CONTRACT.PDF

Arizona Form
Affidavit Bingo
830
This affidavit must be completed b y each person who wishes to assist in the conduct of an y game of bingo. If any information is blank or incorrect, the
affidavit will be returned to you. All information is subject to verification. Disclosure of your Social Security Number (SSN) is voluntary. This information
may be used to establish positive identification for purposes of criminal back ground checks pursuant to Arizona Revised Statutes § 5-404.
Licensee's Name License Number
n
Affiant's VENUE USE ONLY. DO NOT MARK IN THIS AREA.
Social Security Number ' - 13:41of Birth
I I
Address
City State ZIP Code
Home Phone No. (with area code) Work Phone No. (with area code ) 81 PM 80 RCVD
If licensee is a qualified organization, the following section is required:
Member? Date Joined Organization
CI Yes El No I I
Officers? Officer Title
M Yes • No
Do you have an affidavit on file for any other licensee?
CI Yes El No If 'Yes", list license number(s):
ID Position: Proceeds Coordinator
the above-named affiant, under penalty of perjury, upon
AFFIANT'S NAME
oath, depose and say that I will use net proceeds in compliance with the terms of the license, Arizona Revised Statutes,
Title 5, Chapter 4, and the rules of the licensing authority. I am of good moral character and have never been convicted
of any misdemeanor involving moral turpitude or felony. I am not currently serving as a manager, proceeds coordinator or
supervisor on another bingo license. I hereby swear or confirm that I have read and understand the foregoing and verify
that the information and statements made herein are true and correct to the best of my knowledge.
Sig nature of Affiant
Date
ID Position: Manager {_ e : oc- --1-j-;.4--e.e.7,-,z)c— Co,,,,...,,.-„t £424--,,, -,-,..4.% )
I, 161.6;---fru 1,(..,,&_.,(_) the above-named affiant, under penalty of perjury, upon oath,
AFF$ANT 5 NAME
depose and say that I will conduct or assist in conducting all bingo games in compliance with the terms of the license,
Arizona Revised Statutes, Title 5, Chapter 4, and the rules of the licensing authority. I am of good moral character and have
never been convicted of any misdemeanor involving moral turpitude or felony. I am not currently serving as a manager,
proceeds coordinator or supervisor on another bingo license. I hereby swear or confirm that I have read and understand
the foregoing and verify that the information and statements made herein are true and correct to the best of my knowledge.
1, 1111114111111111k
Sign, ant .1!
k
60/c7Ziii/
Date
ADOR 10327 (12(18)

Affiant's Name (as shown on page 1) Bingo Affidavit
0 Position: Supervisor
, the above-named affiant, under penalty of perjury, upon oath,
AFFIANT S NAME
depose and say that I will be continuously present on the premises during all bingo games and until all associated activities
have been completed in compliance with the terms of the license, Arizona Revised Statutes, Title 5, Chapter 4, and the
rules of the licensing authority. I am of good moral character and have never been convicted of any misdemeanor involving
moral turpitude or felony. I am not currently serving as a manager, proceeds coordinator or supervisor on another bingo
license. I hereby swear or confirm that I have read and understand the foregoing and verify that the information and
statements made herein are true and correct to the best of my knowledge.
Signature of Affiant
/7 9
Date
0 Position: Assistant
, the above-named affiant, under penalty of perjury, upon oath,
AFFIANIT'S NAME
depose and say that I will conduct or assist in conducting all bingo games in compliance with the terms of the license,
Arizona Revised Statutes, Title 5, Chapter 4, and the rules of the licensing authority. I am of good moral character and
have never been convicted of any misdemeanor involving moral turpitude or felony. I hereby swear or confirm that I have
read and understand the foregoing and verify that the information and statements made herein are true and correct to the
best of my knowledge.
Signature of Affiant
Date
Review Form and Sign Before Submitting Bingo
Customer Service Center
To avoid processing delays and errors, take a few
moments to make sure you have entered all of the Locations
required information and verify that it is accurate.
8:00 a.m. - 5:00 p.m.
Affiant's Signature Monday through Friday
Sign and date the form. (Except legal Arizona state holidays)
The form can be: Phoenix Office
Emailed to: 1600 West Monroe
bingo@azdorgov Phoenix, AZ 85007
Faxed to:
602-716-7973 Bingo
Customer Service Telephone
Mailed to:
Bingo Tax Unit Number
PO Box 29019
Phoenix, AZ 85038-9019 (602) 716-7801
ADOR 10327 (12118) Page 2

Event Contract
Thank you for choosing IronOaks Country Club as the site to host your upcoming event.
This contract ("Agreement") is made as of June 21st, 2019 between Sun Lakes Homeowners Association No.
3. Inc., an Arizona non-profit corporation ("IronOaks") and Sun Lakes Rotary ("Client"). The purpose of this
Agreement is for IronOaks to provide certain space and services for the temporary use by Client and Client's
guests to conduct an event.
The following is a contract outlining our terms and conditions.
To confirm your event on a definite basis for: Monday evenings please sign this contract and return.
Day of Event: Monday's
Start Time: 5pm to 9pm
Name of Event: Bingo
Location: Oakwood Ballroom
if of Guests:
Client's Name: Sun Lakes Roatray
Phone 41
Address:
1. No outside food or alcohol is allowed on property. Arizona State Liquor Law makes it illegal for a
retailer to knowingly allow a customer to bring spirits/liquor onto the licensed premises. This includes
food and beverages in any areas.
2. Renting Facilities at IronOalts Country Club: Private events scheduled at IronOaks are allowed a
specific amount of time on property. Your event is allowed 2 hours prior to setup and you have up to
6 hours from the start time of the event to the end of your event, to end no later than 11:00pm.
3. Logo Usage: The agreement to use IronOak meeting space does in no way indicate endorsement of the
event. Use of the IronOak logo or any likeness of the logo in ANY marketing materials will result in a
$500 fee.
4. Fire Safety: Tallies must be located in compliance with the local Fire Department regulations
pertaining to mandatory aisles and fire exits. You acknowledge that decorations, props, or staging
brought into the club may be subject to approval by the local Fire Department.
5. Conduct of Event: You agree to conduct the event in an orderly manner in full compliance with
applicable laws, regulations, and our rules. You assume full responsibility for the conduct of all persons
in attendance at your event and for any damages done to any part of IronOaks during the time of your
event. Any club property damaged or removed from the building or surrounding areas becomes the
responsibility of the person hosting the event.
6. IronOalts Country Club assumes no responsibility for lost or stolen articles.
7. Loss of Deposit: A credit card number must be held on file. IronOaks reserves the right to charge the
amount of any damages or breach of this contract to your credit card the night of the event.

8. Amendments/Changes: The parties agree that any amendments or changes to the arrangements
described in this contract must be made in writing, signed by both you and us.
9. Cancellation Policy: You may cancel this Agreement only upon giving written 30 day notice by either
party. In the event that the Ballroom is previously reserved there will be a minimum of 30day notice
given to the Rotary Club.
10. Indemnification: Client shall protect, indemnify, defend and hold harmless IronOaks and its
employees and agents against all claims, losses or damages to persons or property, government
charges, fines and costs (including reasonable attorney's fees) arising out of or connected with the
Event including but not limited to the installation, removal, maintenance, occupancy or use of IronOaks
property or any part thereof by Client, any guest, invitee or agent of Client or any contractor
(independent or otherwise) arranged by Client except those claims arising out of the sole negligence
or willful misconduct of IronOaks. Client shall provide proof of liability insurance with coverage limits
acceptable to IronOaks not later than 14 days prior to the Event. At its sole option, IronOaks may
accept a waiver of liability signed by Client in lieu of the insurance requirement.
11. Schedule of Payments:
a) 70% of all gross receipts shall be paid to IronOaks HOA3 by the last day of each month.
This needs to include documentation of all receipts.
Client: Print Name
x
Client: Signature Date
IronOaks Representative Signature Date