ARIZONA HYGIENE FOR HOPE_REDACTED.PDF

Arizona Department of Liquor Licenses and Control DLLC USE ONLY

https://www.azliquor.gov Job #:
(602) 542-5141 Date Accepted:
Lc:
SPECIAL EVENT LICENSE ]
APPLICATION FEE $25.00 PER DAY License:f:

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: Arizona Hygiene For Hope

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:

I, DO approval CI DisAPPROVAL

Government Official Title

On behalf of

City, Town, County Signature

SECTION 2
Will the event be at a location with a current liquor license and within the approved and licensed area?

Llves VINo

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

[_] _ Suspend license for the duration of the Special Event; Licensee selling all alcohol without retailer involvement.

| Dispense and serve all spirituous liquors under retailer’s license — Business operates normally, minimum of 25% of
gross revenue from alcohol sales will be donated to licensee.

O 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.

O 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.)

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

5/5/2025 Page 1 of 3
Individuals requiring ADA accommodations please call (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: Hemp, Heidi, Lorraine

Last Middle
City State Zip

3. Applicants home/cell — £_x— Non-profit organization phone: 602.752.8040
4. Applicant's email adress

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

Llyes (if yes, attach letter of explanation) Vv] No
Arizona Hygiene for Hope

6. Name of non-profit organization:

7. Non-Profit/IRS Tax Exempt Number: 46-4998097 Arizona Corporation Commission File #: 19160396
Required Required

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

9, Special Event Name: Desert Farm Lights

10. Event Location Name; Desert Farm Lights

11. Event Address: 14629 W Peoria Ave, Waddell, AZ 85355
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 Lparriers

We will have fencing around the peremeter of the event. We will have security roaming the event

Must explain security measures:
Security will be present at enterances and exits as well.

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

[VJon-site consumption Lloft-site (auction/wine/distilled spirits pull) C]poth

2. How many special event days have already been issued to this organization during the current year? 0

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 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 4

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.

5/5/2025 Page 2 of 3
Individuals requiring ADA accommodations please call (602)542-2999

SECTION 5

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

DAYS DATE DAY OF WEEK are ain ican
DAY 1 11/21/2025 Friday 5:00 pm 10:00 pm
DAY 2 11/22/2025 Saturday 5:00 pm 10:00 pm
DAY 3 11/23/2025 Sunday 5:00 pm 10:00 pm
DAY 4
DAY5 R IB ‘on
DAY 7 AUG 27 2025
DAY 8
DAYS CLERK BOARD OF ey. Ss
DAY 10

SECTION 6

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

es oO IT yes, please provi le the Name o e€ specia ‘vent Contractor:
[No If yes, pl ide the Name of the Special Event Contractor: Jordan Kunz

Special Event Contractor Signature: (Aw

4. Is the organization using the services of a series 6, 711, or 12 licensee to manage the sale or service of alcohol?
(Licensees who hold a series 6, 7, 11, or 12 license are automatically qualified to be a special event contractor)

[Wes [V]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 Valley Events and Marketing LLC Percentage: “9%
Address: PO Box 8043 Surprise. AZ. 85374
. Street . City State Zip
Name: Arizona Hygiene for Hope Percentage: 25%
Address: 1830 W Fillmore Street Phoenix, AZ 85007
Street City State Zip

Please read A.R.S. § 4-203.02 and R19-1-205 Special event license rules and Requirements.

Declaration:

. H idi .
|, (Print Name) eidi Hemp , 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.
Signature: Side oP

5/5/2025 Page 3 of 3
Individuals requiring ADA accommodations please call (602)542-2999

900-2 ZrO (Nev) “oN Jomed

b4JO | y0US

wh bXub b8ZIS OOL=,L:3129$ sgese ‘ZV ‘eppem

$z0Z-91-r0:a}eq)| *

BAY PMOSd M 6Z9PL

sonujuog our Ayedoig —/]

aur) Ayadoig,

S00-Zr-L0S

sonujuos our aia

|
| whe
|

woud Bunsx3, a

AIX3) aa |

=

W PEORIA EVENUE

J SS IW Ny
| GG <\\ << SSS

It WK SS. GG EF
= S SS WV _Hi(C.|DG. Wp

——
SSS \ SSN

— “ — j

[ Huva Lie a ja

‘o2u04

S WAXQqo \
NTS vouy iV 15d} | ase

| ESCA H. Mi |

/'
|

ae joWy/seut smonigeboues

|
|
|

unerea

een eee
. =

SNNAAV LSLSLN

a:
( ss0s0y ur Auodoud,

‘sonuyUoD eur] Ayadosd: