Document Text
--- Document: Race Permit Application Document ---
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BOROUGH OF FLORHAM PARK
111 RIDGEDALE AVENUE, FLORHAM PARK, NEW JERSEY 07932
ENGINEERING DEPARTMENT
Telephone: 973-410-5334 Email: Kkaplan@fpboro.net
PERMIT NUMBER: ____________ DATE: ____________
RACE PERMIT APPLICATION
PLEASE PROVIDE 2 COPIES OF THE APPLICATION TO THE ENGINEERING DEPARTMENT WITH A $150.00 FEE AND AN ESCROW DEPOSIT TO COVER THE COST OF
CLEANUP AT LEAST 60 DAYS PRIOR TO EVENT. (TWO SEPRATE CHECKS MADE PAYABLE TO THE BOROUGH OF FLORHAM PARK)
APPLICANT INFORMATION
________________________________________________________ ___________________
_______________________
APPLICANT NAME/RACE ORGANIZER
EMERGENCY TEL. #
FAX NUMBER
________________________________________________________ ___________________
_______________________
APPLICANT ADDRESS
ZIP CODE
E-MAIL ADDRESS
________________________________________________________ ___________________
_______________________
SPONSOR NAME/COMPANY NAME
TELEPHONE NUMBER
FAX NUMBER
________________________________________________________ ___________________
_______________________
SPONSOR ADDRESS
ZIP CODE
E-MAIL ADDRESS
RACE INFORMATION
RACE NAME: _____________________________________________ RACE ROUTE (Attach Map): _________________________________________
RACE DESCRIPTION: _______________________________________ RACE DATE:__________________________RACE DURATION:______________
RACE START TIME: _______________________________________ RACE END TIME:________________EST. # OF PARTICIPANTS:______________
ASSEMBLY AREA: _________________________________________ DISPERSAL AREA: _________________________________________________
FOOD AND DRINK PROVISIONS: _____________________________ PERSONAL HYGIENE PROVISIONS: ____________________________________
LITTER CONTROL PROVISIONS: ______________________________ CROWD CONTROL PROVISIONS: _____________________________________
TRAFFIC CONTROL PROVISIONS: _____________________________ PARKING PROVISIONS: _____________________________________________
REQUEST FOR POLICE TRAFFIC DIRECTORS AND VEHICLES?: _______ IF SO, HOW MANY?_______________________________________________
INCLEMENT WEATHER CONTINGENCY PLANS: __________________________________________________________________________________
ACTIVITY TO REQUIRE:
Sidewalk Closure: _____________ Partial Street Closure: ______________ Full Street Closure: _____________ Other: ________________________
ATTACHED RACE DOCUMENTS (Required):
___Race Map ___Race Schedule ___Detailed Description ___Processing Fee ___Escrow Deposit ___Road Closing Permit
___3rd Party Assignments of Police Officers Application Approval ___Race on Highways Permit ___ County of Morris Permit
___Other Municipality Permits ___Dispense Alcoholic Beverages Permit ___Public Notice ___Indemnification and Insurance ___Other
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APPLICANT RESPONSIBILITIES:
The Applicant shall be responsible for compliance with all of the ordinances of the Borough of Florham Park, as well as any other regulatory
authorities. The Applicant shall designate a specific individual who shall be responsible for being available for communications with Borough
officials at all times during the race, and for race cleanup after the race is conducted. The person designated by the Applicant shall have the legal
authority to act on behalf of the Applicant at all times. In no event, shall a race be scheduled to take place between the hours of 7:00 AM to 9:00
AM, and 4:00 PM to 6:00 PM on weekdays. Applicant shall notify property owners within the race area at least two business days in advance of the
race date. Posting shall be done as permitted by law.
INSURANCE REQUIREMENTS:
The Applicant, its assignees or designees, shall obtain liability insurance and pay all premiums, and declaring the Borough as an additional insured
against all claims for personal injury and property damage arising from conduct of the race, including pre and post race events. The
aforementioned insurance coverage shall not be less than the following amounts:
Comprehensive General Liability (Combined Injury and Property Damage)-
$1,000,000 (Combined single limit)
Auto Liability (Bodily Injury and Property Damage)-
$1,000,000 (Combined single limit)
Excess Liability and Property Damage-
$2,000,000 (Combined single limit)
The Applicant shall provide Worker's Compensation insurance coverage for employees in amounts in accordance with law. Certificates disclosing
proper coverage shall be submitted with the Race Application for review and approval by the Borough Attorney and Borough Insurance Risk
Manager.
AFFIDAVIT OF APPLICANT:
The Applicant agrees to indemnify and hold harmless the Borough of Florham Park, its officers, agents, boards, and employees from any and all
actions at law or at equity, charges, debts, claims, judgment for personal injury, property damage, liens, encumberances, costs, and counsel fees
which may arise directly or indirectly from any such damage or loss arising from the conduct of the race (including pre-race and post race events).
The Applicant further agrees to comply with the pertinent provisions of New Jersey laws, rules and regulations. The Applicant/Sponsor has read the
applicant responsibilities and has agreed to all terms and conditions of this application.
Applicant Name (Print) Signature Date
APPROVAL:
Approved___ Disapproved___ Fee Paid____________ Escrow Deposit Amount Received____________ Deposit Date____________
Reason for Disapproval: _____________________________________________________________________________________
Borough Authorized Signature Date