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D-6. Appprove Private Fireworks Display at Lake Minnewashta on July 4, 20160 CITY OF CHANHASSEN 7700 Market Boulevard PO Box 147 Chanhassen, MN 55317 Administration Phone: 952.227.1100 Fax: 952.227.1110 Building Inspections Phone: 952.227.1180 Fax: 952.227.1190 Engineering Phone: 952.227.1160 MEMORANDUM TO: Todd Gerhardt, City Manager FROM: Mark Littfin, Fire Marshal DATE: May 25, 2016 ®,� SUBJ: Private Fireworks Display at Lake Minnewashta on July 4, 2016 PROPOSED MOTION: "The City Council approves the fireworks display permit from Pyrotechnic Display Inc., on behalf of the Lake Minnewashta Fireworks Committee, to conduct a fireworks show from Minnewashta Regional Park on July 4, 2016, with the conditions noted in the staff report." Approval of this request requires a simple majority vote of the City Council. Fax: 952.227.1170 Staff has received a request from Pyrotechnic Display Inc., on behalf of the Lake Minnewashta Fireworks Committee, to conduct a fireworks show from Minnewashta Finance Regional Park on July 0. This application is similar to what has occurred for the past Phone: 952.227.1140 twelve years and meets Fire Code regulations. Fax: 952.227.1110 The following conditions have been communicated and agreed to by all concerned Park &Recreation parties. Phone: 952.227.1120 Fax: 952.227.1110 1. The fireworks display operator will be required to adjust the launch angle so as to aim over the lake in order to minimize drop-down material from landing in the wetland Recreation Center 2310 Coulter Boulevard area resulting in grass/swamp fires. A plan must be submitted to the Fire Marshal to Phone: 952.227.1400 show how this will be accomplished. Fax: 952.227.1404 2. Staff will require the Fire Department to have a standby crew at the launch site. Planning & Additionally, a boat from either the Carver County Sheriff's Department Water Patrol Natural Resources Division or the Chanhassen Fire Department will be required on the lake to secure the Phone: 952.227.1130 fireworks drop-down zone. I will coordinate this as we get closer to July 4". Fax: 952.227.1110 Additionally, the group has provided a certificate of liability insurance policy covering this event. Public Works 7901 Park Place RECOMMENDATION Phone: 952.227.1300 Fax: 952.227.1310 Staff recommends approval of the request from Pyrotechnic Display, Inc. for a fireworks display permit on July 4, 2016 at Lake Minnewashta Regional Park with the conditions Senior Center noted above. Approval requires a simple majority vote of the City Council. Phone: 952.227.1125 Fax: 952.227.1110 ATTACHMENT Website www.ci.chanhassen.mn.us en.mn.us 1. Application for Display of Fireworks 2. Certificate of Liability Insurance g:\safety\rnl\mwshtafireworkdisplaymemo.doc Chanhassen is a Community for Life - Providing for Today and Planning for Tomorrow APPLICATION FOR OUTDOOR DISPLAY OF FIREWORKS/PYROTECHNIC SPECIAL EFFECTS Applicant instructions: This application must be completed and returned at least 15 days prior to date of display. Name of applicant (Sponsoring Organization): Keening America's Birthday Observation over Minnewashta Address of applicant: 3611 Ironwood Road, Excelsior, Minnesota 55331 Name of authorized agent of applicant: Pyrotechnic Display, Inc. Address of agent: 9405 River Road SE, Clear Lake, MN 55319. Telephone number of agent: 320-743-6496 Ext. _l Date of display: July 4, 2_0.16 Time of display:_ about 10 pm Location of display: Lake_Minnewashta Regional Park - Dlease see attached site map Manner and place of storage of fireworks/pyrotechnic special effects prior to display: Delivery and storage in truck on day of display Type & number of fireworks/pyrotechnic special effects to be discharged: 1.3G Droduct - uD to 5 inch aerial shells and Multi -Shot Box Items & Candles Minnesota State law requires that this display be conducted under the direct supervision of a pyrotechnic operator certified by the State Fire Marshal. Name of supervising operator: Lael Litecky Certificate No.: 1 00219 Required attachments. The following attachments must be included with this application: 1. Proof of a bond or certificate of insurance in amount of at least $ _5,000,000.00 2. A diagram of the grounds at which the display will be held. This diagram (drawn to scale or with dimensions included) must show the point at which the fireworks/pyrotechnic special effects are to be discharged; the location of ground pieces; the location of all buildings, highways, streets, communication lines and other possible overhead obstructions; and the lines behind which the audience will be restrained 3. Names and ages of all assistants that will be participating in the display. Eric Ostman, 48, Craig Armbrust, 35 The discharge of the listed fireworks on the date and at the location shown on this application is hereby approved, subject to the following conditions, if any: I understand and agree to comply with all provisions of this application, MN Statute 624.20 through 624.25, MN State Fire Code, National Fire Protection Association Standard 1123 (2006 edition), applicable federal law(s) and the requirements of the issuing authority, and will ensure that the fireworks/pyrotechnic special effects are discharged in a manner that will not endanger persons or property or constitute a nuisance. Signature of applicant (or agent): �,,��/��✓ Signature of Fire�Cfligf: Printed name of above official:/r�o9� Signature of issuing authority: ./% —lark Printed name of above official: Date of application: May 18, 2016 Date: s/oi `//& Phone: 'S�/d `I//L Date: /, PhoneF-2s —/(&:� DATE (MMIDDYYY) ACORO® YCERTIFICATE OF LIABILITY INSURANCE 15/18/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS LICIESERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P6S 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(ies) must 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 NAME: Britton Gallagher I PHONE FAX FAC EXt1:216-658-7100 IA/C, No): One Cleveland Center, Floor 30 . I E-MAIL 1375 East 9th Street I ADDRESS: Cleveland OH 44114 I INSURER(S) AFFORDING COVERAGE I NAIC q NAMED ABOVE FOR THE POLICY PERIOD INSURERA:Axis Surplus Ins Company INSURED I INSURERB:EVereSt Indemnity_ Insurance CO Pyrotechnic Display Inc. INSURERC:Everest National Insurance ComDanv_ 110120 1 8450 W. St. Francis Road NSURERD:MN WC Assianed Risk Plan Frankfort IL 60423 - INSURER E: I INSURER F: COVERAGES CERTIFICATE NUMBER: 1415406079 REVISION NUMBER: 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. (LTR NSR I TYPE OF INSURANCE NSR I$UBRWVD POLICY NUMBER (MM/DDIYYYYI I (MMLDDYYYYI I LIMITS B GENERAL LIABILITY S18ML00006-151 9/30/2015 9/30/2016 I EACH OCCURRENCE I $1,000,000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITYI PREMISES (Ea occurrence) $500,000 CLAIMS -MADE 1XI OCCUR MED EXP (Any one person) I $ PERSONAL & ADV INJURY I $1,000,000 GENERAL AGGREGATE $2,000,000 1 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 'j POLICY PR� F] LOC I $ C I^ ] AUTOMOBILE LIABILITY S18CA00006-151 9/30/2015 9/30/2016 COMBINED SINGLE LIMI I (Ea accident) I $1,000,000 X ANY AUTO I BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ X AUTOS X AUTOS NON -OWNED YDAMAGE I PRO $ HIRED AUTOS AUTOS accident) I$ A UMBRELLA LIAB OCCUR EAU733983 9/30/2015 9/30/2016 I EACH OCCURRENCE 1 $4,000,000 X EXCESS LIAB CLAIMS -MADE I I AGGREGATE 1 $4,000,000 1 DED I I RETENTION $ I I$ D WORKERS COMPENSATION MNAR0000019718-7 (MN) 9/30/2015 9/30/2016 X I WC TORY LATU- I JOT 1 AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVEi 1 E.L. EACH ACCIDENT 1 $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A '.. (Mandatory in NH) E.L. DISEASE - EA EMPLOYEEI $1,000,000 If yes. describe under DESCRIPTION OF OPERATIONS below i I I E.L. DISEASE -POLICY LIMIT 1 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. DISPLAY DATE: July 4, 2016 LOCATION: Lake Minnewashta Park, Chanhassen, Minnesota ADDITIONAL INSURED: City of Chanhassen, Minnesota; Carver County of Minnesota; Keeping America's Birthday Observation over Minnewashta CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Keeping America's Bithday Observation Over Minnewashta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Ms. Beth Ginther ACCORDANCE WITH THE POLICY PROVISIONS. 3611 Ironwood Road Excelsior MN 55331 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD [ A�R D A�t ®F Ft�EVV ��S �tSpLp,Y S[TE LARCH SITE G To 13, MP NT ABED ARE AR of PEoptE 42�1 TACE FRoM CP 6„ Di IAMETER SF�ELL L�"RG�T D Fool VADIUS °q - E 3 Co ¢a C Ln e C C'+I , All R r-4 °q - E 3 MARK HANSON Sales/Design 612.709.3703 800.507.9074 Ext. 1 ill hans0n(1?pYrodisplay. Coll] Becky Hanson 320-300-4823 MINNESOTA 9405 RIVER ROAD SE CLEAR LAKE, MN 55319 T 800.507.9074 x 1 • F 320.743.6499 KENTUCKY 638 TUCKER LANE SPRINGFIELD, KY 40069 T 800.507.9074 x2 • F 859.284.0644 BUSINESS OFI ICI: 8450 W. ST. FRANCIS ROAD FRANKFORT, IL 60423 T 800.507.9074 x3 • F 815.469.6029 PLEASE FORWARD THIS APPLICATION TO THE CORRECT PARTIES, HAVE IT SIGNED AND MAIL THE SIGNED FORM BACK TO US AT: PYROTECHNIC DISPLAY, INC. 9405 RIVER ROAD SE CLEAR LAKE, MN 55319