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HomeMy WebLinkAboutItem 06.dSeptember 28, 2011 4 0 Item No. TEMPORARY ON -SALE LIQUOR LICENSE 360 COMMUNITIES Proposed Action Staff recommends adoption of the following motion: Move to approve the issuance of a temporary on -sale liquor license to 360 Communities Passage of this motion will result in the ability of 360 Communities to serve alcoholic beverages at their wine tasting fundraiser on Friday, October 28, 2011. Overview 360 Communities submitted an application for a temporary on -sale liquor license for their fundraising event at the Spirit of Brandjen Farm. The event will be held in the Spirit of Brandtjen Farm Community Building from 7:00 to 10:00 p.m. The entire event will be held inside the building, with no outside activities. Due to the nature of the event, there will be no requirement for off -duty police or additional security. Temporary liquor licenses are issued by the State of Minnesota, upon approval by the local governing body. Primary Issues to Consider Does 360 Communities meet the requirements set forth by State Statute to obtain a temporary on -sale liquor license? Yes, 360 Communities is a registered 501(c)(3) organization. Supporting Information ➢ Temporary Liquor License application ➢ Certificate of Liquor Liability Insurance Charlene Friedges, Financial Impact: $ Budgeted: Y/N Source: Related Documents (CIP, ERP, etc.): Notes: �taF we�� 3 P Minnesota Department of Public Safety ALCOHOL AND GAMBLING ENFORCEMENT DIVISION 444 Cedar Street Suite 222, St. Paul MN 55101 -5133 (651) 201 -7507 Fax (651) 297 -5259 TTY (651) 282 -6555 W W W.DPS.STATE.MN.US APPLICATION AND PERMIT FOR A 1 TO 4 DAY TEMPORARY ON -SALE LIQUOR LICENSE TYPE OR PRINT INFORMATION NAME OF ORGANIZATION '�60 Cear�yy.,Lt.,s-t DATE ORGANIZED 9 ark -7a TAX EXEMPT NUMBER 1-11-047 STREET ADDRESS CITY STATE ZIP CODE 5a I E F4w (3 Sk( low '_ mo 5s 33`7 NAME OF PERSO MAKING APPLICATION BUSINESS PHONE HOME PHONE DATES LIQUOR WILL BE SOLD �O .,, SS' _� TYPE OF ORGA ON ORGANIZATION OFFICER'S NAME ADDRESS " —' _VYW�� ORGANIZ ION 'OFFICER'S NAME ADDRESS Sa k� ORGANIZATION OFFICER'S NAME ADDRESS J Location license will be used. If an outdoor area, describe �'� - � • �� L/ Will the applicant contract for intoxicating liquor service? If so, give the name and address of the liquor licensee providing the service. Will the applicant carry liquor liability insurance? If so, please provide the carrier's name and amount of coverage. �" N'L!_hD�i�Pi -Y�C - A �n3 Scc!,.A.JIi'er APPROVAL APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO ALCOHOL & GAMBLING ENFORCEMENT CITY /COUNTY DATE APPROVED CITY FEE AMOUNT LICENSE DATES DATE FEE PAID SIGNATURE CITY CLERK OR COUNTY OFFICIAL APPROVED DIRECTOR ALCOHOL AND GAMBLING ENFORCEMENT NOTE: Submit this form to the city or county 30 days prior to event. Forward application signed by city and /or county to the address above. If the application is approved the Alcohol and Gambling Enforcement Division will return this application to be used as the License for the event s1 PS-09079 (12/09) A� °® CERTIFICATE OF LIABILITY INSURANCE 9/22/2011 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CON DITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID C LAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Certificates Department NAME: Kraus - Anderson Insurance � ONE Ma ExtJ._ (B52 )_707 - JA/C, (952) 890 0535 AI_C, 420 Gateway Boulevard E certificates @kainsuranc com AD DRESS _. _ $ 1 ,000,0 00 PRODUCER 00003648 CU _._. _ __.__ _.._..... INSURE R(S)AFFORDING COVERAGE NA_IC Burnsvil 1 55337 -2790 INSURED INSURERA.Ph Indemnity Ins. Co I INSU IS I_$ 1,000,000 360 Communities INSURER 501 E. Hwy 13 INSU D: ` INSURER E. PRODUCTS AGG Burnsville NAI 55337 INSURER F: COVERAGES CERTIFICATE NUMBER:11 - 12 Cert w/ Liquor Liability REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CON DITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID C LAIMS. INSR j TYPE OF INSURANCE '.ADOE LTR INSR SUBR WVD. - POLICY NUMBER POLICY EFF POLICY EXP LIMITS MM /DD/YYYY MMIDDIYVYY GENERAL LIABILITY ! I EACH OCCURRENCE $ 1,000,000 X _COMMERCIAL GENERAL LIABILITY Lakeville, D'IN 55044 DAMAGE TO RENTED PREMISE�E occ r ence) $ 1 ,000,0 00 A Cl-AIMS MADE `X:_ OCCUR �PHPX635865 10/10/2011 10/10/2012 MED EXP(Any one person) 1 1 _$ 20,000 _ r r i PERSONAL B AD INJURY I_$ 1,000,000 0,000 GEN 'L AGGREGATE LIMIT APPLIE S PER PRODUCTS AGG 3 O, OOO PRO POLICY : X f LOG _00 _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1, 000,000 (Ea e,uderrt) X ANY AUTO - — - BODILY INJURY (Per person) - -_- A ALL OWNED AUTOS pHPK635865 10/10/2011 30/10/2012 _ t_ $ _ -- - - BODILY INJURY (Per are dent) $ SCHEDULED AUTOS I PROPERTY DAMAGE $ HIRED AUTOS NON -OWNED AUTOS (Per ecctlent) I $ UMBRELLA LIAB X OCCUR ,,' i EACH OCCURRE $ 3,000,000 X. EXCESS LIAB 1 CLAIMSMADE i 1 AGGREGATE $ 3,000,000 DEDUCTIBLE I _ 10/10/2011110/10/2012 $ X A RETENTION $ 10 000 HUB323959 $ WORKERS COMPENSATION WC STATU 0TH AND EMPLOYERS' LIABILITY Y I N TQRY LIMIT$ E _,- _ ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ NIA E L EACH ACCIDENT $ ( Mesatleec in N '., E L DISEASE - EA EMP LOYE $ DESCRIPTION OF OPERATIONS below ',I EL DISEASE - POLICY LIMIT 1 $ A Liquor Liability iPHPK635865 10/10/201110/10 /2012 Each Common Cause 300,000 Aggregate 300,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Harvest of Hope Wine Tasting Event at the Spirit of Brandtjen Farms in Lakeville, MN on 10/28/11. The Certificate Holder is an Additional Insured under the Commercial General Liability when required by written contract. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2009/09) © 1988 -2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Lakeville 20195 Holyoke Ave AUTHORIZED REPRESENTATIVE Lakeville, D'IN 55044 Patrick" ACORD 25 (2009/09) © 1988 -2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD