MARIAH'S MIRACLE_REDACTED.PDF

Arizona Department of Liquor Licenses and Control DUC USE ONLY

https://www.azliquor.gov Jobs:
(602) 542-5141 Date Accepted:
tc:
SPECIAL EVENT LICENSE
APPLICATION FEE $25.00 PER DAY Ucense #:

MUST be submitted to the Department of Liquor 10 days prior to the event.
SECTION 2
Name of Non-Profit Organization, Candidate or Political Party: Mariah's Miracle

if the event will be held on anunlicensed 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: |
L CT approvat 0 oisapprovat |
Government Official Title |

On behalf of
| City, Town, County Signature |
|

SECTION 2

Will the event be at a iocation with a current liquor license and within the approved and licensed area?
Ces [Jivo

if yes, MUST attach a letter of explanation/permission from the licensed location and choose ONE option below.

Name of Licensed Location. Liquor License Number

{C1 Suspend license for the duration of the Special Event; Licensee selling all alcohol without retailer involvement.

[2] _ Dispense and serve all spirituous liquors under retailer's license ~ Business onerates normally, minimum of 25% of
gross revenue from alcohol sales will be donated to licensee.

[1 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 licensee. The retailers existing alcohol inventory must be kept
separate from any alcohol used during the special event.

(] 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 ii a separate area from the alcohol that is dispensed by the licensed
location.)

Ol Off Sale only - Wine/Distilled Spirits Pull, Live ar Silent Auctions — Retailer will be permitted to conduct all normal
sales and service of alcohol.

5/5/2025 Page 1 of 3
individuals requifing ADA accormnihations please cad (602)542-2997

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.
. Pierce Teri

1. Applicant:
Last rT
State ip i

Street cry

i 3. Applicants horne/cell phone Non-profit organization plone:

5. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five {5} years?

\ (lives (ifyes, attach letter of explanation) [Z]No !
6. Name of non-profit organization: Mariah's Miracle

7. Non-Profit/iRS Tax Exempt Number: 85-3162245 Arizona Corporation Commission File #: 23078180
Required Required

8. f Out Of State, specify State (Attach letter of good standing):

9, Special Event Name: Desert Farm Lights
Desert Farm Lights

10. Event Location Name: :
14629 W. Peoria Avenue, Waddell, AZ 85355

14. Event Address:

; SECTION 4 °
Must list type of security and control measures will you take to prevent violations of liquor laws at this event.

2 Number of Police Number of Security Personnel [_]Fencing Carriers

Must explain security measures: ‘We will have fencing around the peremeter of the event. We wil hava security roaming the event ;
H

Security wil! be present at enterances and exits as wall.

1. Howis this speciaf event going to conduct all dispensing, serving, and selling of spirituous liquors?
Check one of the following boxes, (R-19-318)

on-site consumption Clott-site tauction/wine/distilled spirits pull) Cleoth

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

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 provistons of your license.

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

==> ATTACH DIAGRAM = |

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 1S STACKED WITH A WINE /CRAFT DISTILLERY FESTIVAL LICENSE,

5/5/2025 Page 2 of 3
individuas requiing ADA accornmodaiions piease coi (602}542-2999

a

SECTION 5
i
; Dates and Hours of Event - Days must be consecutive and may not exceed 10 days per year,
: DAYS DATE DAY OF WEEK TIME AM/PM TIMEAM/PMA
i DAY4 December i0ih Wednesday 5:00pm 16:00 pm
; DAY 2 December 41th Thursday 5:00 pm 10:00 pm
: DAY 3 December 12th Friday 5:00 pm 10:00 pm
1 DAY 4 December 13th Saturday 5:00.pm | 10:00 pm
4 DAYS December 14th Sunday 5:00 pm 10:00 pm
i DAY 6
4 DF
| DAY 8&
DAYS
DAY 10
F SECTION 6

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

[hes Lo if yes, please provide the Name of the Special Event Contractor: Jordan Kunz

Special Event Contractor Signature: : ia\y a —_

me fof
4. is the organization using the services of a series 6, 7,41, or 12 licensee to manage the sale or service of alcohol?
(Licensees who hold a series 6, 7, 14, or 12 license are automatically qualified to be a special event contractor}

(hes [No if yes, Name of Licensee: Liquor License #:

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

2. Name: “West Vallcy Events and Marketing LLC Percentage: 79%
i Address; PO Box 8043 Surprise. AZ. 85374
<p ereet ry State Be
Name: Mariah's Miracle Percentage: 25%
Address: 14557 W Indian School Ste 500 Goodyear AZ 85395
Street ‘Oty State wip

Please read A.R.S, § 4-203.02 and R19-1-205 Special ovent license rules and Requlroments.

Declaration: _
| |, (Print Name} eri Pierce declare under penalty of perjury that { am

authorized to submit this application. | have read the contents and to the best of my knowledge believe all statements

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

| Signature: |

5/5/2025 Page 3of3
individuoa requiing ADA GcCUn Hodutions peur CUE (602]542-299F

3NO 39v1d3u "AIAN TWO V LON SI SIHL

S00Zr 108 (Nd) “ON lee

OOL=.L

“ 006 OOF Os Oe 0

ssese ‘ZV ‘eppem
BAY PMO9d M 629L

wZ bXub b28ZIS

=,,):3]29:
Pe02-91-bo:a1eq|| ‘COb=»b IPOS

1b 40 | Jesus

aun Auedog

900-Cr-L0S

‘sonunuog our, ine

sonujuos oun Auedoig —/|

wet

\

VV

SSNS

I RYGGD
NK WY

SG.

oe

AGI WW
WC WL

WK

ASS

youd Sues |

WK
WN S

—

SS
SSS SS

Se

Wy 1

S
S SS SONS SES
SS ooo OS. nn0nWhnhnnMnw>nwy’ay*»

SS
MOA ON

Body Ply ISIS

Y
OG

ua |

ts

gd
ses

hive une

gary Buppeg dejpuoH—~_ |

‘aes

WE (Nev) "ON 19210d

W PEORIA EVENUE

DCW GG Qs

Sess . =

QQ O]?;’W)

——

SS SG |

ESS SESS {ea

you Buns},

2 |

NY Ys
os Z
tptie, yy ie

—E
=

ANNSAV LSLSL N

JOUO)SUBL ANY 00Z.
GX

SNNSAV LSLSLN

— i

sso20y

our] Ayadosd

youg Suns

sonujUog aur) Ayodoig