HomeMy WebLinkAbout20142560.tiffRESOLUTION
RE: APPROVAL OF RENEWAL APPLICATION AND REPORT OF CHANGES FOR
RETAIL LIQUOR STORE LICENSE FROM RLF, INC., DBA CJ'S LIQUORS AND
AUTHORIZE CHAIR TO SIGN - EXPIRES AUGUST 5, 2015
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, RLF, Inc., dba CJ's Liquors, presented to the Board of County
Commissioners of Weld County, Colorado, an application for the renewal of a Retail Liquor
Store License, for the sale of malt, vinous and spirituous liquors, and a report of changes for the
addition of Jackie Merrill, 210 Eagle Avenue, Mead, CO 80542, as General Operating Manager
and a five percent (5%) shareholder of said company, and
WHEREAS, pursuant to Exhibit 5-H of the Weld County Code, said applicant has paid
the sum of $237.50 to the County of Weld for the renewal of the existing license, and report of
changes, and
WHEREAS, said applicant has exhibited a State Liquor License for the sale of malt,
vinous and spirituous liquors in sealed containers not for consumption at place where sold,
outside the corporate limits of any town or city in the County of Weld at the location described
as follows:
3907 State Highway 119
Longmont, Colorado 80504
WHEREAS, the Licensee shall host "responsible vendor" training every six (6) months
as agreeable to the Colorado Department of Revenue Liquor Enforcement Division, and this
training shall be open to other area licensees. Each employee shall be "responsible vendor"
trained, and the Licensee shall provide documentary evidence that each employee has been
"responsible vendor" trained to the Weld County Sheriff's Office within thirty (30) days of the first
available "responsible vendor" class after hiring. Evidence of such shall be included in the
referral report submitted by the Sheriffs Office at the time of annual renewal.
cc so (PO AWL -
9/2
2014-2560
LC0020
RENEW LIQUOR LICENSE AND REPORT OF CHANGES - CJ'S LIQUORS
PAGE 2
NOW, THEREFORE, BE IT RESOLVED that the Board of County Commissioners of
Weld County, Colorado, having examined said application and the other qualifications of the
applicant, does hereby grant License Number 2014-19 to said applicant to sell malt, vinous and
spirituous liquors in sealed containers not for consumption at place where sold, and the Board
does hereby authorize and direct the issuance of said license by the Chair of the Board of
County Commissioners, attested to by the Clerk to the Board of Weld County, Colorado, which
license shall be in effect until August 5, 2015, providing that said place where the licensee is
authorized to sell malt, vinous, and spirituous liquors in sealed containers not for consumption at
place where sold, shall be conducted in strict conformity to all of the laws of the State of
Colorado and the rules and regulations relating thereto, heretofore passed by the Board of
County Commissioners of Weld County, Colorado, and any violations thereof shall be cause for
revocation of the license.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said application.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 18th day of August, A.D., 2014.
BOARD OF COUNTY COMMISSIONERS
ATTEST: C�1itiLi s , ,,/ L
Weld County Clerk to the Board t�
BYt
ty Clerk tp[he Boa
ounty Attorney
William F. Garcia
Date of signature: z7
LD COUNTY, COLORADO
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arbara Kirkmeyer, ro-Tem
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2014-2560
LC0020
THIS LICENSE MUST BE POSTED IN PUBLIC VIEW
DR 8402 (07/01/2012)
STATE OF COLORADO
DEPARTMENT OF REVENUE
LIQUOR ENFORCEMENT DIVISION
1881 Pierce Street, Suite 108
Lakewood, Colorado 80214
RLF INC
dba C J'S LIQUORS
39071IWY 119
LONGMONT CO 80504
ALCOHOL BEVERAGE LICENSE
Liquor License Number
14398830000
License Expires at Midnight
August 05, 2015
License Type
LIQUOR STO
Authorized Beverages
MALT, VINOUS, AND SPIRITUOUS
This license is issued subject to the laws of the State of Colorado and especially under the
provisions of Title 12, Articles 46 or 47, CRS 1973, as amended. This license is nontransferable
and shall be conspicuously posted in the place above described. This license is only valid
through the expiration date shown above. Any questions concerning this license should be
addressed to: Colorado Liquor Enforcement Division, 1881 Pierce Street, Suite 108, Lakewood,
CO 80214.
In testimony whereof, I have hereunto set my hand. 8/27/2014 SJC
7-i?aiLd 444
Division Director Executive Director
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NON -TRANSFERABLE.
TO BE POSTED IN A CONSIMRFS PLACE.
DR 8400 (Revised 09101112)
COLORADO DEPARTMENT OF REVENUE
LIQUOR ENFORCEMENT DIVISION
SUBMIT TO LOCAL LICENSING AUTHORITY
LIQUOR OR 3.2 BEER LICENSE
RENEWAL APPLICATION
C J'S LIQUORS
3907 HWY 119
LONGMONT CO 80504
Fees Due
Renewal Fee
Storage Permit $100 x
$312.50
Optional Premise $100 x
Related Resort $75 x
Amount Due/Paid
Make check payable to: Colorado Department of Revenue.
The State may convert your dock to a one-time electronic
banking transadiom Your bank account may be debited as early
as the sane day received by the State. It convected your cheek
will not be returned. IT your dock is rejected due to insuttdent or
uncollected funds. the Department may collect the payment
amount directly horn your banking accaent electronically.
PLEASE VERIFY & UPDATE ALL INFORMATION BELOW
RETURN TO CITY OR COUNTY LICENSING AUTHORITY BY DUE DATE
Licensee Name
RLF INC
DBA
C J'S LIQUORS
Liquor License #
14398830000
License Type
Liquor Store (county)
Sales Tax License #
14398830000
Expiration Date
8/5/2014
Due Date
6/21/2014
Street Address
Phone Number
3907 HWY 119 LONGMONT CO 80504
(303) 776 8359
Mailing Address
3907_HWY 119 LONGMONT CO 80504 - — - - —
Operating Manager
Date of Birth
Home Address
Phone Number
Brenda Phillips
16858 Weber Way, Mead, CO 80542
303-503-3020
1. Do you have legal possession of the premises at the street address above? ® YES ❑ NO
Is the premises owned or rented? ❑ Owned ® Rented* elf rented, expiration date
of lease 1-1-16
2. Since the date of filing of the last annual application, has there been any change in financial interest (new notes, loans, owners, etc.)
or organizational structure (addition or deletion of officers, directors, managing members or general partners)? If yes, explain in detail
and attach a listing of all liquor businesses in which these new lenders, owners (other than licensed financial institutions), officers,
directors, managing members, or general partners are materially interested. El YES ❑ NO
NOTE TO CORPORATION, LIMITED LIABILITY COMPANY AND PARTNERSHIP APPLICANTS: If you have added or deleted any
officers, directors, managing members, general partners or persons with 10% or more interest in your business, you must complete
and return immediately to your Local Licensing Authority, Form DR 8177: Corporation, Limited Liability Company or Partnership
Report of Changes, along with all supporting documentation and fees.
3. Since the date of filing of the last annual application, has the applicant or any of its agents, owners, managers, partners or lenders
(other than licensed financial institutions) been convicted of a crime? If yes, attach a detailed explanation. ❑ YES ® NO
4. Since the date of filing of the last annual application, has the applicant or any of its agents, owners, managers, partners or lenders
(other than licensed financial institutions) been denied an alcohol beverage license, had an alcohol beverage license suspended or
revoked, or had interest in any entity that had an alcohol beverage license denied, suspended or revoked? If yes, attach a detailed
explanation. ❑ YES ® NO
5. Does the applicant or any of its agents, owners, managers, partners or lenders (other than licensed financial institutions) have a direct
or indirect interest in any other Colorado liquor license, including loans to or from any licensee or interest in a loan to any licensee? If
yes, attach a detailed explanation. ❑ YES El NO
__
6. SOLE PROPRIETORSHIPS, HUSBAND -WIFE PARTNERSHIPS AND PARTNERS IN GENERAL PARTNERSHIPS: Each person
must complete and sign the DR 4679: Affidavit — Restriction on Public Benefits (available online or by calling 303-205-2300) and
attach a copy of their driver's license, state -issued ID or valid passport.
AFFIRMATION & CONSENT
I declare under penalty of perjury in the second degree that this application and all attachments am true correct and complete to the best of my knowledge.
Type or Print Name of Applicant/Authorized Agent of Business
Title
Brenda Phillips
Owner
Signature
,z%4.
Date
6 _/,-/y
REPORT & APPROVAL OF CITY OR COUNTY LICENSING AUTHORITY
The foregoing application has been examined and the premises, business conducted and character of the applicant 2014-2560 report
that such license, if granted, will comply with the provisions of Title 12, Articles 46 and 47, C.R.S. THEREFORE THI:
Local Licensing Authority For
Date
Signature
Title
Attest
DO NOT WRITE IN THIS SPACE
DR 8177 (05/09/08) PAGE 1
COLORADO DEPARTMENT OF REVENUE
LIQUOR ENFORCEMENT DIVISION
1375 SHERMAN STREET
DENVER CO 80261
(303) 205-2300
REPORT OF CHANGES 21
CORPORATION, LIMITED LIABILITY
COMPANY AND PARTNERSHIP
Liquor and 3.2 Beer Licenses
(2355) ❑ LLC/PARTNERSHIP SEE INSTRUCTIONS AND
(2350) J CORPORATION
1. Corporate/L.L.C./Partnership Name
RLF, INC.
2. State Tax Account Number
14398830000
3. State Liquor License Number
14398830000
4. Trade Name
CJ's Liquors
5. Telephone Number
303-776-8359
6. Address of Licensed Premises
3907 Highway 119
City
Longmont
State
CO
ZIP Code
80504
7. Mailing Address if different than above
City
State
ZIP Code
8. LIST ALL officers, directors (corporation) or Managing Members (L.L.C.) or General Partner(s). Each
Officer, Director, Managing Member or Partner MUST FILL OUT a DR 8404-I (Individual History Record).
Position
Held
Names
Home Address
DOB
Replaces
Director
Brenda Phillips
16858 Weber Way, Mead, CO 80542
new
9. LIST ALL 10% (or more) Stockholders or 10% (or more) Members or 10% (or more) Limited Partners.
Each person listed Must Fill out a DR 8404-I (Individual History Record)
Stockholders/Members/Partners
owning 10% (or more) of business
%
Owned
Home Address
DOB
Replaces
P
Brenda Phillips
95
16858 Weber Way, Mead, CO 80542
---
10. Registered Agent
Address For Service
Brenda Phillips
3907 Highway 119, Longmont, CO 80504
OATH OF APPLICANT
I declare under penalty of perjury in the second degree that this application and all attachments
are true, correct, and complete to the best of my knowledge.
11. Authorized Sign re
ks� ��j`�';
Title
Owner
Date
Date
REPORT OF LOCAL LICENSING AUTHORITY
The foregoing changes have been received and examined by the Local Licensing Authority.
12. Local Licensing Authority For
County ❑ Town/City
Signature
Title
Date
Attest
Date
DO NOT WRITE IN THIS SPACE — FOR DEPARTMENT OF REVENUE USE ONLY
LIABILITY INFORMATION
License Account Number
Period
Cash Fund
-100 (999)
TOTAL
A
FEE SCHEDULE ON PAGE 2
°lease Include a typed
ell -addressed envelope
MUST BE TYPED
FILING FEE: $50.00
MUST SUBMIT TWO COPIES
Name XLE, Inc -
Mall to: Secretary of State
Corporations Section
1560 Broadway, SuIte 200
Denver, CO 80202
(303) 894-2251
Fax (303) 894-2242
v
1
For office use only
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1
ARTICLES OF INCORPORATION $ 50.00
SECRETARY OF STATE
01-04-1999 14:41:28
Principal Street Address 3907 Highway 119, Lamont, Colorado 80504
Cumulative voting shares of stock Is authorized. Yes O No El
If duration Is less than perpetual enter number of years N A
Preemtive rights are granted to shareholders Yes x No _ shares of the corporation.
Stock Information: (If additional space Is needed, continue on a separate sheet of paper.)
Stock Class Cowl Authorized Shares _
Stock Class
50,000 Par Value No/Par
Authorized Shares Par Value
The name of the initial registered agent and the address of the registered office Is:(Corporations use last name
space)
Last Name Fahrenholtz First & Middle Name Ronald L.
Street Address 3907 Highway 119, Longmont, Colorado 80504
Signature of Registered Agent _
The articles are to have a delayed effective date of 01-01-99
Incorporators: Names and addresses: (If more than two, continue on a separate sheet of paper.
NAME ADDRESS
Ronald L. Fahrenholtz
3907 Highway 119. Lona"nt. CO 80504
Incorporator(s) who are natural person(s) must be 18 years of age or more. The undersigned, acting as
incorporator(s) of a corporation under the Colorado Business Corporation Act, adopt the above Articles of
"corporation.
Signature 4/441
Rae
/CO° - ""
RESOLUTION
The following informal action is taken by unanimous written consent of the Board of
Directors of RLF, INC., a Colorado Corporation in lieu of a meeting in accordance with 7-
108-202, C.R.S.
, 2014
The undersigned, being all the directors of RLF, INC., a Colorado corporation (the
"Corporation") and acting pursuant to 7-108-202, C.R.S and the Bylaws of the Corporation,
hereby adopt the following resolution by unanimous written consent, which shall have the same
force and effect as if unanimously adopted at a duly convened meeting of the Board of Directors
of the Corporation, and a copy of which shall be filed with the minutes of the Corporation.
WHEREAS, the Corporation has before it a proposal to transfer five percent (5%) of the
issued and outstanding shares of stock of the Corporation from Brenda L. Phillips to Jackie
Merrill.
NOW, THEREFORE, BE IT RESOLVED, that the Corporation hereby waives its right to
purchase five percent (5%) of the issued and outstanding shares of stock from Brenda L. Phillips
and the Board hereby authorizes and consents to the transfer of those five percent (5%) of the
issued and outstanding shares of stock of the Corporation by Brenda L. Phillips to Jackie Merrill.
RESOLVED: That the transfer of shares of the Corporation on substantially the terms and
conditions as set forth in the form of the Gift and Transfer of Shares, attached hereto and
incorporated by reference herein, be and the same is hereby approved.
RESOLVED: That Brenda L. Phillips is hereby authorized and directed to execute and
deliver the Gift and Transfer of Shares in the form attached hereto and incorporated by reference
herein, and the proper officers of the Corporation be and they are hereby authorized to take any and
all action to execute, acknowledge, seal and file any and all instruments and documents deemed
necessary or proper in connection therewith.
RESOLVED: That Jackie Merrill shall be hereby appointed to the Board of Directors of the
Corporation.
This Informal Action of the Board of Directors may be executed in counterparts.
WITNESS our signatures the day and year first above written.
By: lcl2w‘ 5. -at
Brenda L. Phillips
GIFT AND TRANSFER OF SHARES
AGREEMENT made 2-3 , among Brenda L. Phillips (hereinafter
"Phillips"), and Jackie Merrill (hereinafter "Merrill").
Whereas RLF, INC. is a corporation having authorized and issued common shares of
stock, and
Whereas Phillips is the sole shareholder of the Corporation, and
Whereas Merrill desires to acquire an interest in the ownership of the Corporation, and
Whereas the Corporation and its shareholders desire to transfer certain shares to Merrill.
It is therefore agreed:
1. Gift and Transfer of shares. Phillips hereby agrees to transfer to Merrill five percent
(5%) of the issued and outstanding common shares of the Corporation now held by
her.
2. Title to shares. The title to five percent (5%) of the common shares shall remain
vested in Merrill, and she shall enjoy all the privileges of ownership, including the
right to vote such shares and to collect dividends thereon.
3. Transfer of title to shares. The Corporation shall cancel the necessary certificate(s)
and issue a new certificate for a number of shares equal to five percent (5%) of the
total issued and outstanding common shares of the Corporation in the name of
Merrill. The Corporation shall then deliver to Merrill said certificate and a copy of the
express terms of such shares, without charge.
In witness whereof the parties have signed and sealed this Agreement.
RLF, INC.
By
Brenda L. Phillips
OFFICE OF THE SECRETARY OF STATE
OF THE STATE OF COLORADO
CERTIFICATE
I, Scott Gessler, as the Secretary of State of the State of Colorado, hereby certify that, according to the
records of this office,
RLF, INC.
is a Corporation formed or registered on 01/04/1999 under the law of Colorado, has complied with all
applicable requirements of this office, and is in good standing with this office. This entity has been
assigned entity identification number 19991000330.
This certificate reflects facts established or disclosed by documents delivered to this office on paper
through 06/09/2014 that have been posted, and by documents delivered to this office electronically
through 06/10/2014 @ 11:57:59.
I have affixed hereto the Great Seal of the State of Colorado and duly generated, executed, authenticated,
issued, delivered and communicated this official certificate at Denver, Colorado on 06/10/2014 @
11:57:59 pursuant to and in accordance with applicable law. This certificate is assigned Confirmation
Number 8872285.
%—;rak__
Secretary of State of the State of Colorado
*********************tar*******rrrr*r ********End of Certificate********************************************
Notice: A certificate issued electronically from the Colorado Secretary o/ Slate's Web site is fully and immediately valid and effective. However,
as an option, the issuance and validity of a certificate obtained electronically may he established by visiting the Certificate Confirmation Page of
the Secretary of Slate's Web site, hap: hrnv_nocaate.tv_us he Cenifiram S,arrhCritcria.da entering the certificate's confirmation number
displayed on the certificate, and following the instructions displayed Confirming the issuance of a certificate is merely optional and is not
necessary to the valid and effective issuance of certificate. For more information, visit our Web site, Imp : a vo socamle. coup click Business
Center and select "Frequently Asked Questions "
CERT GS_D Revised 08,20/2008
DR 8404-I (07/25/11)
COLORADO DEPARTMENT OF REVENUE
LIQUOR ENFORCEMENT DIVISION
1881 PIERCE STREET RM 108A
DENVER CO 80261
INDIVIDUAL HISTORY RECORD
To be completed by the following persons, as applicable: sole proprietors; general partners regardless of percentage ownership,
and limited partners owning 10% or more of the partnership; all principal officers of a corporation, all directors of a corporation,
and any stockholder of a corporation owning 10% or more of the outstanding stock; managing members or officers of a
limited liability company, and members owning 10% or more of the company; and any intended registered manager of
Hotel and Restaurant or Tavern class of retail license.
NOTICE: This individual history record requires information that is necessary for the licensing investigation or inquiry. All questions
must be answered in their entirety or the license application may be delayed or denied. If a question is not applicable, please indicate
so by "N/A". Any deliberate misrepresentation or material omission may jeopardize the license application.
1. Name of Business
CJ's Liquors
2. Your Full Name (last, first, middle)
Merrill, Jackie Lea
3. List any other names you have used.
Jackie Lea Edlund
4. Mailing address (if different from residence)
5. List current residence address. Include any previous addresses within the last five years (attach separate sheet if necessary).
STREET AND NUMBER
CITY, STATE, ZIP
FROM
TO
Current
210 Eagle Avenue
Mead, CO 80542
2007
present
Previous
6. List all employment within the last five years. Include any se f employment. (Attach separate sheet if necessary)
NAME OF EMPLOYER OR BUSINESS
ADDRESS (STREET, NUMBER, CITY, STATE, ZIP)
POSITION HELD
FROM
TO
CJ's Liquors
3907 Highway 119, Longmont, CO 80504
Clerk/Manager
2000
present
7. List the name(s) of relatives working in or holding a financial interest in the Colorado alcohol beverage industry.
NAME OF RELATIVE
RELATIONSHIP TO YOU
POSITION HELD
NAME OF LICENSEE
Craig Werner
Spouse
Sales Manager
American Eagle Distributing
8. Have you ever applied for, held, or had an interest in a Colorado Liquor or Beer
inventory to any licensee? If yes, answer in detail. U Yes
License,
or loaned money, furniture, fixtures, equipment or
V No
9. Have you ever received a violation notice, suspension, or revocation for a liquor law violation, or have you applied for or been denied a liquor or beer
license anywhere in the United States? If yes, explain in detail. Yes V No
10. Have you ever been convicted
or do you have any charges
of a crime or received a suspended sentence, deferred sentence, or forfeited bail for any offense in criminal or military court
pending? (If yes, explain in detail.)
E Yes V No
11. Are you currently under probation (supervised or unsupervised), parole, or completing the requirements of a deferred sentence? (if yes, explain in detail.)
r —
❑Yes No
12. Have you ever had any professional license suspended, revoked, or denied? (If yes, explain in detail.)
Yes V No
PERSONAL AND FINANCIAL INFORMATION
Unless otherwise provided by law, the personal information required in question #13 will be treated as confidential.
The personal information required in question #13 is solely for identification purposes.
13a. Date of Birth ' b. Social Security Number SSN
.
c. Place of Birth 1 d. U.S. Citizen?
Deadwood, South Dakota I Yes � No
e. If Naturalized, State where
f. When
g. Name of District Court
h. Naturalization Certificate Number i. Date of Certification
j. If an Alien, Give Alien's Registration Card Number
k. Permanent Residence Card Number
I. Height , m. Weight
5'4" 185
n. Hair Color'o. Eye Color
brown brown
p. Sex
F
C
q. Race 1 r. Do you have a
current Driver's License? If so, give number and state
1. MYes ENo
14. Financial Information.
a. Total purchase price $ 0 (if
buying an existing business) or
investment being made by the applying entity, corporation,
partnership, limited liability
company, other $5% gift from mother
b. List the total amount of
stock purchases or fees paid
your investment in this business including any notes, loans, cash, services
$0
or equipment, operating capital,
c. Provide details of the Investment described in 14.b. You must account for all of the sources of this investment. Attach a separate sheet if needed.
Type: Cash, Services or Equipment
Source
Amount
NA
d. Loan Information (attach copies of all notes or loans)
Name of Lender
Address
Term
Security
Amount
NA
Oath of Applicant
I declare under penalty of perjury that this application and all attachments are true, correct, and complete to the best of my knowledge.
Authorized Signature
Title
Manager ` ) j`v.V-,-----.1L-1)
7
Dat
(CALM
20140805-11571
DATE 07/27/2014
SO WELD COUNTY RECORDS GREELEY
1950 "0" STREET
GREELEY, CO 80631
RE: MERRILL,JACKIE LEA DATE OF BIRTH:
SOC: XXX-XX-
No Colorado record of arrest has been located based on above
name and date of birth or through a search of our fingerprint
files.
The Colorado Bureau of Investigation's database contains
detailed information of arrest records based upon fingerprints
provided by Colorado law enforcement agencies. Arrests which are
not supported by fingerprints will not be included in this
database. On occasion the Colorado criminal history will
contain disposition information provided by the Colorado
Judicial system. Additionally, warrant information, sealed
records, and juvenile records are not available to the public.
Since a record may be established after the time a report was
requested, the data is only valid as of the date issued.
Therefore, if there is a subsequent need for the record, it is
recommended another check be made.
Falsifying or altering this document with the intent to
misrepresent the contents of the record is prohibited by law
and may be punishable as a felony when done with intent to
injure or defraud any person.
Sincerely,
Ronald C. Sloan, Director
colorado Bureau of Investigation
Page 1
Colorado Bureau of Investigation
Identification Unit
690 Kipling Street, Suite 3000
Denver, CO 80215
(303) 239-4208
The enclosed documents are being returned to you because of reason(s) indicated below:
We have not attempted to process your fingerprints due to the poor quality of the prints. Please submit a new set of fingerprints.
Include this form and the enclosed rejected card with your new submission. Since your card is being returned to you and we have
not made an attempt to process the card, this does not qualify as one of the two required attempts before a name -based background
check is authorized.
To obtain a new fingerprint card, call the State Forms Center at 303-370-2165.
Full name, date of birth, and physical information are mandatory.
The Colorado Revised Statute number that applies to the profession or reason fingerprinted must be included in the reason fingerprinted
box.
The employer address box must have a complete mailing address. The employer's address is where the background results will be
mailed.
The request was not accompanied with the proper fee. Either a payment was not included or the wrong amount was paid. For requests
that require payment, we need to receive a money order, cashier's check, pre-printed business check, or credit card form. The credit
card form is available on our website at •
Please send $ for your request.
Personal checks and temporary checks are not accepted. Please resubmit with an acceptable form of payment (see above).
The account number is missing or incorrect. Please include this in the OCA box.
The daycare license number or provider number is missing or incorrect. Please include this in the Miscellaneous MNU box if applicable.
Your account has been sent to collections. Until the account is paid in full, we can not process your request. Contact Financial Services at
303-239-4450.
We require both a fingerprint card and a name check form only if two separate responses are needed. A name check form is not
required for a fingerprint card submission. If both are requested, the combined fee is $29.50.
Other: The 0111s address need, .o be in the Employer nod Address.
Please Note:
All checks or money orders must be made payable to the Colorado Bureau of Investigation or CBI.
Your check or money order # :._.'..
in the amount of $-...,.. is enclosed.
Please complete changes and/or additions and submit to the CBI with all attachments. Your cooperation is appreciated. You may contact CBI
staff at (303) 239-4208 for clarification or questions.
Sincerely,
y: Chris Schae r
Agent in Charge
Identification Unit
/ps
RECEIVED
JUL 0 9 1014
WELD COUNTY
COMMISSIONERS
bvuudad rp-
ocuuLA au, bat.
7/2/2014
Chris Schaefer
Agent in Charge
7/11/2014 mkh
Colorado Bureau of Investigation
690 Kipling Street, Suite 3000 Denver, CO 80215
(303) 239-4208
Identification Unit
cbi.state.cc.us/id
The enclosed documents are being returned to you because of the following reason(s):
We have not attempted to process your fingerprints due to the poor quality of the prints. Please submit a new set of
fingerprints. Include this form and the endosed rejected card with your new submission. Since your card is being returned
to you and we have not made an attempt to pi mess the card, this does not qualify as one of the two required attempts
before a name -based background check is authorized.
To obtain a new fingerprint card, call the State Forms Center at 303-370-2165.
Full name, date of birth, and physical information are mandatory.
The Colorado Revised Statute number that applies to the profession or reason fingerprinted must be included in the
reason fingerprinted box.
The employer address box must have a complete mailing address. The employer's address is where the background
results will be mailed.
The request was not accompanied with the proper fee. Either a payment was not included or the wrong amount was paid.
For requests that require payment, we need to receive a money order, cashiers check, pre-printed business check, or
credit card form. The credit card form is endosed if you choose to pay by credit card.
Please send $ for your request.
Personal checks and temporary checks are not accepted. Please resubmit with an acceptable form of payment (see
above).
wI<I The account number is missing or incorrect. Please include this in the OCA box.
The daycare license number or provider number Is missing or incorrect. Please indude this in the MNU box.
Your account has been sent to collections. Until the account Is paid in full, we can not process your request. Contact
Financial Services at 303-239-4450.
We require both a fingerprint card and a name check form only if two separate responses are needed. A name check form
is not required for a fingerprint card submission. If both are requested, the combined fee is $29.50.
ICI /�J Other: The employer and address field must reflect the agency requesting the results. If it is the weld county clerk, they
�must provide their ORI in the OCA or their CONCJ# in the OCA field. If they do not have an account that can receive liquor
licensing results then the address for the Weld Count' SO must be in the employer field.
Please Note:
X
All checks or money orders must be made payable to the Colorado Bureau of Investigation or CBI. Personal checks are not
accepted.
Your check or money order #27031 in the amount of $38.50 is enclosed.
Please complete changes and/or additions and submit to the CBI with all attachments. Your cooperation is
appreciated. You may contact CBI staff at (303) 239-4208 for clarification or questions.
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Jeffrey J. Kahn
John Wade Gaddis
Bradley A. Hall
Steven P. Jeffers
Anton V. Dworak
Adele L. Reester
Catherine A. Tallerico
Scott E. Holwick
Cameron A. Grant
Richard N. Lyons, II
Senior Counsel
Lyons Caddis Kahn Hall
.Jeffers Dworak a Grant
A Professional Corporation � Attorneys and Counselors
Eve I. Canfield
Matthew Machado
Madoline Wallace -Gross
Chad A. Kupper
Blair M. Dickhoner
Suzan D. Fritchel
Special Counsel
Wallace H. Grant
Of Counsel
Daniel F. Bernard
June 20, 2014 (1942-2011)
Esther Gesick
Clerk to the Board
11515 0 RECEIVED
0 0 Street - Administration Building
PO Box 758
Greeley, CO 80632 JUN 2 3 2014
Re: CJ's Liquors Renewal Application and Report of Changes WELD COUNTY
COMMISSIONERS
Dear Esther,
Per our conversation today, enclosed are the following documents for CJ's Liquors:
1. Renewal Application with a check in the amount of $312.50 made payable to the Colorado
Department of Revenue and check in the amount of $137.50 made payable to the Clerk to
the Board.
2. Report of Changes with a check in the amount of $100 made payable to the Clerk to the
Board.
3. Articles of Incorporation
4. Certificate of Good Standing
5. Individual History Record of Jackie Merrill
6. Fingerprint cards
We will be sending the corporate minutes next week to your attention, as we discussed. Thank you
for taking the time to speak with me and for your assistance. Please call me if you have any
questions.
Sincerely,
LYONS GADDIS KAHN HALL
JEFFERS DWORAK & GRANT, PC
By: van
Kathleen Kava gh, Parale
kkavanagh@Igkhlaw.com
Enclosures
515 Kimbark Street • Second Floor • P.O. Box 978 • Longmont, CO 80502-0978
Phone: 303-776-9900 • Fax: 303-776-9100 • www.lgkhlaw.com
Rafaela Martinez
From:
Sent:
To:
Subject:
Kathleen P. Kavanagh [KKavanagh@Igkhlaw.com]
Wednesday, June 25, 2014 10:50 AM
Rafaela Martinez
RE: CJ's Liquors
Rafaela,
Thank you for letting me know. I will get a check to you right away!
Kathleen P. Kavanagh, Paralegal
P.O. Box 978
Longmont, CO 80502-0978
303-776-9900; Facsimile 303-776-9100
Email: kkavanagh@Igkhlaw.com Website: www.lgkhlaw.com
Lyons Caddis Kahn Hall
Jcffcrc Owortik a. Grant
CONFIDENTIALITY STATEMENT: THIS E-MAIL MESSAGE AND ANY ACCOMPANYING DOCUMENTS CONTAIN INFORMATION WHICH IS ATTORNEY CLIENT PRIVILEGED, CONFIDENTIAL AND
INTENDED ONLY FOR THE USE OF THE ABOVE -NAMED RECIPIENT. IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY
DISSEMINATION, DISTRIBUTION, PRINTING OR COPYING OF THIS MESSAGE IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS MESSAGE IN ERROR, PLEASE IMMEDIATELY NOTIFY US BY
TELEPHONE OR RETURN THE E-MAIL MESSAGE TO US. THANK YOU.
From: Rafaela Martinez[mailto:ramartinez@co.weld.co.us]
Sent: Wednesday, June 25, 2014 8:43 AM
To: Kathleen P. Kavanagh
Subject: CJ's Liquors
Good Morning Kathleen,
I am currently processing the Renewal Application and Report of Changes for CJ's Liquors. I need to send the fingerprint
cards for Jackie Merrill, however I need to have either a check or Money order made out to the Colorado Bureau of
Investigation for $38.50. I can't send the card until I have the funds as they won't be able to process it. If you could send
that or have the applicant send it as soon as possible we can move forward with the renewal.
Please let me know if you need anything else, otherwise I will hold onto her fingerprints until I get the necessary funds.
Thank you,
ltqfaela .4. Martinez
Deputy Clerk to the Board
1150 0 Street/P.O. Box 758'Greeley, CO 80632
tel: (970) 336-7215 X5226
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed
and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please
immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents
of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
1
Jeffrey J. Kahn
John Wade Gaddis
Bradley A. Hall
Steven P. Jeffers
Anton V. Dworak
Adele L. Reester
Catherine A. Tallerico
Scott E. Holwick
Cameron A. Grant
Richard N. Lyons, II
Senior Counsel
Lyons Gaddis Kahn Hall
Jeffers Oworak S. Grant
A Professional Corporation ('"' Attorneys and Counselors
Rafaela A. Martinez
Deputy Clerk to the Board
1150 0 Street
P.O. Box 758
Greeley, CO 80632
Re: CJ's Liquors
Dear Ms. Martinez,
June 30, 2014
Eve I. Canfield
Matthew Machado
Madoline Wallace -Gross
Chad A. Kupper
Blair M. Dickhoner
Suzan D. Fritchel
Special Counsel
Wallace H. Grant
Of Counsel
RECEIVED Daniel F. Bernard
(1942-2011)
JUL 01 2014
WELD COUNTY
COMMISSIONERS
Enclosed is a check in the amount of $38.50 made payable to the Colorado Bureau of Investigation.
We are still working on getting the minutes submitted to your office. Let me know if you need
anything else. Thank you.
Sincerely,
LYONS GADDIS KAHN HALL
JEFFERS DWORAK & GRANT, PC
By:
Enclosure
�
Kathleen Kavana , Paralen
kkavanagh@Igkhlaw.com
515 Kimbark Street • Second Floor • P.O. Box 978 • Longmont, CO 80502-0978
Phone: 303-776-9900 • Fax: 303-776-9100 • www.Igkhlaw.com
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To: Weld County Board of Commissioners
From: Deputy Lisa Carpenter
Date: July 10, 2014
RE: RLF, Inc., dba CJ's Liquors
Dear Commissioners,
I have researched and found two reported calls for service at the RLF Grill,Inc., DBA
CJ's Liquors, located at 3907 Hwy 119, Longmont, CO 80504, for the Calendar year of 2013 to
present day.
The reported calls for service are a theft from the store on December 4, 2014 and a
vandalism that occurred inside the store on August 16, 2014.
I find no grounds for disapproval for the renewal of the liquor license.
Respectfully Submitted,
Deputy Lisa Carpenter
Community Resource Officer
Weld County Sheriff's Office
1950 "O" Street
Greeley, CO 80631
WELD C 0UNTY SHERIFF'S OFFICE
Community Reso'iirce Office
Llr�UDR ENFDRgrp1ENT WQRKSHEET
x1950 fltteet
GFeeley, Colorado 80631
Voice (970) 356.4015 Fax (970) 304-6467
Inspection Report
Incident Report
CRit:
:.iceme trade name: k L rr Z f`1
licensee Name: Q, ' S [ i U (! l
license t!Type:
L Ctuj�I� s r cli2 C
Date of Report! rnadet ! �-' - / c -
Address: 376 ri t,, i I 1 9
p�1
Pe son CentaCk a:� j ---C Ale Ie r, it
city, state, Z'p:Lt mu �'� Ct . .
Teleptiooe t: 3x7 ....s' o 3 3O e
State Liquor License Posted
✓Manager
..
Registered
✓
State Sales Tax License Posted
✓
License in Control of Prenises
County Liquor License Posted
T
Trade Name Properly Registered
Federal Fom 11 * Call (800) 398-2822
►!Premises
Physical Control Adequate
✓
Food Service. License Posted
✓
Acceptable Dispensing System
r
Minor Warning Sign Posted
✓
Off Premise Storage Licensed
v. -
Meals arid Snacks Available
✓
Only Permitted Items Sold
✓
Cleanliness Adequate .
✓
Alcohol From Permitted Source
✓
Books:&InvoicesAvailable
/
Discuss Sales of: Liquor to. Minors
✓
.
Alcohol. Beverage Stock Acceptable
7.
Discuss Sales to Intoxicated Persons
✓
OWaming ElFollow-Up Inspection
P 1014
'Representative Signature Date
viataton:
Date:
1 Time:
Sint:
Dos::
war.
Hair
Clothing:
DL !Dr,:
State:
Address:
City
State:
7LP:
Evidence: Yes NO
HfW Phone #:
Summons Ir:
Court Date:
merles: Yes NO
Narrative:
Deputy:
sr Date: - `t
Rafaela Martinez
From:
Sent:
To:
Subject:
Janet Lundquist
Wednesday, July 09, 2014 9:26 AM
Rafaela Martinez
Re: Liquor License Renewal - RLF, Inc dba CJ's Liquors
This is an existing location. Public Works doesn't have any issues at this time.
Janet Lundquist
Sent from my iPhone
> On Jul 9, 2014, at 9:06 AM, "Rafaela Martinez" <ramartinezOco.weld.co.us> wrote:
>
> In accordance with the procedure for liquor and/or beer license checks, please review all
records on the following establishment for any associated reports during the last year and
return your report to the Weld County Clerk to the Board's Office within two weeks. Your
report will be used by the Board of County Commissioners in considering renewal of the liquor
and/or beer license.
>
> PLEASE RESPOND NO LATER THAN: July 23, 2014
>
> ESTABLISHMENT: RLF, Inc dba CJ"s Liquors
>
> Current License Expires: August 5, 2014
>
> File Location: LC0020
>
> Thank you,
>
>
> Rafaela A. Martinez
> Deputy Clerk to the Board
> 1150 0 StreetIP.O. Box 758IGreeley, CO 80632
> tel: (970) 336-7215 X5226
>
> [cid:image001.ipg(d01CF9B55.03C94040]
> Confidentiality Notice: This electronic transmission and any attached documents or other
writings are intended only for the person or entity to which it is addressed and may contain
information that is privileged, confidential or otherwise protected from disclosure. If you
have received this communication in error, please immediately notify sender by return e-mail
and destroy the communication. Any disclosure, copying, distribution or the taking of any
action concerning the contents of this communication or any attachments by anyone other than
the named recipient is strictly prohibited.
>
> <Untitled.pdf>
> <image001.jpg>
1
Rafaela Martinez
From:
Sent:
To:
Subject:
Frank Piacentino
Wednesday, July 09, 2014 9:23 AM
Rafaela Martinez
RE: Liquor License Renewal - RLF, Inc dba CJ's Liquors
Rafaela,
Building Inspection Department has no concerns with the renewal of liquor licenses
Frank Piacentino
Building Official
Weld County Building Inspection
970-353-6100 Ext 3531.
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for
the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
From: Rafaela Martinez
Sent: Wednesday, July 09, 2014 9:06 AM
To: Dan Joseph; Deb Adamson; Mark Mellon; Lisa Carpenter; Frank Piacentino; Bethany Salzman; Bob Choate; Janet
Lundquist; Roy Rudisill
Subject: Liquor License Renewal - RLF, Inc dba CJ's Liquors
In accordance with the procedure for liquor and/or beer license checks, please review all records on the following
establishment for any associated reports during the last year and return your report to the Weld County Clerk to the
Board's Office within two weeks. Your report will be used by the Board of County Commissioners in considering renewal
of the liquor and/or beer license.
PLEASE RESPOND NO LATER THAN: July 23, 2014
ESTABLISHMENT:
Current License Expires:
File Location:
Thank you,
Raffle/a.1. Martinez
Deputy Clerk to the Board
1150 O Street/P.O. Box 758/Greeley, CO 80632
RLF, Inc dba CJ"s Liquors
August 5, 2014
LC0020
1
MEMORANDUM
Rafaela Martinez, Deputy Clerk to the Board July 11, 2014
From: Bethany Pascoe, Zoning Compliance Officer, Dept. of Planning Services
Subject: LC0020
Review of the following liquor license renewal by the Department of Planning Services shows the following:
14-39883-0000
RLF, Inc.
dba CJ's Liquor
3907 Highway 119
Longmont, CO 80504
Zone District: C-3
This use is allowed through the zone district and a Site Plan Review (SPR-129). There are no violations
occurring at this time.
RECEIVED
JUL 1 1 2014
WELD COUNTY
COMMISSIONERS
SERVICE, TEAMWORK, INTEGRITY, QUALITY
Rafaela Martinez
From:
Sent:
To:
Subject:
Dan Joseph
Wednesday, July 23, 2014 10:12 AM
Rafaela Martinez
RE: Liquor License Renewal - RLF, Inc dba CJ's Liquors
We don't currently inspect this facility, however I checked to see if we had received any complaints and there weren't
any. No issues from us.
Dan Joseph CP-FS
Food Program Coordinator
Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley. CO 80631
phone: 970.304.6415 x 2206
fax: 970.304.6411
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain
information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and
destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the
named recipient is strictly prohibited.
From: Rafaela Martinez
Sent: Wednesday, July 09, 2014 9:06 AM
To: Dan Joseph; Deb Adamson; Mark Mellon; Lisa Carpenter; Frank Piacentino; Bethany Salzman; Bob Choate; Janet
Lundquist; Roy Rudisill
Subject: Liquor License Renewal - RLF, Inc dba CJ's Liquors
In accordance with the procedure for liquor and/or beer license checks, please review all records on the following
establishment for any associated reports during the last year and return your report to the Weld County Clerk to the
Board's Office within two weeks. Your report will be used by the Board of County Commissioners in considering renewal
of the liquor and/or beer license.
PLEASE RESPOND NO LATER THAN: July 23, 2014
ESTABLISHMENT:
Current License Expires:
File Location:
Thank you,
RLF, Inc dba CJ"s Liquors
August 5, 2014
LC0020
Rafaela .4. Martinez
Deputy Clerk to the Board
1150 O Street'P.O. Box 758/Greeley, CO 80632
1
CJ'S LIQUORS
RLF INC
PH, 303-776-8359
3907 HWY 119
LONGMONT, CO 80504
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CERTIFIED MAILTM RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
Postage
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item 4 if Restricted Delivery Is desired.
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2. Article Number
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