HomeMy WebLinkAbout931123.tiffRESOLUTION
RE: APPROVE CHANGE OF CORPORATE STRUCTURE FOR CONO-SERVICES, INC., DBA CONOCO
#06355, AND AUTHORIZE CHAIRMAN 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, Cono-Services, Inc., dba Conoco #06355, the holder of a 3.2% Beer
License in Weld County, Colorado, has presented the Board with a Change of
Corporate Structure, and
WHEREAS, Cono-Services, Inc., has indicated said change of corporate
structure is as follows: James G. Fuqua, Jr., replaces Keith A. Pichanick, as
secretary and director, and
WHEREAS, after review, the Board deems it advisable to approve said change
of corporate structure.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Change of Corporate submitted by Cono-Services, Inc.,
dba Conoco #06355, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is,
authorized to sign said change.
The above and foregoing Resolution was, on motion duly made and seconded,
adopted by the following vote on the 13th day of September, A.D., 1993.
ATTEST:
Weld County Clerk to the Board
BY:
Deputy Clerk to the Board
APPROVED AS TO FORM:
Attorney
BOARD OF COUNTY COMMISSIONERS
WELL)., COUNTY, COLORADO
Constance L. Harrbert, Chairman
W. Y, Webster, Prro-Tem
2
ge/E. Baxt'r
Dale K. Hall
11,
L
/Barbara J. Kirkmey r O
LCU011
931123
DR 8176 (09/91)
COLORADO DEPARTMENT OF REVENUE
Liquor Enforcement Division
1375 Sherman Street
Denver, CO 80261
303-866-3741
REPORT OF CHANGES
• Use to report change of corporate
-- - structure or change of manager only.
Liquor and 3.2 Beer License • Submit to Local Authority
(Local Authority will submit to State)
DO NOT USE THIS FORM TO REFLECT A CHANGE IN PARTNERSHIP. IF THERE IS A CHANGE IN PARTNERSHIP, USE
THE DR 8404 OR DAL 403 AND FILE A CHANGE OF OWNERSHIP WITH YOUR LOCAL LICENSING AUTHORITY.
ALL LICENSEES FILL OUT THIS SECTION (Press firmly or typs1.,.
SALES TAX ACCOUNT No.
21-35816 -0051
APPLICANT NAME
CONO-SERVICES, INC.
LICENSE NUMBER
21-35816 -0051
TRADE NAME
CONOCO #06355
TELEPHONE NUMBER
659-7290
ADDRESS OF LICENSED PREMISES:
Street Address 12435 WELD COUNTY RD #2 City BRIGHTON State CO Zip 80601
MAILING ADDRESS: ATTN: WARNER KRAATZ
Street Address P.O. BOX 4784—TR3036 City HOUSTON State TX Zip 77210
CHANGE OF CORPORATE E STRUCTURE (Applies to corporate licensees only) MUST attach a certificate of Good Corporate standing;
and, for each NEW officer, director, and stockholder, MUST attach a DRL 404-I, Individual Fistory Record and Copy of Minutes.
NAME of NEW corporate officers & directors:
HOME ADDRESS
D.O.B.
REPLACES (Name):
President
Vice President
Treasurer
Secretary JAMES G. FUQUA, JR.
3605 E. WHITE BAY DR, HIGHLANDS RANCH
12-15-4:
KEITH A. PICHANICK
NEW STOCKHOLDERS/TRANSFERS OF CAPITOL STOCK
HOME ADDRESS
D.O.B.
% OF STOCK NOW OWNED
NEW DIRECTORS:
HOME ADDRESS
D.O.B.
REPLACES (Name):
JAMES G. FUQUA, JR.
PLEASE SEE ABOVE
KEITH A. PICHANIIX
CHANGE OF MANAGER (For Beer & Wine, Tavern, Club, Arts, Racetrack and all 3.2 Beer -except "Off Premises")
HoleVRestaurant Licensees must submit a DR &J67, Managers Registration
FORMER MANAGER: Name WLE°�,
A,GICED
NQ
Date of Birth
NEW MANAGER: Name 1nr1r]
DC T 1 A 1393
Date of Birth
OATH OF APPLICANT SL
I declare under penalty of perjury in the second degree that I have read this report and all attachments thereto and that I know the contents hereof,
and that all matters and information set forth therein are true, correct and complete to the best of my knowledge and information- and I agree to
conform to all applicabled all rules and regulations promulgated by the Colorado Department of Revenue in connection therewith.
pDSIGJ
T SIDE if yq [ion)
DATE:.?
REPORT OF LOCAL LICE ING AUtH RITY
The foregoing changes have been received and examined by the Local Licensing Authority.
LOCAL LICENSING AUTHORITY I.D. NUMBER:
84-6000813
LOCAL LICENSING AUTHORITY FOR: u COUNTY
WELD COUNTY, COLORADO ■ TOWN/CITY
SIG RE
1/���-,
TITLE CHAIRMAN, WELD COUNTY BOARD
OF COMMISSIONERS
DATE
09/13/93
,� !L/
A EST O ��K
ZIGu�l Lmer,
/J /
BY:1/ �r _t j ��'�" ex:
tom4v
DATE
09/13/93
CLERK 0 THE BOARD \1
DEPUTY
Note: Local authority, for corporate structure changes, please submit all copies to the Liquor Enforcement Division. One
copy will be returned to the applicant and one to the local authority upon acknowledgement.
For change of managers, submit one copy to the Liquor Enforcement Division, retain one copy for local lic 931 12 3
DILL DILL CARR & STONBRAKER
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
September 1, 1993
Carol Harding
Weld County Commissioner's Office
P.O. Box 758
Greeley, CO 80632
Re: Cono-Services Inc.
Daniel F. lironslrin John A. Huk hing,
Daniel W. Carr L<.Ile Block ICA))
El. Alan Dill Ca*ey I). Paoli ii
Robert A- Dill Ion Stonbrakar
Thomas NI. Dunn Pain( k U_ Toolev
Dear Carol,
Enclosed are applications for a change of corporate structure for
Cono-Services Inc. d/b/a Conoco. Mr. Fuqua is replacing Mr.
Pichanick as secretary and director. We will send letters of
reference as soon as they are available.
We are in the process of applying for a new Master File letter from
the Department of Revenue. We will send you copies when we receive
it.
Please let me know if you have any questions,
Sincerely,
Lois Rentz
Paralegal
1r/kg
encl.
455 SHERMAN STREET, SUITE 300 / DENVER, COLORADO 80203 / FAX (303) 777-3823 / (303) 777-3737
3-31123
DR 8481 112/921
STATE OF COLORADO
LIQUOR ENFORCEMENT DIVISION
Deoanment ca Revenue
1375 Sherman Street. Room rrtN
Denver. Coloraao 61):61
Phone .103)866-174)
FAX 303)866-3541
Sept 7, 1993
Cono-Services, Inc.
d/b/a Conoco
P.O. Box 4784-TR 300
Houston, TX 77210
Re: Chain Store Application for Cono-Services, Inc., d/b/a Conoco.
Dear Sir or Madam:
This is to advise you that the State Liquor Enforcement Division has, at your
request, created a "master file" for the above -listed applicant.
As of the date of this letter our master file includes the following items which you
have submitted:
1. Individual History Records (Form DR -404I) for the following
persons:
David Charles Rising
Robert B. Merchant
Keith A. Pichanick
James G. Fuqua, Jr.
DOB
2. Fingerprint cards bearing the names and birthdates of the persons
listed in paragraph 1, above. Ail the fingerprint cards have been
submitted by us to the Colorado Bureau of investigation. The CBI
and FBI have checked the prints and reportedly found no record of
any criminal history.
This Division has not received the fingerprints results back for
JAMES G. FUQUA, JR. his prints were submitted to CBI on
Sept. 9, 1993.
3. Certificate of Authority or a Certificate of Good Corporate standing
from the Colorado Secretary of State which indicates that Cono-
Services, Inc. d/b/a Conoco is a corporation authorized to do
business in Colorado.
Rov Romer
Governor
Ronny i.pan
('ecuine Director
David C. Reitz
favlsion Director
WHERE EXCELLENCE ADDS UP
COLORADO DEPARTMENT OF REVENUE
931. 123
Cono-Services, Inc.
d/b/a Conoco
Sept 7, 1993
Page 2
You must check with the local licensing authority to determine what documents
they may require of you to process your application. Please feel free to provide
them with a copy of this letter, as many local authorities will not require you to
submit fingerprint cards to them if you have already submitted such documents
to the State Liquor Enforcement Division. This letter will serve to inform the
local authorities exactly which documents you have already submitted to the State
Liquor Enforcement Division.
Finally, once the local authority has approved your application, it must be sent to
the Liquor Enforcement Division. The only documents which are needed by the
Division are:
1. The approved application signed by the local authority;
2. The appropriate fees;
3. A copy of this letter,
4. Proof of possession of the premises;
5. A diagram of the licensed premises;
6. Completed form DR 8367, if manager's registration is required
Sincerely,
Matt D. Cook
Licensing Administrator
div-cor-4
conoco5.mas
931123
DR 8404-I (07/92)
COLORADO DEPARTMENT OF REVENUE
LIQUOR ENFORCEMENT DIVISION
1375 SHERMAN STREET
DENVER CO 80281
INDIVIDUAL HISTORY RECORD
To be completed by each Individual applicant, each general and over 5% limited partner of a partnership, each officer, director, and
over 5% stockholder of public corporation, over 5% limited liability company memberslpersons and managers
NOTICE: This individual History Record provides basic information which is necessary for the licensing authorities investigation. ALL
questions must be answered in their entirety. EVERY answer you give will be checked for its truthfulness. A deliberate falsehood will
jeopardize the application as such falsehood within Itself constitutes evidence regarding the character and reputation of the
applicant.
1. Name of Business
CONO—SERVICES, INC.
Date
3-8-93
Social Security Number
2. Your Full Name (last, first, middle)
FUQUA, JAMES GORDON, JR.
3. Also Known As (maiden name/nickname, etc.)
JIM FUQUA
4. Mailing Address (if different from residence)
SAME
Home Telephone
j303) 470-1786
5. Residence Address (street and number, city, state, zip)
3650 E. WHITE BAY DR., HIGHLANDS RANCH, CO 80126-5005
6.
Is your residence O owned
■
rented
If rented, from whom?
N/A
7. Date of Birth
Place of Birth
AMARILLO, TX
8. U.S. Citizen?
El Yes ❑ No
If Naturalized, slate where
N/A
When
N/A
Name of U.S. District Court
N/A
Naturalization Certificate Number
N/A
Date of Certificate
N/A
9 an Mien, Give Alien's Registration Card Number
N/A
Pernanera Residence Card Number
N/A
9. Height
6.0"
Weight
220
Hair Color
BROWN
Eye Color
BLUE
Sex
MALE
Race
CAUC.
10.
Do
l
You Have a Colorado Drivers License? If yes, give number
Yes ❑ No
11. What Is your relationeh p to the applicant? (sole owner, partner, corporate officer, director, stockholder, member or manager)
CORPORATE OFFICER AND DIRECTOR
12. If stockholder, number of shares owned beneficially or of record
NONE
Percent of outstanding stock owned
N/A
13.
If partner, state whether
■ General
U
Limited _
Percent of Partnership Owned
N/A
If Limited Liability Company, percent owned
N/A
14. Name of Present Employer
CONOCO INC.
15. Type of Business or Employment
RETAIL GASOLINE/CONVENIENCE MARKETER
16. Address of Business Where Employed (street number, city, state, zip)
6855 S. HAVANA, STE. 600, ENGLEWOOD, CO 80112
Business Telephone
(303) 649-4022
17. Present Position
RETAIL MARKETING MANAGER
18. Marital Status
MARRIED
19. Name of Spouse (Include maiden name If applicable
FREDNA ROSS
20. Spouse's Dale of Birth
Spouse's Place of Birth
CLINTON, SOUTH CAROLINA
21. Spouse's residence address, if different than yours (street and number, city, state, zip)
SAME
22. Spouse's Present Employer
BEVERLY ENTERPRISES INC.
Occupation
FINANCIAL CONSULTANT
23. Address of Spouse's Present Employer
BEVERLY ENTERPRISES, SOUTMEASTERN REGION, STE. 101, 3483 SATELLITE BLVD, DULUTH, GA 30136
24.
List the name(s) of all relatives working in the liquor industry.
Name of Relative
Relationship to You
Position Held
Name of Employer
Location of Employer
NONE
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rnununcnr.0 n r..r....r.m..-
25. Do you now, or have you ever held a direct or indirec est
WITH RESPECT:
in a State of Colorado Liquor or Beer License? If yes wer in detail
CGNO-SERVICES, INC. WHICH H01... NUMEROUS 3.2% BEER LICENSE:.
.O
''� Yes NO
❑
IN COLORADO.
26. Do you now, or have you ever had a director indirect interest
yes, describe in detail.
1) CONOCO INC. PARENT
in a liquor or beer license, or been employed in a liquor or beer related business outside the State of Colorado? If
COMPANY OF LICENSEE, HOLDS NUMEROUS TYPES OF LICENSES
2) FAS GAS RETAIL SERVICES OF TEXAS.
7 Yes ❑ No IN VARIOUS STATES.
27. Have you ever been convicted of a crime, fined, imprisoned, placed on probation, received a suspended sentence or forfeited bail for any offense in criminal or military court? (Do
not indude traffic violations, unless they resulted in suspension or revocation of your drivers license, or you were convicted of driving under the influence of alcoholic beverages.)
If yes, explain in detail.
❑ Yes j7 No
28. Have you ever received a violation notice, suspension or revocation
CONO—SERVICES,
fora liquor law violation, or been denied a liquor or beer license any wherein the U.S.? If yes, explain in detail.
INC. HAS RECEIVED VIOLATION NOTICES AND/OR SUSPENSIONS OF
LICENSES.
Yes U No SOME OF ITS BEER
29. Have you ever held a gambling or gaming license or owned a
Federal Gambling Stamp? If yes, explain in detail below.
❑ Yes .7 No
State/Federal
Year
City
State
State/Federal
Year
City
State
30 Military Service (branc))
U.S. ARMY
From
1964
To
1967
Sena! Number
Type of Discharge
HONORABLE
31.
List all addresses where you have lived for the past five years. (Attach separate sheet if necessary)
Street and Number
City, State, Zip
From
To
3650 E. WHITE BAY DRIVE
HIGHLANDS RANCH, CO 80126-5005
1992
PRES.
22506 UNICORNS HORN LANE
KATY, TX 77449
1989
1992
5825 ROYAL OAKS DR.
SHOREVIEW, MN 55126
1983
1989
32.
List all former employers or business engaged in within the last five years. (Attach separate sheet if necessary.)
Name of Employer
Address (street, number, city, state, zip)
Position Held
From
To
CONOCO INC.
600 N DAIRY ASHFORD RD, HOUSTON TX
VARIOUS/
1971
PRES.
MANAGEMENT
33.
List the names of persons who can vouch for your good character and fitness in connection with this application.
Name of Reference
Address (street, number, city, state, zip)
Number of Years Known
CHARLES TITLOW
3516 WOODLARK DR., ROSWELL, GA 30075
12
HAZEL & TOM HANDLER
17205 HIDDEN GLEN, DALLAS, TX 75248
17
PASTOR MICHAEL MILLER
5050 HODGSON RD., SHOREVIEW, MN 55126
10
OATH OF APPLICANT: I declare under penalty of perjury in the second degree that I have read the foregoing application and all attach-
ments thereto, and aSt to thebestof my knowledge.
therein is true, correct, and complete
that
�/to
���t.GtY/ / Iti (/�, A i
�plet
��Sig
TitlYti'//iYlNt % "(//ni�7'r///f . -
Date _/ h�
9."1.1 ti3
DEPARTMENT OF
STATE
CER Tlh ICATE
I, NATALIE MEYER, Secretary of State of the State of
Colorado hereby certify that
According to the records of this office
CONO-SERVICES INC.
(COLORADO CORPORATION)
file # 871461256 was filed in this office on JANUARY 14, 1982,
and has complied with the applicable provisions of the
laws of the State of Colorado and on this date is in good
standing and authorized and competent to transact business
or to conduct its affairs within this state.
Dated: MARCH I8, 1993
SECRETARY OF STA
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CONSENT ACTION OF BOARD OF DIRECTORS
OF
CONO-SERVICES INC.
The undersigned, collectively constituting all of the
remaining members of the Board of Directors of cono-Services Inc.,
a Colorado corporation, hereby consent to the following:
RESOLVED, that the resignation of K. A. Pichanick as a
Director and the Secretary of this Corporation is hereby
accepted; and
FURTHER RESOLVED, that James G. Fuqua, Jr. is appointed a
Director and elected the Secretary of this Corporation.
All of the above actions to be effective JUNE 1, 1993
This written consent is given pursuant to Section 7-5-108
of the General Corporation Law of the State of Colorado.
R. B. Mercha t
Dated:
JUNE 1, 1993
I
9V D. C. Ris g
(3)
931123
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