INTERNATIONAL MOUNTAIN BICYCLING ASSOCIATION_REDACTED.PDF
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DLLC USE ONLY
Arizona Department Liquor License and Control
800 W Washington St. 5th Floor
Phoenix, AZ 85007-2934
azliquor.gov
602-542-5141
SPECIAL EVENT LICENSE APPLICATION
FEE $25.00 PER DAY
Job#:
Date Accepted:
CSR:
License#:
A service fee of $25.00 will be charged for all dishonored checks (A.R.S § 44-6852
1-10 days consecutive days only, Cash. Checks or Money Orders Only
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: Kenneth Hill
2. Applicant's mailing address:
Street
City
Stale
Zip
3. Applicants home/cell phone:
Applicant's business phone: ________ _
4. Applicant's email address:
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SECTION 2 Name of Non-Profit Organization, Candidate or Political Party/Gov.: b 1~
I~ 'A.:J
A ~ ~ o c; "'-~I' 01
SECTION 3 Non-Profit/IRS Tax Exempt Number: _4_:_7:_-_4..::..8-=-=8-=2=-6=-2=-=5'-------------------
SECTION 4 EventLocation: 16300 E McDowell Mtn Rd, Fort McDowell, AZ 85264
SECTION 5 Dates and Hours of Event. Days must be consecutive but may not exceed 10 consecutive days.
4/9/2021
See A.R.S. § 4-244(15) and (17) for legal hours of service.
Days
DAY 1:
DAY 2:
DAY3:
DAY 4:
DAY 5:
DAY 6:
DAY 7:
DAY 8:
DAY 9:
DAYlO:
**SEPARATE APPLICATION FOR EACH "NON-CONSECUTIVE" DAY**
Date
Day of Week
12/11/2021
Saturday
Page 1of3
Event Start
TimeAM/PM
4PM
Individuals requiring ADA accommodations please call (602)542-9027
License End
Time AM/PM
11PM
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.)
_Q ______ Number of Police _Q ______ Number of Security Personnel
0Fencing
0Barriers
Explanation: There will be barriers around the beer garden with a single E
be the location for consumption. Beer will be served out of a keg ir
No food, no garnish.
SECTION 7 Will this event be held on a currently licensed premises and within the already approved premises?
D Yes 0 No If yes, Local Governing Body signature is 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.
0Place license in non-use
0Dispense and serve all spirituous liquors under retailer's license
IZlDispense and serve all spirituous liquors under special event
Osplit premise between special event and retail location
SECTION 9 What is the purpose of this event?
00n-site consumption
Doff-site (auction/wine/distilled spirits pull)
0Both
SECTION 10
1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
0 Yes 0 No If yes, attach explanation.
2. How many special event days have been issued to this organization during the calendar year? _1 ______ _
3. Is the Organization using the services of a Licensed Contractor?
D Yes 0 No If yes, please provide the Name of the 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?
D Yes 0 No if yes, please provide the Name of Licensee: _________ License#: _______ _
5. The applying non-profit organization must receive 253 of the gross revenues of the total liquor sales. List the names
of the individuals or organizations who will receive the rest of the proceeds, MUST EQUAL 1003.
Name: International Mountain Bicycling AssCPercentage:_1_0_0 _____
_
Address: 14295 W Roanoke Ave
Goodyear
Street
City
Stale
Zip
Name: _________________________ Percentage: ___________ _
Address: ________________________________________ _
Street
City
Slate
Zip
4/9/2021
Page 2 of 3
Individuals requiring ADA accommodations please call (602)542-9027
Please read A.R.S. § 4-203.02 Special event license: rules and Rl 9-1-205 Requirements for a Special Event License.
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 QISTILLEQ SPIRITS
PULL SEALEQ CONTAINERS OR THE SPECIAL EVENT LICENSE IS STACKEQ WITH WINE /CRAFT QISJ!LLERY 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 applicaHon
requirements and submission deadlines. Additional licensing fees may also be required before approval may be granted. for
more information, please contact your local jurisdiction.
SIGNATURE
I, (Print Eull Name)
hereby swear u11der penalty of perjury and in compliance
with A.R.S. § 4-2lO(A)(2 and (3) that I have read and ut1derstand the foregoing and verify that the information and
statements that I have made herein are true and correct to the best of my knowle~
Applicant Signature:
~
GOVERNING BOARD
Date Received: ________ _
I,---------------
recommend
0APPROVAL
0 DISAPPROVAL
------------
(Government Ofllclal)
(Title)
On behalf of ______________________________ ---------
(City, Town, County)
Slg~ature
Dote
Phone
DLLC USE ONLY
II DAPPROVAL D DISAPPROVAL
BY:
DATE:
II
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 mode 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 12-820.02.
4/9/2021
Page 3 of 3
Individuals requiring ADA accommodations please call (602)542-9027
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