Address o— f � .�-- --rLj _� Qualifications of the Operator(proof may be required) 1. _Fireworks Operator License from another state 2. Pyrotechnics Guild International,Inc.Certification 3. _ Other formal fireworks safety training. Please specify: Insurance Company - ; AJ AM.A 4- to 61-144- 7_71 Policy Amount / , �lA� /.1,00 P _- Fire Prevention Measures � � '�'^ f 1 I approve of the location and fire prevention measures for this Fireworks Display, Fire Chief _iG -- - ----- ----- - �_- Mayor I hereby affirm that I have read the City of Fairfax Fireworks Permit Resolution 02-06-11-4; that I understand the Resolution's term; that no person shall handle or explode Fireworks while under the influence of alcohol, narcotics or drugs which could adversely affect judgment, movements or stability; that no person will set up or explode Fireworks who is not 18 years of age and qualified as set out above or who is not under the direct supervision of the Operator;that the Operator will conduct a thorough search for any unexploded Fireworks or fuses; that any unexploded Fireworks will be stored or disposed of in a safe manner;and that the Sponsor,Operator and I will follow its terms and the laws of the State of Iowa. Further, I specifically agree to protect,defend and hold City of Fairfax, its officers and employees and the Fire Chief who signs this application harmless from any and all damages or claims for damages that might arise or accrue by reason of the granting of the permit for which I am applying. f Signature of Applicant Date ACCAR" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) . 16. 04/27/2017 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(les)must have ADDITIONAL INSURED provisions or 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 CONTACT Bonnie White NAME: West Side Agency,Inc. PHONE . (319)851-2147 A/� No): (319)851-5808 120 Vinton Street, PO Box 200 ADDRESS: bellewhite@netins.net Palo, IA 52324 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Grinnell Mutual Reinsurance Company 14117 INSURED INSURER B: West Side Mutual William Barry INSURERC: Mary Barry INSURERD: 5110 Longview Drive INSURER E: Fairfax, IA 52228 INSURER F COVERAGES CERTIFICATE NUMBER: 00000000-18375 REVISION NUMBER: 1 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM/DDY LTR /YYYY MM IDEXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TCLAIMS-MADE D OCCUR PREM SESOEa occu RETEence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D PRO LOC JECT PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A UMBRELLA LIAB X OCCUR 0026028835 05/12/2016 05/12/2017 EACH.OCCURRENCE $ X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I X I RETENTION$ 1000 $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Y/N STER I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B HOMEOWNERS 9204072WR 04/0712017 04/07/2018 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) LIAIBILITY LIMITS SHOWN ARE SUBJECT TO CLAIMS FIREWORKS DISPLAY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN CITY OF FAIRFAX ACCORDANCE WITH THE POLICY PROVISIONS. 525 VANDERBILT ST. Fairfax, IA 52228 AUTHORIZED REPRESENTATIVES / BBw ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by BBW on April 27,2017 at 12:54PM