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CSR: Amount: DLLC USE ONLY Job #: SPECIAL EVENT LICENSE Date Accepted: APPLICATION FEE $25.00 PER DAY CSR: Arizona Department of Liquor Licenses and Control - 800 W. Washington St. 5" Floor Phoenix, AZ 85007 Ucensei®: (602) 542-5141 Application MUST be submitted to the Department of Liquor 10 days prior to the event. SECTIO 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: Julie Cornelius (Must be an Officer/Member of the N naan Middle 2. Applicant's mailing address Cily State Zip 3. Applicants home/cell phon 4. Applicant's email -cer Saguaro Soiree Applicant's business phone: 5. Special Event Name: 6. Name of Non-Profit Organization, Candidate or Political Party/Gov.: World Ride 7. Non-Profit/IRS Tax Exempt Number: 82-3676618 8. Arizona Corporation Commission File #: If out of State please specify;Utah (Aftach lelter of good standing) 9. Event Location Name: Usery Regional Park 3939 N. Usery Pass Rd. Mesa, AZ 85207 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** DAY 1: 11/10/2024 Sunday 10:00AM 7:00PM DAY 2: DAY 3: DAY 4: DAY 5: DAY 6: DAY 7: RECEIVED DAYS: SEP 05 2024 DAY 9: “ DAY10: CLERK BOARD OF SUPERVISORS 2/6/2023 Page 1 of 3 Individuals requiring 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 Number of Security Personnel Fencing Cbarrers Must explain security measures; Our beer garden is fully fenced in with one entrance/exit.Our licenced bag checks all ID's and distributes wristbands to those over 21. He/she also ensures no alcohol leaves th SECTION 3 What is the purpose of this event? [Zlon-site consumption (oftt-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) M1 Special Event being held on an unlicensed premises will require approval and signature by the Local Governing Body on page 3. (If checked move to section 4) B) CL) 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) LPlace license in non-use - Special Event Licensee selling all alcohol without retailer involvement Must attach letter from the location suspending license for duration of special event LiDispense and serve alll spirituous liquors under retailer's license — Business operates normally, minimum of 25% of gross revenue from alcohol sales is donated to licensee Lbispense and serve alll 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 separated from any alcohol used during the special event. Must attach letter from the location suspending license for duration of special event ‘split 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 areas. 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.) Lo# sale 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 [ZINo If yes, attach letter of explanation. 2. How many special event days have been issued to this organization during the calendar year? 0 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 and service of alcohol. ) MZ] Yes CINo If yes, please provide the Name of the Special Event Contractor: Aravaipa Running LLC 4, Is the organization using the services of a series 6, 7, 11, or 12 licensee fo 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) (1 Yes B71 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. 2/6/2023 Page 2 of 3 Individuals requiring ADA accommodations please call (602)542-2999 Name: World Ride Percentage: 5% ct Street Cily State Zip Name: Aravaipa Runniing LLC Percentage: 29% Address: 2401 S. 24th St. Phoenix, AZ 85034 Street Cily State Tip 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 Department of Liquor Licenses and Control. Please contact the local governing board for additional information. APPLICANT SIGNATURE Declaration: |, (Print Name) Julie Cornelius , 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. ( — Signature LOCAL GOVERNING BODY Date Received: I, recommend LIAPPROVAL [1 DISAPPROVAL (Government Official) (Title) On behalf of (City, Town, County) Signature The local governing body (city, town or municipality where the fair/festival will take place) may require additional applications to be completed and submitted. Please check with local government as fo 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 LI DISAPPROVAL BY: 2/6/2023 Page 3 of 3 Individuals requiring ADA accommodations please call (602)542-2999 A SECURE ONLINE SERVICE FROM UTAH.GOV Support Font Size: AAA WO R LD R | D E Update this Business Entity Number: 10629995-0140 Company Type: Corporation - Domestic - Non-Profit Address: State of Origin: Registered Agent: Julie Cornelius Registered Agent Address: po View Management Team Status: Active Purchase Certificate of Existence Status: Active © as of 01/24/2024 Renew By: 12/31/2024 Status Description: Current The "Current" status represents that a renewal has been filed, within the most recent renewal period, with the Division of Corporations and Commercial Code. Employment Verification: Not Registered with Verify Utah History View Filed Documents Registration Date: 12/12/2017 Last Renewed: 01/24/2024 Additional Information Get Business Info On Your Mobile Commerce Searches ° Business Search ° Data Request o Professional License o Real Estate License c Registered Principal ° Trademark © Uniform Commercial Code ° Verify Utah Department of Commerce ° Department of Commerce Home ° Division of Corporations ° Contact Us ° Disclaimer ~ TRAIL RUNS i SITE MAP oath : 4 Vendors & Social ° Rocket OC Beer fe Aravaipa Rides Beer Garden Layout 20’x20’ tent surrounded by 3’ tall fencing. One ID check point with a licensed bartender checking all who enter.