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CITY OF WEST CHICAGO
PUBLIC AFFAIRS COMMITTEE
AGENDA ITEM SUMMARY
ITEM TITLE: a
AGENDA ITEM NUMBER: C.
Pro-Life March
St. Mary’s Parish FILE NUMBER:
COMMITTEE AGENDA DATE: January 24, 2022
COUNCIL AGENDA DATE:
STAFF REVIEW: Tom Dabareiner sionaureZ- OA
APPROVED BY CITY ADMINISTRATOR:
SIGNATURE,
ITEM SUMMARY:
St. Mary's Catholic Church is seeking approval for a Pro-Life March scheduled for Sunday, March 27, 2022 from
2:00pm to 4:00pm.
St. Mary's has requested Police support for a rolling street closure during the march which takes place along
approximately 1.7 miles of city streets as outlined in the provided map.
ACTIONS PROPOSED:
Recommend event for approval as proposed.
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
a Intent to Meet Insurance Requirements
a Section 1 — General Information
a Section 2 — Narrative
0 Section 3 — Permits
a Section 4 — Site Plan and/or Route Map
a 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)
Building Permit Application (temporary tents — see min. requirements) - $50
a Raffle Registration Application — requires separate application
a Temporary Liquor License Application — requires separate application
a Temporary Food Service Permit (DuPage Co. Health Dept. 630-682-7979)
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FOR OFFICE USE ONLY
Received: Fee Paid: $.
Receipt # Check #
Event Acknowledgement Form returned by:
2 ss pd
Police Dept. x Fire Dist. % PW ParkDist
a Background checks completed by Police Dept. Date
a DuPage Co. Health Department notified Date
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.
|, Rev. David Lawrence , representing St. Mary's Parish
(print name of authorized person) (organization)
have contacted the appropriate insurance 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.
DDS - 13 [a
(signature) (date)
F Mark 27
Pro-Life March January 3, 2022
(name of event) (date of event)
De
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SECTION 1 —- GENERAL INFORMATION
Name of Event: Pro-Life March
Type of Event:
O Parade Walk/Run/Bike O Carnivals O Fireworks O Festival
Cl Other March
Location of Eat at Mary's Parish
Date(s) of Event: Janae, 2022 Hours of Event: 2:00 pmtg 4:00 pm Est, Attendance: 150
Event Website:
Purpose of event: Pray for the protection of life, from conception to natural death; pray for fetus to get again
independent rights under the law of Illinois and the revoking of the Supreme Court law approving abort
Name of Sponsoring Organization(s): St. Mary's Catholic Church
Organization's Legal Status (i.e. NFP, Partnership, Corporation): NFP
Contact person from sponsoring organization: Rev. David Lawrence
Organizer address: 140 N. Oakwood Ave.
City/State/Zip: West Chicago, IL 60185 Phone: 630-231-0013
Cell Phone: 630-6403528 E-mail: father.david@stmarywc.org
Emergency contact information (provide mobile numbers for on-site coordinators during event):
4°‘ Contact: Sr. Rosanny Contreras : Phone: 630-877-5782
2"4 Contact: Carol Vigsnes Phone: 630231-1777
Is this an annual event? 0 Yes O No If Yes, provide next year's event date: January 2023
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.
No past problems on January 2020
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.
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Narrative for St. Mary’s Pro-Life March
St. Mary’s Pro-Life March is a peaceful and prayerful event organized to publicly
raise awareness of the dignity of all human life from conception to natural death.
We will also be offering prayers to Almighty God for the legal protection of all
human life. We will assemble outside of St. Mary’s Church and share testimonies
of the dignity of life. Then we will begin our prayers and singing as we process
through the streets of our neighborhood. The event will conclude at St. Mary’s
Church with prayers and blessings for all present.

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SECTION 3 - PERMITS
Will your event include a carnival? o Yes oNo
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 oNo
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 oNo
If yes, you must submit a Fireworks 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. 135 for an application.
Are you holding a raffle at your event? o Yes oNo
If yes, you must submit a Raffle Registration 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? +o Yes oNo
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? o Yes oNo
If yes, you may be required to submit a Temporary 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:/Avww.dupagehealth. org/temporary-food-service for additional
information.
Are you requesting services from these departments?
@ Police Fire District / Paramedics © Public Works
Specify services: Rolling closure for 1.7 miles aprox. (See next page). Estimated time 2 hours.
Will you be utilizing any of the following services?
CO Water Electric/Generator Other No
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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?
Yes ONo If yes, please indicate the property that you are requesting to use.
City streets
sn
Would you like to request the closing of City streets? O Yes O No ye
If yes, please fill in the following information or submit a route map along with this application:
Street _ From TO) Dates ~ Times _
Garden St. E. York Ave. E. Washington aes 2:20-2:25
E. Washington Garden St. 140 N. Oak St, a " "2:25-2:30 pm
140 N. Oak St, E. Washington St. E. Grandlake Blvd. " " " 2:30-2:40 pm
E. Grandlake Blvd. N. Oak St. Fremont St. ‘ i "2:40-2:50 pm
Fremont St. E. Grandlake Blvd __ E. Yourk Ave. " "2:50-2:55 pm
E. York Ave. Fremont St. Garden St. " " "2:55-3:05
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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 Days Due
(All items due to City unless noted) Before Event Due Date
Submit “Intent to Meet Insurance Requirements” . . Par
‘ i . . Prior to Prior to application
Document (included with Special Event Permit Prd ; ;
Application, pg.2) application review review
Submit Special Event Permit Application 90 days
Submit Carnival Permit Application 90 days
Submit Fireworks Permit Application 30 days |
Submit Temporary Liquor License Application 30 days
Submit Building (Temporary Tent) Permit
Mae 30 days
Application
Submit Temporary Food Service Permit |
Application(s) 30 days
(DuPage County Health Dept. — 630-682-7979) :
Submit Original Certificate of Insurance* 21 days*
Submit Raffle Registration Application 14 days
Notify residents/businesses of special event 14 days
Post “No Firearms" signs at all public entrances
(See IL State Police requirements for standardized N/A Day of Event
sign in West Chicago's Special Events Policy)
*If this requirement is not met, the proposed event may be cancelled.
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SECTION 6 — WAIVER AND HOLD HARMLESS AGREEMENT
In consideration of the St. Mary's Pro-Life March (name of organization) and its Members,
employees, volunteers or guests, being allow to participate in St. Mary's Pro-Life Margthe Activity) the
undersigned hereby recognizes, acknowledges and assumes any and all risk pertaining to
St. Mary's Pro-Life March (name of organization) participation in the Activity.
To the fullest extent permitted by law, the St. Mary's Pro-Life March (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 attomeys fees), which may in anywise accrue against the City of West Chicago, its
officials, agents and employees, arising in consequence of St.Mary's Pro-Life March (name of
organization) participation in the Activity, or which may in anywise result therefore, except that arising out
of the sole legal cause of the City of West Chicago, its agents or employees. The
St. Mary's Pro-Life March (name 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 St. Mary's Church (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 St. Mary's (name of organization).
Agreed this 8th day of November 2021
St. Mary's
Name of Organization
Rev. David Lawrence
Print Name of Authorized Person
= oe.
Signature of Authorized Person
Pastor
Title
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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.
St. Mary's Rev. David Lawrence
(Name of Organization) (Print Name of Signatory) (Date)
Pa f- mm). Stud
Notary Public Sta G .
My Commission Expires 05/11/2026 (Notaiy Public)
Signed and sworn to before me this | ? ye day of LCP Mbor , 20 oa} E
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
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FOR OFFICE USE ONLY
ARICA ETI III AIS IIIA IIA IIS STANT TAS ATO ISO IOI TIO RII AS IBAA IOS AOS AOA TAA IBIAS A A
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:
C1 Approved Permit No. :
O Denied
Remarks:
Authorized Signature
Title Date
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