TEAM RED WHITE BLUE - REDACTED.PDF

FOR DLLC USE ONLY
Arizona DeparynerTh-qf LiquoritcensOs and Control Event dote(s):
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APPLICATION !Atm SPECI Ev T,LICENSE
Fee= $25:'0:a l per*y.,fo.r 1-10 , ,c ra s (;c6nsecutive)
A service fee of $25.0041 be `ch6e0 :forall,c11 .0onord Y checks (A.R.S. §44-6852)
IMPORTANT INFORMATIONi.Thl*:daa0 eiithiqst, '14elukdatrialeted or it will be returned.
The Department of Liquor Licenses oOd::::ointi;Ou,ripst*i . 'eiye*s aPWation ten (10) business days prior to the
event. If the special event will be held ata locaflonwithovtçi pefflianent liquor license or if the event will be on any
portion of a location that is not covered by the existi#g„Ijvor license, this application must be approved by the
local government before submission to the Department of ,I.tquor Licenses and Control (see Section 15).
SECTION 1 Name of Organization: TEAM RED WHITEA BLUE INC
SECTION 2 Non-Profit/IRS Tax Exempt Number: 27-2196347
SECTION 3 The organization is a: (check one box only)
@Charitable (501.C) El Fraternal (must have regular membership and have been in existence for over five (5) years)
DReligious OCivic (Rotary, College Scholarship) OPolitical Party, Ballot Measure or Campaign Committee
SECTION 4 Will this event be held on a currently licensed premise and within the already approved premises?
DYes No
Name of Business License Number Phone (include Area Code)
SECTION 5 How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors?
Please read R-19-318 for explanation (look in special event planning guide) and check one of the following boxes.
OPlace license in non-use
D Dispense and serve all spirituous liquors under retailer's license
@ Dispense and serve all spirituous liquors under special event
EISplit premise between special event and retail location
(It not using retaii license, submit a letter of agreement from the agent/owner of the licensed premise to suspend the
license during the event. If the special event is only using a portion of premise, agent/owner will need to suspend that
portion of the premise.)
SECTION 6 What is the purpose of this event? @On-site consumption DOff-site (auction) ElBoth
SECTION 7 Location of the Event: Estrella Mountain Regional Park
Address of Location: 14805 West Vineyard Avenue Goodyear Arizona 95338
Street City County/State Zip
SECTION 8 Will this be stacked with a wine festival/craft distiller festival? :hes In No
SECTION 9 Applicant must be a member of the qualifying organization and authorized by an Officer, Director or
Chairperson of the Organization named in Section 1. (Authorizing signature is required in Section 13.)
1. Applicant: CourY Jamil Peter
Last First Middle Date of Birth
2. Applicant's mailing address:
City State Zip
3. Applicant's home/cell phone: Applicant's business phone: ( )
4. Applicant's email address:
30/17/14
Individuals requiring ADA accommodations call (602)542-9027.

SECTION 10
1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
OYes ill No (If yes, attach explanation.)
2. How many special event licenses have been issued to this location this year? 0
(The number cannot exceed 12 events per year; exceptions under A.R.S. §4-203.02(D).)
3. Is the organization using the services of a promoter or other person to manage the event? DYes E No
(If yes, attach a copy of the agreement.)
4. List all people and organizations who will receive the proceeds. Account for 100% of the proceeds. The
organization applying must receive 25% of the gross revenues of the special event liquor sales. Attach an
additional page if necessary.
Name TEAM RED WHITE & BLUE INC Percentage 50
Address 1110 W. Platt Street Tampa Florida 33606
Street City State Zip
Name ARAVAIPA RUNNING LLC Percentage 5°
Address 1731 E. Palmaritas Phoenix Arizona 85020
Street City State Zip
5. Please read A.R.S. §4-203.02 Special event license: rules and RI 9-1-205 Requirements for a Special Event License.
Note: ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY.
"NO ALCOHOLIC BEVERAGES SHALL LEAVE SPECIAL EVENT UNLESS THEY ARE IN AUCTION SEALED CONTAINERS
OR THE SPECIAL EVENT LICENSE IS STACKED WITH WINE /CRAFT DISTILLERY FESTIVAL LICENSE"
6. What type of security and control measures will you take to prevent violations of liquor laws at this event?
(List type and number of police/security personnel and type of fencing or control barriers, if applicable.)
0 Number of Police I Number of Security Personnel EFencing OBarriers
Explanation: ID Check & wrist bands to those over 21 years of age. Security personnel at front of
trailhead area making sure no alcohol leaves the serving area which is the trailhead.
SECTION 11 Date (s) and Hours of Event. May not exceed 10 consecutive days.
See A.R.S. §4-244(15) and (17) for legal hours of service.
Event Start License End
Date Day of Week Time AM/PM Time AM/PM
DAY 1: 06/27/2015 Saturday 4PM 2AM
DAY 2:
DAY 3:
DAY 4:
DAY 5:
DAY 6:
DAY 7:
DAY 8:
DAY 9:
DAY 10;
10/17/14 Page 2 of 4
Individuals requiring ADA accommodations call (602)542-9027.

SECTION 12 License premises diagram. The licensed premises for your special event is the area in which you are
authorized to sell, dispense or serve alcoholic beverages under the provisions of your license. The following
space is to be used to prepare a diagram of your special event licensed premises. Please show dimensions,
serving areas, fencing, barricades, or other control measures and security position.
10/17114 Page 3 of 4
Individuals requiring ADA accommodations call (604542-9027.

SECTION 13 This section is to be completed only by an Officer, Director or Chairperson of the organization
named in Section 1.
1-6'14-1 (Ur/ -11 / declare that I am an OFFICER, DIRECTOR, or CHAIRPERSON
(Pffnt full name)
appointing the applicant listed in Section 9, to apply on behalf of the foregoing organization for a Special Event
4(fal( y f// ii'7 411
Title/ Position Date Phone #
The foregoing instrument was acknowledged before me this M cr-f- 2.0g—
Day MARY LORWFATU174Eil
State A County of fv-1 Q'- NOTARY PUBLIC - ARIZONA
MARICOPA COUNTY
My Commission Expires
July 19,2015
My Commission Expires on:
Date Signature of Notary Public
SECTION 14 This section is to be completed only by the applicant named in Section 9.
Jamil Peter Coury declare that I am the APPLICANT filing this application as
(Print full name)
listed in Section 9. I have read the application and the contents and all statements are true, correct and
complete.
President 3/06 is— 602-361-7440
X
tJ (Signatur Tffle/ Position Date Phone #
The foregoing instrument was acknowledged before me this t/ m Ag a4
Day rMent19--------Year- ---
MARY LORETTA DURRER
State „4 County of rvi I e- (6)6 NOTARY MABICOPA PUBLIC COUNTY - ARIZONA
My Commission Expires
July 19, 2015
My Commission Expires on: Cif —
Date Signature of Notary Public
The local governing body may require additional applications to be completed and submitted. Please check with
local government as to how far in advance they require these applications to be submitted. Additional licensing
fees may also be required before approval may be granted. For more information, please contact your local
jurisdiction: http://www.azliquor.gov/assets/docurnents/hornepacre docs/spec event links.pdf.
SECTION 15 Local Governing Body Approval Section
recommend 0APPROVAL 0 DISAPPROVAL
(government official) (Title)
on behalf of
(City, Town, County) Signature Date Phone
FOR DEPARTMENT OF LIQUOR LICENSES AND CONTROL USE ONLY
0APPROVAL 0 DISAPPROVAL BY: DATE:
10/17/14 Page 4 of 4
Individuals requiring ADA accommodations call (602)542-9027.