HORSES HELP FOUNDATION_REDACTED.PDF

CSR:

Amount:
DLLC USE ONLY
Job #:
SPECIAL EVENT LICENSE —
APPLICATION FEE $25.00 PER DAY ue
CSR:
Arizona Department of Liquor Licenses and Control
800 W. Washington St. 5"" Floor Phoenix, AZ 85007 Hcense #:

(602) 542-5141
Application MUST be submitted to the Department of Liquor 10 days prior to the event.

SECTION 1 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, Goodman Gregg Stephen
(Must be an Officer/Member of the No "
2. Applicant's mailing address;

a
3. Applicants home/cell phone: Applicant's business phone: 602-569-6056

Barn Bash

5. Special Event Name:

Horses Help Foundation

6. Name of Non-Profit Organization, Candidate or Political Party/Gov.:

7. Non-Profit/IRS Tax Exempt Number: 74-2477097

8. Arizona Corporation Commission File #: 01982985 __If out of State please specify:
(Altach lelter of good standing)

9. Event Location Name: Horses Help
6525 East Dixileta Dr. Cave Creek Arizona 85331

10. Event Address:

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

**SEPARATE APPLICATION FOR EACH “NON-CONSECUTIVE” DAY**

Event Start License End
Days Date Day of Week Time AM/PM Time AM/PM

DAY 1: Nov 2, 2024 Saturday 5:00 PM 10:00 PM

DAY 2:

DAY 3:

DAY 4:

DAY 5:

DAY 6:

DAY 7:

DAY 8:

DAY 9:

DAY10:

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Individuals requiting ADA accommodations please call (602)542-2999

SECTION 2 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.)

2 _____ Number of Police 10 ___ Number of Security Personnel [Fencing Caniers

Must explain security measures: At regisration, adults will be issued a wrist bands.

2 MCSO Sherrif and 10 volunteers for security overshight and will be wearing shirts as designation,

SECTION 3 What is the purpose of this event?

“On-site consumption (lo#-site (auction/wine/distilled spirits pull) Cboth

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)

A) 2) Special Event being held on an unlicensed premises will require approval and signature by the Local Goveming
Body on page 3. (If checked move to section 4)

B) (] Will this event be held on a currently licensed premises and within the already approved and licensed area?
(Must attach a letter from the licensed premises with an explanation of the option checked below)

Name of Business License Number Phone (Include Area Code)

CPtace license in non-use - Special Event Licensee selling all alcoho! without retailer involvement
Must attach letter from the location suspending license for duration of special event

L1bdispense and serve alll spirituous liquors under retailer's license — Business operates normally, minimum of 25% of gross
revenue from alcoho! sales is donated to licensee

Dibispense and serve alll spirituous liquors under special event - The special event licensee is in charge of selling alcoho! that was
purchased or donated by the special event licensee. The retailers existing alcohol inventory must be separated from any alcohol
used during the special event. Must attach letter from the location suspending license for duration of special event

Dspiit premise between special event and retail location - Both the special event licensee and the retailer will conduct
sales of alcohol. (These sales will be done in separate creas. If alcohol is donated or purchased by the special event licensee
it must be in a separate area than the alcohol that is dispensed by the licensed retailer.)

Clot sate only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer will still be permitted to conduct all normal sale and
service of alcohol.

SECTION 4
1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?

(Yes [4] No If yes, attach letter of explanation.
2. How many special event days have been issued to this organization during the calendar year? 6 -

3. Is the Organization using the services of a Special Event Contractor? (A licensee can utilize the services of a special event
contractor who may purchase and sell alcohol on behalf of the licensee. If no special event contractor is listed, the licensee is

responsible for the sales andservice of alcohol. }
(Yes [¥I No If yes, please provide the Name of the Special Event Contractor:

4. |s 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 the special event contractor} oO

Yes [¥] No if yes, please provide the Name of Licensee: License #:

5. List the name of the Individual or Organization that will receive revenues, MUST EQUAL 100 PERCENT.
Attach additional sheet if necessary.

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Individuals requiring ADA accommodations please call (602)542-2999

Name: Horses Help Foundation Percentage: 100

Address: 8525 East Dixileta Dr. Cave Creek AZ 85331
Street City State ip
Name: Percentage:
Address;
Street City State lip

Please read A.R.S. § 4-203.02 Special event license; rules and R19-1-205 Requirements for a Special Event License.
ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY.

SECTION _5 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. Please attach a diagram
of your special event licensed premises. Please show dimensions, serving areas, fencing, barricades, or other control
measures and security position.

ATTACH DIAGRAM

If the special event will be held at a location without a permanent liquor license or if the event will be on any portion of a location
that is not covered by the existing liquor license, this application must be approved by the local governing body before submitting
to the Deparment of Liquor Licenses and Control. Please contact the local governing board for additional information.

APPLICANT SIGNATURE

Declaration:

|, (Print Name) Gregg Stephen Goodman , declare under penalty of perjury that | am
authorized to submit this application. | have read the contents of this application, and to the best of my knowledge

believe all statements made on this application to be true, correct and complete.
Cds Srephe, C rer are
Signature

Ge ——————————————————EEE

LOCAL GOVERNING BODY -

ee a eee
_

Date Received:

I, recommend CIAPPROVAL [1] DISAPPROVAL
(Government Official) (Title)

On behalf of , , ”

(City, Town, County) Signature Date Phone

The local governing body (city, town or municipality where the fair/festival will take place) may require additional
applications to be complefed 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.

AZDLLC USE ONLY

CIAPPROVAL [J DISAPPROVAL BY:

2/6/2023 Page 3 of 3
Individuals requiring ADA accommodations please call (602)542-2999

Horse Help — Barn Bash
November 2, 2024-5 PM till 10 PM
6525 E. Dixileta Dr., Cave Creek, AZ 85331

E Dixileta Dr E Dixileta Dr E Dixileta Dr

Main Entrance

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Arizona
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Entrance

| ID Check
4 Volunteers/
Security

Red Line — Liquor Perimeter — Existing
) Fence

Additional Security / Volunteers will
roam.

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