ARIZONAS FOR THE PROTECTION OF EXPLOITED CHILDREN AND ADULTS_REDACTED.PDF

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Job &:

SPECIAL EVENT LICENSE J
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 Heense #:
(602) 542-514
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 Goverment enitty and
authorized by an Officer, Director, or Chatrperson of the Organization.

1, Applicant: Olson Janet Rae
(iust be an Officer/Member of the No!

2. Applicant's mailing address:

State Up
3. Applicanis home/cell phone plicant's business phone: 623-247-6026

4, Applicant's email address;
5. Special Event Name: Desert Farm Lights

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

7, Non-Profit/IRS Tax Exempt Number: 20-2762968

8. Arizona Corporation Commission File #: 11083906 If out of State please specify:
(Attach letter of good standing)
9. Event Location Name: Desert Farm Lights L

10. Event Address: 14629 W Peoria Avenue Waddell, AZ 85355
Dates and Hours of Event - Days must be consecutive and may not exceed 10 consecutive days.

"SEPARATE APPLICATION FOR EACH “HON-CONSEGUTIVE? DAY*«

DAY I: 11/17/2023 Friday 5:00pm 10:00pm
DAY 2: 11/18/2023 Saturday 5:00pm 10:00pm
DAY 3: 11/19/2023 Sunday 5:00pm 10:00pm
DAY 4: 11/20/2023 Monday 5:00pm 10:00pm
DAY 5: 11/21/2023 Tuesday 5:00pm 10:00pm
DAY 6: 11/22/2023 Wednesday 5:00pm 10:00pm
DAY 7: 11/23/2023 Thursday 5:00pm 10:00pm
DAY 8: WW2H\2022 FA bay B.00pn7 10.00 oN
DAY 9:

DAY10:

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

SECTION 2 What type of securily and control measures will you take to prevent violations of liquor laws at this event?
(Ust type and number of Police/securtty personnel and type of fencing or control banter, if applicable.)

2 Number of Police Number of Security Personnel Fencing [leaniers

Must explain security measures: We have fencing around the peremeter of the event. We will have security roaming the event and

at the enterance and exit

SECTION 3 Whatis the purpose of this event?

On-site consumption (Cloft-site (auction/wine/distilted sphits pull) Cloth
How is this special event going fo conduct all dispensing, serving, and selling of spirituous liquors?
Check one of the following boxes. (R-19-318)

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

B) [will this event be held on a curently licensed Premises and within the already approved and licensed area?
(Must attach a letter from the llcensed premises with an explanation of the option checked below)

Name of Business Ucense Number Phone (Include Area Code)

[Place 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

Cibispense and serve all spirituous liquors under retailer's license — Business operates normally, minimum of 25% of gross
revenue from alcohol sales is donated to licensee

Dbdispense and serve all 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 alcoho! 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 areas. If alcohol is donated or purchased by the special event licensee
it must be in a separate area than the alcoho! that is dispensed by the licensed retailer.)

(loft sale onty - Wine/Distilled Spirits Pull, Live or Sitent Auctions - Retailer wil still be permitted to conduct all normal sale and
service of alcohol,

SECTION 4

|. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
Dives 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 alcoho! 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; Pour Masters

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, | 1, or 12 license are automatically qualified to be the special event contractor)

ClYes [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 Events and Marketing, LLC Percentage: 75%

Address; 14963 W. Tasha Drive Surprise Arizona 85374
Streot City
Name: APECA

State Zp
Percentage: 25%

Address: 14175 W Indian School Rd, Ste B4-184, Goodyear, AZ 85395

Street Clty State Dp
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 § 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.

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

APPLICANT SIGNATURE
Declaration:

1, {Print Name) Janet Olson . 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.

ats Oaes

Signature

LOCAL GOVERNING BODY

Date Received:

(Goverment Otfictal)
On behalf of

(City, Town, County)

The local govesning body (city, town or municipality where the falr/festival will take place) may require additionat
applications to be completed and submitted. Please check with local govemment as to how far in advance they require
these applications fo be submitted. Additional licensing fees may also be required before approval may be granted.

AZDLLC USE ONLY

CIAPPROVAL CJ DISAPPROVAL BY:

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

Entrance/ Exit

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First Off-Duty

Police Stationed