AMERICANS FOR PROSPERITY FOUNDATION_REDACTED.PDF
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Arizona Department of Liquor Licenses and Control 800 W Washington 5th Floor Phoenix, AZ 85007-2934 www.azliquor.gov (602) 542-5141 FOR DLLC USE ONLY Received Date: Job #: CSR: License #: APPLICATION FOR SPECIAL EVENT LICENSE Fees: $25.00 per day for 1-10 days (consecutive) Cash Checks or Money Orders Only A service fee of $25.00 will be charged for all dishonored checks (A.R.S § 44-6852) IMPORTANT INFORMATION: This document must be fully completed or it will be returned. The Department of Liquor Licenses and Control must receive this application ten (10) business 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: Duff Hayden Won Min Phillip Last Middle Date of Birth 2. Applicant's mailing address: City State Zip 3. Applicant's home/cell phone: Applicant's business phone: ( ) 4. Applicant's email address: SECTION 2 Name of Organization, Candidate or Political Party/Gov.: Americans For Prosperity Foundation SECTION 3 Non-Profit/IRS Tax Exempt Number: 52-1527294 SECTION 4 Event Location: White Tank Stables Event Address: 20300 W Olive Ave Waddell AZ 85355 SECTION 5 Dates and Hours of Event. Days must be consecutive but may not exceed 10 consecutive days. See A.R.S. § 4 -244(15) and (17) for legal hours of service. PLEASE FILL OUT A SEPARATE APPLICATION FOR EACH "NON-CONSECUTIVE" DAY DAY 1: DAY 2: DAY 3: DAY 4: DAY 5: DAY 6: DAY 7: DAY 8: DAY 9: DAY 10: Date Day of Week 04/03/2020 Friday Event Start Time AM/PM 5pm License End Time AM/PM 1 1 PM 2/8/2019 Page 1 of 3 Individuals requiring ADA accommodations call (6021542-2999 SECTION 6 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.) Number of Police 6 Number of Security Personnel OFencing [larders Explanation: We will have ranch hands helping with security at the venue and Making sure everyone is safe. SECTION 7 Will this event be held on a currently licensed premise and within the already approved premises? Dyes No (If yes, Local Governing Body Signature not required) Name of Business License Number Phone (Include Area Code) SECTION 8 How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors? Please read R-19- 318 for explanation and check one of the following boxes. OPlace license in non-use ElDispense and serve all spirituous liquors under retailer's license DDispense and serve all spirituous liquors under special event Dsplit premise between special event and retail location (IF USING RETAIL LICENSE, PLEASE SUBMIT A LETTER OF AGREEMENT FROM THE AGENT/OWNER OF THE LICENSED PREMISES TO SUSPEND OR RUN CONCURRENT WITH THE PERMANENT LICENSE DURING THE EVENT. IF THE SPECIAL EVENT IS ONLY USING A PORTION OF THE PREMISES, AGENT/OWNER WILL NEED TO SUSPEND THAT PORTION OF THE PREMISES.) SECTION 9 What is the purpose of this event? On-site consumption DOff-site (auction/wine/distilled spirits pull) DBoth SECTION 10 1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years? 0Yes E No Of yes, attach explanation.) 0 2. How many special event days have been issued to this organization during the calendar year? (The number cannot exceed 10 days per year.) 3. Is the Organization using the services of a Licensed Contractor? OYes No If yes, please provide the following: Name of Licensed Contractor: 4. Is the organization using the services of a series 6, 7, 11, or 12 licensee to manage the sale or service of alcohol? DYes U No If yes, please provide the following: Name of Licensee License #: 5. List all people and organizations who will receive the proceeds. Account for 100% of the proceeds. The organization applying must receive 25% of the gross revenues of the special event liquor sales. Attach an additional page if necessary. Name Americans For Prosperity Foundation Percentage: 25 Address 2111 Wilson Blvd Arlington VA 22201 Name Heroes for Horses Percentage: 75 Address 20300 W Olive Ave Waddell AZ 85355 Street City State Zip 2/8/2019 Page 2 of 3 Individuals requiring ADA accommodations call 1602)542-2999 Please read A.R.S. § 4-203.02 Special event license; rules and R19-1-205 Requirements for a Special Event License. Note: ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY. NO ALCOHOLIC BEVERAGES SHALL LEAVE A SPECIAL EVENT UNLESS THEY ARE IN AUCTION WINE OR DISTILLED SPIRITS PULL SEALED CONTAINERS OR THE SPECIAL EVENT LICENSE IS STACKED WITH WINE /CRAFT DISTILLERY FESTIVAL LICENSE. SECTION 11 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 government before submission to the Department of Liquor Licenses and Control. Please contact the local governing board for additional application requirements and submission deadlines. Additional licensing fees may also be required before approval may be granted. For more information, please contact your local jurisdiction. I, (Print Full Name) Hayden Duff , hereby swear under penalty of pOury and in compliance with information and statements A.R.S. § 4-210(A)(2) and (3) that I have read and understand the foregoing and verify that that I have made herein are true and correct to the best of my knowledge. Applicant Signature: LOCAL GOVERNING BOARD Date Received: recommend DAPPROVAL El DISAPPROVAL (Government Official) (Title) (City, Town, County) Signature Date Phone On behalf of DLLC USE ONLY DAPPROVAL EIDISA PPROVAL BY: DATE: / / A.R.S. § 41-1030. Invalidity of rules not made according to this chapter; prohibited agency action; prohibited acts by state employees; enforcement; notice B. An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a basis for imposing a licensing requirement or condition unless a rule is made pursuant to that general grant of authority that specifically authorizes the requirement or condition. D. THIS SECTION MAY BE ENFORCED IN A PRIVATE CIVIL ACTION AND RELIEF MAY BE AWARDED AGAINST THE STATE. THE COURT MAY AWARD REASONABLE ATTORNEY FEES, DAMAGES AND ALL FEES ASSOCIATED WITH THE LICENSE APPLICATION TO A PARTY THAT PREVAILS IN AN ACTION AGAINST THE STATE FOR A VIOLATION OF THIS SECTION. E. A STATE EMPLOYEE MAY NOT INTENTIONALLY OR KNOWINGLY VIOLATE THIS SECTION. A VIOLATION OF THIS SECTION IS CAUSE FOR DISCIPLINARY ACTION OR DISMISSAL PURSUANT TO THE AGENCY'S ADOPTED PERSONNEL POLICY. F. THIS SECTION DOES NOT ABROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.01 OR 12-820. 2/8/2019 Page 3 of 3 Individuals requiring ADA accommodations call (602)542-2999 Venue area for Americans for Prosperity Foundation Heroes for Horses Ride.