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CITY OF WEST CHICAGO
CITY COUNCIL
AGENDA ITEM SUMMARY
ITEM TITLE:
AGENDA ITEM NUMBER: 4.D.
America 250 Parade Special Event Permit Application ;
Western DuPage Chamber of Commerce COMMITTEE AGENDA DATE: April 20, 2026
COUNCIL AGENDA DATE: April 20, 2026
STAFF REVIEW: Kelley Chrisse, AICP, CEcD seoarone_Lilb MUA
ITEM SUMMARY:
As part of the City’s America 250 programming, the America 250 Parade is planned for July 5, 2026 as a
featured community event. The Western DuPage Chamber of Commerce has agreed to serve as the
coordinating organization responsible for planning and executing the Parade. The proposed start time is at
10:00 a.m. and will be starting on National Street near Turtle Splash Park to Arbor, Arbor South to McConnell.
This is an approved parade route.
The Special Event Permit Application has been reviewed and approved by staff from the Police, Public Works,
Business & Community Relations, and Community Development Departments as well as the West Chicago
Fire Protection District and Park District. The plans will be reviewed during the upcoming monthly coordination
meetings.
ACTIONS PROPOSED:
Recommend proposed parade plans to proceed as outlined, contingent upon submittal and approval of
required insurance documentation.
COMMITTEE RECOMMENDATION:
This item is being presented to the Public Affairs Committee for consideration prior to the City Council
meeting.

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City of West Chicago
THIS FORM MUST BE COMPLETED IN FULL & SUBMITTED
90 DAYS PRIOR TO THE EVENT
PERMIT NO.
Special Event Permit Application
The Special Event Application must be submitted 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 and/or city personnel. The 90-day time period allows sufficient time to evaluate
the request and provide a recommendation to the City Council for its consideration. For
any late submittals (applications submitted less than 90 days prior to the event), a $50 late
fee must be paid with the application. Further, the applicant runs the risk of their Special
Event request being denied.
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
. Completed and signed Special Event Application
o Intent to Meet Insurance Requirements
a Section 1 — General Information
a Section 2 — Narrative
a Section 3 — Permits
a Section 4 — Site Plan and/or Route Map
o Section 5 — Task List and Due Dates
o Section 6 — Hold Harmless Agreement
. Completed and signed applications(s) for other permits(s) (See Section 3)
0 Carnival Permit Application - $50 per employee
0 Fireworks Permit Application —
$125 (Check made payable to the West Chicago Fire Protection District)
a Building Permit Application (temporary tents — see min. requirements) - $50
o Raffle Registration Application — requires separate application
o Temporary Liquor License Application — requires separate application
o Temporary Food Service Permit (DuPage Co. Health Dept. 630-682-7979)
IRIS III IIIS TOO IOI TIT III IAI IAI AI IAI IAI AAI AAS AIAN IAA SAINI AAA A IAAI AAI ASA SAA AAA AS AISA AIAN ANI AIA
FOR OFFICE USE ONLY
Iererrererrrerir eT TTirtretieteerririteeee ricer errr eer rer etter rier tecrrrerrectc rrr recrrcrr cer trcre rer tre rr ct ry
Received: S121 Lo Fee Paid: $__—~
Receipt # Check # so
Event Acknowledgement Form returned by:
Police Dept. Fire Dist. PW Park Dist. CDD
0 Background checks completed by Police Dept. Date aaa
o DuPage Co. Health Department notified Date —
0 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 IML-RMA 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.
WESTERN DUPAGE
L_DAw Dd J SABATHNVE __. representing CHAMBER of CammeRCe _
(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.
3/27
signature) he
America 2 SO Parade 7/s [2027
(name of event) date of event)
Page 2 of 8

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SECTION 1 — GENERAL INFORMATION
Name of Event: AMERIZAZSO Parade.
Type of Event:
Ji Parade O Walk/Run/Bike O Carnivals O Fireworks O Festival
0 Other
Location of Event: Reed Kegaler Pack, South on Arher te 2a Comstall Bre.
Date(s) of Event:_7/s/2oz¢ Hours of Event: \Oom _\UI"_to \\ ae Est. Attendance:
SS
Event Website: Western dupage chan maber com
Purpose of event: Aity bepuesT — America 250 year fe lebeat joal
Name of Sponsoring Organization(s): City and Chamber af Commerce
Organization's Legal Status (i.e. NFP, Partnership, Corporation): <¢6{CG AEP loc cp:
Contact person from sponsoring organization: _ Devi a gy: Sahathne
Organizer address: 30 sMasu StreeT—
City/State/Zip: uber yo, IL @0)8S Phone:
Cell Phone E-mail: Z7am@ weslerddufage Chamber. com
Emergency contact information (provide mobile numbers for on-site coo!
1" Contact: Daud Sabath we Phone:
2"4 Contact: Mayas. Lofton Phone:
Is this an annual event? 0 Yes No If Yes, provide next year’s event date:
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.
— AfA
What, if anything, are you doing to rectify the problem(s)?
AA
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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SECTION 3 — PERMITS
Will your event include a carnival? o Yes ‘\No
If yes, you must submit a Carnival Permit Application ninety (90) days prior to the event.
Please visit www.westchicago.org under Forms 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? 1 Yes No
If yes, you must submit a Building Permit Application thirty (30) days prior to the event.
Please visit www.westchicago.org under Forms for an application.
Will your event include a fireworks display? o Yes \QNo
If yes, you must submit a Fireworks Permit Application thirty (30) days prior to the event.
Please visit www.westchicago.org under Forms for an application.
Are you holding a raffle at your event? o Yes “s.\No
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? so Yes\o No
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? co Yes
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://www.dupagehealth.org/temporary-food-service for additional
information.
Are you requesting services from these departments?
# Police O Fire District/ Paramedics Xl Public Works w
Specify services: Secuerty 4 roacl élosuces Tpettagy
Will you be utilizing any of the following services?
O Water O Electric/Generator © Other _ A/O
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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?
8 Yes ONo if yes, please indicate the property that you are requesting to use.
Metonal Street From ARC easT +o Arhor, Arhoc South to
LNs Connell fyenwe.
Would you like to request the closing of City streets? O Yes 0 No
If yes, please fill in the following information or submit a route map along with this application:
Street 5 From To Dates Times
_Alatrena | AKC Arbor Gleow
Arboc Met ional Meluaelt 7/sJroze
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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: ] | 5 | Le
Tasks to be completed Days Due
(All items due to City unless noted) Before Event Due Date
Submit “Intent to Meet Insurance Requirements” Prior to Prior to applicati
: . ' , pplication
penlgation sae with Special Event Permit application review review
Submit Special Event Permit Application 90 days 4 | lo
Submit Carnival Permit Application 90 days —_—
Submit Fireworks Permit Application 30 days —
Submit Temporary Liquor License Application 30 days —_
Submit Building (Temporary Tent) Permit
oo 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* lo ] iy
Submit Raffle Registration Application 14 days —
Notify residents/businesses of special event 14 days (9/2
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 Wester Dalags Chaeshe (name of organization) and its Members,
employees, volunteers or guests, being allow to participate in Amevee 250 Facade, (the Activity) the
undersigned hereby recognizes, acknowledges and assumes any and all risk pertaining to
Ulesteea Dutegr Chawhe— (name of organization) participation in the Activity.
To the fullest extent permitted by law, the whsteers bulage Lhamk xe ___ (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 ldestew bulage Chamber (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
Ubestaw Souter Abawbe (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 hdestew Dulage Charmhe~ — (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 WesTexal Dubege Chamber (name of organization).
Agreed this 27] day of Mascl, , 2020
Wdesterat Dufrge. Chamber
Name of Organizatio'
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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.
-—Deguid_ 9. Naha tane Lo
(Print Nanfe of Signatory) (Date)
NORA SCHOO
OFFICIAL SEAL
Notary Public - State of Illinois
Commission No. 975432
(Notary Public)
Signed and sworn to before me this 2] si day of M arch ,202@ .
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
FEISS IOI IIIS TIO IIT IT IT I IAI ASIA TIT IAA TOI ISAS ASAI SITS IAI IA ASAI IAAI AAAI ASI ISI IAAI AAI SAINI IAAI AIA IIASA ASAI SAAIA IAA
FOR OFFICE USE ONLY
FEI IIIS III IO IIT IATA TOS IIA BOI ATI AAAS AIA IAI AAI AI OA IAI IAI AAA AA AA IAAI AAI SANS SAIS IAI SAIS IAS SII I SIONS IAG
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
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