THIND, CATTE CITY OF SAN BERNARDINO
COMMUNITY DEVELOPMENT AND HOUSING
DEPARTMENT
HABETH AND INTEROFFICE MEMORANDUM
TO: Eric Levitt, City Manager
Tanya Romo, Deputy City Manager
FROM: Gabriel Elliott, Director of Community Development and Housing Michael Rosales, Senior Plannel
Gabriela Sosa, Planning Aide
SUBJECT: Annual YMCA Christmas Parade
DATE: November 3, 2025
Please see the enclosed form to approve the waiving of the Street Closure fee associated with Special Event Permit 25-031 for the annual YMCA Christmas Parade hosted by the YMCA and City of San Bernardino Police Department in accordance with Chapter 3.13 of the City's Municipal Code.
Best Regards
Michael Rosales
Senior Planner
CITY OF SAN BERNARDINO
FEE WAIVER REQUEST/SPONSORSHIP FORM
PLEASE PRINT LEGIBLY
Date of Application: 10/23/2025
[ 1 Banner ($200.00) Install Date:
Remove Date:
Location:
BANNER TEXT:
11 Filming Permit ($260.00)
1 1 Facility Rental $. Which Facility?
Date:
Time:
(Begin) (End)
Reserving of Perrs Hill park on 12/13/2025 from 6:00am-3:00pm for the 48lh annual Christmas Parade Row Permit Pl: 1737•79
CD$A: 1279-20 APPLICANT/ ORGANIZATION INFORMATION
San Bemardino YMCA
Parks d Rec: 2,150
P Rame: ephanieva
Address: 808 E 21st Street, San Bemardino CA 92404
Phone: 909-881-9622 OFFICE USE ONLY
Total: Approval Cheddist:
qa INSTRUCTIONS FOR APPLICATION - Type of Program/Event? _ Owner/Principals of the Organization?
$ 13.666.= All application must be accompanied by the following: _ Name of the Organization? _ Address of the Organization?
- Clear Total?
2. oyne Principals evehe Clear Department Costs?"*
Owner/Principals of the Organization Proof of Tax Status?
3. Name of the Organization Description of the Event?
4. Address of the Organization - Diagram/plot plan of the Event?
5. - Location f Banners?
amar statement of the total waiver/sponsorship
Resident Benefit?
_ Total Cost Authorized?
Recommended for Approval:
8. Description of the Event Print Name Date
9. Diagram/plot plan of the Event
10. Location f Banner Signature
I1. Number of San Bernardino residents benefited Date
(estimate) Approved:
Staphanie Tovar 10/23/2025
Authorized for Submittal Date
City Manager Date
CITY OF SAN BERNARDINO
Community Development Department, Planning Division
Office: 201 North E Street, 35d Floor
Mail: 290 North D Street
SPECIAL EVENT PERMIT San Bernardino, CA 92401
Phone (909) 384-7272 • Fax (909) 384-5155
COUNTH DIN 1AD APPLICATION Web address: www.sbcity.org
GENERAL INFORMATION *For City facilities a Facility Use Agreement Application is also required Name of Event: Location of Activity (Address): Perris Hill Park San Bemardino YMCA Christmas Parade
Organization Name: San Bernardino Family YMCA
Telephone: 909-881-96221
Applicant Name: Stephanie Tovar 909-379-9608
Mailing Address: 808 E 21st Street, San Bernardino CA 92404 909-881-96221
Telephone: 909-379-9608
On-Site Contact Name: Stephanie Tovar
eclare, under penaity of perjury, that the information on this application is true and correct to the best of my knowledge. I further understand that knowingly providing any fo armation is cause for the Immediate denial of a Special Event Permit or its suspension/revocation if one has been issued. I hereby state that 1 am aware that it is my responsibilit attempt to maintain order at said event, and will provide such personnel as may be required and approved by the City.
Signature of Applicant Date Signed
DATE(S)/TIME(S) INFORMATION
Time(s): 6:00 AM Tear-down Date(s): 12/13/2025 Time(s): 3:00PM Set-up Date(s): 12/13/2025
Date(s) of Activity: From: 12/13/2025 To: 12/13/2025
Hours of Operation: 10:00AM- 12:00PM
DESCRIPTION OF EVENT
Describe Planned Activities: Christmas Parade with Marching band, Car Clubs, dance groups, and local organizations Expected Attendance: 5000
Alcoholic beverage sales/on-site consumption: Yes XNO Will food be prepared on site: _ _ Yes _X No If yes, attach copy of ABC Permit If yes, attach copy of County Health Permit Structures including vendor booths/tents (provided by applicant): _Yes X No Booth Fence Portable Toilets _Bleachers _ Stage Other:
If yes, type: _ * Tent * Canopy
X
Sound System (provided by applicant): Yes No
If yes, type:_ _Bull Horn Siren_XAmplified Sound System _Other:
Electrical (provided by applicant): Yes No
If yes, type: _X Generator _Temp. Power Pole Light String/Booth Lighting_ _ Pole Lighting/Flood Lights -Rides/Generators Other:
PROPERTY OWNER AUTHORIZATION (for non-City facilities only) O Property Owner Agent (A letter of authorization is required to be submitted along with signature below) Title: Program Director
Name (Please Print): Stephanie Tovar
Mailing Address: Phone: 909-881-9622 EX 7404
808 E 21st Street, San Bernardino CA 92404
Signature Authorizing this Application: Date: 10/22/2025 ACTION
• Approved By: • Denied By:
Comments:
Application Date: Received By: Receipt No: Fee(s) Paid: Fee(s) Due:
Permit Number:
SPRCSD 8/7/2017 revised by Planning Division June 2021
SUMMARY OF REGULATIONS FOR
SPECIAL EVENT PERMITS
General Information: No person or entity shall operate, maintain, conduct, advertise, or provide admission for any temporary special event within the City of San Bernardino without possessing a permit for each such temporary special event.
A Special Event in the City of San Bernardino is defined as; group assemblies with more than 100 attendees and/or for a duration longer than three days, circuses, rodeos, and carnival (subject to compliance with Chapter 5.42 of the Municipal Code), Fairs, Festivals and concerts, when not held within premises designed to accommodate such events, such as auditoriums, stadiums, or other public assembly facilities. Food events (more than 3 trucks), and certified Farmers Markets.
Submittal Requirements Checklist:
Site Plan- should include; north arrow and drawing to scale, dimensions and shape of the lot, location and name of abutting streets and alleys, location of nearest off-site structures on the site, placement/locations of tents/canopies, identification of the use(s) within tents/canopies, Interior seating plan within tents and method of seating, location, composition and height of all existing and proposed walls and/or fences, location of driveways showing all pints of ingress/egress to the site and event, parking layout showing accessible parking spaces and path of travel from the public right-of-way to the proposed event, location on site landscaping if existing, location of restroom facilities, any equipment, storage, generator, any other materials associated with the event, location of refuse enclosures, and placement/location of temporary signage.
Copy of Facility Reservation application/Authorization Letter, if applicable Copy of County Health Permit, if applicable
Copy of County Fire Department Permit
Copy of ABC License, if applicable
Copy of security contract and potable restroom purchase order, if applicable Copy of certificate of liability insurance
Insurance: Before a Special Event Permit is issued, a certificate of insurance must be submitted. The following may be requirements of your event/organization:
• Minimum $1,000,000 General Liability Limit • On an additional insured endorsement the City, its elected officials, • Minimum $1,000,000 General Automobile Liability officers, and agents are to be named as additional insured • Minimum $1,000,000 Worker's Compensation • Minimum limits of coverage may change depending on event X Insurance Certificate Attached • Insurance Certificate On File •insurance Certificate Not Available Insurance Company: Expiration Date:
Additional fees may apply (i.e. street closures, Police Department Fees, City personnel fees, utilities, facility rental, etc.) Review Process: Once the application is submitted to the Community Development Department, a permit number will be issued.
City staff will route the application and all other associated documents to all applicable departments who will review the event is approved, a letter will be written for the approval which will contain conditions under which the event will be permitted to operate. A copy of this approval letter and event conditions must be kept on site for the duration of the event.
Security and Portable Restrooms: In the event that a carnival/street fair and/or alcohol service will be included in the event, an alcohol garden and security plan will need to be submitted along with a security contract and/or public safety staffing plan for review by the Police Department. Portable restrooms are required when estimated attendance exceeds what the host facility's restrooms can accommodate.
By signing below, I agree to indemnify, hold harmless, and defend the City and its officials, employees, and agents, against all claims, liabilities, and losses arising from activities connected with or undertaken pursuant to the Permit. The City is not liable for any business loss, property loss, or other damage that may result from the use of the Permit, or suspension or revocation of the Stephanie Tovar Stephanie Tovar Date: 10/22/2025
Name: Signature:_
SBPRCSD 8/7/2017 revised by Planning Division June 2021 YMCA Annual Children Christmas Parade Map
valencia Windsor Cedar Lawrence Harrison
XX XXXXXX XXXXXX xxXXxx *
XX XX
XX XX
XX HIGHLAND AVE HIGHLAND AVE XX
No Street Parking No Street Parking Parking Lot Pariing Lot Pool & Tennis Courts
No Finish
Perris Hills Park Vehicies
Buses 8 Ball Park
No Street Parking Rest Rooms Participants Stadium
Parking
Pick up Area
Volunteers
Senor Permit SB YMCA
Center Parking
No Street Parking Only Participant Check In
Trophys Recelved Parade Line Parade Line
Section 1 Section 2 Section 3 Secton 4
* * * * ****** ************** ********* *
E 21st Street E 21st Street
XXXXXX Section 5
* Barricade Check Point San Gabriel Perris
-at Crestview Ave. & E 21st Street
Park * Section 5
Road XXXXXXXXXXXX
Pacific Street
Participant &
Bus Drop Off
Area
YMCAOFT-01 ASHUNN
DATE SADDAYYY)
ACORDi CERTIFICATE OF LIABILITY INSURANCE 9/26/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. if SUBROGATION 1S WAIVED, subject to the terms and conditions of the pollcy, certain polleles may require an endorsement. A statement on his certificate doas not confer rights to the certificate holder in lleu of such endorsements).
PRODUCER License # 0M63276
allant Risk and Insurance Services, LLO To No, aNy: (951) 368-0700 FAC, Mox: (951) 368-0707 160 Temescal Canvon Rd. Suite 214
Corona, CA 92883
-.. PBUERS) AFFORDIO COVERAGE NAIC I
INSURER A: Nationwide Mutual Insurance Co 23787
INSURER: Arch Insurance Company 11150
INSURED
INSURER C:
YMCA OF THE EAST VALLEY
500 E Citrus Avenue INBURERD:
Redlands, CA 92373 INBURERE:
INBURER F:
CERTIFICATE NUMBER: REVISION NUMBER:
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED.
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,
ADDL SUBR' OLICY EFI LAITS
INSR TYPE OF INSURANCE POLICY NUMBER
(TRI INSD WVD. 1,000,000
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
X MAGE TO RENT 100,000
| CLAIMS MADE X OCCUR ACPCG013201931080 6/1/2025 6/1/2026 EMISES IRA OCCUITM 5,000
MED EXP (Any one person).
1,000,000
PERSONAL & ADV INJURY
3,000,000
GENERAL AGGREGATE
GENZ AGGREGATE LIMIT APPLIES PER: 3,000,000
PRODUCTS - COMPIOP AGG 3.
POLICY I LOC
OTHER: COMBINED SINGLE LIMIT 1,000,000
A AUTOMOBILE LIABILITY
ACPCG013201931090 6/1/2025 6/1/2026 BODILY INJURY (Fer person)
X ANY AUTO
BODILY INJURY (Per accident).
CUTS ONLY ROPERTY DAMAG
Per accider
X NURES ONLY
5,000,000
EACH OCCURRENCE
A UMBRELLA LIAB OCCUR 6/1/2025 5,000,000
ACPCU013201931090 6/1/2026 AGGREGATE.
EXCESS LIAB CLAIMS-MADE
DED X RETENTIONS 10,000
X PFATUTE
6/1/2025 6/1/2026 1,000,000
YIN ACWCC2532802 EL. EACH ACCIDENT
1,000,000
NIA E.L. DISEASE - EA EMPLOYEE $
1,000,000
8/1/2025 6172026 2M A98. PUNT t 1,000,000
ACPCG013201931090 1,000,000
ACPCG013201931090 6/1/2025 8/1/2026|2M Agg/ each occ
A Sexual Abuse/Molesta
ery disan bernario is elected over, or econd gear mated a alone red were rate eral Lability.
CANCELLATION
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
community Development Department, Planning Divisio alty of San Bernardin 290 North D Street AUTHORIZED REPRESENTATIVE
San Bemardino, CA 92401 Annie-shunn
® 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Policy Number: ACP3201931090 COMMERCIAL GENERAL LIABILITY NCG 73 08 01 20
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
HUMAN SERVICES LIABILITY ENHANCEMENT
ENDORSEMENT
This endorsement modifies insurance provided by the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy and this endorsement's contract wording.
Limit of Insurance Page Number
Coverage Applicable
$1,000,000 2
60650000026258 Damage to Premises Rented to You 2
Included
Extended Property Damage
Less than 58 feet 2
Non-Owned Watercraft 3
$20,000
Medical Payments 3
Medical Payments-Extended Reporting Period 3 years
Amended 3
Athletic Activities 3
$7,500
Supplementary Payments - Ball Bonds 3
Supplementary Payment - Loss of Earnings $1.500 per day $25,000 3
Employee Indemnification Defense Coverage for Employee 3 Included
Named Insured - Newly Acquired 4
Named Insured - Broadened Named Insured Included
Included 4
Additional Insured - Medical Directors and Administrators Included 4 Additional Insured - Funding Source Included 4
Additional Insured - Home Care Providers Included 4
Additional Insured - Managers, Landlords, or Lessors of Premises 4 Additional Insured - Lessor of Leased Equipment - Automatic Included Status When Required in Lease Agreement With You Included 4 Additional Insured - Grantors of Permits Included 5
INSURED COPY Additional Insured - Broad Form Vendors
Included 5
Additional Insured - Grantor of Franchise Included 6
Additional Insured - As Required by Contract Included 7 Additional Insured - State or Political Subdivisions $100,000 limit 8 Limited Rental Lease Agreement Contractual Liabllity
$50,000 limit 8
Damage to Property You Own, Rent or Occupy Clarification 8 CA 60212 Transfer of Rights of Recovery Against Others To Us Included 8 Duties in the Event of Occurrence, Claim or Sult Included 9 Unintentional Failure to Disclose Hazards Included 9
Liberalization Included 9
Bodily Injury - Includes Mental Anguish
Includes copyrighted matertal of Insurance Services Office, Inc., with its permission. Page 1 of 10 NCG 73 08 01 20
NCG 73 08 01 20
Personal and Advertising Injury - includes Abuse of Process, Included 9 Discrimination
Key and Lock Replacement - Janttorial Services Client Coverage $15,000 Limit 10 A. Damage to Premises Rented to You Contractual Liabllity of this endorseme he term "client as used in this secti
1. If damage by fire to premises rented to you is means a person under your care and not otherwise excluded from this Coverage supervision for whom you are providing goods Part, the word "fire" is changed to "fire,
lightning, explosion, smoke or leakage from
automatic fire protective systems" where it B. Extended "Property Damage" appears in: SECTION I - COVERAGES, COVERAGE I
BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Subsection 2. Exclusions, Paragraph
INJURY AND PROPERTY DAMAGE a. is deleted and replaced by the following:
a. Expected or Intended Injury
b. The first paragraph immediately following "Bodily Injury" or "property " damage" Exclusion 1(6) of SECTION expected or intended from the standpoint COVERAGES, COVERAGE A BODILY of the insured. This exclusion does not INJURY AND PROPERTY DAMAGE apply to "bodily injury" or "property LIABILITY under Subsection 2. damage* resulting from the use of reasonable force to protect persons of
c. SECTION III - LIMITS OF INSURANCE, property.
Paragraph 6.; C. Non-Owned Watercraft
d. SECTION V - DEFINITIONS, Paragraph SECTION I - COVERAGES, COVERAGE A
9.a. BODILY INJURY AND PROPERTY DAMAGE
2. If damage by fire to premises rented to you is LIABILITY, Subsection 2. Exclusions, Paragraph not otherwise excluded from this Coverage g. (2) is deleted and replaced by the following:
Part, the term "Fire insurance" is changed to (2) A watercraft you do not own that is:
'insurance for fire, lightning, explosion,
(a) Less than 58 feet long; and
or leakage from automatic fire
protective systems" where it appears in: (b) Not being used to carry persons or property for a charge;
a. SECTION COMMERCIAL
This provision applies to any person, who with
GENERAL HABILITEr CONSTERS your consent, either uses or is responsible for Subsection insurance, the use of such a watercraft. This insurance is Paragraph b. Excess Insurance, items excess over any other valid and collectible b. (1)(a)(il). insurance available lo the insured whether
3. The Damage to Premises Rented to You Limit primary, excess or contingent. shown on the Declarations is deleted and
replaced by $1,000,000. $1,000,000 is the D. Medical Payments - Limit Increased to only limit of liability for Damage to Premises $20,000, Extended Reporting Period Rented to You and this limit will not be If COVERAGE C MEDICAL PAYMENTS is not combined with the limit shown on otherwise excluded from this Coverage Part:
Declarations for this coverage. This is the 1. The Medical Expense Limit shown on the most we will pay for all damage proximately Declarations is deleted and replaced by caused by the same event, whether such $20,000. $20,000 is the only limit of insurance damage results from fire, lightning, explosion, for Medical Expenses and this limit will not be smoke, or leaks from automatic fire protective combined with the limit shown on the systems or any combination thereof. Declarations for this coverage.
Provided, however, that if you assume liability 2. COVERAGE C MEDICAL PAYMENTS, in a contract or agreement regarding the Subsection Insuring Agreement, rental or lease of a premises on behalf of your Paragraph a(3)(b) is amended to read:
"client", this Damage to Premises Rented by provided that:
You limit is superceded and replaced by the
limit of insurance provided by Section l.
Limited Rental Lease Agreement
Includes copyrighted matertal of Insurance Services Office, Inc., with Its permission. NCG 73 08 01 20
NCG 73 08 01 20
(b) The expenses are incurred and this Coverage Part, Paragraph 3.a. Is deleted reported to us within three years of and replaced with the following:
the date of the accident; and a. Coverage under this provision is afforded until the end of the policy period during
E. Athletic Activitles which you acquired or formed the SECTION | - COVERAGES, COVERAGE C organization.
MEDICAL PAYMENTS, Subsection
Exclusions, Exclusion e. Athletic Activities is 2. Each of the following is also an insured:
deleted and replaced with the following: a. Broadened Named Insured - Any e. Athletic Activities organization and subsidiary theref which you control and actively manage
To a person injured while practicing or (whether through ownership of voting participating in any physical exercises or securities, by contract or otherwise) on games, sports, or athletic contests. This the effective dale of this • policy. exclusion shall not apply to an insured However, coverage does not apply to any while providing instruction with respect to organization or subsidiary not named in any physical exercises or games, sports, the Declarations as a Named Insured If or athletic contests. they are also insured under another F. Supplementary Payments similar policy, or would have been insured Under the SUPPLEMENTARY PAYMENTS - but for such policy's termination or the 8L650000026228 COVERAGE A AND B provision, items 1.b. and
1.d. are amended as follows: b. Medical Directors and Administrators - Your medical directors and
1. The limit for the cost of bail bonds is
administrators, but only while acting
changed from $250 to $7,50D; and
within the scope of and during the course
2. The limit for loss of eamings is changed of their duties as such. Such duties do not from $250 a day to $1,500 a day. include the furnishing or failure to furnish G. Employee Indemnification Defense Coverage professional services as a physician or Under the SUPPLEMENTARY PAYMENTS - psychiatrist in the treatment of a patient.
COVERAGES A AND B provislon, the following c. Home Care Providers - At the first is added: Named Insured's option, any person or
3. We will reimburse you for defense costs organization under your direct supervision that you incur in defense of an and control while providing on your behalf "employee" who is directly involved in a private home respite or foster home care criminal proceeding that arises out of for the developmentally disabled such "employee's" acts or omissions 3. Each of the following is also an additional within the scope of their employment by insured when you have agreed in writing in a you or while performing duties related to contract or agreement that such person or the conduct of your business and which organization be added as an additional would otherwise be covered by this insured on your policy, provided the written insurance. contract or agreement:
The most we will reimburse you for (1) Is currently in effect or becomes effective INSURED COPY defense costs that you incur in the during the term of this policy; and defense of an "employee" who is alleged
to be directly involved in a criminal (2) Was executed prior to the "bodily injury". proceeding is $25,000, subject to an "property damage" or "personal and limit of $25,000 for advertising injury" for which the additional reimbursements that we make during the insured seeks coverage. policy period on behalf of all 'employees, a. Funding Source - Any person or regardless of the organization with respect to their liability "employees", claims or "sults" brought or arising out of:
CA 60212 persons or organizations making claims (1) Their financial control of you; or or bringing "suits. (2) Premises they own, maintain or
H. SECTION II - WHO IS AN INSURED is amended control while you lease or occupy as follows: these premises.
1. If coverage for newty acquired or formed This insurance does not apply to:
organizations is not otherwise excluded from
Includes copyrighted malarial of Insurance Services Office, Inc., with its permission. Page 3 of 10 NCG 73 08 01 20
NCG 73 08 01 20
(a) Any "occurrence" or offense (a) The existence, maintenance, which takes place after you cease repalr, construction, erection, or to lease or occupy that premises; removal of advertising signs, or
(b) Structural
construction
operations performed by or on
behalf that person
organization.
b. Managers, Landlords, or Lessors of
Premises - Any person or organization
with respect to their liability arising out o
he ownership, maintenance or use o
that part of the premises leased or rented
. Broad Form Vendors - Any person s) :
organization(s) which or who is or are a
This insurance does not apply to: vendor of "your products", but onty with (1) Any "occurrence" which takes place respect to "bodily injury" or "property after you cease to be a tenant in that damage" arising out of "your products" which are distributed or sold in the regular
premises; or course of the vendor's business, subject
(2) Structural alterations, new
to the following additional exclusions:
construction or demolition operations The insurance afforded the vendor does performed by or on behalf of that
person or organization. not apply to:
1. "Bodily injury" or "property damage"
c. Lessor of Leased Equipment - Such for which the vendor is obligated to person or organization is an insured only pay damages by reason of the with respect to liability for "bodily injury". assumption of liability in a contract or "property damage" or "personal and agreement. This exclusion does not advertising injury caused, in whole or in apply to liability for damages that the part, by your maintenance, operation or vendor would have in the absence of use of equipment leased to you by such
the contract or agreement;
2. Any express warranty unauthorized
agreement. by you;
A person's or organization's status as an 3. Any physical or chemical change in additional insured under this the product made intentionally by the endorsement ends when their contract or vendor,
agreement with you for such leased 4. Repackaging, except when unpacked salely for the purpose of inspection,
substituten of parts testing, or the
substitution under
instructions from the manufacturer.
and then repackaged in the original
expires. container,
d. Grantors of Permits - Any state or 5. Any failure to make such political subdivision granting you a permit inspections, adjustments, tests or in connection with your premises subject servicing as the vendor has agreed to the following additional provision: to make or normally undertakes to make in the usual course of
(1) This insurance applies only with business, in connection with the respect to the following hazards for
which distribution or sale of the products;
the state
subdivision has issued a permit in 6. Demonstration, installation, servicing or repair operations, except such
operations performed at the vendor's
Includes copyrighted material of Insurance Servicee Offico, Inc., with its permission. NCG 73 0B 01 20
NCG 73 08 01 20
premises in connection with the sale coverage will be excass over any other insurance availabie to the
of the product, addittonal insured which is conferred
7. Products which, after distribution or onto Bald person or organization by a sale by you, have been labeled or soparate additionsi insured relabeled or used as a container, part endorsement.
or ingredient of any other thing of f. Grantor of Franchise - Any person (s) or substance by or for the vendor, or organization(s) with respect to their
8. "Bodily injury" or "property damage"
arising out of the negligence of the
vendor for its own acts or omissions Other Insurance
or those of its employees or anyone
else acting on its behalf and which
was not caused in whole or in part by
you or any person or organization
acting on your behalf. However, this
exclusion does not apply to:
(a) The exceptions contained in
Subparagraphs 4. Or 6.; or that the
insurance,
(b) Such inspections, adjustments,
tests or servicing as the vendor
83797000005927
has agreed to make or normally
undertakes to make in the usual
course of business, in connection
with the distribution or sale of the
products.
This insurance does not apply to any
insured person or organization, from
whom you have acquired such
2. products, or any ingredient, part or met
container, entering into,
accompanying or containing such
products. this
as being
Other Insurance
1. If specifically required by the written
contract or agreement with the
vendor, any coverage provided by insured
this endorsement to such additional separate additional be primary and any
ther valid and collectible insuranc
vailable to the additional insure whom "you" are
this
INSURED COPY the are leasing,
under such other lane ted
ract does not require this
overage to be primary and th
dditional insured's coverage to b
on-contributory, then this insuran
ill be excess over any other val
and collectible insurance available to
2. Even If the requirements of paragraph
Immediately above are met
establishing this coverage as primary
and the additional Insured's coverage
as being non-contributory, this
material of Insurance Page 5 of 10
NCG 73 08 01 20 Includes copyrighead
NCG 73 08 01 20
a "Named Insured, but in both inslances giving rise to the additional Insured's only as specified under the written potential liabiity. contract, lease, sublease or agreement. A 2 This insurance does not apply to the person's or organization's status as an additional Insured's liablity to additional insured under Indemnify, defend or hold harmless a endorsement enda the earlier of when third party.
"your on-going operations for that 3. This Insurance does not apply lo additional insured are completed or when "bodily injury, "property damage" or "you" no longer are contractually required "personal and adverlising injury for to Include such person or organization as which the additlonal Insured is an additional insured under "your" policy. 32 obfgated to pay damages by reason The insurance provided to an additional of the assumption of flability in a insured by this endorsement is limited as contract or agreement. This exclusion follows: does not apply to liability for damages
1. The additional insured is covered only that the additional insured would have for such damages which are caused, In the absence of the contract or in whole or in part, by the acts or agreement.
omissions of the "Named Insured" to 4. "Bodily injury", "property damage" or which the additional insured is "personal and advertising Injury entitled to be indemnified by the arising out of the rendering of, or the "Named Insured" pursuant to the failure to render, any professional written contract, lease, sublease or architectural, engineering agreement referenced in the first surveying services, including:
paragraph of this subsection g. above (a) The preparing, approving, or and only for those sums that the failing to prepare or approve, additional insured is legally obligated maps, shop drawings, opinions, to pay as damages under tort law reports, surveys, field orders, principles the injured party change orders or drawings and because of "bodily injury", "property specifications; and damage* or "personal and advertising Inspection,
which this insurance (b) Supervisory,
injury to architectural or engineering
applies, and in accordance with the
activities.
stated policy limits and policy
conditions. This coverage does not 5. "Bodily injury" or "property damage" apply for defense or indemnity of the occurring after.
additional insured if state or federal (a) All work, Including materials, law does not permit indemnification of pars or equipment furnished in the additional insured by the "Named connection with such work, on the Insured for the claim of the third project (other than service party.
2 : The limits of insurance are those set
forth in the policy and Declarations or
those specified in the written contract, the covered operations has been sublease agreement completed; or
lease,
referenced in the first paragraph of this (b) That portion of "your work" out of subsection g, whichever is less. which the injury or damage arises With respect to the insurance afforded to has been put to its intended use an additional under this by any person or organization
ubsection g., the following exclusion other than another contractor or re added subcontractor engaged
performing operations for a
1. This insurance does not apply if the principal as a part of the same written contract, lease, sublease or project.
Other insurance
1. If specifically required by the written
Insured" prior to the "occurrence" contract, lease, sublease Includes copyrighted matertal of insurance Services Office, Inc., with is permission. NCG 73 08 01 20
NCG 73 08 01 20
agreement referenced in the first damages under fort law principles to paragraph of this the injured party because of bodily
above, any coverage provided by this injury*. "property damage" endorsement to an additional insure "personal and advertising Injury" to shall be primary and any other vall which this insurance apples, and in and collectible insurance avallable to accordance with the stated policy the additional insured shall be non- limits, exclusions, limitations and contributory with this insurance. If the conditions except as expressly written contract, lease or sublease modified by this endorsement. does not require this coverage to be 2 The limits of Insurance are those set primary and the additional insured's forth in the policy Declarations o coverage to be non-contributory, then those specified in the written contrac this insurance will be excess over any or agreement referenced abov other valid and collectible insurance hichever is les:
available to the additional insured.
3. The state or political subdivision's
2. Even if the requirements of paragraph status as an additional insured under
1. immediately above are met
this policy ends when the permit
establishing this coverage as primary ends.
and the additional insured's coverage
Other Insurance
as being non-contributory, this
92650000026228 coverage will be excess over other 1. If specifically required by the written insurance available to the additional contract or agreement referenced insured which is conferred onto said above, any coverage provided by this person or organization by a separate subsection h. to an additional insured additional insured endorsement. shall be primary and any other valid and collectible insurance available to
Definitions
the additional insured shall be non-
Solely for purposes of the insurance contributory with this insurance. If the afforded to an additional insured by this written contract does not require this endorsement: coverage to be primary and the
additional insured's coverage to be
non-contributory, then this insurance
shown on the Declarations. will be excess over any other valid "You" or "your" means a "Named Insured" and collectible insurance avallable to the additional insured.
as defined above.
h. State or Political Subdivisions - Any state 2. Even if the requirements of paragraph immediately above are met
or political subdivision with respect to
operations performed by you or on your establishing this coverage as primary behalf for which the state or political as being non-contributory, this subdivision has issued a permit or
license. over insurance actio
This insurance does not apply to:
INSURED COPY 1. "Bodily injury", "property damage" or
"personal and advertising Injury separate
arising out of operations performe endorsement.
or the state or political subdivision; o However, this insurance afforded to such
2. "Bodily injury" or "property damage" additional insureds described in a. through h. included within "products
completed operations hazard". (1) Only applies to the extent permitted by The insurance provided to such additiona law: and
nsured state or political subdivision by (2) Will not be broader than that which you this endorsement is further limited as are required by the contract or agreement follows: to provide for such additional insured.
1. The additional insured is covered only The most we will pay on behalf of the additional for such sums that such additional Insured is the amount of insurance:
insured is legally obligated to pay as
NCG 73 08 01 20 Includes copyrighted material of insurance Servicee Office, Inc., with its permission. Page 7 of 10 NCG 73 08 01 20
(1) Required by the contract or agreement; or to property is caused by your "clent", in which (2) Avallable under the applicable Limits of case we will provide coverage for such "property Insurance shown in the Declaralions; damage" for which you are legally obligated to pay up to a $50,000 Amit per "occurrence". This
whichever is less. limit is the only limit of insurance This provision shall not increase the Limits of "property damage" and will not be combined with Insurance shown in the Decierations. the Each Occurrence Limit set forth in Section li Limited Rental Lease Agreement Contractual - Limits of Insurance and will be included within
1. and not be in addition to the Each Occurrence
Liability
The following is added to Paragraph (2) of Limit. A "client", as used in this provision, is defined as a person under your direct care and
Exclusion b. Contractual Lability of SECTION I
COVERAGE A. BODILY supervision for whom you are providing goods - COVERAGES, and/or services.
INJURY AND PROPERTY DAMAGE LIABILITY,
under Subsection 2. Exclusions: Any and all damages paid under the terms and conditions of this provision will further be applied
We agree to indemnify the Named Insured for
their liability expressly assumed in a contract or against and will reduce the Aggregate Limit of Insurance shown on the Declarations page, as
agreement regarding the rental or lease of a provided in the Commercial General Liability premises on behalf of their "client", up to Coverage Form in the same manner and in $100,000 per "occurrence". This limit of insurance addition to all other coverages of the Commercial is the only limit of insurance for your llability General Liability Coverage Form that are also expressly assumed in a contract or agreement
regarding the rental or lease of a premises on subject to the Aggregate Limit. behalf of your "client" whether or not such K. Transfer of Rights of Recovery Against Others contract qualifies as an Insured contract". This
limit will not be combined with the Each As a clarification, the following is added to Occurrence Limit set forth in Section III - Limits COMMERCIAL GENERAL of Insurance and is included within and not in LIABILITY CONDITIONS, Paragraph 8. Transfer addition to the Each Occurrence Limit. This of Rights of Recovery Against Others To Us:
coverage extension only applies to rental lease Therefore, the insured can waive the insurer's agreements. This coverage is excess over any Rights of Recovery prior to the occurrence of a renter's liability insurance of the "client". The term loss, provided the waiver is expressly made in a "client" as used in this section means a person written contract. under your care and supervision for whom you L. Duties in the Event of Occurrence, Claim or are providing goods and/or services.
Suit
Any and all damages paid under the terms and 1. The requirement in Paragraph 2.a. of conditions of this provision will further be applied SECTION IV - COMMERCIAL GENERAL against and will reduce the Aggregate Limit of
Insurance shown on the Declarations page, as LIABILITY CONDITIONS that you must see to it that we are notified as soon as
provided in the Commercial General Liability practicable of an "occurrence" or an offense Coverage Form in the same manner and in which may result in a claim or a "suit", applies addition to all other coverages of the Commercial only when the "occurrence" or offense which General Liability Coverage Form that are also may result in a claim or a "suit" is known to:
subject to the Aggregate Limit.
a. You, if you are an individual;
J. Damage to Property You Own, Rent or Occupy
SECTION I - COVERAGES, COVERAGE A b. A partner, if you are a partnership; or BODILY INJURY AND PROPERTY DAMAGE c. An executive officer or insurance LIABILITY, Subsection 2. Exclusions, Paragraph manager, if you are a corporation.
J. Damage to Property, Item (1) is deleted in Its 2. The requirement in Paragraph 2.b. of entirety and is replaced with the following: SECTION TV - COMMERCIAL GENERAL Property you own, rent, or occupy, including any LIABILITY CONDITIONS that you must see costs or expenses incurred by you, or any other to it that we receive notice of a claim or "suit person, organization or entity, for repair, as soon as practicable will not be considered restoration or breached unless the breach occurs after such replacement, enhancement,
maintenance of such property for any reason, claim or "suit" is known to:
including prevention of injury lo a person or a. You, if you are an individual; damage lo another's property, unless the damage b. A partner, if you are a partnership; or
NCG 73 08 01 20
c. An executive| officer or insurance (2) Directly or indirectly related to the employment, former or prospective
manager, if you are a corporation.
employment, termination of employment,
M. Unintentional Failure to Disclose Hazards demotion, failure to promote or It is agreed that, based on our rellance on your application for employment of any person representations as to existing hezards, if you or persons by an insured; or should unintentionally fail to disclose all such (3) Directly or Indirectly related to the sale, hazards prior to the beginning of the policy period rental, lease or sublease or prospective of this Coverage Part, we shall not deny coverage sales, rental, lease or sub-lease of any under this Coverage Part because of such failure. room, dwelling or premises by of at the N. Liberalization direction of any insured; or
If we make a change which broadens coverage (4) Insurance for such discrimination is under this edition of this endorsement without prohibited by or held in violation of law, edditional premium charge, that change will public policy, legislation, court decision or automatically apply to your insurance as of the administrative ruling. implement the change in your state, This coverage does not apply to fines or provided that this implementation date falls within penalties imposed because 45 days prior to or during the policy period stated in discrimination. the Declarations.
Q. Key and Lock Replacement - Janitorial
O. Bodily Injury - Mental Anguish Services Client Coverage 576500004642 Paragraph 3, of the DEFINITIONS Section is 1. We will pay for the cost to replace keys and deleted in its entirety and replaced by the locks at the "janitorial services client's" following: premises due to theft or other loss to keys
"Bodily Injury": entrusted to you by your "janitorial services a $15,000 limit per
a. Means bodily injury, sickness or disease client", up sustained by a person, and includes mental occumrence/$15,000 policy aggregate. anguish resulting from any of these; and 2. We will not pay for loss or damage resulting b. Except for mental anguish, includes death from theft or any other dishonest or criminal resulting from the foregoing (Item a. above) at act that you or any of your partners, members, officers, "employees", "managers",
any time.
P. Personal and Advertising Injury - Abuse of directors, trustees, authorized representatives or any one to whom you entrust the keys of a
Process, Discrimination "janitorial services client" for any purpose If COVERAGE PERSONAL AND commit, whether acting alone or in collusion ADVERTISING INJURY LIABILITY COVERAGE with other persons. is not otherwise excluded from this Coverage The following, when used in this coverage Part, the definition of "personal and advertising 3.
injury" is amended as follows: only, are defined as follows:
1. Paragraph 14.b. of the DEFINITIONS Section a. "Janitorial services client" means an individual, company or organization with
Is amended to read: whom you have a written contract or work b. Malicious prosecution or abuse of order for your services for a described INSURED COPY process; premises and you have billed for your
2. Paragraph 14. of the DEFINITIONS Section is services. b. "Employes" means:
"Personal and advertising injury" also means (1) Any natural person:
injury, including consequential "bodily injury". a) While in your services or for 30 arising out of discrimination based on race, days after termination of service excer, religion, sex, age or national origin, (b) Who you compensate directly by (1) Done intentionally by or at the direction salary, wages or commissions; 60212 of, or with the knowledge or consent of: and
(c) Who you have the right to direct
(8) Any insured; or control while performing
(b) Any executive officer, director, services for you; or stockholder, partner or member of the
insured; or
Includes copyrighted material of Insurance Services Offica, Ino., with is permission. Page 9 of 10 NCG 73 08 01 20
NCG 73 08 01 20
(2) Any natural person who is fumished a) Any agent, broker, person lease temporarily to you: o you by a labor leasing fim
as defined In Paragraph
bove, who is on leave; o
(b) To meet seasonal or short-term
hlle that person is subject
(3) "Employee" does not mean: °. Media capart for a on sted to in y company.
All terms and conditions of this polley apply unless modified by this endorsement.
--
RE NoW SEP25-031 for the 4tth YMCA parade
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San Bechardioo. Cairomia $2401
CONFIDENTIALITY NOTICE
На Менор
Tom.
RE- Save the Date: 430h Argul YSICA Christmars Parade-Saturdy December 13, 2025 (City of S8-Permits/Road Closures) The SEPD Tuite Division à on bord 1 can pravide Moler Olfces ill) and iade Control Do en (7 Li 4x Noisel Siams, Screcast
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MICHAEL ROSALES
SEDOR PLAMMER
COPIMUNITY DEVELOPMENT AND
PANNENA DANSION
Outlook
Your Fire Special Event Permit application has been submitted.
From noreply-ezop <[email protected]>
Date Thu 10/23/2025 12:41 PM
To Stephanie Tovar <[email protected]>
You don't often get email from [email protected]. less.wi.this.simpedent -
Dear Applicant,
Record FSEP-2025-00250, has been successfully submitted through the San Bernardino EZ Online Permitting Sustem (EZOR). County Fire may invoice you for any additional required fees within the next few business days to continue the application process. Please note, the review process does not begin until all fees have been paid. The status of your application can be viewed through the EZOP Citizen Access Portal.
What's Next?
Applications are reviewed for completeness within 1-2 business days from date of submittal.:
• Incomplete Applications;
If your application is deemed incomplete or is missing required documents, an email notification will be sent to the applicant that the application has been withdrawn. Please do not create a new application. • Complete Applications:
Once your application is accepted, fees will be generated, and an invoice will be sent to the email address that has been provided by the applicant. Once fees are paid, your plans will be routed for review. Plan check review time is 15-21 days after payment has been received.
If you have any additional questions, please contact the Office of the Fire Marshal at (909) 386-8400 and reference the project number FSEP-2025-00250.
Assigned Activity #
City of San Bernardino
Public Works Department (Office Use Only)
300 N. D Street
San Bernardino San Bernardino, CA 92401 **Right of Way** (909) 384-7272 Pormit Application
[email protected]
* * General Information **
Job Address / APN / Location: 808 E 21st Street San Bernardino CA 92404 - Nearest Cross Streets): Valencia & Highland Ave !
Purpose of Permit: YMCA 48th Annual Christmas Parade
Sewer Water Other:
Cable Electric Telephone Gas
Utility (Circle):
Work Order #: Dates of Work:
Times of Work (If Different from Mon - Fri, 8am - 4pm, no Holiday/Wkends):
Lane / Road Closure
Lane Closure - # of Construction Days: 1 Lane Closure - # of Special Event Days: 1 Road Closure - # of Construction Days: 1 Road Closure - # of Special Event Days: 1 ** * *
Excavation
Total Length: _ Total Width:
Excavation - # of Days:
**
* Encroachment
Encroachment Only, No Lane Closure - # of Days: Permanent Encroachment (Y/N):
24 Hour Notice Required Prior to Work Being Done Call (909) 384-7272 Contractor Information (Please Print):
Company Name and Address:
Contact Name:_ Contact Ph #:
Co. Phone #
City of SB Bus Lic # & Exp Date: CSLB Lic #, Class & Exp Date:
_GL Policy #: GL Policy Exp Date:
General Liability Ins Co:
Applicant Name (Please Print): Stephanie Tovar Applicant Signature: Stephanie Towar Office Use Only: (Do not Write Below This Line)
ROW Permit# • On / Off-Site Permit#
Date:
PARKS, RECREATION AND COMMUNITY SERVICES
APPLICATION/PERMIT
TO USE PUBLIC PARK OR RECREATION FACILITY
(CITY MUNICIPAL CODE 12.68.020; 12.78; 1280)
HIS PERMIT IS SUBJECT TO GANCELLATION BY ANY POLICE OFFICE
HO DETERMINES A VIOLATION OF ANY PROVISION OF THE CITY MUNICIPAL GOD Date of Application: 1012312025 Individual Organization C Organization Name: San Bernardino YMCA Facility Requested: Perris Hill Park
Date of Activity: 12113/2025 Time of Activity: 6:00AM A.M./P.M. To. 3:00PM A.M./P.M.
Nature of Activity/Event: 48th Annual YMCA Christmas Parade Describe Planned Activities: Community Christmas parade featuring music, partipants walking or riding the parade route This event included holiday theme preformances youth groups, and local schools/ oranizations No
Estimated Attendance: 5,000 Is Activity Open to the Public? Yes _Admission Fee?
HOLD HARMLESS AGREEMENT
Applicant hereby acknowledges that he/she has read, understands and will comply with all provisions of Chapter 12.80, Municipal Code, City of San Bemardino, California pertaining to use of Park and Recreation facllties.* Applicant hereby assumes all responsibility to leave areas in a neat and clean condition. Applicant agrees to hold harmless and indemnify the City of San Bernardino, Calffomia, from any and all liability for injury to persons of property occurring as a result of this activity and agrees to be liable to said City for all damage to any park, facility, bullding, pool, equipment and furniture wned or controlled by City, which results from the activity of permittee or is caused by any participant in said activity.
AVAILABLE FOR USE: San Bemardino YMCA
Printed Name of Applicant/Organization Rep.
YES NO
808 E 21st Street
SPECIAL CONDITIONS APPLY:
Address
YES NO
San Bernardino 92404 909-881-9622
LIABILITY INSURANCE WITH THE CITY
NAMED AS "ADDITIONAL INSURED" IS REQUIRED? City Zip Phone Number X NO Stephanie Tovar
_YES
Signature of Applicant/Organization Rep.
FEES:_ RECENED BY:_
ON RECEIPT #: DATE:
EY DEPOSIT: Keys shall be returned within two (2) working da s Issued. If key(s) Is r • APPROVED • DISAPPROVED DATE:
returned promptly, the deposit shall be forfeited.
DEPOSIT (S): _ _ DATE
DIRECTOR, PARKS, RECREATION & COMMUNITY SERVICES
DEPOSIT RETURNED TO: BY: _ _DATE
DISTRIBUTION HITE: DEPT /FACILITY
! SIGNATURE GREEN: APPLICANT/USER
CANARY: DEPOSIT FILE
PINK: POLICE DEPT
ADDRESS GOLDENROD: RISK MGMT
YMCA Annual Children Christmas Parade Map
Valencia Windsor Cedar Lawrence Harrison
XX xXXXXX XXXXXX xXXXXX
XX XX
XX + XX
XX HIGHLAND AVE HIGHLAND AVE XX
No Street Parking No Street Parking Parking Lot Parking Lot Pool & Tennis Courts
No Finish
Perris Hills Park Vehicles
Buses & Ball Park
No Street Parking Rest Rooms Participants Stadium
Parking
Pick up Area
Volunteers
Senior Permit SB YMCA
Center Parking
No Street Parking Only Participant Check In
Trophys Received Parade Line Parade Line
Sectlon 1 Section 2 Section 3 Section 4
****** ******* **************** ****
E 21st Street E 21st Street
XXXXXX * Section 5
* Barricade Check Point San Gabriel Perris
+ at Crestview Ave. & E 21st Street Hill
Park * Section 5
Road XXXXXXXXXXXX
Pacific Street
Participant &
Bus Drop Off
Area