HORSES HELP FOUNDATION_REDACTED.PDF

DLLC USE ONLY _

SPECIAL EVENT LICENSE —_ _
APPLICATION FEE $25.00 PER DAY a ; epled:

Arizona Department of Liquor Licenses and Control
800 W. Washington St. 5 Floor Phoenix, AZ 85007 license #:
p (602) 542-5141

Application MUST be submitted to the Department of Liquor 10 days prior to the event.

SECTION J Applicant must be a member of a qualifying nonprofil organization, political party, or Government entity and
authorized by an Officer, Director, or Chairperson of the Organization. Yq

1. Appicant: Horses Help Foundation/Gregg Goodman y

(Must be an Officer/Member of the No!

City State Tip
3. Applicants home/cell — Applicant's business phone: 602-569-6056

4, Applicant's email address:
Barn Bash

5. Special Event Name:

6, Name of Non-Profit Organization, Candidate or Political Parly/Gov.: Horses Help Foundation

7. Non-Profit/IRS Tax Exempt Number: 74-2477097
4. 01982985

8. Arizona Corporation Commission File If out of State please specify:

{Altach tetter of good standing)
9, Event Location Name: Herses Help Therapeutic Riding Center

10. Event Address: 0925 East Dixileta Dr. Cave Creek Az 85331

Dates and Hours of Event - Days must be consecutive and may not exceed 10 consecutive days.
‘SEPARATE APPLICATION FOR EACH “NON-CONSECUTIVE” DAY"*

Event Start License End
Time AM/PM Time AM/PM

DAY): Nov 4, 2023 Saturday 5 pm 10 pm

Days Date Day of Week

DAY 2:

DAY 3:

DAY 4:

DAY 5:

DAY 6:

DAY 7:

DAY 8:
DAY 9:

DAYIO:

2/6/2023 Page 1 of 3
Individuals requiting 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/securily personnel and type of fencing or control barrlers, if applicable.)

2 mcso Number of Police 20 Number of Security Personnel [Fencing Clganriers

Must explain security measures: Guests are pre reglistered. | D Check for age appropriateness for drinking and wil have a wristband issued

20 Vovuwtien is cimorrshen to’ [thee tee snars: a

SECTION 3 What is the purpose of this event?

[on-site consumption (Clot-site (auction/wine/distilled spirits pull) Doth

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)

CoPlace license in non-use - Special Event Licensee selling all alcohol without retailer involvement

Tere Len onal rees ln wap eae Bh em ni
Must altack lottor from the location suspending Hcense for duration of specian event

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

Ddispense and serve alll spirituous liquors under special event - The special event licensee Is in charge of selling alcoho! 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

(spit premise between special event and refaill location - Both the special event licensee and the retailer will conduct
sales of aicuhul, (These sules wii be dorie in separate areas, if aiconoi is donated or purchased by ihe special event licensee
‘it must be in-a separate area than the alcohol thatis-dispensed by the licensed retailer.}

Cott 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?
Cl Yes Io if yes, attach ietter of expianation.

2. How many special event days have been issued to this organization during the calendar year? 8

3. |s the Organization using the services of a Special Event Contractor? (A licensee can ulllize 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. )

D1 Yes M1No ff yes, please provide the Name of the Special Event Contractor:

4. |s 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)

(Yes [4] 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: Horses Help Foundation Percentage: 100

Address; 6525 East Dixileta Dr Cave Creek AZ 85331
Street Ccily State Up

Name: Percentage:

Address:

Street Clty State ip

Please read A.R.S. § 4-203.02 Speciat 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, baricades, 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 confact the local governing board for additional information.

APPLICANT SIGNATURE

Declaration:

|, (Print Name) Gregg Goodman , 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
belleve all statements made on this application to be true, correct and complete. LO

SS. —LOAVUNA | <
§{gnature
— — —

LOCAL GOVERNING BODY _

ELT TEE ERTL EEE DEAT LATER AEDT ALERT TAEDA TETRA ELE LD

Date Received:
I, recommend CIAPPROVAL [1 DISAPPROVAL
(Government Official) (Title)

On behalf of , ,
(City, Town, County) Signature Date Phone

—

The local governing body (cily, town or municipallly where the falr/festival will take place) may require additional
applications to be completed and submited. 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

DIAPPROVAL CI DISAPPROVAL BY: DATE:

2/6/2023 Page 3 of 3
Individuals requiring ADA accommodations please call (602)542-2999

Horse Help — Barn Bash
November 4, 2023 —5 PM till 10 PM
6525 E. Dixileta Dr., Cave Creek, AZ 85331

E Dixileta Dr E Dixileta Dr E Dixileta Dr

Entrance
ID Check
4 Volunteers/
Security

7

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Entrance
ID Check
4 Volunteers/
Security

Red Line — Liquor Perimeter — Existing
Fence

Additional Security / Volunteers will
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