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Home My WebLink About820759.tiffRESOLUTION RE: APPROVAL OF CHANGE OF CORPORATE STRUCTURE CONCERNING BOB-MIM, INC., D/B/A THE ENTERTAINER (THE COVE) 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, Bob-Mim, Inc., 2630 6th Avenue, Greeley, Colorado 80631 currently has an existing Tavern Liquor License, and WHEREAS, the officers of the corporation were listed as Robert P. Mimnaugh, President, and Max E. Kingsley, Secretary - Treasurer, and WHEREAS, a request has been presented to the Board of County Commissioners of Weld County, Colorado that the corporate struc- ture be changed to name Barbara Gigliotti, President, and June Wilkinson, Secretary -Treasurer, and WHEREAS, said request also included that the trade name be changed from, The Cove to the Entertainer, and WHEREAS, after review, the Board deems it advisable to approve said change of corporate structure and the change of the trade name. NOW, THEREFORE, BE IT RESOLVED by the Board of County Com- missioners of Weld County, Colorado that the corporate structure of Bob-Mim, Inc. be, and hereby is, approved to name Barbara Gigliotti, President, and June Wilkinson, Secretary -Treasurer. BE IT FURTHER RESOLVED by the Board that the trade name, The Cove be, and hereby is, changed to The Entertainer. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 17th day of November, A.D., 1982. ATTEST: Weld County Clerk and Recorder and Clerk to the Board (� �8 LL?_Deputy County Clerk APPR&?ED AS TO FORM: f! lg-1ef-, C '1)c - By: o</ County Attorney BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO / //i///44./J Jo artin, Chair an uck Carlson, ro_-Tem Norman Carlson W. Kirb DATE PRESENTED: January cH 1 S7 d / -e?"-n71)/(C144{ 5, 1983 /ne K. Steinmark 820759 C 6 u ., a._ O C 6? GIRL 432 (Rev. 2/77) 'ttttr of Totorttdn DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION 1375 SHERMAN STREET DENVER, COLORADO 80261 REQUEST TO CHANGE TRADE NAME In accordance with the provisions of the Colorado Liquor Code Regulation No. 12-47-106.4, or Colorado Beer Code Regulation No. 12-46-106.3 presently DBA located at ame of Licensee) (Trade Name) a109,30 (Street) (City) (County) hereby request permission to change the trade name of the establishment from to a ?FiN_ Sts I q, c J ) e effective 19 (Month) (Day) License Number )4 -alit 19 NQ (Licensee) IN REPLY REFER TO CORPORATION LICENSEE BY PRESIDENT OR SECRETARY OF THE CORPORATION DRL 432 (Rev. 2/77) *tatr of ToWrap DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION 1375 SHERMAN STREET DENVER, COLORADO 80261 REQUEST TO CHANGE TRADE NAME In accordance with the provisions of the Colorado Liquor Code Regulation No. 12-47-106.4, or Colorado Beer Code Regulation No. 12-46-106.3 I �..J6t<ae. a, a,te. `c/i (/f-i 17Sn presently DBA (Name of Licensee) Thy (O u - (Trade Name) located at ,2 4 3O 4f il/d2 . r //) (Street) ' laity) 7(aL(i- 11/z JD (County) hereby request permission to change the trade name of the establishment esp from J 7e_ C6)//e-- to /%a /77 ;feR / a,.11 e_ /? e effective 19 (Month) (Day) License Number /e-/- ,2/y 77 IN REPLY REFER TO CORPORATION LICENSEE BY PRESIDENT OR SECRETARY OF THE CORPORATION DEPARTMENT IV co P1 O. • N UCO LL i O O cc z Q cc W W 2 N In N M z 0 _N O I- z W W W U S 0 LL z W O O O J PERMIT TO CHANGE TRADE NAME U CO THIS CERTIFIES THAT (Name oe Licensee) ci U 0 U N M 0 O D E 2 v F aJ U) CU Ii N Q.) a 4▪ 4 .0 O O N LOCATED AT STATE LICENSE No. 0 O U 0 cc ENTERTAINER IA. H C) AH U q DATED AT DENVER, COLORADO THIS 28th DAY OF Z 0 N LL 1 0 CIu -w z au NQ N 0 (nu. <2 CLw Ott L.'. ILO % t w 7 0-i } (Rev. 10/75) THIS PERMIT MUST BE POSTED CONSPICUOI 'SLY ON LICENSED PREMISES ORL 433-ar DR C so4 (Mel'.. 8/79) STATE OF COLORADO DEPARTMENT OF REVENUE/LIQUOR ENFORCEMENT APPLICATION FOR A LIQUOR LICENSE DATE OF ISSUANCE OF LICENSE: LIQUOR LICENSE NUMBER: EXPIRATION DATE: This application, and all applicable fees and attachments, must be filed with the Colorado Department of Revenue, Liquor Enforcement Division, State Capitol Annex, 1375 Sherman Street, Denver Colorado 80261, (303) 839-3741. Each applicant (including all general and over 5% limited partners of partnership and all officers, directors and over 5% stockholders of a corporation) and managers must complete and file form DRL 404-I, "Individual History Record" in duplicate, with this application. For those retail licenses described in Column A, be ow, this application must FIRST BE FILED WITH AND APPROVED BY THE LOCAL LICENSING AUTHORITY. IMPORTANT: Check the appropriate box for the type of license(s) being applied for. This is an original application and a copy must be kept in your files for reference when applying for renewal licenses. You may attach separate sheets or additional documents if necessary to fully complete this application. COLUMN A ❑ RETAIL LIQUOR STORE LICENSE -City ❑RETAIL LIQUOR STORE LICENSE -County ❑ LIQUOR LICENSED DRUGSTORE -City ❑ LIQUOR LICENSED DRUGSTORE -County _ ❑ BEER & WINE LICENSE -City ❑ BEER & WINE LICENSE -County ❑BEER& WINE LICENSE -Resort Hotel ❑ CLUB LICENSE ❑ HOTEL & RESTAURANT LICENSE -City & County State Fees Local Fees COLUMN B ' State Fees $177.50_ $ 22.50 262.50 177.50 262 50 152.50 237.50 170.00 110.00 301.25 TAVERN LICENSE -City & County 301.25__ ❑ RACE TRACK LICENSE 301.25 ❑ARTS LICENSE 110.00 ❑EXTENDED HOURS SPECIAL LICENSE (Beer and Wine, 170.00_ Hotel and Restaurant, Club, Tavern, and Arts) ® CHANGE OF CORPORATE STRUCTURE 61 ❑ OTHER (Specify) 37.50 22.50 37.50 22.50 37.50 30.00 15.00 48.75 48.75 48.75 15.00 30.00 O LIMITED WINERY LICENSE $ 25.00 ($10,000 bond required) ❑WINERY LICENSE 250.00 ($10,000 bond required 500.00 O WHOLESALE BEER LICENSE (May require bond) ❑ WHOLESALE LIQUOR LICENSE ($10,000 bond required) ❑ MANUFACTURER LICENSE 1,000.00 ($10,000 bond required) ❑ IMPORTER'S LICENSE 250.00 ❑ BREWERY (BEER) LICENSE 250.00 ❑ PUBLIC TRANSPORTATION LICENSE _each 25.00 (Plane, bus, car) 1,000.00 The undersigned hereby makes application for a state license as indicated above under the provisions of Title 12, Article 47, CRS 1973 as amended, and for that purpose makes the following answers to the questions contained in this application. Every applicable question must be answered. Any false answer or statement made by the applicant herein or in an attachment hereto constitutes perjury and the person making such false statements subjects any license issued herein to revocation. ALL ANSWERS MUST BE PRINTED IN BLACK INK OR TYPEWRITTEN 1. Name of Apptcant(s): g M_UNA n\ c Social Security or Taxpayer I.D. No.: 2. Trade Name of Establishment: '(h e C r*e_c k e s% 3. Address of Premises: (Exact location of premises must be given. Give street and number, when possible. If' place to be licensed is located in a town or rural dis- trict where it is impossible to give street and number, the lot and block number or part of section where located must be given.) 0%30 to v_e n,, e. City: Once 4. Mailing Addreesss::(Nu)ber and Street) Countty:, _ 4d4 State: C�1ec'cLEe City or Town: 5. Are these premises now .j icensed under the State Liquor or Beer Code? If answer is "yes", to whom is the license issued? EKES ❑NO !� Trade Name of Establishment: T State License No.: "Mt WVi. 6. Does the applicant have legal pos ❑YES ❑NO Business Telephone: Zip Code: Zip Code: 14- x1979 on of the premises for which this application for • Type of License: ' Expiration Date' 'ravecn 7. 19 -es cense s made? If answer is "no", explain in detail. Page 1/4 Continued 7. Are the premises owned or leased? t-1 If leased, from whom? OWNED ®LEASED Rc4ar -The �-Nn1A Wt s,A Attach copy of deed, lease or contract, and interior plans and specifications of building, if built, or if not built, attach plot plan, interior sketch and architect's drawing of the building to he constructed 8. If this is a transfer of location, on what date do you plan to move? 9. Has the applicant filed a Form 11 with the Internal Revenue Service? If answer is "no", explain in detail. ® YES ONO 10. Is applicant, or all over 5% partners; or officers, over 5% stockholders or directors of the corporation; citizens of the United States? If answer is "no", give name and Alien's Registration Card Number and Premanent Residency Card number. YES ❑ NO 11. Is the applicant; or any of the over 5% partners; or officers, over 5% stockholders or directors of said applicant (if a corporation); or manager of applicant; under the age of twenty-one years? DYES NINO 12. Has the applicant; or any of the over 5% partners; or officers, over 5% stockholders or directors of said applicant (if a corporation); or employees of applicant; or persons lending assistance or financial support to the applicant; ever been convicted of a crime? If answer is "yes", explain in detail. Ei YES ELNO 13. Has the applicant; or any of the over 5% partners; or officers, directors or over 5% stockholders of said applicant (if a corporation): or employees of applicant; ever (a) been denied an alcoholic beverage license? DYES ® NO (b) had an alcoholic beverage license suspended or revoked. ❑ YES I NO If answer is "yes", explain in detail; (Attach separate sheet if necessary.) 14. Does the applicant have a Colorado State Sales Tax Account? If answer is "yes", give Account number. ▪ YES ONO Aw F permit Do the applicable zoning laws permit the sale of alcoholic beverages on the licensed premises? ®YES ONO 17, Does or did the applicant; or any of the partners; or officers, directors or stockholders of said applicant (if a corporation), have a direct or indirect interest in any other Colorado Liquor license (include loans to or from any licensee, or interest in a loan to any licensee)? If the answer is "yes", explain in detail, No 16. Has a retail liquor license for the licensed premises been refused within the preceding two years? DYES ®NO 18. Identify the persons, firms or corporations who now or will have, a financial interest, evidenced either by loans or equity ownership in the business for which this license is requested. State the names and addresses, and the amount and source of such financial interest expressed in dollars or other items of value, such as inventory, furniture or equipment, (Use separate sheet if necessary) Name: Address: 1....,.... arbac�a Gic\\; OTh aso% e,11Dt}hS1„.„4 Rss.d A lo,crcr VI 1 une ��,\ti krin"Son._ ._._.._ __ wts+ 1" Skvtt� 3 ►6,�orc Name: Business: previous question are materially interested, (Use separate sheet if necessary): Address: 0\64 0143 51- Attach copies of all notes and seeljrity instruments, and any written agree t or details of any oral agreement, by which any person (including a corporation) vii share in the profit or gross proceeds of this establishment, and any agreement relating to the business which is contingent or conditional in any way by volume, profit, sales, giving of advice or consultation. 20. Are the licensed premises located within 500 feet of any premises occupied by a public or parochial school, or the principal campus of any college, university or seminary? If answer is "yes", answer in detail. YES ®NO 21. Does the applicant for a Liquor Licensed Drug Store have a Drug Store License issued by the Colorado Board of Pharmacy? If answer is "no", explain in detail. YES ONO t 22. Is the applicant, or does the applicant for a Liquor Licensed Drug Store employ a Registered Pharmacist in the State of Colorado? If "yes", give License No. DYES ONO .0I(j 23. If the applicant is an individual or partnership, answer the fallowing: (Attach separate sheet if necessary) INDIVIDUAL PARTNERSHIP (a) Name of individual or name and class of each partner: Home Address and City: Date of Birth: % of ownership: (b) Name of Manager: • Icl If oartnershinwhen di :d ...,...-..w:.. ----- Home Address and City: Date of Birth: s affidavit) tluing business? (Att ach a copy of the partnership agreement (except husband and wife) and trade name Pag*-204 -,1 'Attach the management agreeme ▪ written, or if none, attach a statement setting tartar:uties, terms and compensation of the mansger. Continued • a > .;k OBL 404/Continued) 24. If the applicant is a corporation, answer the fc` 19: ' (a) Corporation is organized under the laws of the State of: rt a AC (b) Principal business is conducted at: °)() lfat� Je��e Cmt-e.v.1r: (c) Date of filing last annual corporate report to the secretary of sta County of: \ 1A State of: Date: (d) Name of each officer listed below: President: atAMfar C,; 04; Home Address and City: as CA -21.0 *''s\t—A C 5e .y G - ,I(3 Date of Birth: ( Vice -President: t .. /I Juhere\it\K ,., cc -,n 44 as ‘.1.._\ 1 ti.S3, G,etifj, cA511, ► Secretary: W• \h late t tnSorl tt I ( I f Manager•: go t bix �G G. 1t: at,t.t. k-U:lktr. c., Same as cal-)Ls%)e_ (e)List ail stockholders: Include actual owner or /[� Name of Stockholder: er /(2)far‘ L)Qr1-CI. (-a_ G (a?, ;c,t pledgee. (Use separate sheet if necessary) Home Address and City: 1 ` (� l /+ d.%c ale 4, A\ rA UW.siVe k £1 IO % of stock: So 70 Date of Birth: n ( Names of all Directors or Trustees tn� of Corporation: CJc�- nrd Gtc�;� � Home Address and City: aSOS Q10 1-i, s_.\- rQ Date of Birth: 6)- Attach a'copy it l h,i certificitte of incorporation, the articles of incorporation, stock certificates, the authority to transact business in Colorado (if a foreign corporation); and the curparata minutes authorizing the filing of this application and electing the current officers and directors, or trustees). 25. When did zppl cantin,urcha! this business, or If new, when does app l leant plan to begin operating this business? If purchased, from whom? 0�e) k-c4..'a acc3K i ar\ oh 1 -au- 6 \ censer, orrcLv kd �r�c ��t w\per t 26. f this application is for a Club Li uor License, answer the fol owing: (a) Complete items 24 (a) through (d) and (f) and file all attachments described under item 25. (b) Is the applicant organization operated solely for a national, social, fraternal, patriotic, political or athletic purpose and not for pecuniary gain? DYES [ZINO (c) How long has the club been incorporated? NIa (d) How long has applicant occupied the premises to be licensed as a club? NIA 27. If the applicant is a manufacturer, importer or wholesaler, answer the following: (a) Does applicant own, lease or operate any wa ehouse or storage plant in connection with its business?(if "yes", give full address) DYES ❑NO (b) If the applicant is an importer or manufacturer, does any owner, part owner, shareholder, director or officer have any direct or indirect financial interest in an importer, manufacturer, wholesaler or retailer already licensed by the State of Colorado to sell malt, vinuous or spirituous liquor? If answer is "yes", attach explanation in detail. DYES ONO (c) It the applicant is a wholesaler, does any owner, part owner, shareholder, director or officer have any direct or indirect financial interest in a wholesaler, retailer, manutacturer or importer already licensed by the State of Colorado to sell malt, vinuous or spirituous liquor? If answer is "yes", attach explanation in detail. DYES ONO (d) If the applicant is an importer or manufacturer, to what Colorado licensed wholesaler do you intend to ship your merchandise? (e) If the applicant is an importer, are you the primary source of supply in the U.S.? ❑YES NO (f) (fl Does the applicant have a valid Federal Basic Permit? If "yes", attach a copy of the permit; if "no", explain in detail. DYES NO Page Page 3/4 •Attach the management agreement, if written, or if none, attach a statement setting forth the duties, terms and compensation of the manager. Continued AFFIDAVIT This affidavit is to be signed and acknowledged by individual, each general partner or partnership and by corporate applicants. STATE OF COLORADO SS. COUNTY OF WELD Barbara Gigliotti and being by me first duly sworn, if for himself, deposes and says: that he is the applicant above named, or a general partner, or that he is (title) President of the above named corporation; that he has read the foregoing application and attachments, and that he knows the contents thereof, and that all matters and things therein set forth are true of his own knowlegde and he agrees to conform to all the rules and regulations promulgated by the State Department of Revenue in connection therewith. Subscribed and sworn to me this I:M .19 82 (Signature of P ic) ��3�Y�' Ave., Greeley, CO 80631 (AFT ix SEAL) My co&roi,I ssiPanlerq r/Ps�,r tc:/y1y, Corry�3i :Jr, Expiry 1C... 1,1�.' I/``,\\. !\`; 11111111111 INDIVIDUALS AND ALL GENERAL PARTNERS OF PARTNERSHIPS MUST -SIGN HERE: CORPORATIONS SIGN HERE: (Corporate Seal) REPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY (MANUFACTURERS, IMPORTERS, WHOLESALERS DISREGARD THIS SECTION) The foregoing application has been examined and the premises, business conducted and character of the applicant is satisfactory, and we do re- port that such lic'nse, if granted, will meet the reasonable requirements of the neighborhood and the desires of the inhabitants, and complies with the provisi.�. of Title 12, Article 47, CRS 1973 as amended. THEREFORE THIS APPLICATION IS HEREBY APPROVED. DATED AT' BY this 1? day of (Name V Town, City and County) �Lfi i i"2%/!Ai/2isJ A.D 1 yytt-- APPROVAL OF STATE LICENSING AUTHORITY (JAfyor, hairman of Board of county commissioners or oth itle of the licensing authority.) ATTEST: at41lI4m/. (clerk, secr ry of other officer having the official seal of the ice - ing authority.) DEC 231982 If the premises are located within a town or city, the above approval should be signed by the mayor and clerk; if in a county, then by the chair- man of the board of county commissioners and the clerk to the board, If, by ordinance or otherwise, the local licensing authority is some other - official, then such approval should be given by such official.) Page 4/4 '/'•� r STATE OF COLON --:ADO DEPARTMENT OF REVENUE/I. IOUOR ENFORCEMENT APPLICATION FOR A LIQUOR LICENSE This .4)p1 cation end all applicable fees and attachments, must be •,L d with the Colorado Department of Revenue, Liquor Enforcement Dit s. en, State Capitol Annex, 1375 Sherman Street, Denver Col He 30761, (303) 839-3/41. E,ch applicant (including all general and over 5% limited partners of per' ersh'-p and all officers, directors and over 5% stockholders of a c(c:aesatloal and m inegms must ccnlplete and file form DRL 404-I, "InuHicival History Record" in duplicate, with this application. COLUMN A DATE OF ISSUANCE OF LICENSE: ENSE LlOUOR LICENSE NUMBER: Cat )),N JAIE. For those etail licenses described in Column A,be m:', this p'ketion 'must HEST IF FILED WITH AND APPROVED BY Tf, - I.1_OCAI_ I I( ICYINC, AUTHORITY. IMPORTANT: Check the appropriate box for the type of lic-mee(s) being applied for. This is an original application and a copy must be kept in your files for reference when applying for Ieneveal IC -crises. You may attach separate sheets or additional documents if :iccessasy to fully complete this application. m. State Local Fees.......,..-�.. ,.......,..,.,.., _.._. Fees Fees COLUMN B ❑ RETAIL LIQUOR STORE LICENSE -City ❑ RETAIL LIQUOR STORE LICENSE -County ❑ LIQUOR LICENSED DRUGSTORE -City ❑ LIQUOR LICENSED DRUGSTORE -County ❑ BEER & WINE LICENSE -City ❑ BEER & WINE LICENSE -County ❑ BEER & WINE LICENSE -Resort Hotel ❑ CLUB LICENSE HOTEL & RESTAURANT LICENSE -City & County TAVERN LICENSE -City & County RACE TRACK LICENSE 301.25 ARTS LICENSE EXTENDED HOURS SPECIAL LICENSE (Beer and Wine, 170.00_ Hotel and Restaurant, Club, Tavern, and Arts) CHANGE OF CORPORATE STRUCTURE OR_ti-OCATION ❑ OTHER (Specify) 5177.50. __ 822.50 262.50 37.50 177.50 22.50 262.50_ 37.50 152.50 22.50 237.50 37.50 170.00 30.00 110.00 15.00 301.25 48.75 301.25_ 48.75 48.75 110.00 15.00 3000 ❑ LIMITED WINERY LICENSE___ (510,000 bond required) ❑ WINERY LICENSE ($10,000 bond required ❑WHOLESALE BEER LICENSE (May require bond) ❑ WHOLESALE LIQUOR LICENSE ($10,000 bond required) ❑ MANUFACTURER LICENSE ($10,000 bond required) ❑ IMPORTER'S LICENSE ❑BREWERY (BEER) LICENSE ❑ PUBLIC TRANSPORTATION LICENSE each (Plane, bus, car) State Fees S 25.00 230.00 °.n0 00 1,020.00 1 030 00 250.00 250-00 5.00 The undersigned hereby makes application for a state license as indicated above under the provisions of Title 12, Article 47, CRS 1973 as amended, and for that purpose makes the following answers to the questions contained in this application. Every applicable question must be answel ed. Any false answer or statement made by the applicant herein or in an attachment hereto constitutes perjury and the person making such false statements subjects any license issued herein to revocation. ALL ANSWERS MUST BE PRINTED IN BLACK INK OR TYPEWRITTEN 1. Name of App icant(s): >C — Nom\1M 1 NvC Social Security or Taxpayer I.D. No.: 2. T,ace Name of Estahlishment: • {V\Q I n."\—r.itt, kl-Lj 2. Address of Premises: (Exact location of premises must be given. Give street and number, when possible. IT place to be licensed i located in a town or rural his. 'dirt where it is impossible to give street and number, the lot and block number or, part of section where located must be given.) Business Telephone: City: G, ' e 1 '2-.1 County: •\1� d A State: C., 1,.; ,_dt. Zp Code: ci--.:.(--.(: ' r 4. Mailing Aodrress: (Nuglber and Street) City or Town: Zip Code: 5. Are these premses now thcensed under the State Liquor Liquor or Beer Code? If answer is "yes", to whom is the license issued? EKES ❑No O{'ll ` \'\\ \ 1.\\O Trade Name of Establishment: State License No.: (� Type of License: Esoiration Date: i P C'Ve /4 >�i`i l -t ---r-,---,,,',._.,-,-, '7- i9 f; 6. Does the apollcant have legal possession of the premises for which this application for license is made' If answer is "no". explain in detail. ❑ YES ❑ NO Page 1/4 Continued sid? Ifefm.-.i, f ..rron1? r,E L,.C' SD I \\ \ l , ,I 1 I I_ of o ct, d t n s 1 q..5' f isu Iding, if t, or if not I h of p an, h v. :: r I. y I" Leg to l.e Cucynatructed '. It Ms se ire Ye, oflccaYror at dare do you Prst to Hove? . r..a tl e afro!. -term filed a Form 11 with the Internal Revenue Service? If answer is"to", explain in detail. YES LINO p_ I. ;nt', or all over Ss, He -triers: or otiicers over EiN stockholders or rim .tors of the ore a Mph; t, nt. s of ;he unite S:at_s? d Abor ,eg:stra;ion Carl Nurrdier arid Prerransrat R. s...-n_y Card number. YES ❑ NO 11. Is to applicant, or any of the over 5N partners; or officers, Me age of tdienty one years? DYESNNO 12, Nes The applicant;or :my ut the or persons lendingnas t:,i e or fir DYES NINO 3. H: s the applicant; or any of the over 5°6 partners; or oft ockhoiders or d —Mors of seld ;aplican fa cor-o,etion); or manager of of officers, ,1- stockr-aI.l do ^ i dapi,cant (1a no the I „rti ester :aryl ir ? If knacker is Y's '. e> I I_ n re , directors or over 5,;, stockho d, s of said applicant (if a corporation); or employees Of ar ph ;mt. (a) been denied an alcoholic beverage license? OYES (b) had an alcoholic beverage license suspended or revoked. ❑ YES If enterer is "yes", explain in detail; (Attach separate sheet if necessary,) INC) NMI) O 14. Does the applicant have a Colorado State Sales Tax Account? It answer I DYES ONO Bk "Lxt=\ 15. Do the applicable zoning laws permit the sale of alcoholic beverages on the licensed premises? "yes give Account number. 16. Has a retail liquor license for the licensed premises Leen refused within the preceding two years? DYES ❑NO El YES ©NO 17. Does or did the applicant: or any of the par tners: or officers, di:enters or stockholders of said applicant (if a corporation), have a direct or indirect intern st in any other 11Coinrado Liquor license linclude loans to or from any licensee, or interest in a loan to any licensee)? If the answer is "yes", explain in detail, r 18. Identify the persons, firms or corporations who now or will here, a financial interest, evidenced either by loans or equity ownership in the business for which tees license is requested. State the names and addresses, and the amount and source of such linen( lal interest expressed in dollars or other items of serre, such as inventory, furniture or equipment, ( Use separate sheet if necessary) Name. Address: Interest: )c;c\ c t'Cl ( tC 1c\; c' \-� \ •'�`JL�,� ,�11.5 C\lei'1 �r.. n.d ' I(` (�(-��1_ S 4.11; k`ic, r/ 5 rmlr«_V U:f (CC' 19_ List the naines and addresses of all businesses in which any of the persons in the previous question are materially interested. (Use separate sheet if necessary): Name: Rosiness: Address: C/ [ \ Nix ` Si - % �`�'\ 1t" � 1 r. V' m c _ I I I VYI \ . i � �^ �` �.{ . c \ c -n L\ L ` L � Lam- iLy Attach copies of all notes and secdrity instruments, and any written agreement or details of any oral agreement, by which any person (including a corpol ation r will share in the profit or gross proceeds of this establishment, and any agreement relating to the business which is contingent or conditional in any way by volume, profit, sales, giving of advice or consultation. 20. Are the licensed premises located within 500 feet of any premises occupied by a public or parochial school, or the principal campus of any college, unne airy or seminary? If answer is "yes", answer in detail_ D YES [23 NO 21. Does the applicant for a Liquor Licensed Drug Store have a Drug Store License issued by the Colorado Board of Pharmacy? If answer is ''no", explain in detail. DYES ONO loin 22. Is the applicant, or does the applicant for a Liquor Licensed Drug Store employ a Registered Pharmacist in the State of Colorado? It "yes", give License No. DYES ❑ NO rec. Itj 23. If the applicant is an individual or partnership, answer the following. (Attach separate sheet if necessary) INDIVIDUAL D PARTNERSHIP - (al Name of individual or name and class of each partner Home Address and City. Date of Birth: er of ownership Pal Name or Manager * Home Address and City: Tate o' Birth: nen dip said part-ersh,o commence doing pus.. ess? (Attach a copy of the partnership agreement l ex rem husband and .vile) and red ti_ . 404 •Gene y .. •�4. It-. , . r int is a Lrj•porasite, aes.+er :).e f•. •,. :Ding~ rat C'':,;,f . n is r, n::nA u,•a.:r the laves o• the State of: D :e. �...! �. l ' 1:_C1. In) Prins ii,d1 I, • ss rs rr,•srlu te,l ,rte ' _ 1v.1., ► ._ 1, L�_1.� (c) —Cate c.f filing last annual rorpor;,te retort to the secretary of sta- County of: - rd) Name of each officer listed below: President: /: 1 l - V;ce P:ec.uent: T•easu,er: 1/ • t�▪ Manager••j .� '-,tif INC (elList all stockholders: Include actual owner or pledgee. (Use separate sheet if necessary) Home Address and City: Secretary: Home Address and City: • Na,ne of Stockholder: A (f) Names of all Directors or Trustees of Corporation: rt ,t_, c,\- (-A ,t -t?.. ��, ( ,, State of: Date of Birth: _ . % of sock: Date of Birth: C•C; ( - ._)� � s\.� � iN 1y•-1 Home Address and City: :)1r,► -h _� �f•1 Lk:: '7)-4. •.* Date of Birth: Attach a copy of tl•e certificate of incorporation, the articles of incorporation, stock certificates, the authority 10 transact business in Colorado (if a foreign corporation), and the corporate minutes authorizing the filing of this application and electing the current officers and directors, or trustees), 2 .• ��. 2b. 6 Vhen did applicant purchase this business, or if new, when does applicant plan to begin operating this business? If purchased, from whom? �• 1t : •f. t.,i: `. r� l: I " rk Z-..l_i ....X\ Y[�q '1 '.+,�� ' �,. t -..1 v1.•• t e. 11r•rt ( fYc � \ 26. f this application is for a Club Liquor License, answer the following. (a) Complete items 24 (a) through (d) and (f) and file all attachments described under item 25. (b) Is the applicant organization operated solely for a national, social, fraternal, patriotic, political or athletic purpose and not for pecuniary gain? DYES ZINO (c) How long has the club been incorporated? (d) How long has applicant occupied the premises to be licensed as a club? 27. If the applicant is a manufacturer, importer or wholesaler, answer the following: (a) Does applicant own, lease or operate any warehouse or storage plant in connection with its business?(if "yes", give full address) YES ONO (b) If the applicant is an importer or manufacturer, does any owner, part owner, shareholder, director of officer have any direct or indirect financial interest in an importer, manufacturer, wholesaler or retailer already licensed by the State of Colorado to sell malt, vinuous or spirituous liquor? If answer is "yes", attach explanation in detail, El YES ❑NO (c) If the applicant is a wholesaler, does any owner, part owner, shareholder, diiector or officer have any direct or indirect financial interest in a wholesaler, retailer, manufacturer or importer already licensed by the State of Colorado to sell malt, vinuous or spirituous liquor? If answer is "yes", attach exp'anatior in detail. DYES No Id) Id) If the applicant is an importer or manufacturer, to what Colorado licensed wholesaler do you intend to ship your merchandise? (e) If the applicant is an importer, are you the primary source of supply in the U.S.? YES NO (1) Does the applicant have a valid Federal Basic Permit? If"yes", attach a copy of the permit; if "no", explain in detail. YES � NO Pege 3/4 • Attach the management agreement, if written, or if none, attach a statement setting forth the duties, terms and compensation of the manager. Continue( n AFFIDAVIT This affidavit is to be signed and ackno:vk:dged by individual, each general partner or partnership and by corporate ai ptirs:nts. STArE OF COLORADO SS. COUNTY OF _ WELD Barbara Gigliotti otti and .s,eii;g by me first duly sworn, if for himself, deposes and says: that he is the applicant above named, or a general partner, or that he is (title)—___Preslant .__.._ ____._of the above named corporation; that he has read the foregoing application and attachments, Lilt! that h knows the contents thereof, and that all matters and things therein set forth are true of his own knowtegde and he agrees to conform to all the rules and r.11ulations promulgated by the State Department of Revenue in connection therewith. Subscribed and sworn to me this 7Ddiay of J1ctobet ,19_ 8? (signature of I JU7 P' h`)Ave. , Greeley, CO 80631 (AFFIX SEAL) My commission, expires: INDIVIDUALS AND ALL GENERAL PARTNERS OF PARTNERSHIPS MUST SIGN HERE: CORPORATIONS SIGN HERE: •t7 7 By: (Corpo•a;c Sea REPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY (MANUFACTURERS, IMPORTERS, WHOLESALERS DISREGARD THIS SECTION) The foregoing application has been examined and the premises, business conducted and character of the applicant is satisfactory, and we do re- port that such lie nse, if granted, will meet the reasonable requirements of the neighborhood and the desires of the inhabitants, and complies with the provisioni of Title 12, Article 47, CRS 1973 as amended. THEREFORE THIS APPLICATION 1S HEREBY APPROVED. DATEDrAT__ i i%`-tom this AT: (Name of Town, City and County) BY: 1? day of ,A.D.t ai (itidd\ (Mayor, chairman of Board of county commissioners or other itle of the licensing authority.) , ATTEST:{{rr? �^.1. �1 ( t1 '.� Q; ��:✓J't./ / C' i � � �—`C �` (Clerk, secre ry of other officer having the official sealof the)'icer}iing authority If the premises are located within a town or city, the above approval should be signed by the mayor and clerk; if in a county, then by the chair man of the hoard of county commissioners and the clerk to the board, If, by ordinance or otherwise, the local licensing authority is some other official, then such approval should be given by such official.) 4-. COLORADO To mEmoRAnDum THE BOARD From THE CLERK TO THE BOARD OFFICE Subject. TAVERN LICENSE Date NOVEMBER 17, 1982 On July 12, 1982, you approved a change of ownership request for Bob -Min, Inc., DBA The Cove. The corporation owners were Robert P. Mimnaugh and Max Edwin Kingsley. On October 26, 1982, we received a change of corporate structure application on this facility. The corporation will remain under the same name, Bob -Min, Inc., the trade name will be The Entertainer, and the new corporate owners are Barbara Jean Gigliotti and June Diane Wilkinson. The Sheriff's office records reflected no problems. The Health Department's records reflected that Barbara Gigliotti has applied for a 1982 food service license. The facility was inspected and they received a score of 96. Mr. Stow stated that the facility was in very good order. Lee Morrison, assistant county attorney, has reviewed this change of corporate structure application and has "found it to be in order. I hope that this memorandum has helped to inform you of what is transpiring. Thank you, Hello