Public Safety & Welfare Committee
Regular MeetingVerona, WI · August 23, 2021
Minutes
CITY OF VERONA
MINUTES
PUBLIC SAFETY AND WELFARE COMMITTEE
August 23, 2021
Verona City Hall
1. Call to order: Heather Reekie called the meeting to order at 5:32 p.m.
2. Roll Call: Heather Reekie and Evan Touchett. Also present: Police Chief Bernie Coughlin,
Sergeant Jesse Christensen, and City Clerk Holly Licht. Phil Hoechst was absent and
excused.
3. Public Comments: None
4. Approval of Minutes: Motion by Reekie, seconded by Touchett to approve the minutes
from the July 26, 2021 Public Safety and Welfare Committee meeting. Reekie noted
there was a correction for agenda item 5. The minutes should read that the motion was
made by Reekie. City Clerk Holly Licht noted she would make the correction. Motion
carried 2-0.
5. Discussion and Possible Action Re: Special Event Permit application and Temporary Class
“B” Fermented Malt Beverage and “Class B” Wine license from Le Jordan, Verona Area
Chamber of Commerce, for Hometown Days on Friday, September 3-Sunday, September
5
Hometown Days will again be located at Festival Park located behind City Hall. The
general layout of the festival is consistent with previous years. Fireworks will be held on
Friday night. Other weekend activities include pony rides, a petting zoo, the Hometown
Hustle 5K run/walk, live music, food stands, carnival rides, the Hometown Rumble car
show, and the Hometown Days parade.
The Temporary Class “B” Retailer’s License allows the Verona Area Chamber of Commerce
to sell beer and wine spritzers at the Hometown Days event. The beer tent will be open
Friday through Sunday. Beer will be served in cans; there will be no draft beer. Children
aged 14 and under will be allowed in the beer tent with a parent until 8:00 p.m. on Friday
and Saturday nights, and until 5:30 p.m. on Sunday. A safe ride program will be provided.
A licensed bartender will be on site during all beer tent hours.
Motion by Reekie, seconded by Touchett, to recommend that the Common Council
approve a Special Event Permit application and a temporary Class “B” Fermented Malt
Beverage and “Class B” Wine license from Le Jordan, Verona Area Chamber of Commerce,
for Hometown Days on Friday, September 3- Sunday, September 5, contingent upon
receipt of a certificate of insurance listing the City of Verona as an additional insured.
Motion carried 2-0.
6. Discussion and Possible Action Re: Special Event Permit application from Lyndsay
Andrae, Sugar Creek PTO, for the Sugar Creek Fun Run from 8 a.m.-11 a.m. on Saturday,
October 2, 2021
This is the 5th year for this fundraising event for the Sugar Creek Elementary School
PTO. The course begins and ends at Sugar Creek Elementary School. There will be 2
police officers on site for traffic control.
Motion by Reekie, seconded by Touchett to approve the special event permit
application from Lyndsay Andrae, Sugar Creek PTO, for the Sugar Creek Fun Run from 8
a.m.-11 a.m. on Saturday, October 2, 2021. Motion carried 2-0.
7. Discussion and Possible Action Re: Special Event Permit application from Matthew
Giesfeldt, for the Mama Goose Memorial Run/Walk on Saturday, September 18th from 7
a.m.-11 a.m.
This will be the 12th year for the Mama Goose Run/Walk. All proceeds from the event
go to the Carbone Cancer Center. The 5k course starts and ends at Veterans Park. There
will be volunteers at every corner on the course. There will be no polices officers
controlling traffic for the event. On average, there are 150-200 participants.
Motion by Reekie, seconded by Touchett , to approve a special event permit from
Matthew Geisfeldt for the Mama Goose Memorial Run/Walk on Saturday, September
18th from 7 a.m.-11 a.m. Motion carried 2-0.
8. Discussion and Possible Action Re: Special Event Permit application from Abbey
VanValkenburg, Ironman/World Triathlon Corp, for Ironman Wisconsin on Saturday,
September 12th from 6 a.m.-7 p.m.
The cycling portion of the Ironman Wisconsin Race will pass through Verona twice. The
race thing year will include a half Ironman and full ironman. Sergeant Christensen stated
that the added volume of cyclists should not be a problem. The first cyclist is expected
to be in the city at approximately 8:15 a.m. The last cyclist will pass through the city no
later than 5:30 p.m. There will be several road closures including the ramps at US-
18/151. Multiple officers will be directing traffic. Electronic sign boards will be placed on
Main St. and E. Verona Ave. 5 days before the race to notify motorists and residents of
the race.
Motion by Reekie, seconded by Touchett, to approve a special event permit application
from Abbey Van Valkenburg, Ironman /World Triathlon Corp., for Ironman Wisconsin on
Sunday, September 12th from 6 a.m.-7 p.m. Motion carried 2-0.
9. Adjournment: Motion by Reekie, seconded by Touchett to adjourn at 6:00 p.m. Motion
carried 2-0.
Respectfully Submitted,
Holly Licht, City Clerk
Agenda
City of Verona
PUBLIC SAFETY AND WELFARE COMMITTEE
Monday, August 23, 2021 AT 5:30 PM
COUNCIL CHAMBERS
VERONA CITY CENTER
111 LINCOLN STREET, VERONA, WI 53593
AGENDA
1. Call to order
2. Roll Call
3. Public Comments
4. Approval of Minutes from the July 26, 2021 Public Safety and Welfare Committee
meeting.
5. Discussion and Possible Action Re: Special Event Permit application and Temporary Class
“B” Fermented Malt Beverage and “Class B” Wine license from Le Jordan, Verona Area
Chamber of Commerce, for Hometown Days on Friday, September 3-Sunday, September
5
6. Discussion and Possible Action Re: Special Event Permit application from Lyndsay
Andrae, Sugar Creek PTO, for the Sugar Creek Fun Run from 8 a.m.-11 a.m. on Saturday,
October 2, 2021
7. Discussion and Possible Action Re: Special Event Permit application from Matthew
Giesfeldt, for the Mama Goose Memorial Run/Walk on Saturday, September 18 th from 7
a.m.-11 a.m.
8. Discussion and Possible Action Re: Special Event Permit application from Abbey
VanValkenburg, Ironman/World Triathlon Corp, for Ironman Wisconsin on Saturday,
September 19th from 6 a.m.-7 p.m.
9. Adjournment
Heather Reekie, Chairperson
POSTED: Verona City Hall
Miller & Sons Market
Verona Public Library
City Web Page at: www.ci.verona.wi.us
Notice is hereby given that a quorum of the members of the City Council or other standing
committees of the City Council may be present at the meeting of the Public Safety and Welfare
Committee to gather information about a subject over which they have decision-making
responsibility. The City Council and any other standing committees will not take formal action at
this meeting
IF YOU NEED AN INTERPRETER, MATERIALS IN ALTERNATIVE FORMATS OR OTHER ACCOMODATION
TO ACCESS THE MEETING, PLEASE CONTACT THE CITY CLERK AT 608-845-6495 AT LEAST 48 HOURS
PRECEDING THE MEETING. EVERY REASONABLE EFFORT WILL BE MADE TO ACCOMMODATE YOUR
REQUEST.
CITY OF VERONA
MINUTES
PUBLIC SAFETY AND WELFARE COMMITTEE
July 26, 2021
Verona City Hall
1. Call to Order: Heather Reekie called the meeting to order at 7:02 p.m.
2. Roll Call: Heather Reekie and Evan Touchett were present. Also Present: Police Chief
Bernie Coughlin, Sergeant Jesse Christensen, City Administrator Adam Sayre, and City
Clerk Holly Licht.
3. Public Comments: None
4. Approval of Minutes: Motion by Reekie, seconded by Touchett to approve the minutes
from the June 28, 2021 Public Safety and Welfare Committee meeting. Motion carried
2-0.
5. Discussion and Possible Action Re: Special Event Permit application from Ann
Schwarzwalder, Brazen Dropouts, for the Verona Criterium Cycling Race from 8 a.m.-6
p.m. on Saturday, August 14, 2021
This is the first year of this cycling race event race will start and end at the high school.
The course is 1.2-mile loop around the high school. Three will be 11 different race
categories and start times throughout the day. The applicant is requesting 1 road
closure. An officer will be at West End Circle and Wildcat Way. Volunteers will be at the
other intersections to help guide traffic. The applicant is going to follow up with the
school district tomorrow regarding other possible events at the school that day.
Motion, second by Touchett to approve the Special Event Permit application from Ann
Schwarzwalder, Brazen Dropouts, for the Verona Criterium Cycling Race from 8 a.m.-6
p.m. on Saturday, August 14, 2021 with the following conditions: the applicant must
submit an updated certificate of insurance, and completion of the background check.
Motion carried 2-0.
6. Discussion and Possible Action Re: Special Event Permit application and Temporary Class
“B” Fermented Malt Beverage and “Class B” Wine license from Michael Obrien, Verona
Wildcat Youth Hockey, for the Hometown Brewdown beer tasting event from 1p.m.-6
p.m. on Saturday, September 25, 2021
This event is a craft beer fest, with the proceeds going to the Verona Ice Arena. The
event is held on the Verona Ice Arena property. Craft beer, cheese and other foods will
be served. Games and a small band will also be provided. A Temporary Class “B”
Retailer’s License will be required for this event. Licensed bartenders will be on site
serving the alcohol. There will be 2 officers at the event and fencing surrounding the
grounds. They are hoping that it will draw 1300-2000 attendees.
Motion by Reekie, second by Touchett to recommend that council approve a Special
Event Permit application and Temporary Class “B” Fermented Malt Beverage and “Class
B” Wine license from Michael Obrien, Verona Wildcat Youth Hockey, for the Hometown
Brewdown beer tasting event from 1p.m.-6 p.m. on Saturday, September 25, 2021 with
the following conditions: the applicant must submit an updated certificate of insurance,
and completion of the background check. Motion carried 2-0.
7. Adjournment: Motion by Reekie, seconded by Touchett to adjourn at 7:20 p.m. Motion
carried 2-0.
Respectfully Submitted,
Holly Licht, City Clerk
Date: ________________
CITY OF VERONA CR#: ___
Account #: 100-44910
APPLICATION FOR A SPECIAL EVENT/NEIGHBORHOOD EVENT PERMIT
For Parades, Runs, Walks, Bicycle Events, Triathlons, Festivals, Neighborhood Events, etc.
*All required application materials must be submitted at least 45 days prior to the event. Failure to meet this requirement may
y of Verona Code of Ordinances*
Application Fee:
$150.00 + any additional fees
Non-Profit Organization: $50.00 + any additional fees
REQUIRED INFORMATION
Please include the following information/materials regarding the event with your application:
License
Route map and description and/or map of event layout
--------------------------------------
Certificate of Insurance at least 30 days prior to event
APPLICANT INFORMATION
Name: Phone:
First M.I. Last
Address:
Driver License #: DOB:
Email:
AGENCY/ORGANIZATION INFORMATION
Name: Phone:
Address:
If this is a non-profit organization, please provide your EIN number for verification:
EVENT INFORMATION
Name of Event: Type of event
Event date(s): Event time(s):
Set up Start Time: Tear Down End Time:
(Application Continues on Reverse)
Last updated
Date:________________
Initials:_______________
Informational Questions No Yes Notes
Was a Special Event Permit previously approved in times
1
past for this event?
2 Will there be outdoor amplified sound? Additional application required.
Will alcohol be sold, served or consumed? Additional licenses may be
3
required.
4 Are you requesting any City streets to be closed to traffic? See Below*
Will your event use County, State or US Highways? If yes, please provide a map clearly
marking the highways that will be
5
used. Additional permission from
the County is required.
Will park, conservancy land, or trails be used? If so, have Contact Parks Department:
you reserved a park, pavilion, or any other city facilities for 845-6695
the event? If using park facilities, the
6
application will not go before the
Public Safety Committee without
Parks Department approval.
Will items or services be sold or given away at this event? If yes, please attach a list of types
7
of items or services.
Does this event involve a plan for tents, stages, inflatable Include on event layout map.
8
bounce houses or temporary structures?
Does your event include the use of fireworks, rockets, Must receive written approval from
9 lasers, other pyrotechnics, or open flame? Fire Chief or his designee. 608-845-
9401
10 Do you plan to provide portable toilets at your event?
Will your event have dedicated coverage by an Emergency
11
Medical Provider?
Is this a race or timed event where participants need the If traffic control is desired, a police
12
right of way on City streets? officer is required, per WI Law.
13
emergency vehicles throughout your event?
Does your event include running or biking that will need a Posting of No Parking signs by PD
14
dedicated lane of travel on City streets? will be needed and billed to event.
*If you answered YES to street closures, please attach a map/diagram of the portion(s) of street you wish
to have closed for your event. Please include street names and as much information as possible.
If you are NOT intending to close any City Streets, or request the right of way, but intend to use City Streets,
you will share the street with vehicular traffic and agree to abide by all traffic laws. Failure to comply with
traffic laws will result in the immediate termination of all event activities.
*Applicant Initial Here:
EVENT CONTACTS
PLEASE LIST NAMES, LOCATIONS AND CELL PHONE NUMBERS OF EVENT CONTACT PERSONS
NAME DOB LOCATION AT EVENT CELL PHONE
as shown on ID (Ex: Race Start, Supply (Ex: 10 a.m. to
Tent etc.) 2 p.m.)
APPLICATION PROCEDURES
1. Application and all required materials shall be submitted to the City Clerk a minimum of 45
days prior to the event. ( )
2. Upon verification of the application the City Clerk shall submit the application to the Police Chief for
further review.
3. The applicant will be contacted by the Police Department Staff to review event route and the
event.
4. The applicant is subject to a background check.
5. All police traffic control/city staff time incurred shall be billed to the applicant upon the completion
of the event.
6. The applicant may be required to attend a Public Safety and Welfare Committee meeting
and/or a Common Council meeting at which the event application will be reviewed for
approval.
7. Once the application is approved by the appropriate official(s) the permit will be issued.
APPLICANT SIGNATURE
PLEASE READ CAREFULLY BEFORE SIGNING
I understand the application and event requirements and agree to adhere to all applicable federal, state, and
municipal laws in addition to the requirements on the application. I agree to pay any invoices received from the
City of Verona for staff time at the event within 30 days of the invoice date. I understand that failure to adhere to
any application requirements or any federal, state or municipal laws involving the event will result in the denial of
the application or immediate termination of the event. The violation of federal, state or municipal laws will be
subject to applicable fines and penalties.
Applicant Signature Date
Once application is approved, the permit will be issued to applicant via email.
A copy of the permit must be available at event for conformation.
OFFICE USE ONLY
PLEASE DO NOT WRITE ON THIS PAGE
CHIEF OF POLICE
Date Received by Police:
The event application has been reviewed and the following issues need to be addressed:
Meeting with Applicant: Yes No If YES, Date of Meeting:
Barricades needed? Yes No
Traffic Control/Officers Needed:
CIB Information:
CERTIFICATION OF APPLICATION BY CHIEF OF POLICE:
Approved Denied
Signature of Chief of Police Date
MUNICIPAL CLERK
Application Received Date: 45 Day Application Requirement Met: YES NO
Date Submitted to Police on: All required documents submitted: YES NO
Items Still Required:__________________________________________________________________________
PUBLIC SAFETY & WELFARE COMMITTEE: Date of meeting: __ APPROVE DENY
COMMON COUNCIL: Date of meeting: __ APPROVE DENY
Signature of Municipal Clerk: Date:
Copy provided to applicant: Yes No Date:
Copy provided to: EMS: Yes No | Fire: Yes No | PD: Yes No | PW: Yes No
START FINISH
3 mile
1 mile
2 mile
Park Pavilion
Parking Lot
KEY:
Timing Tent = DJ area =
Registration Tent/Table = Race Finishers’ Area =
B I K E C O UR S E
Valmont Rd.
56 MILES / 1 LOOP
MADISON, WISCONSIN
LAKE MENDO TA
14
Mineral Point Rd.
55
Timber Lane
30
14
18
35 18
d.
oy R
McC 5
50 14 BE
AU
W
40 KE
LA
S. Syene Rd.
25
20
Grandview Rd.
15 45
Irish Lane
Whalen Rd. 10
Valley Rd.
69
14
LEGEND
TRANSITION AREA
START LINE
FINISH LINE
1 MILE MARKERS
WATER/AID STATION
COPYRIGHT © WORLD TRIATHLON CORPORATION. ALL RIGHTS RESERVED.
BIKE COURSE
56 MILES / 1 LOOP
MADISON, WISCONSIN
TU R N B Y TU R N D I R E C T I O N S
• Exit Monona Terrace down ramp onto John Nolen Dr.
• Left on E. Lakeside St.
• Bear right on Olin-Turville Ct.
• Right on Wingra Bike Path under John Nolen Dr.
• Bear Left on Olin Ave.
• Right on Expo Way enter Alliant Energy Center parking lot
• Right on Alliant Energy Center Parking Lot Perimeter Rd.
• Bear Left across Alliant Energy Center Parking Lot to South Entrance/Exit
• Left on Rusk Ave.
• Right on Rimrock Rd.
• Right on E. Badger Rd.
• Left on Ski Ln. (becomes Oregon Rd.)
• Right on McCoy Rd.
• Bear left on S. Syene Rd.
• Right on Irish Ln.
• Left on Caine Rd.
• Right on Whalen Rd.
• Right on County Route-M
• Left on Locust Dr.
• Right on Bruce St.
• Left on Paoli St.
• Right on Valley Rd.
• Right on Sugar River Rd.
• Left on Marsh View Rd.
• Left on County Highway G
• Right on Messerschmidt Rd.
• Right on Route 92
• Right on N 8th St.
• Right on County Highway S
• Left on Witte
• Right on County Highway J
• Left on Garfoot Rd.
• Left on W Mineral Point Rd.
• Right on Garfoot Rd.
• Right on County Highway KP
• Right on Bourbon Rd.
• Right on County Highway P.
• Left on Stagecoach Rd.
• Right on North Birch Trail
• Left on Old Sauk Pass Rd.
• Right on Timber Ln.
• Left on Midtown Rd.
• Right on Shady Oak Ln.
• Left on County Highway PD
• Right on N. 9 Mound Rd.
• Left on Cross Country Rd. • Right on County Highway M
• Left on Verona Avenue (Business 18/151)
• Right on Old County Highway PB
• Right on Whalen Rd.
Left on Whalen Rd.
• Left on Caine Rd.
• Right on Irish Ln.
• Left on S. Syene Rd.
• Bear right on McCoy Rd.
• Left on Oregon Rd. (becomes Ski Ln.)
• Right on E. Badger Rd
. • Left on Rimrock Rd.
• Left on Rusk Ave.
• Right into Alliant Energy Center South Entrance
• Bear right into Alliant Energy Center Parking Lot Perimeter Rd.
• Left out of Alliant Energy Center Northwest Entrance
• Right on Expo Way
• Left on Olin Ave.
• Left on Wingra Bike Path
• Left on E. Lakeside St.
• Right on John Nolen Dr.
• Right on South Parking Ramp to Monona Terr.
Start Elevation: 850 ft • Finishing Elevation: 850 ft • Gain: 2,490 ft
1200 FEET
1100
1000
900
800 MILES
0 10 20 30 40 50 60
COPYRIGHT © WORLD TRIATHLON CORPORATION. ALL RIGHTS RESERVED.
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 7/14/2021
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
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 have ADDITIONAL INSURED provisions or 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:
Insurance Office of America, Inc. PHONE FAX
1855 West State Road 434 (A/C, No, Ext):
E-MAIL
(A/C, No):
Longwood FL 32750 ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
License#: 0E67768 INSURER A : Everest National Insurance Company 10120
USATRIA-01
INSURED INSURER B : United States Fire Insurance Company 21113
USA Triathlon of Colorado
5825 Delmonico Dr INSURER C :
Colorado Springs CO 80919 INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 1075551894 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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY Y Y SI8GL01727-201 12/1/2020 12/1/2021 EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 1,000,000
X Part. Legal Liab MED EXP (Any one person) $
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO-
POLICY JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000
X OTHER: Event $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
A UMBRELLA LIAB X OCCUR SI8EX01472-201 12/1/2020 12/1/2021 EACH OCCURRENCE $ 10,000,000
X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
B Participant Accident US1394363 12/1/2020 12/1/2021 Accident Medical 25,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage applies to the USA Triathlon sanctioned or approved event specified on this certificate.
The certificate holder is an additional insured, where required by written contract or written agreement, but only with respect to the operations of the named
insured, and subject to the provisions and limitations of form ECG20 600 - Additional Insured - Blanket when required by written contract, but only with respect
to the USAT sanctioned or approved event specified on this certificate.
The General Liability policy is primary as per Form ECG24 520 (04/02) and the General Liability policy contains Form ECG24 522 (04/02): Waiver of Transfer of
Rights of Recovery Against Others to US, but only as required by written contract or agreement executed by the named insured prior to an occurrence resulting
See Attached...
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Verona
111 Lincoln St. AUTHORIZED REPRESENTATIVE
Verona WI 53593
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: USATRIA-01
LOC #:
ADDITIONAL REMARKS SCHEDULE Page 1 of 1
AGENCY NAMED INSURED
Insurance Office of America, Inc. USA Triathlon of Colorado
5825 Delmonico Dr
POLICY NUMBER Colorado Springs CO 80919
CARRIER NAIC CODE
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
in a loss or a claim.
Ironman Wisconsin | 2021-09-12 | 2021-09-12 | Madison, WI 53713
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
COMMERCIAL GENERAL LIABILITY
ECG 20 600 05 09
THIS ENDORSEMENT CHANGES THE COVERAGE PART. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -- AUTOMATIC STATUS WHEN
REQUIRED IN A WRITTEN AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II ---- Who Is An Insured is amended to C. The Limits of Insurance afforded to an additional
include as an additional insured any person or or- insured shall be the lesser of the following:
ganization with whom you have a written agree- 1. The Limits of Insurance required by the written
ment that such person or organization be added agreement between the parties; or
as an additional insured on your Coverage Part.
Such person or organization is an additional in- 2. The Limits of Insurance provided by this Cov-
sured only with respect to liability for "bodily in- erage Part.
jury", "property damage" or "personal and advertis- D. With respect to the insurance afforded to an addi-
ing injury" but only to the extent caused, in tional insured, this insurance does not apply to
whole or in part, by: "bodily injury", "property damage" or "personal and
1. Your acts or omissions; or advertising injury" arising out of any act or omis-
sion of an additional insured or any of its employ-
2. The acts or omissions of those acting on your ees.
behalf;
in the performance of your operations for an addi-
tional insured.
B. The insurance afforded to an additional insured
shall only include the insurance required by the
terms of the written agreement and shall not be
broader than the coverage provided within the
terms of the Coverage Part.
ECG 20 600 05 09 Copyright, Everest Reinsurance Company 2009 Page 1 of 1
Includes copyrighted material of Insurance Services Office, Inc., used
with its permission.
INSURED COPY
COMMERCIAL GENERAL LIABILITY
ECG 24 522 04 02
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS
AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV --- COMMERCIAL
GENERAL LIABILITY CONDITIONS) is amended by the addition of the following:
We waive any right of recovery we may have against the person or organization shown in the Schedule above
because of payments we make for injury or damage arising out of your operations or "your work" done under a
written agreement that requires you to waive your rights of recovery. The written agreement must be made prior to
the date of the "occurrence". This waiver applies only to the person or organization shown in the Schedule above.
ECG 24 522 04 02 Includes copyrighted material of Insurance Services Office, Page 1 of 1
Inc., with its permission.
INSURED COPY
COMMERCIAL GENERAL LIABILITY
ECG 24 520 04 02
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT -- OTHER INSURANCE
(PRIMARY NONCONTRIBUTORY)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Paragraph a. Primary Insurance of 4. Other Insur-
ance of SECTION IV COMMERCIAL GENERAL
LIABILITY CONDITIONS is replaced by the following:
a. Primary Insurance
This insurance is primary except when b. below
applies. If this insurance is primary, our obliga-
tions are not affected unless any of the other
insurance is also primary. Then, we will share
with all that other insurance by the method de-
scribed in c. below, except that we will not seek
contribution from any party with whom you
have agreed in a written contract or agreement
that this insurance will be primary and noncon-
tributory, if the written contract or agreement
was made prior to the subject ‘‘occurrence’’ or
offense.
ECG 24 520 04 02 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1
with its permission.
INSURED COPY
B I K E C O UR S E
112 MILES / 2 LOOPS
MADISON, WISCONSIN
Bourbon Rd.
80
KP S.
LAKE
40 Br
Stagecoach Rd. oo
m MONONA
P
N. Birch Trail
St
.
D r.
e
d
. r
R ho
oot N. S
Old Sauk Pass Rd. 151 John Nolen Dr.
Gar f
Old Sauk Rd.
MONONA Olin-Tur ville Ct.
BAY
Timber Ln.
Bay Creek 110
Pine Bluff
.
St 110
E xpo Way rk
S Pa
14
J Valley View Rd.
P
Midtown
Wit te Rd.
Rusk Ave.
Rd. Rimrock Rd.
90 18 18
50 d.
MM
J
Shady Oak yR
N. 8th 30 Ln. er
St. at
ch
H
Nor thern h
is
P Lights Rd. 18
F
PD McCoy
Rd.
S Syne Rd.
70 PD
Cross Countr y Rd. Lacy Rd. 14
Marsh
Fitchrona Rd.
151 View Rd.
151
60
18
92
100
J Whalen Rd. Rd. 10
20
er y
G Valley Rd. Locust Dr.
Sugar Paoli St. atch
River Rd.
Me sse rsc hm idt Rd . S Fish H
14
LEGEND
TRANSITION AREA
START LINE
FINISH LINE
1 1ST LOOP MILE MARKERS
5 2ND LOOP MILE MARKERS
WATER/AID STATION
BEGIN 2ND LOOP
COPYRIGHT © WORLD TRIATHLON CORPORATION. ALL RIGHTS RESERVED.
BIKE COURSE
112 MILES / 2 LOOPS
MADISON, WISCONSIN
TUR N BY TU RN D I REC T I O NS
• Exit Monona Terrace down ramp onto John Nolen Dr. • Left on Verona Avenue (Business 18/151)
• Left on E. Lakeside St. • Right on Old County Highway PB
• Bear right on Olin-Turville Ct. • Right on Whalen Rd.
• Right on Wingra Bike Path under John Nolen Dr. • Proceed onto second loop
• Bear Left on Olin Ave. • At end of second loop turn left on Whalen Rd.
• Right on Expo Way enter Alliant Energy Center parking lot • Left on Caine Rd.
• Right on Alliant Energy Center Parking Lot Perimeter Rd. • Right on Irish Ln.
• Bear Left across Alliant Energy Center Parking Lot to South Entrance/Exit • Left on S. Syene Rd.
• Left on Rusk Ave. • Bear right on McCoy Rd.
• Right on Rimrock Rd. • Left on Oregon Rd. (becomes Ski Ln.)
• Right on E. Badger Rd. • Right on E. Badger Rd.
• Left on Ski Ln. (becomes Oregon Rd.) • Left on Rimrock Rd.
• Right on McCoy Rd. • Left on Rusk Ave.
• Bear left on S. Syene Rd. • Right into Alliant Energy Center South Entrance
• Right on Irish Ln. • Bear right into Alliant Energy Center Parking Lot Perimeter Rd.
• Left on Caine Rd. • Left out of Alliant Energy Center Northwest Entrance
• Right on Whalen Rd. • Right on Expo Way
• Right on County Route-M • Left on Olin Ave.
• Left on Locust Dr. • Left on Wingra Bike Path
• Right on Bruce St. • Left on E. Lakeside St.
• Left on Paoli St. • Right on John Nolen Dr.
• Right on Valley Rd. • Right on South Parking Ramp to Monona Terr.
• Right on Sugar River Rd.
• Left on Marsh View Rd.
• Left on County Highway G
• Right on Messerschmidt Rd.
• Right on Route 92
• Right on N 8th St.
• Right on County Highway S
• Left on Witte
• Right on County Highway J
• Left on Garfoot Rd.
• Left on W Mineral Point Rd.
• Right on Garfoot Rd.
• Right on County Highway KP
• Right on Bourbon Rd.
• Right on County Highway P.
• Left on Stagecoach Rd.
• Right on North Birch Trail
• Left on Old Sauk Pass Rd.
• Right on Timber Ln.
• Left on Midtown Rd.
• Right on Shady Oak Ln.
• Left on County Highway PD
• Right on N. 9 Mound Rd.
• Left on Cross Country Rd.
• Right on County Highway M
Start Elevation: 871 ft • Finishing Elevation: 871 ft • Gain: 4,120 ft
1197
FEET
1064
931
MILES
798
0 22 45 67 89 112
COPYRIGHT © WORLD TRIATHLON CORPORATION. ALL RIGHTS RESERVED.
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