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Item 06.n
October 12, 2010 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, November 12, 2010. 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 Charlene Friedges, City TEMPORARY ON -SALE LIQUOR LICENSE 360 COMMUNITIES ➢ Temporary Liquor License application ➢ Certificate of Liquor Liability Insurance erk Item No. Financial Impact: $ Budgeted: Y/N Source: Related Documents (CIP, ERP, etc.): Notes: NAME OF ORGANIZATION YtD 0,0 unc ∎Ls DATE ORGANIZED TAX EXEMPT NUMBER Es -- a5 �a(, STREET ADDRESS 5 14 W y 1 3 1 Bu tte 109. CITY tiAtr6OLLC STATE M N ZIP CODE ( 5 1- S33 - 9 NAME OF PERSON MAKING APPLICATION C 9 CG . i\i ' BUSINESS PHONE ( TS? 73s - L r r HOME PHONE ( 4/2 ) CP 70 —act° 7 DATES LIQUOR WILL BE SOLD t ` I I Y TYPE OF "rCN �.• TION CLUB HARITABI. i RELIGIOUS y 135u, 1froa ��,, OTHER ONPROFIT ,lie, t1Mss> ORGANIZATION OFFICER'S NAME W\ e MAX - I ke) CU) ADDRES 561 I i ORGAN! ATION OFFICER'S NAME l l — E=Y€c AD- ADDRESS 5C 1 NIA] 13, 3.1 /oa erbv kkk) x` 333 ORGANIZATION OFFICER'S NAME ADDRESS ' Location license will be used. If an outdoor area, describe ` �:2.FWD-i cPQ 1 l6 X741,1. fl3 R.m V' 101- 1 ROLEt LL E 1.)\1 5ny 9 r Wilt the applicant contract for intoxicating liquor service? If so, give the name and address of the liquor [icensee providing the service. Will the applicant carry liquor liability insurance? If so, please provide the carrier's name and amount of coverage. 'F\tl I\ VF__'�tl1H �Y\SAQP, )I'F APPLICATION MUST BE APPROVED BY APPROVAL CITY OR COUNTY ENFORCEMENT BEFORE SUBMITTING DATE APPROVED LICENSE DATES TO ALCOHOL & GAMBLING CITY /COUNTY CITY FEE AMOUNT DATE FEE PAID SIGNATURE CITY CLERK OR COUNTY OFFICIAL APPROVED DIRECTOR ALCOHOL AND GAMBLING ENFORCEMENT TYPE OR PRINT INFORMATION 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 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 PS -09079 (12/09) KELLER ii n us for a fundraising event of wine taing, music and Hors d'oeuvres to benefit 360 Communities. The evening will nclude a silent auction and a chance to win a Wall of Wine! For more information or to t involved please visit our website: www.kwharvestofhope.com car contact us at 952 - 431 -5100. Keller Wi ltiams Realty "H . est of Hope" Wine Tasting Fundraiser $25 per person, tickets are limited Friday, November 12, 2010 Event goes from 7:00 pm to 10:00 pm For ticket purchases and general information, contact: KW Premier Realty in Apple Valley at 952 - 431 -5100 The Barn at Spirit of Brandtjen Farms 16965 Brandtjen Farm Drive Lakeville, MN 55044 THiS 15 TO CERTIFY THAI THE 000101E5 OF INSURANCE LISTED BEL OLN 11005 355±1 INDICATED NO0MIT0S1A11DIN0 051 REQUIREMENT, 1 :000 00 CONDITLON OE ANN CERIIFICATE MAY BE ISSUED OR MAY PER1AIN, 1HE INSURANCE. AITORDED BY 1 EXOLLACIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAv HAVE 00E1430000E0 Erna I TR TYPE Or INSURANCE ADEL SUER Wyk KNEE_ POL101 NUMBER 155030 10 THE 1050030 000E0 ABOVE 000 :HE 001.101 PEIRMIN CONTRACT 00 OTHER 00000051 1210 3050007 TO WHICH THIS 1HE POI IOUS DEscRraEo HEREIN IS SUBJECT 10 At 1 THE TE.RMS ay PA■D CLAWS POIXCY EFT POLICY EXP EEMEEDNYKKII IMMIDONKEW LIMITS E.105 H GEGUESEE NEE E: a , 000 , 000 DAMAGE TEI 0, 7111 0 ^10 ' 000 200 10/10/2010 10/10/2011 ,,,,i, wone o o rs,n, , 20 , 000 t, Any IKEEP y .5 1,000,000 GENERA's ANNALCA1E s 3,000, 3,000,000 GENERAL L TARE ITY i X Commcso GrI1ERAI I ■AtrE:Th I I A CEEESIS X ESEGGES 2555535065 I cvasoNAL I . I GEN% AGGREGATE LftATE AEP: ;ES sER AUTOMOREE LIABILITY 1 A 0:: EAGesS:ESEGES s s SERE:: ALS GS P02PEE35.9.65 . ILK EXX 0 / 0 040 , 000 :10/10/2010 10/1012011 . ....„ „ . . p:EA,EGE Ems Cs ! :SE ' 1 . 10 1 . EASGs /',, 1-1 S. 3,00 x EXCESS LIAR . , ,,-- 3,300,000 i St:MUGS:at E , A X FEE7EIGION S jp, , GO 0 'Plirla3239EE 10/10/2010 1E1E0E2011 1 WORKERS 00031540I )0N ' . 4 AND EMPLOYERS LIABILITY y i onsEisEkiVAELUSESS EVEGA: E.:) j GNIA . Who/Wow in NHI --- ' I II xy44 EKEYWN NEWT ' ' C. .. - X L DISTASTE - ET WEEK 11K11 X X. E 1 EISETTE TEX ICY : MG E I A Liquor Liabinty . 0HP.F.6255.65 10/1212010 in/IC/2011 5, ,„,,,,,,02,„ 300,000 ! - , 300,000 DESCRIPTION CIP' OPERANDES :10001100S ; 0E14/01ES INItach ECORD WI. AddirwwIRranwks Scnedule, .0 more space Ts re:NKE PE: Ripe Tasting Event at the Spirit of arandtjen Farms in Lakeville, PIN on 11/12/10, The Certificate Holder is an Additional Insnre* under the Commercial General Liability •nthen xegnired by written contract. g ACOF?L) THIS CERTIFICATE 15 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 CONST)TUTE A CONTRACT BETWEEN THE ISSUING INSURER(5), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. =PORTANT: 11 the certificate holder is an ADDITIONAL INSURED, the policyCies) must be endorsed, If SUBROGATION 15 WANED, 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), 05000000 ? 4 Erica IloIdt Kraus -Anderson Insurance PH°NE t952) 7D? -8200 iAir sto IIITKIt 013.1r. I.LNI No, EEC 420 •Gateway Boulevard 1 '4G1 certi f, icatesflainsurance . cam I PRODUCER Azi p, 005205001030 my -5 ° .; 5— Burnsville ? 55337 INS0RERiSy033OR0ING COVERAGE 1 50/00 INSURED 360 Communities :.501 E, Hwy 13 Burnsville COVERAGES CERTIFICATE HOLDER :City of Lakeville 20195 Holyoke M Lakeville, MN 55044 ACORD 25 (2009/09) 155025 2 Vcdy, CERTIFICATE OF LIABILITY INSURANCE . 10 . 501000: INSURER MN 55337 INSURER r wsueeee.Phaladelphla Indemnity Ins. Co 1/451IRER INSURER C CERTIFICATE NUMBER:10 -11 Cer t Liquor Liability REVISION NUMBER: CANCELLATION ENTE ANEWEETYY 10/11/2010 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELEVERED IN ACCORDANCE WITH THE POLICY PROVISfORS AUTHORIZED REPRESENTATIVE Patr clz Kennedy/AMBER ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD