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CITY OF WEST CHICAGO
PUBLIC AFFAIRS COMMITTEE
AGENDA ITEM SUMMARY
ITEM TITLE:
AGENDA ITEM NUMBER: 4.€.
Memorial Day Race
ABD Cycle Club FILE NUMBER:
COMMITTEE AGENDA DATE: March 25, 2019
COUNCIL AGENDA DATE:
SIGNATURE Z——
APPROVED BY CITY ADMINISTRATOR:
Michael Guttman SIGNATURE
STAFF REVIEW: Tom Dabareiner
ITEM SUMMARY:
ABD Cycle Club is seeking approval for a Memorial Day Cycling Event scheduled for Monday, May 27,
2019 from 7:30 a.m. — 3:00 p.m. with an estimate of 100 attendees.
ABD Cycle Club has requested the use of Enterprise Circle from 7:30 a.m. — 3:00 p.m. for their event.
The event will be managed by ABD Cycle Club with the support of volunteers.
Representatives from Simpson Strong-Tie and DSC/DS Containers have confirmed that they have no
issues with the event taking place as proposed. Simpson Strong-Tie and DSC/DS Containers will be
closed on the event day.
The Special Event Permit Application, which includes the requests of the City, has been reviewed and
approved by staff from the Police, Public Works, and Community Development Departments as well as
the West Chicago Fire Protection District. The Special Event Permit Application is attached, which
includes the cycling race route along Enterprise Circle.
ACTIONS PROPOSED:
Recommend event for approval as proposed, contingent upon submittal and approval of required
insurance documentation.
COMMITTEE RECOMMENDATION:

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City of West Chicago -
SPECIAL EVENT PERMIT APPLICATION
THIS FORM MUST BE COMPLETED IN FULL & SUBMITTED
90 DAYS PRIOR TO THE EVENT
PERMIT NO.
Special Event Permit Application
The Special Event Application is due to the City of West Chicago a minimum of ninety (90)
days prior to the event if it requires closure of public streets or use of public parking lots.
The 90-day time period allows sufficient time to evaluate the request and provide a
recommendation to the City Council for its consideration.
Note: Prior to review of the Special Events Permit Application, all applicants must
submit the Intent to Meet Insurance Requirements form (page 2).
Submittal Checklist
1. Completed and signed Special Event Application
o Intent to Meet Insurance Requirements
0 Section 1 — General Information
© Section 2 — Narrative
a Section 3 — Permits
a Section 4 — Site Plan and/or Route Map
0 Section 5 — Task List and Due Dates
a Section 6 — Hold Harmless Agreement
2, Completed and signed applications(s) for other permits(s) (See Section 3)
a Carnival Permit Application - $50 per employee
a Fireworks Permit Application —
$125 (Check made payable to the West Chicago Fire Protection District)
o Building Permit Application (temporary tents — see min. requirements) - $50
o Raffle Registration Application — requires separate application
a Temporary Liquor License Application — requires separate application
0 Temporary Food Service Permit (DuPage Co. Health Dept. 630-682-7979)
=
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FOR OFFICE USE ONLY
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Received: ay 4 / \ Fee Paid: §$. N/ A
Receipt # N/ Check # IN [4 \
Event Acknowledgement Form returned by:
Police Dept. Fire Dist. PW Park Dist.
o Background checks completed by Police Dept. Date Na i A
a DuPage Co, Health Department notified Date N/ L\
a Certificate of Insurance received and approved Date
Page 1 of 8

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“* INTENT TO MEET INSURANCE REQUIREMENTS ***
Must be returned prior to application review by City staff
Prior to the issuance of a Special Event Permit, all organizations must
present a certificate of insurance meeting the criteria listed below:
1, Required limits per IRMA are $1mil per occurrence and general aggregate no less than
$2mil for contractors/vendors.
2. ***PLEASE NOTE: Under the box labeled “Description of
operations/locations/vehicles/exclusions added by endorsement/special provisions", the
following language must appear:
“The City of West Chicago, its officials, agents, employees, and volunteers is/are named
additionally insured. The additional insured is covered as respect to liability arising out of any
work or activities performed on behalf of (company involved) for (event) (date, times (if
applicable), location) No endorsements or additional forms modify or limit coverage provided
to additional insured. Coverage provided to additional insured is primary as it relates to
(event)".
3. Vendors shall furnish the additional insured endorsement (consult insurance professional;
examples include but are not limited to forms CG 2010 or CG 2026) to support the certificate
of insurance. The endorsement shall also name “The City of West Chicago, its officials,
agents, employees, and volunteers” as primary and non-contributory.
4. If applicable, vendor shall furnish the City with evidence of Worker’s Compensation
coverage with statutory limits.
5. The insurance provider will need to submit the Certificate of Insurance and supporting
endorsement form preferably via email to specialevents@westchicago.org or fax
(630-293-1257) to be considered an original document.
representing
(print name of authorized person) (organizatjon)
have contacted the appropriate insuraiice provider and acknowledge that the above
insurance criteria can be met. | understand that the Special Event Permit Application
will not be reviewed until this document has been signed and returned to the City of
West Chicago.
(signature)
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4 \ Cy ata
| We: erc! ae [ia
(date of event)
Page 2 of 8

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SECTION 1 —- GENERAL INFORMATION
‘ .
Name of Event: { y 10. Stes 4 ( lemoc.a | | day ; neycle ac’,
Type of Event:
Wall/RugBike) 0 Carnivals O Fireworks O Festival
4
Name of Sponsoring Organization(s):
Organization's Legal Status (i.e. NFP, Partnership, Corporation):
Contact person from sponsoring organization: :
Organizer address: _*
Emergency contact information (provide mobile numbers for on-site coordinators d ing event):
1* Contact: Phone: (p 20 646 a! et
2" Contact: Phone: (p20 GG 2 74
Is this an annual event’? Gh Yes O No If Yes, provide next year's event date: 5 IDS LO
If the event is a recurring event, please state any problems and/or incidents that have occurred in past
years, such as noise or neighborhood parking complaints.
a L) Ya ¢
What, if anything, are you doing to rectify the problem(s)?
SECTION 2 —- NARRATIVE
On a separate sheet, provide a detailed description of the overall event. The narrative will serve as
the special event proposal to City Council.
Page 3 of 8

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ABD Cycling Club Bicycle Race Proposal
05/27/2019 @ Enterprise Circle
Primary Organizer: Athletes By Design Cycling Club (ABD)
e Founded in 1998, the ABD is a 200-member, volunteer-based
organization based in Winfield, Illinois.
e ABD's primary goal is to support young athletes with Olympic
potential and promote the sport of cycling. We also support a
local Paralympic racer,
e Membership is primarily comprised of professionals (doctors,
teachers, municipal employees, teachers, small-business owners)
between the ages of 35 and 55.
e Currently ABD organizes 15 sanctioned races each year in the
communities of Winfield, Wood Dale, Maple Park, and Geneva
e The volunteer event staff ranges between 12 and 120 people
depending on the event. The average age of an ABD volunteer is
35 years old and they have experience in at least 10 previous
events. Some volunteers have worked over 50 events for ABD.
e ABD's largest event is the Winfield Criterium, first held in 2000.
It attracts over 400 riders and up to 3,000 spectators each year.
The course incorporates Winfield Road and affects over 300
residents,
Governing & Insuring Body: American Bicycle Racing (ABR)
Event Directors:
e Mary Lee Geraghty, ABD Vice-President
e Mike Farrell (On-site Director), ABD Administrator
“Prep Work:"
e Have contacted Trish Tell at Strong Ties and received permission
for use of their parking lot and the road.
e Have contacted Mike Rolanda at DSC/DS Containers and received
his permission to use the roads, they are closed that day.
General Details:
e Set-up starts at 7:30 a.m. and tear down finishes at 3 p.m.
Races begin at 9 a.m. and conclude at 2:20 p.m. The loop is

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approximately 6/10 of one mile.
Approximately 100 competitors are expected to participate, but
they are spread throughout the day into six (6) separate race
categories.
Parking for racers will be at Strong Ties.
Three (3) port-o-lets will be set up near the racer registration
area for all racers and volunteers
Course marshals will be stationed aroound the course as well as
necessary intervals to maintain a "line of sight" so that they can
see the marshal stationed before and after them at all times.
Orange flags will be raised to indicate approaching riders.
A Pace Car will precede the racers around the course at a
distance of approximately 50 yards. It includes an experienced
driver and passenger who can communicate back to the racers
with hand signals. The pace car lets marshals know to expect
riders coming through but can also bring the riders to a halt in
less than 10 seconds should there be an emergency.
We have arranged for a licensed EMT's to be stationed on the
course.
3 ABR officials, and an announcer and an ABD volunteer are
stationed at the Start/Finish line all day.
Race registration will have two to four people at it all day
(depending on the "field" size of the upcoming races)
All officials, EMT's and course marshals will communicate via
two-way radios and a cell phone list is distributed to key
personnel should the radios fail.
A "wheel pit" is manned by an official and provided for riders who
suffer a mechanical failure and need to replace a wheel or repair
their bikes. (Riders are typically given 1 "free lap" during a race)
Lunches, water and soft drinks will be provided for all race
officials and volunteers. Two "floating" volunteers will travel the
course to distribute this as well as provide relief to volunteers
that need it.

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SECTION 3 —- PERMITS
Will your event include a carnival? 0 Yes lo
If yes, you must submit a Carnival Permit Application ninety (90) days prior to the event.
Please visit www.westchicago.org under Forms or contact the City of West Chicago at (630)
293-2200 ext. 135 for an application.
Does your event include the use of a temporary tent in excess of 400 sq. ft. in area with side curtains
or 700 sq. ft. in area without side curtains? o Yes Beto
If yes, you must submit a Building Permit Application thirty (30) days prior to the event.
Please visit www.westchicago.org under Forms or contact the City of West Chicago at (630)
293-2200 ext. 131 for an application.
Will your event include a fireworks display? o Yes ‘sie
If yes, you must submit a Fireworks Permit lication thirty (30) days prior to the event.
Please visit www.westchicago.org under Forms or contact the City of West Chicago at (630)
293-2200 ext. 135 for an application.
Are you holding a raffle at your event? o Yes So
If yes, you must submit a Raffle Registra Application fourteen (14) days prior to the
event. Not all applicants will qualify for a license. Please visit www.westchicago.org under
Forms or contact the City of West Chicago at (630) 293-2200 ext.170 for an application.
Will you be applying for a Temporary Liquor License? 0 Yes Be
If yes, you must submit a Temporary Liquor License Application thirty (30) days prior to the
event. To qualify for a Class D license, the applicant must be a local organization or group
providing beer and/or wine at a picnic, carnival or similar function. A Class D license shall be
authorized on a day-to-day basis but not for more than seven (7) consecutive days. Please
contact the City of West Chicago at (630) 293-2200 ext. 170 for an application.
Will you be serving food at your event? oa yeu No
If yes, you may be required to submit a Ts orary Food Service Permit Application thirty
(30) days prior to the event. Please contact the DuPage County Health Department at (630)
682-7979 or visit http://www.dupagehealth.org/temporary-food-service for additional
information.
Are you requesting services from these departments? |) 0
O Police O Fire District / Paramedics O Public Works
Specify services:
Will you be utilizing any of the following services? =~) OD
O Water O Electric/Generator 0 Other
Page 4 of 8

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SECTION 4 — SITE PLAN AND/OR ROUTE MAP
Please attach a separate sheet to illustrate the layout for your event.
If applicable, the following must be included:
Location of garbage receptacles (G) Location and number of barricades (B)
Location of toilets (T) Location of fire lane (FL)
Location of hand washing sinks (HWS) Location of fire extinguishers (FE)
Location of retail vendors (RV) Public entrances and exits (PE)
Location of food vendors (FV) Location of "No Firearms" signage (NF)
Location of first aid (FA) Location of sound stages and amplified sound (S)
Location of residential streets surrounding event
Are you requesting the use of any City-owned property, i.e. City streets, parking lots, or sidewalks?
MLYes O No _Ifyes, please indicate the property that you are re esting to use.
a ‘
US =e or Ersteceris et yer x
BE Z/b/\ 4
Would you like to request the closing of City streets? O Yes LNT
If yes, please fill in the following information or submit a route map along‘with this application:
Street From Dates Times
To
Eyktwp ci ce Cir 1am ~ SL: OC pm
SSCS
Wwe have spoken to oth business
and recewed PEecmissiorn. SQOKe Ke
Strong Th 26 Trish Hd on 24-2014:
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Page 5 of 8

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SECTION 5 —- PLANNING WORKSHEET AND REQUIRED TASK DUE DATES*
Use this form to determine the date each of these tasks needs to be completed. For tasks that do not apply,
please mark "N/A" in the Due Date column. If the Due Date falls on a weekend or holiday, the Due Date
becomes the next normal business day. However, this does not affect the other Due Dates, as they are only
dependent on the date of the special event.
Note: This section must be completed by event organizer prior to notary signature.
Date of Special Event:
Tasks to be completed
All items due to City unless noted
Submit “Intent to Meet Insurance Requirements”
Document (included with Special Event Permit
Application, pg.2)
Days Due
Before Event
Prior to
application review
Due Date
Prior to application
review
Submit Special Event Permit Application
90 days 54 / b /|4
Submit Carnival Permit Application
90 days
Submit Fireworks Permit Application
Submit Temporary Liquor License Application
anne: aeees, Pee sear:
30 days
30 days
M/A
Submit Building (Temporary Tent) Permit
Application
Submit Temporary Food Service Permit
Application(s)
DuPage County Health Dept. — 630-682-7979
Submit Original Certificate of Insurance”
30 days
|= SS ___
30 days
N/A
N/A
21 days*
ST o/14
Submit Raffle Registration Application
| ep
Notify residents/businesses of special event
Post “No Firearms" signs at all public entrances
(See IL State Police requirements for standardized
Saar EIUTpT Taper So UeneTennE EE
_ sign in West Chicago's Special Events Policy)
14 days
14 days
N/A
SABA
N/A
Day of Event
“If this requirement is not met, the proposed event may he cancelled.
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SECTION 6 — WAIVER AND non HARMLESS AGREEMENT
In consideration of the A ( 14 ) ( } 4c Lec lu Diname of nucle Ug and its Members,
employees, volunteers or guests, being allow to participate in the Activity) the
undersigned hereby recognizes, acknowledges and assumes any and all risk pertaining to
VU (fame of organization) participation in the Activity.
To the fullest extent permitted by law, the Nt f) ( 4 le ( ly b (name of organization)
hereby agrees to defend, indemnify and hold harmless the City of West Chicago, its officials, agents and
employees, against all injuries, deaths, loss, damages, claims, suits, liabilities, judgments, cost and
expenses (including attorneys fees), which may in anywise accrue against the City of West Chicago, its
Officials, agents and employees, arising in consequence of
organization) participation in the Activity, or which may in anywise result therefore, except that arising out
of the sole leg henuse of t! ityjof West Chicago, its agents or employees. The
Y Vie of organization) shall, at its own expense, appear, defend and
pay all charges of attorneys and all costs and other expenses arising therefore or incurred in connections
therewith, and, if any judgment shall be rendered against the City of West Chicago, its officials, agents
and employees, in any such action, the ay 2 ( ) LE. (2. fi 1) | B; (name of organization) at
its own expense, satisfy and discharge the same.
The invalidity or unenforceability of any of the provisions hereof shall not affect the validity or
enforceability of the remainder of this Agreement.
The undersigned represents it has full authority to execute this Waiver and Hold Harmless Agreement on
behalf of the 3 (name of organization).
Ort 4]
Agreed this_{ 9 day of 1) 7. iM AL20 j
)
ALO Cicle Cb _
Name of Organization
cy ly Aly
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The Organization and the authorized signatory below agree to inform the City of West Chicago of any
changes in the application at least thirty (30) days prior to the event. Please note: Final approval of
this event is pending satisfactory completion of Certificate of Insurance requirements.
Signatory agrees to abide by all requirements of the Special Events Policy, including
compliance with the State of Illinois Firearm Concealed Carry Act.
*All applications must be signed and notarized.
ABDC fale plat th Lip —-ye— 3-2/7
(Name of a ion) (Print Name of Sighatory) (Date)
(le, In. TS ban.
(Notary Public)
Signed and sworn to before me this lem day of Var (eA : ad / Fd ,
After submitting all forms, your application will be reviewed by City staff. All departments that will be
involved in providing services or permits for the event will be notified. Please do not assume that all
aspects of the event will be approved. You may be asked to make some changes to your plan
based on the availability of services or scheduling of other events.
The City of West Chicago reserves the right to cancel any event at any time for reasons deemed
necessary by the City Council and/or City Administrator.
Deliver all completed items to:
City of West Chicago
Attn: Community Development — Special Events
475 Main Street
West Chicago, IL 60185
ARLENE M FISHER
NOTARY PUBLIC - STATE OF ILLINOIS
MY COMMISSION EXPIRES:04/11/21
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' FOR OFFICE USE ONLY
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Based on the information which has been submitted and contingent upon approval of any necessary inspections
the day of the event, the request for a permit has been:
O Approved Permit No.
Authorized Signature -
Title Date
Page 8 of 8