INTERNATIONAL MOUNTAIN BICYCLING ASSOCIATION_REDACTED.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 800 W. Washington St. 5 Floor Phoenix, AZ 85007 lcense#: (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. 1. Applicant; Kenneth Hill (Must be an Officer/Member of the a. ©] Middle 2. Applicant's mailing address: City State Zip 3. Applicants home/cell on — Applicant's business phone: 4. Applicant's email address: Dawn to Dusk 5. Special Event Name: International Mountain Bicycling Ass 6. Name of Non-Profit Organization, Candidate or Political Party/Gov.: ASSoUtaHow 47-4882625 4. 20547510 7. Non-Profit/IRS Tax Exempt Number: If out of State please specify: 8. Arizona Corporation Commission File (Attach letter of good standing) 9. Event Location Name: McDowell Mountain Regional Park 16300 E McDowell Mountain Road Fort McDowell, AZ 85264 10. Event Address: 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 Buys Pete Ray of eek Time AM/PM Time AM/PM DAY I: 12/09/23 Saturday 4PM 11PM DAY 2: DAY 3: DAY 4: DAY 5: ¥ | 62 d5S 16202 W DAY 6: ee til DAY 7: DAY 8: DAY 9: DAY 10: 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 contro! baniers, if applicable.) 0 0 Number of Police Number of Security Personnel CFencing [Z]Barriers The beer garden will have barriers around it so that people entering will be organ Z ized Must explain security measures: SECTION 3 What is the purpose of this event? [4]0n-site consumption C1Off-site (auction/wine/distilled spirits pull) [Both 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) l¢] Special Event being held on an unlicensed premises will require approval and signature by the Local Governing Body on page 3. (If checked move fo section 4) B) [[] 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) [Place 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 [Dispense 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 Libispense 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 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 [split 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.) (ot Sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer wil 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? D1Yes [¥]No If yes, attach letter of 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 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. } 1 Yes [¥] No If 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 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) (1 Yes [¥]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. Name: International Mountain Bicycling Association Percentage: 100 << Street City State lip Name: Percentage: Address: Street City State Tip 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. ==> 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 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) Ken Hill , 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, corect and LX» ~~ / Signature LOCAL GOVERNING BODY Date Received: I, recommend LIAPPROVAL [1] DISAPPROVAL (Government Official) On behalf of (City, Town, County) The local governing body (city, town or municipality where the fair/festival will take place) may require additional applications fo 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 CIAPPROVAL C1 DISAPPROVAL BY: 4 Peaks Staging Area - on AS. ARIZONA “iD “VENUE MAP Ogeerttert=sSae— 7am-7pm McDowell Mountain Park Scottsdale, AZ 2 “es. Ge, a's 8% "Moun ait 7 4 Peaks staging % * * — area/venue ey ® * ig *., o Competitive Track ——— & taging area/parking N. McDowell Mountain|Ra, ia atel eeee Course Road @® camping == Driveway/Fire Lane wv Start/Finish Line © Medical aid » Restrooms A N To Competitive Track Vv Sanctioned by ZHAI Proudly Supported by e* Endurance e a DISCOUNT TIRE xaos Seoradaie & Tue200 CORE Competitive Track/staging area Shower 2P> M cDowelt Mountain Park Dr. N. McDowell Mountain Rd.