REDACTED WEST VALLEY TRAIL ALLIANCE.PDF
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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 7 rs 800 W. Washington St. 5" Floor Phoenix, AZ 85007 pense (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. Murphy, Brian 1. Applicant: (Must be an Officer/Member of the Non Profit Entity) Last First Middle 2. Applicant's mailing address: Street City State Zip 3. Applicants home/cell phone: | Applicant's business phone: 720-935-3798 4. Applicant's email cress Vertigo Night Rides 5. Special Event Name: West Valley Trail Alliance 6. Name of Non-Profit Organization, Candidate or Political Party/Gov.: 7. Non-Profit/IRS Tax Exempt Number: 47-4882625 8. Arizona Corporation Commission File #: 20547510 If out of State please specify: (Attach letter of good standing) 9. Event Location Name: White Tank Mountain Regional Park 10. Event Address: 20304 West White Tank Mountain Rd. Waddell, AZ 85355 Dates and Hours of Event - Days must be consecutive and may not exceed 10 consecutive days. **SEPARATE APPLICATION FOR EACH “NON-CONSECUTIVE” DAY** Days sei BISQUE Bol Tea pay: 8/9/2024 Friday 7:00PM 41:59PM DAY 2: DAY 3: DAY 4: h \ DAY 5: REGEN JED DAY 6: 7 f DAY 7: MAY al ay DAY: cunt PORRD OF SUPERVISORS DAY 9: DAY 10: 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.) 1 Number of Police _ Number of Security Personnel [Fencing Cobarriers Must explain security measures: Our beer garden is fully enclosed by fencing with one entrance/exit. It is manned by our licensed bartender who ensures each patron is 21+ and issues wristbands.He/She also ensures no alcohol leaves the designated beer area. SECTION 3 What is the purpose of this event? [On-site consumption (off-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) 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) [J 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) LoPlace 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 L1Dispense 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 Lsplit 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 stil! 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? (1 Yes [YJ No 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. } Yes L]No If yes, please provide the Name of the Special Event Contractor: Aravaipa Running LLC 4. ls 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) (Yes [V1 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: West Valley Trail Alliance Percentage; 100% Accress ee Street City State Zip Name: Percentage: Address: Street City State Zip 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. 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) Brian Murphy , 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, a 7 ee Sig n&fore LOCAL GOVERNING BODY Date Received: 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 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 TDIAPPROVAL LI DISAPPROVAL BY: 2/6/2023 Page 3 of 3 Individuals requiring ADA accommodations please call (602)542-2999 o a" 2 S S S D = ONDE OND Yd uojsue}x3 " sopiy Yoon teiniioS