THE SKATING CLUB OF PHOENIX-12.3-12.7_REDACTED.PDF
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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 Beense#i MUST he submitted to the Department of Liquor 10 days prior to the event. SECTION 1 Name of Non-Profit Organization, Candidate or Political Party: Fhe Skating Club of Phoenix If the event will be held on an unlicensed premises, it UST be approved and signed by the Local Governing Body Before submitting to the Arizona Department of Liquor. LOCAL GOVERNING BODY Date Received: CO approval C1 pisAPpPROVAL 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? Llyes 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. [-] 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.) | 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: Grauberger Renee Nadine 2. Applicant’s mailing address 3. Applicants home/cell phone: Non-profit organization phone: N/A 4. Applicant's eval es A 5. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years? [les (if yes, attach letter of explanation) Vv] No 6. Name of non-profit organization: The Skating Club of Phoenix 7. Non-Profit/IRS Tax Exempt Number: 86-0622143 Arizona Corporation Commission File #: 08197361 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 Avenue, 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 Carriers Must explain security measures: We will have fencing around the peremeter of the event. We will have security roaming the event 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) [lon-site consumption [off-site (auction/wine/distilled spirits pull) L]poth 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 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. E> ATTACH DIAGRAM @aam 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 ee ee sealer DAY 1 12/3/2025 Wednesday 5:00 pm 10:00 pm DAY 2 12/4/2025 Thursday 5:00 pm 10:00 pm DAY 3 12/5/2025 Friday 5:00 pm 10:00 pm DAY 4 12/6/2025 Saturday 5:00 pm 10:00 pm DAY5 12/7/2025 Sunday 5:00 pm 10:00 pm DAY 6 DAY 7 DAY 8 DAY 9 DAY 10 SECTION 6) 3. Is the Organization using the services of a DLLC approved Special Event Contractor from the list on our website? [Ves [no If yes, please provide the Name of the Special Event Contractor: Jordan Kunz Special Event Contractor Signature: Awe 4, Is the organization using the services of a series 6, 7,11, 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 [VINo 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: 75% Address; PO Box 8043 Surprise. AZ. 85374 Street City State Zip Name: The Skating Club of Phoenix Percentage: 25% Address: 19892 N 83rd Avenue Peoria. AZ. 85382 Street City State Zip Please read A.R.S. § 4-203.02 and R19-1-205 Special event license rules and Requirements. Declaration: , . |, (Print Name) ‘enee Grauberger , 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. few Signature: 5/5/2025 Page 3 of 3 Individuals requiring ADA accommodations please call (602)542-2999 JON ‘ABAUNS TWO V LON SI SIHL O0L= ub SBUOV 6L7/+ 007 (sauov 21 O0E 9sn puey 900-2r-L0S (Nd) “ON joed Lb 40 | yeaUS wh bXub bSZIS ssese ‘ZV ‘eppem $Z02-91-70:3}C 100 L=,b:3}29S @AV E09 M 6Z9bL ‘sonujuog our Auodog/] eur] Ayadoid: O0e S00-Zr-L0S /00r Os Oe 0 enu04, senuAuOD euIT iii youd Guns}3. ae ua oury Auodosd | lu / W PEORIA EVENUE = AAA SS VV S MQ. I MG IN IN Xv“ LAWN WX —— _ - — Bay Piy: Wild I WSS SSG, GG F RRR AAT | | aad = i} HLVd La NEN | | | | | | | | | —. Teary Buyyeg deoipueH—_ | — > ___ 900-2r-L0g (Nd) “ON 190d — BW \ | i | y, | | | | you Bunsix3, | | | srconsonenaseboues ponsrea ec | “Fie? 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