AUGIES QUEST TO CURE ALS INC._REDACTED.PDF

Arizona Department of Liquor Licenses and Control DLLC USE ONLY

: https://www.azliquar.gov Job it:
(602) 542-5142 Date Accepted:
) Le:
SPECIAL EVENT LICENSE
APPLICATION FEE $25.00 PER DAY License ii

MUST be submitted to the Department of Liquor 10 days prior to the event.

SECTION 1
Name of Non-Profit Organization, Candidate or Political Party: A Wie s Bas} ty Uuee Bly dnc.

If the event will be held on an unlicensed premises, it MUST be approved and signed by the Local Governing
Body Before submitting to the Arizona Department of Liquor.

LOCAL GOVERNING BODY

Date Received:

[1 approval. C1 pisAppROVAL.

Government Offictal Title
On behalf of
City, Town, County Signature
os ae eee a
SECTION 2

Will the event be at a location with a current liquor license and within the approved and Ilcensed area?
i
Yes (no {if no skip to section 3)
If yes, MUST attach a letter of explanation/permission/suspension from the licensed location and choose ONE option below.

8
Name of Licensed Location Teloqy at Nev oe Laven Liquor License Number DbLox ob4!

Cc Suspend license for the duration of the Special Event; Licensee selling all alcoho! without retailer involvement.
Letter of suspension required,

[1 __ Dispense and serve all spirituous liquors under retaller’s license — Business operates normally, minimum of 25% of
gross revenue from alcohol sales will be donated to licensee. Letter of permission required. ™

(C]_ Dispense and serve all spirituous liquors under special event - The special event licensee is in charge of selling alcohol
that was purchased or donated by the special event ticensee. The retallers existing alcoho! inventory must be kept
separate from any alcohol used during the special event. Letter of suspension required.

XM Split premises between special event and licensed location - Both the special event licensee and the licensed
location will conduct sales of alcohol. (These sales must be done in separate areas. If alcohol is donated or purchased
by the special event licensee, it must be in a separate area from the alcohol that Is dispensed by the licensed
location.) Letter of explanation and permission required.

CL] of Sale only - Wine/Distilled Spirits Pull, Live or Silant Auctions — Retailer will be permitted to conduct all normal
sales and service of alcohol, Letter of permission required.

10/28/2025 Page 1 of 4
individuals requiing ADA accommodations please cali {602)542-2999

SECTION 3

Applicant MUST be a member of a qualifying nonprofit organization, political party, or Government entity and
authorized by an Officer, Director, or Chairperson of the Organization.

1. Applicant: Wey he Shannon K.
last
city State Zip
3, Applicants home/cell =_ &€£

4, Applicant's email address:

Non-profit organization phone: 14 “TAI So+o

5, Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
Lives (If yes, attach letter of explanation)

SECTION 4
1. Name of non-profit organization: _ _ Ay hes Rutt ty Cue Ys Tog.

2. Non-Profit/IRS Tax Exempt Number: $3 “OA s-03y44), L yi __ Arizona Corporation Commission File #:

Required Required
3. If Out Of State, specify State (Attach letter of good standing): ATT CheD ,
4, Special Event Name: Finties Guy h bol} tla SVG Presented by Shee, Yo mes
SECTIONS

5, Event Location Name: Teslogy €@ @ Verne Awe en
LE504 N Veroe Rawev Way | Rio. Vode AL 951.63

6. Event Address:

SECTION 6

st list type of security and contro! measures will you take ta prevent violations of liquor laws at this event.

- 0” __Number of Police - 0- Number of Security Personnel Trencing Clearriers

Must explain security measures: ALL grey | Players afew 4ol 4 Cavs trad.

do aot leave. bowndvy ok bolt fowse It Aline] duspeaten by
Lemen yo Seve tHe Yo levhifed Bevlenders,

1. How Is this special event going to ‘conduct all dispensing, serving, and selling of spirituous llquors?
Check one of the following boxes, (R-19-318)

Con-site consumption [_loft-site (auction/wine/distilled spirits pull) oon

~0-

2. How many special event days have already been issued to this organization during the current year? __

10/28/2025 Page 2of 4
Individuals requiing ADA accommodations please call (602)542-2999

Dates and Hours of Event - bays must be consecutive and may not encead 10 days per year.

pays Da pavorweex — EWENWTSTART. EVENT END
bavi: 03| 8 s| we Te Oy FO Oy
DAY2 te . — a
DAY 3 .
DAY 4
DAY 5
DAY 6 FEB 07 2026
DAY 7. R MAR SD ot so RVISORS
DAY &
DAY 9
DAY 10 a €

SECTION 8

1. Is the Organization using the services of a DLLC approved Special Evant Contractor from the list on our website?

*

[ves Xie If Yes, please provide the Name of the Special Event Contractor:

,

Special Event Contractor Signature: ,

2, Is the organization usirig the services of a series 6, 7, 14, or 42 licensee to manage the sale or service of alcohol?
{Licensees who hold a serles 6, 7, 11, or 12 license are automatically qualified to be a special event contractor)

Bives Eno if yes, Name of Licensee: Hilogy Ll Vevng Rwae Liquor License #: 0b OF at

3.List the name of the Organization/indjidual that will receive revenues:
MUST EQUAL 100 PERCENT,/APPLYING NON-PROFIT MUST RECEIVE A MINNA OF 25% oF THE PROCEEDS,

nome: Avge Oust fo (ude ALS Tne. percentage ino Yo
Address: fp Box 4866 Deny Cy bor 04
Name: = " percentage! 7
Address: _* — a aa i

Please read A.R.S. § 4-203.02 and R19-4-205 Special event license rules antl Requirements.

10/28/2025 Page 3of4 —
Ineividinis ranitiinn ADA necammoaciniians Mlecita Al fANNEAI.N000

SECTION 9

Licensed location 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.

Must attach a diagram of your special eveint showing the area where alegho! will be sold,
served, and consumed, Must include dimensions of event area, fencing, barricades,
or other control measures, and include positions of security personnel,

NO ALCOHOLIC BEVERAGES SHALL LEAVE A SPECIAL EVENT UNLESS THEY ARE IN SEALED CONTAINERS FOR AN AUCTION OR
WINE/ DISTILLED SPIRITS PULL, OR THE SPECIAL EVENT LICENSE IS STACKED WITH A WINE /CRAFT DISTILLERY FESTIVAL LICENSE,

Declaration:
[ |, (Print Name} Tom Scarawme ae

made on this application to be true, correct, and complete.

Signature:

AB.
a

SPECIAL EVENT DIAGRAM AND
SAFETY PLAN STANDARDS

Diagrams do not need to be overly complicated, they can be hand drawn. However, we
do not accept photographs or aerial views that do not show the premises clearly. The
diagram should clearly depict the special event area in relation to the entire premises.

Each diagram must include:
e Overview of the location
e The event area clearly outlined with black marker v
e Where alcohol will be served/stored +t
e All entrances and exits
» Where security will be positioned «]#
« Square footage of event area
e Show North, East, South, West

wv

aN

10/28/2025 page 40f 4 ;
Individuals requiing ADA accommodations please call {602)542-2999

ven yew

PRopeRry

Hove #2

Hove tf

es

ND Foop. of} PBVERAG

UoLe & 3

Koop on Hie ds — see Arracie?

+
BEVERAGE

HOLE #3

Hole #3 Tented (10ftx1 Oft)
Food & Drink-Nachos &
Margaritas Staffed by
certified Food handler and
mixologist

HOLE #6

Hole #6 Tent(1 Oftx1 Oft) Food
& Drink-Sliders & Beer Staffed by
certified food handler and
Mixologist

HOLE # 12

Hole #12 Tent(10ftx10ft) Food &
Drink-Brisket Sandwich & Old
Fashioneds Staffed by certified
food handler & Mixologist

HOLE #15

Hole #15 (Tent-10ft.x10ft.) Food
& Drink-Seafood-Kim Crawford
wines to be served by certified
Food Handler and Mixologist

INTERNAL REVENUE SERVICE DEPARCHRN? OF ‘THR PREASORY
B, O. BOX 2HO8
CINCINNATI, OH 45201

Employer tdentitieatlon Number:

Date: a o B3-O934624
\UG 01 2018 plats
17053190438020
AUGLES QUES 10 CURE ALS ING Contach Person;
PO BOX 73336 JACOB A MCDONALD Int aLeay
SAN CLEMENTE, CA 92673-1216 Contact Pelephone Naber:

(877) 929-3800
Accounting Period Eading:
December 31

Public Qharity Status:

470 (b) (2) (A) (vi)

Form 990/990-82/990-N Required:
Yes

Effective Daka of ‘Bxemption:
May 31, 2016
Contiibution Daductibility:
Yer
Addenduis Applies:

No

Dear Applicant:

We're pleased to teli you we detexmined you're exenpt from Federal income tax
under Internal Revenue Code (IRC) Sectiow $01 (ce) (3). Donery can deduct.
contributions they make to you under IRC Section 170. You're also qualified
to receive tax deductible bequests, devises, tansférs or gifts amder
Section 2065, 2106, ov 2522. Yhis letter could help renolve questions on your
exempt otatug. Please keep it for your records.

Organizations exempt under INC Section 501(¢} (3) ate further classified as
either public charities ox private foundations. We determined you're a public
charity under the ikt Section listed at the top of this letter.

1£ we indicated at the top of this letter that you're ragulved ¢ to file Form
990/990-B2/990-N, Our records show you'xé xeqiired to £2¢ an anniial
information return (Form 990 or Form 990-BZ) or electronie notice {Form 990-N,
the e-Posteard}. If you don’t file a required return or notice fox three
vonsecutive years, your exempt status will be automatically revoked,

Tf we indicated at the top of this letter that an addendum applies, the
encloged addendum is an integral part of this letter,

For impoxtant information. about your responsibilities as a tax-exempt
organization, go to ww. irs.goy/charities. Enter "4221-PC" iti thé search bar
to View Publication 4221-P0, Coimplidrice Guide for 601(c) (3) Public Charities,
which ‘deserihes your recordkeeping, reporting, and disclosure requirements.

beter 947

Secretary of State
Certificate of Status

|, SHIRLEY N, WEBER, PH.D., Callfornia Secretary of State, hereby certify:

Entity Name: AUGIE'S QUEST TO CURE ALS, INC,
Entity No. 4156332

Registration Date: 05/31/2018

Entity Type: Nonprofit Corporation - CA - Public Benefit
Formed In: CALIFORNIA

Status: Active

The above referenced entity is active on the Secretary of State's records and Is authorized to exercise all
its powers, rights and privileges in California.

This certificate relates to the status of the entity on the Secretary of State’s records as of the date of this
certificate and does not reflect documents that are pending review or other everits that may inpact status.

No information is available from this office regarding the financlal condition, status of licenses, If any,
business activities or practices of the entily.

IN WITNESS WHEREOF, | execute this certificate and affix
the Great Seal of the State of California this day of Januaty

27, 2026,

Ay f2-

SHIRLEY N. WEBER, PH.D.
Secretary of State

Certificate No.: 414625218

To varify the issuance of this Certificate, use the Certificate No, above with the Secretary of State
Certification Verification Search available at bizflleOnline.sos.ca.gov.

& Outlook

\

Permission to Dispense Spirits Wine and Liquor

From Tom Scaramellina
Date Tue 2026-01-27 12:19 PM
To Shannon Shryne

Ce Matt Anzaloni Derik Martine: i Tom
Scarameilino

Dear Shannon,

We are excited to host Augie's Quest to Cure ALS on March 4 and 5, 2026. This letter to provide your charity
permission to provide your tournament player's donated beverage to include spirits, wine and beer on our golf
course. Please note that all players must consume while playing on our golf course and cannot take any products
provided on the golf course into any area of our clubhouse. We wiil provide proper signage and notice. Further
more all spirits will be distributed by our trained staff following all Arizona Alcohol and Beverage codes.

Please note all of this ls contingent on approval by the Arizona Department of Liquor Licenses and Control.

Best regards,
Tom Scaramelline

Vig TOM SCARAMELLINO] Club General Manager
u ‘a t CG, i Verde River Golf & Soclal Club
: 28509 N Verde River Way, Rio Verde, AZ 85263
iH (O) 480.508,7852 (M) 760,235,5315 |tom.scaramellino@verderiverclub.com

mn na eman renee Hn

oi Outlook

Re: Certificate of Status from CA

From Shannon K, Shryne Po

Date Tue 2026-01-27 1:19 PM
To fom Scaramellin

We do not have an Atlzona Commision File number because we are not registered as a corporation in AZ. The
state of AZ does not require non-profits register in AZ to do business, so we should put n/a there.

When | spoke with our rep at the compliance company she said she would file the paperwork today to register us
as a corporation so it's easier in the future, but we do hot have that number currently. We only register as a
corporation in the states where we pay staff (Colorado and Callfornia) and AZ does not require us to register so
N/A is our only option on that line.

Thanks,

On Tue, Jan 27, 2026 at 1:15PM Tom Scaramellinc I wrote:

That's great any luck on the Arizona Corp, commisston file number?

TOM SCARAMELLINO| Club General Manager

No ;
B lu eC S U a ¥ Verde River Golf & Soclal Club

a sy .28509 N Verde River Way, Rio Verde, AZ 85263
om (0) 480.508.7852 (M) 760.235.5315 | tom.scaramellino@verderiverclub.com

WE OFING TOGETHER WHAT 2aNGS YOU TOGETHER

From: Shannon shy iii

Sent: Tuesday, January 27, 2026 1:12 PM
To: Matt Anzalone| Tom Scaramellino

Subject; Certificate of Status from C

Here it is ~

Let me know if you need anything elsell

Thanks for letting me know if this is what you need,

Shannon. We ne ge ne _ - ceonene
From: Shannon Shryne

Date; Tuesday, Jantiary 27, 2026 at 1:09 PM
‘To: Matt Anzalone|

Tor Scarameliino

, Gretchen Simoneau Fo

Ce; Derik Martinez