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HomeMy WebLinkAbout20100610RESOLUTION RE: APPROVAL OF SPECIAL EVENTS PERMIT ISSUED TO MAKE -A -WISH FOUNDATION OF COLORADO, INC., AND AUTHORIZE CHAIR TO SIGN 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, Make -A -Wish Foundation of Colorado, Inc., do Greg Risedorf, presented to the Board of County Commissioners of Weld County, Colorado, an application for a Special Events Permit for the sale of malt, vinous and spirituous liquors for consumption by the drink on the premises only, and WHEREAS, said applicant has paid the sum of ONE HUNDRED DOLLARS ($100.00) to Weld County, Colorado, pursuant to the laws providing therefore in payment for a County Retail Permit for the sale of malt, vinous and spirituous liquors for consumption by the drink on the premises only, for an event scheduled for one day only on May 16, 2010, from 8:00 a.m., to 9:00 p.m., outside the corporate limits of any town or city in the County of Weld at the location described as follows: Anderson Farms, 6728 County Road 3.25, Erie, Colorado 80516; being further described as part of Section 32, Township 2 North, Range 68 West of the 6th P.M., Weld County, Colorado WHEREAS, said applicant has also paid the sum of TWENTY-FIVE DOLLARS ($25.00) to the Colorado Department of Revenue and has exhibited a State Special Events Permit for the sale of malt, vinous and spirituous liquors for consumption by the drink on the premises only. 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 Special Events Permit Number#2010-04 to said applicant to sell malt, vinous and spirituous liquors for consumption by the drink on the premises only, only at retail at said location; and the Board does hereby authorize and direct the issuance of said permit by the Chair of the Board of County Commissioners, attested to by the Clerk to the Board of Weld County, Colorado, which permit shall be effective from 8:00 a.m., until 9:00 p.m., on May 16, 2010 , providing that said place where the permitee is authorized to sell malt, vinous and spirituous liquors for consumption by the drink on the premises only, 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 permit. LC; co, 11 -PQ 2010-0610 LC0022 nut I n SPECIAL EVENTS PERMIT - MAKE -A -WISH FOUNDATION OF COLORADO, INC. PAGE 2 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 29th day of March, A.D., 2010. BOARD OF COUNTY COMMISSIONERS ELD COUN _! •RADO Weld County Clerk to the Boa APPROVED ,95 TO FORM: Date of signature: LiNbC) 2010-0610 LC0022 DR 8428 (10/29/07) COLORADO DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION 1881 PIERCE STREET, SUITE 108 LAKEWOOD, COLORADO 80214 STATE OF COLORADO DEPARTMENT OF REVENUE VALID ONLY FOR THIS ORGANIZATION AT THIS LOCATION MAKE A WISH FOUNDATION OF CO FRANKS RIDE FOR CHILDRE 6728 COUNTY ROAD 3.25 ERIE CO 80516 License Number GE 27-14685-0006 SPECIAL EVENTS PERMIT MALT, VINOUS AND SPIRITUOUS LIQUOR VALID ONLY FOR THE FOLLOWING PERIODS FROM Date MAY 16, 2010 Hour 8:00 AM TO Date MAY 16, 2010 Hour 9:00 PM FROM Date XXXXXXXXXXX Hour XXXXXXX TO Date XXXXXXXXXXXX Hour XXXXXXX This permit is issued subject to the laws of the State of Colorado and especially under the provisions of Title 12, Article 48, Colorado Revised Statutes. This permit is non -transferable. It is issued only for the specific location described above, and must be conspicuously posted at that location. In testimony whereof, I have hereunto set my hand and seal 04/26/10 KA F: V!f y A4 1 // r� � A�lP�f�! ��yU-IR-?/tip � � K' T ORQ/ ~' ' IOU R ENFORCEMENT DIRECTOR %ECU E DIRECTOR \ ) } O THIS LICENSE EXPIRES COLORADO ct ( EVENTS PE ) taa SPECIFY: Retail Liquor Store, Liquor Licensed Drug Store, Hotel and Restaurant. Club. T AND SPIRITUOUS con ( TO SELL AT RETAIL SPECIFY KINDS OF LIQUORS irituous a License to sell 00 75 0 %) E /\0 ttv cn ( \ ]\\\\ ®+:2a fCbr) UV • }�C .O O #t b 3\\ 2 \)2 2«co ®\ tti) O\ otoa the drink for • a. \ \ )/)\ / o \\\ \ \\mot- \ 4-1 )255) } ) j §/(C 4 \\)`�O U co �,/s/ 2 o \§ ) - \)� a) cbjj \)) );§ /;� \j\/)jC s o \000 cn \ \§ @ 2tz 2O -- co O 0 OZ TO BE POSTED IN A CONSPICUOUS PLACE. NON -TRANSFERABLE. V4 HART INTFRCIVIC R 8439 (06/28/06) COLORADO DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION 375 SHERMAN STREET DENVER CO 80261 303) 205-2300 APPLICATION FOR A SPECIAL EVENTS PERMIT IN ORDER TO QUALIFY FOR A SPECIAL EVENTS PERMIT, YOU MUST BE NONPROFIT AND ONE OF THE FOLLOWING (See back for details.) ❑ SOCIAL ❑ ATHLETIC ❑ PHILANTHROPIC INSTITUTION ❑ FRATERNAL ❑ CHARTERED BRANCH, LODGE OR CHAPTER ❑ POLITICAL CANDIDATE ❑ PATRIOTIC g OF A NATIONAL ORGANIZATION OR SOCIETY ❑ MUNICIPALITY OWNING ARTS ❑ POLITICAL ❑ RELIGIOUS INSTITUTION FACILITIES Department Use Only LIAB TYPE OF SPECIAL EVENT APPLICANT IS APPLYING FOR: 2110S MALT, VINOUS AND SPIRITUOUS LIQUOR $25.00 PER DAY 2170 FERMENTED MALT BEVERAGE (3.2 Beer) $10.00 PER DAY 1. NAME OF APPLICANT ORGANIZATION OR POLITICAL CANDIDATE } r N n 4 , 5 S; c4 c Fe r MAkc-A- LAJis 11 Founca#i o rY o -c CO ch;loirtn 2. MAILING ADDRESS OF ORGANIZATION OR POLITICAL CANDIDATE (include street, city/town and ZIP) DO NOT WRITE IN THIS SPACE LIQUOR PERMIT NUMBER 1951 6. rnaplewood Ave. S,.:+c- tab fire--enwooJ U;1)a9el Co 86111-`-Y769 NAME DATE OF BIRTH State Sales Tax Number (Required) A —65cf0r1 3. ADDRESS OF PLACE TO HAVE SPECIAL EVENT (include street, city/town and ZIP) L rla• Gown$ Rc&4 3.a5 Erse. ) co goslb HOME ADDRESS (Street, City, State, ZIP) PHONE NUMBER 4. PRES./SEC'Y OF ORG. or POLITICAL CANDIDATE 5. EVENT MANAGER G T,eorL-A A. R: sccior-f- 6. HAS APPLICANT ORGANIZATION OR POLITICAL CANDIDATE BEEN ISSUED A SPECIAL EVENT PERMIT THIS CALENDAR YEAR? xi NO YES HOW MANY DAYS? 8. DOES THE APPLICANT HAVE POSSESSION OR WRITTEN PERMISSION FOR THE USE OF THE PREMISES TO BE LICENSED? ❑ Yes ❑ No a54 -P-1 J4re.+4 Dry vC t_4d) co seS 303 ff5-9190 7. IS PREMISES NOW LICENSED UNDER STATE LIQUOR OR BEER CODE? NO n YES TO WHOM? LIST BELOW THE EXACT DATE(S) FOR WHICH APPLICATION IS BEING MADE FOR PERMIT Date 5 )itoJao it Hours From 5. o...m. To ct p Date Hours From To Date Hours From To Date Hours From To Date Hours From To OATH OF APPLICANT I declare under penalty of perjury in the second degree that I have read the foregoing application and all attachments thereto, and that all information therein is true, correct, and complete to the best of my knowledge. SIGN RE TITLE DATE C 1—,O1/4; r rr0. r I /✓ REPORT AND AP OVAL OF LOCAL LICENSING AUTHORITY (CITY OR COUNTY) The foregoing application has been examined and the premises, business conducted and character of the applicant is satisfactory, and we do report that such permit, if granted, will comply with the provisions of Tit e 12, Article 48, C.R.S., as amended. THEREFORE, THIS APPLICATION IS APPROVED. LOCAL LICENSING AUTHORITY (CITY OR COUNTY) County of Weld SIGNATU -1/414,1 Douetas Ra mache ❑ CITY EX COUNTY TITLE Chair, Board of Weld County Commissioners TELEPHONE NUMBER OF CITY/COUNTY CLERK 970-356-4000 X4200 DO NOT WRITE IN THIS SPACE - FOR DEPARTMENT OF REVENUE USE ONLY DATE MAR 2 9 2010 LIABILITY INFORMATION License Account Number Liability Date State TOTAL -750 (999) (Instructions on Reverse Size) 2010-0610 APPLICATION INFORMATION AND CHECKLIST THE LLOWING SUPPORTING DOCUMENTS MUST BE ATTACHED TO THIS APPLICATION FOR A PERMIT TO BE ISSUED: Appropriate fee. Diagram of the area to be licensed (not larger that 8 1/2" X 11" reflecting bars, walls, partitions, ingress, egress and dimensions. ote: If the event is to be held outside, please submit evidence of intended control, i.e., fencing, ropes, barriers, etc. RA - Copy of deed, lease, or written permission of owner for use of the premises. Certificate of good corporate standing (NONPROFIT) issued by Secretary of State within last two years; or If not incorporated, a NONPROFIT charter; or If a political Candidate, attach copies of reports and statements that were filed with the Secretary of State. ❑ APPLICATION MUST FIRST BE SUBMITTED TO THE LOCAL LICENSING AUTHORITY (CITY OR COUNTY) AT LEAST THIRTY (30) DAYS PRIOR TO THE EVENT. ❑ THE PREMISES TO BE LICENSED MUST BE POSTED AT LEAST TEN (10) DAYS BEFORE A HEARING CAN BE HELD. (12-48-106 C.R.S.) ❑ ANAPPROVED APPLICATION MUST BE RECEIVEDBYTHE LIQUOR ENFORCEMENTDIVISIONATLEASTTEN(10)DAYSPRIORTOTHE EVENT. ❑ CHECK PAYABLE TO THE COLORADO DEPARTMENT OF REVENUE (12-48-102 C.R.S.) A Special Event Permit issued under this article may be issued to an organization, whether or not presently licensed under Articles 46 and 47 of this title, which has been incorporated under the laws of this state for the purpose of a social, fraternal, patriotic, political or athletic nature, and not for pecuniary gain or which is a regularly chartered branch, lodge or chapter of a national organization or society organized for such purposes and being non profit in nature, or which is a regularly established religious or philanthropic institution, and to any political candidate who has filed the necessary reports and statements with the Secretary of State pursuant to Article 45 of Title 1, C.R.S. A Special Event permit may be issued to any municipality owning arts facilities at which productions or performances of an artistic or cultural nature are presented for use at such facilities. If an event is cancelled, the application fees and the day(s) are forfeited. SPECIAL EVENT PERMIT QUESTIONNAIRE AND AFFIDAVIT 1. What type of an event is planned (e.g., annual, quarterly, benefit, etc.)? l 2. Explain in detail the nature of your organization, its function, and who or what benefits from its operations (attach separate sheet if necessary). See -V-A- c_ c f_01l 3. Who or what organization will be the recipient of funds derived from this event? S,e e a+i uc__ eat 4. How many attendees are expected at this event? see Cl 14 a c Ltd o! 5. Describe the premises at which this event will take place. ,$ 2. e cr/ -1 4 I e -mil 6. What type of security will be provided at this event? S c Le -dl 7. How many security personnel will be on hand? 5e t a +-1-ac-- h cal 8. How will security personnel be identified? q c a ++4 c Lad 9. If this event is being held outdoors, how will the exterior boundaries of the premises be marked (e.g., roped, fenced, etc.)? / 5 10. What type of entertainment will be provided, if any, for this event? Sec 4+ 4- 11. 11. What method will be used in checking identification for proper age of attendees (e.g., at the door, at the bar, etc.) and how will underage patrons be identified so as not to be served alcoholic beverages (e.g., stamp or mark on the hand, etc.) M:ICTBICTB FO RMSIFOSPECIALEV ENT. DOCS pec is I Event 12. How will the conduct and level of intoxication of attendees be monitored and by whom? .Set a+-+4 c- cl 13. Have volunteers or members of your organization been trained in the sale/service of alcoholic beverages: If yes, what training have they received and by whom? st-1-4 c_ 14. What types of alternate beverages and food/snacks will be available? a'} -}u 15. Has a State Sales Tax Number been initiated by you or a member of your organization? If so, write that number in the space provided. See q+lac-Jv'CO/ 16. Explain how this event will be marketed describing what kinds of advertising material will be distributed and the targeted recipients of such material. I hereby certify, under penalty of perjury, that the information provided to the Board of County Commissioners of Weld County contained in this affidavit is true and accurate to the best of my knowledge. Applicafit's Signature STATE OF COLORADO COUNTY OF WELD Subscribed and Witness my hand and ) ss Date this day of I V , 20N. MY COMMISSION EXPINES:05-19.2013 M:\CTB\CTB FO RMS\FOS P EC IALEV ENT. DOCSpecialEvent Frank's Ride for Children Special Events Permit May 16, 2010 Question 1: Question 2: Question 3: Question 4: Question 5: Questions 6, 7, & 8 Question 9: Question 10: Question 11: Questions 12& 13 Question 14: Question 15: Question 16: Annual Benefit The mission of Frank's Ride is to help Colorado Children who are fighting life -threatening illnesses and who want to have a wish granted. The children we sponsor participate in our run- riding in our sidecars. They and their families have a great time and really enjoy seeing all the motorcycles and vehicles supporting their wishes. Make -A -Wish Foundation of Colorado The total number we expect 1,000 to 1,500 to attend the 2010 event The premises contains permanent buildings that include, public facilities, drinking fountains, and a kitchen facility. Permanent interior and exterior lighting is located throughout the premises. The entire volunteer staff of Frank's Ride will provide security for the event. The staff members are identified by wearing black "Frank's Ride Poker Run Staff' shirts. Additionally, there will be twenty staff members designated specifically as "Frank's Ride Security. The premises has permanent fencing around its entire boundaries. Live music and games Attendees will be identified by two separate colored wrist bands according to age (over 21 years and under 21 years) Fifteen of our Volunteer staff of Frank's Ride have current TIPS certifications and will be monitoring the attendees as well as Mountain View Fire Protection District, Longmont Emergency Unit personnel, and Police staff. Water fountains, bottled water, soft drinks, bbq pork and beef with all the trimmings. No. 100% of the profits are donated to Make -A -Wish Foundation of Colorado Flyers, ads in location magazines and news papers, and ads on local radio. '.1.7 . +fit• -t- r S n ter is) :Q. u 1/4n r a 6 • b • _•� 4 ‘41ft at at y` « w ot 1�i v um. it .- J • i p • r'; „1 9• 1 IP f f gel Z re =_ O r� mi a MN a Q D x a O N Pony Rides Concession x S j N r4 K C_ r. C V C+ 4 K r, Z L C C Z r - 1 - CO N e4 1 it ike TTnc-k C r;•• w r J r. V tre a a h et el Ticket Booth a el am to C LETTER OF CONSENT I, Jim Anderson, do hereby authorize the use of my property for the sole purpose of hosting the event known as Frank's Ride for Children. This event benefits Make -A -Wish Foundation of Colorado and is scheduled for Sunday, May 16, 2010. I do understand that there will be approximately 1,000 to 1,500 people attending, as well as, staff members from Frank's Ride and Make -A -Wish Foundation of Colorado. It is also my understanding that there will be a pig roast (served with all the trimmings), alcoholic/non-alcoholic beverages, as well as, live entertainment on the event premises. My property is completely fenced with one main gate serving as the main entrance to the event premises. R pe ens ctfully� Jim erson 6728 W R 3 ''A Erie, Colorado 80516 Jennifer VanEgdom From: Sent: To: Cc: Subject: Attachments: Thank you, Greg — Jennifer, attached permission to sign Patti Forsythe Patti Forsythe [pforsythe@colorado.wish.orgj Monday, March 15, 2010 3:44 PM 'Greg Risedorf Jennifer VanEgdom RE: Franks Ride Weld.pdf I just received the insurance information on Friday. is the insurance form you require. Please use this email as authority to give Greg Risedorf the permit on behalf of Make -A -Wish. Let me know if you need anything else. Patti Forsythe, Director of Events/Promotions Make -A -Wish Foundation of Colorado, Inc. 7951 E. Maplewood Avenue, Suite 126 Greenwood Village, CO 80111 303-750-9474 303-755-3108 fax pforsvth e @colorado. wish. orq Follow us on Twitter Become a fan on Facebook CHECK WHAT MATTERS: This tax season, help fulfill the wishes of kids with life -threatening medical conditions by making a contribution to Make -A -Wish Foundation() of Colorado on your state tax return. From: Greg Risedorf [mailto:Greg.Risedorf@cityofthornton.net] Sent: Monday, March 15, 2010 3:04 PM To: pforsythe@colorado.wish.org Cc: Jennifer VanEgdom Subject: Franks Ride Hi Patty, The CC is who we need to send the insurance paper work and letter stating that I can sign for Make -A - Wish. If you have any questions please call Jennifer at Weld County. Thanks. Greg Risedorf City of Thornton Senior Equipment Operator Street Operations Office: 720-977-6388 Cell: 303-726-9464 1 ACORD CERTIFICATE OF LIABILITY INSURANCE OPID 5S MAREA-1 DATE(MMDD/YYYY 03/12/10 PRODUCER Brown S Brown Insurance of AZ 2800 N. Central Ave . , #1600 P.O. Box 2800 Phoenix AZ 85002-2800 Phone:602-277-6672 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Make A Wish Foundation of Colorado 7951 E. Maplewood Avenue #126 Greenwood Village CO 80111 INSURER A: Philadelphia Indemnity Ins Co. 18058 INSURER B: INSURER C: INSURER D: INSURER E: 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 CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LLTR NSRC TYPE OF INSURANCE POLICY NUMBER DATE (MMDDM')E DATE (MMIDD/YY))N LIMITS A X GENERALUABILITY X COMMERCIALGENERALLIABILITY PHPK463157 09/01/09 09/01/10 EACH OCCURRENCE $ 1000000 PREMSES(Eatoccurence) $ 100000 CLAIMS MADE X OCCUR MED EXP (Anyone person) $ 5000 GEN'L PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2000000 POLICY PRO- JECT A AUTOMOBILE X X X LIABILITY ANY AUTO PHPK463157 09/01/09 09/01/10 COMBINED SINGLE LIMIT (Eaacddent) $ 1000000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS/UMBRELLA X X LIABILITY I OCCUR CLAIMS MADE PHUB282943 09/01/09 09/01/10 EACH OCCURRENCE $ 10000000 AGGREGATE $ 10000000 $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Il yes,describeunder SPECIAL PROVISIONS below I TORYSLIMITS I IDER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS *Except 10 days notice of cancellation for non-payment of premium. RE: Frank's Ride for Children to be held on May 18, 2010 from 7am to 5pm. Weld County Government is an Additional Insured with respects to General Liability per form PI -SE -001 (12/05). Weld County Government 1762 Weld County Road 20 Longmont CO 80504 1/2 WELDCO1 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AD�gA,I v ENr`/�y�(�f�. �^" ACORD 25 (2001/08) OFFICE OF THE SECRETARY OF STATE OF THE STATE OF COLORADO CERTIFICATE 1, Bernie Buescher, as the Secretary of State of the State of Colorado, hereby certify that, according to the records of this office, MAKE -A -WISH FOUNDATION OF COLORADO, INC. is a Nonprofit Corporation formed or registered on 05/02/1983 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 19871519647. This certificate reflects facts established or disclosed by documents delivered to this office on paper through 03/11/2010 that have been posted, and by documents delivered to this office electronically through 03/16/2010 @ 10:10:12. 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 03/16/2010 @ 10:10:12 pursuant to and in accordance with applicable law. This certificate is assigned Confirmation Number 7600812. Secretary of State of the State of Colorado *********************************************End of Certificate******************************************** Notice: A certificate issued electronically from the Colorado Secretary of State's Web site is fully and immediately valid and effective. However, as an option, the issuance and validity of a certificate obtained electronically may be established by visiting the Certificate Confirmation Page of the Secretary of Slate's Web site, �://www.sos.state.co.us/biz/CertiheateSearchCriteria.do 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 a certificate. For more information, visit our Web site, httplIwww.sos.state.co.us/ click Business Center and select "Frequently Asked Questions." CERT GS D Revised 08/20/2008 Hello