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HomeMy Public PortalAboutFUNKY FISH.pdfCITY OF TYBEE ISLAND SIDEWALK CAFE OR IT MERCHANDISE CAHANDI E DISPLAY Phone numbers of applicant. Business Relationship of applicart to owner (same. employee. agent. etc.) Mailing address of appliant Application is for: El Sidewalk Cafe Merchandise Display 1. The length and width in feet of the public right-of-way to be used: 2. The number of tables and chairs to be provided at the Sidewalk Cafe: 3. Hours of operation of the Sidewalk Cafe or Merchandise Display: Sunday: u until Monday: until Tuesday: until Wednesday : until Thursday: until Friday: until Saturday: �_- until o et and merchandise displays must be secured daily when normal business operations cease Sidewalk no elements the app a the layout without written asahoriza ion from the Planning and Zoning Manager. The applicant shell not replace approved items or eharrg DOCUMENTS REQUIRED WITH APPLICATION O Affidavit (must be notarized; see page 2) ❑ Indemnification Agreement (must be notarized; see page 3) ❑ Cert ficate(s) of Insurance listing the City of Tybee Island as an additional insured (see page 4) O A Site Nan to scale with measurements of the proposed sidewalk area and all items to be placed on or within it (see page 4) ❑ Photograph(s) of the sidewalk area (optional) 1 Applicant's signature Printed name FOR OPMZy$( ONLY awl ANdard new ,,i Albfk4441 Lrun[r gum Date l r2,1 ROUTING City \Wshal Planning a'c Zuucg Mann`v Page I of 6 APYRO I OR DENY 8Y DATE 403 Butler Avenue, P.O. Box 2749, Tybee Island. Georgia 31328 (912) 472-5033 FAX (912) 786-9539 Ischaafrn�eityoftybee.org • coat Um Fee SO.A An appl+ctc maY ra dor, w wore to ram. DIRECT AN APPEAL OF PER►fft DENLtt. TO ThE CITY MANAGER S 1%14.'201. AFFIDAVIT I. W► \ i elm t 1(Ai i) Yl _ acting in the capacity of on behalf of the establishment known as col 1k I- ►' % k41S -er 141) Ciumeir ..�aliNK MOM..; , Tybee Island, Georgia, attest to the following: V I have reviewed this application and all entries are correct and accurate to me best of my knowledge, a" There are no omissions of fact. located 3t c There are no items located on the sidewalk where the Sidewalk Cafe or Merchandise Display is proposed that would prohibit the Planning and Zoning Manager from issuing a Sidewalk Cafe or Merchandise Display Permit. o/ No violationis) of Georgia Law, Federal Law, Local Ordinance, or any Rule or Regulation of the State Revenue Commissioner, or any Rule or Regulation of the City of Tybee Island or Chatham Comity have been adjudicated against this business wittatn the last 12 months preceding the dare of the application. , r. The following violations; of Georgia LAW, Federal Law, Local Ordinance, or Rule or Regulation of the State Revenue Commissioner, or Rule or Regulation of the City of Tybee Island or Chatham County have been adjudicated against this business within the 12 months preceding die date of the application - 1 have read the South End Policies and Procedures and will abide by said South End Policies and Procedures at all times during the term of the Sidewalk Cafe or Merchandise Display Permit comrized Signature Printed Name M\,\oki'fh OWDn STATE OF GEORGIA COUNTY Of CHATHAM The foregoing mama nent was acknowledged before me this J2 J �7 t day of Si Date: who is personally laiown to a :,e or who has produced identification ,��I11111f/�t' 'co''''''',_-..,,.. •L s 4 ,3/wiy Commission expires. � � o2 ; r = Saar : *6 0 P �2S of Notary /2 /41,2012 INDEMNIFICATION AGREEMENT (RELEASE AND HOLD HARMLESS AGREEMENT) Th.s Indemnification. Relea.4e and Hold Harmless Agreement is trade this 1244' day of Georgia (`CIEs . ) when and each member thereof, ',t\ 1 &p.- (V(jt.Jt)C1 ("APPLICANT-) for the benefit ache City Tybee Istaod. referred to herein, the CITY means the Planning and Zoning Manager. r: r a±unicipality. its City Council. and its officers, employees, advisory board members and represenutt''vs WHEREAS, the APPLICANT is the owner or lessee of the property located at IA l5 l .X '1'2r Island, Georgia; and., WHEREAS, the APPLICANT has applied for a Sidewalk Cafe or Merchandise Display Permit for the temporary use of the sidewalk area abutting the property described above pursuant to City Codes. ordinances, and policies and is required thereby to indemnity defend and ho'.d and save the CITY harmless for its cse of the public right-of-way (hereinafter collectively the "PROPERTY";, and. WHEREAS, the APPLICANT is authorized to and has obtained all necessary approvals for this Agreement, NOW, THEREFORE, in considerauon of the CITY allowing the APPLICANT to u -se the public right-of-way for Sidewalk. Cafe or Merchandise Display the APPLICANT agrees as follows: 1 the above recitals are true, and correct and are incorporated herem by reference, 2 The APPLICANT agrees to indemnify and hold and save the CITY harmless from any and all damages, toss or liability occurring by reason of any injury of any person or property which may occur as a result or consequence of the issuance of the Sidewaii. Cafe or Merchandise Display Permit or the use of the PROPERTY by the APPLICANT or their family, officers, agents representative, guests, employees, invitees, or persons contracting with either or any of them or occasioned by an act or omission, neglect, or wrongdoing of the APPLICANT or their holly, officers, agents, representative, guests, employees, invitees, or persons contracting with either or any of diem. APPLICANT will at their owt cost and expense. defend and protect the CITI against any and all such suits. claims or demands which may be claimed to have arisen as a result or consequence of or in connecnon with the issuance of the Sidewalk Cafe or Merchandise Display Permit or the use of the PROPERTY by the APPLICANT or their family, officers, agents, representative, guests, employees. invitees, or persons contracting with either or any of there, or occasioned by an act or omission, neglect, or wrongdoing of the APPLICANT or their family, officers. agents. representative, guests, employees, invitees, or persons contracting with either or any of them.. Notwithstanding the foregoing, this should not be construed so as to require the applicant or anyone else to indemnify the CITY for claims arising tion; the sole negligence of the CITY its agents. employees, or officers. 3 The APPUCAN r does hereby remise, release, satisfy, quit clam, and forever discharge the CITY from any and all actions _u?t;. claims or demands that they ever had, now has or may have in the fume against the CITY as a result of the granting t if Sidewalk Cafe Merchandise Display Permit or because of the use of the PROPERTY by the APPLICANT or their farnii} officers, agents, represenrarives, guests, employees, invitees, or petscns contracting with either or any of therm. 4 The APPLICANT will maintain liability or other insurance as regwred by City codes, ordinances, and policies which shall name the CITY as an additional insured and for which the CITY will be given a current certificate. Said liability or other insurance shall provide coverage for our suit or claim arising from the issuance of the Sidewalk Cafe or Merchandise Display Permit or the use of the PROPERTY by the APPLICANT. e The terms of this Indemnification Agreement shall be binding upon and inure to the benefit of the parties and their heirs, lega' reortsentatives, successors and assigns ,20 L .b Notarized Signature Printed name k.a..?\% q„ n !9 Date 1\v,i1 ST ATE OF GEORGIA COUNTY OF CHATHAM The foregoing tnstrutattu was acknow:edged before me this Pig day of v u , 204? 7� tOl' l I Q J 6r-- who u personally known to me or who has produced identification Sigana f Natal}, My Commission expires - Pale 3 ,,j6 L _ . Cybce ttittilIii,i M /04 %. 4, 9C "‘,17 icfp C .. b h r' PU▪ R• L /mmmit► 12/14/20i? LX r It _______________ Ln D ',I/7) /i� _51 I:\ f 7) ACQRa CERTIFICATE OF LIABILITY INSURANCE DATE1 0203rn THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: It 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 Chatham Insurance Partners, LLC 2502 Habersham St. Savannah GA 31401 License#:202416 CONTACT Jacquelyn Tucker PHONE FAX (A/c. No. Exn• 912-650-2808 (A/C, l): ACoREss: jacquelyn(chathaminsurance.com INSURER(S) AFFORDING, COVERAGE NAC 8 INSURER A: CINCINNATI INSURANCE COMPANY 10677 INSURED NAVOENT-01 Funky Fish, Inc. Insurance Department P.O. Box 2497 Tybee Island GA 31328 INSURER B : Nutmeg Insurance Company 39608 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1168459543 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 INSR LTR TYPE OF INSURANCE AWL JNSD SUBR WVD POLICY NUMBER POLICY EFF IMMIDD/YYYY1 POLICY ESP {MMIDDIyrYYI LIMITS A X COMMERCIAL GENERAL UABILITY Y ENP 0398909 9/1/2022 9/1/2023 EACH OCCURRENCE $ 1.000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY OTHER LIMIT APPLIES PER: PRO- JECT LOG PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE X X LIABILITY ANY ALTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED ENP 0398909 9/1/2022 9/1/2023 COMBINED SINGLE LIMIT (Ea accident) $ 3.4.00_000 $ BODILY INJURY (Per person) BODILY INJURY (Per accident) 9 PROPERTY DAMAGE (Per accident) $ s UMBRELLA L(AB EXCESS LIAR _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ S DED RETENTION $ 6 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORJPARTNER/EXECUTIVE Ya OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A 20WECAH40Z6 8/22/2022 523/2023 X I PER , STATUTE OTH- ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500.900 E.L. DISEASE - POLICY LIMIT $ 500.900 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required) RE: Short Term Rental Dwellings City of Tybee Island is listed as Additional Insured as required by written contract with respect to the following locations: Funky Fish, Inc. - 23 Tybrisa St, Tybee Island, GA 31328 Silver Waves Inc. - 27 Tybrisa Ave, Tybee Island, GA 31328 Funky Fish, Inc. - 211 Butler Ave, Tybee Island, GA 31328 Funky Fish, Inc. -1415 Butler Ave, Tybee Island, GA 31328 104 18th Street, LLC -104 18th St, Tybee Island, GA 31328 15 15th Street, LLC - 15 15th St, Tybee Island, GA 31328 See Attached... CERTIFICATE HOLDER CANCELLATION City of Tybee Island P.O. Box 2749 Tybee Island GA 31328-2749 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE W1LL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE -iel;rn°7°4-1/4—is- ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. Ali rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: NAVOENT-01 LOC %: AC D ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Chatham Insurance Partners, LLC NAMED INSURED Funky Fish, Inc. Insurance Department P.O. Box 2497 Tybee Island GA 31328 POLICY NUMBER CARRIER NAM CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER. 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Davis 222, LLC -10 17th Place, Tybee Island, GA 31328 1402 6th Avenue, LLC -1402 6th Ave, Tybee Island, GA 31328 Southeast Marketing (USA), LLC - 103 Lewis Ave, Tybee Island, GA 31328 5th Avenue Rental, LLC - 1305 5th Ave, Tybee Island, GA 31328 ACORD 101 (2008(01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD