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HomeMy WebLinkAbout971924.tiffRESOLUTION RE: APPROVE CHANGE OF OWNERSHIP REQUEST FOR HOTEL/RESTAURANT LIQUOR LICENSE FROM SCOTT PYLE, LLC, DBA WAG'S PLACE 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, Scott Pyle, LLC, dba Wag's Place, presented to the Board of County Commissioners of Weld County, Colorado, an application for a Change of Ownership of a Hotel/Restaurant Liquor License for the sale of malt, vinous, and spirituous liquors for consumption by the drink on the premises only, said license previously held by Wag's, Inc., dba Wag's Place, and WHEREAS, pursuant to Weld County Ordinance No. 6, Section II., C., said applicant has paid the required fees to the County of Weld for a Change of Ownership of the existing license, and WHEREAS, said applicant has exhibited a State Liquor License for the sale of malt, vinous and spirituous liquors for consumption by the drink on the premises only, outside the corporate limits of any town or city in the County of Weld at the location described as follows: 4322 Highway 66, Longmont, Colorado 80504-9633 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 97-14 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 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 September 3, 1998, providing that said place where the licensee 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 license. 971924 LC0032 C'L ; So; LaJgs CHANGE OWNERSHIP OF LIQUOR LICENSE - WAG'S PLACE PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 21st day of July, A.D., 1997. ATTEST: Weld County Clerk t BY D-puty Clerk to the Board APPROVE . AS TO FORM: y A ttor Dale K. Hall BOARD OF COUNTY COMMISSIONERS WELD UNTY, CO RADDOO V George t=. Baxter, Chair onstance L. Harbert, ;o -Tam„ EXCUSED Barbara J. Kirkmey9r /11J i; W. H. Webster 971924 LC0032 THIS LICENSE MUST BE POSTED IN PUBLIC VIEW OR 2402 -qro (101921 STATE DEPARTMENT ALCOHOLIC OF COLORADO OF REVENUE Liquor Enforcement Division 1375 Sherman Street Denver, Colorado 80261 SCOTT PYLE LLC WAGS PLACE 4322 HWY 66 LONGMONT CO 80504-9633 BEVERAGE LICENSE Account Number Liability Information AT MIDNIGHT County City Indust. Type Liability Date l LICENSE EXPIRES 24-51454-0000 i 03 206 5813 B 090497 SEP 03, 1998 Type Name and Description of License Fee 1970 2190 HOTEL AND RESTAURANT LIQUOR LICENSE - MALT, VINOUS, AND SPIRITUOUS COUNTY 85 PERCENT OAP FEE $ 50.00 $ 425.00 TOTAL FEE(S) This license is issued subject to the laws of the State of Colorado and especially provision of Title 12, Articles 46 or 47, CRS 1973, as amended. nontransferable and shall be conspicuously posted in the place above described. only valid through the expiration date shown above. Questions concerning be addressed to the Department of Revenue, Liquor Enforcement Division, Street, Denver, CO 80261. �gtestimony whereof, I have hereunto set my hand. jetr CJC ii,v-tn SEP 0 5 1991 Division Director Executive l $ 475.00 under the This license is This license is this license should 1375 Sherman et Director •oo A os idISOSU um4eU 6ulen Jo; noA Mue41 U.S.G.P.O 1989-234-555 PS Form 3800, June 1985 P 387 472 368 RECEIPT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) Sent to St SCOTT PYLE, LLC P. DBA WAG'S PLACE 4322 HWY 66 P` LONGMONT, CO80504 Ce SF _ - Restricted Delivery Fee Return Receipt showing to whom and Date Delivered Return Receipt showing to whom. Date. and Address of Delivery TOTAL Postage and Fees 5 Postmark or Date N ON alp Em U U 24O 8 m — - v B SQ g,) cc m m C N 0 n 2 03 CC V O O O 0 0 m 0 N: a CO M ED V O L) 0 ro 0 -J< O EL J (/) (O H Z dQ O O Q N z co 5. Received By: (Print Name) 0 omestic Return L°PIS SSJSASJ inn uo peteldWOO SS3HOOd 1.18111314 inoA SI 21 Present Trade Name of Establishment (DBA) �s yol 2300 3,99, 2310 212li 2121: 2122 DR 8404 (06/97) Page 1 COLORADO DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION 1375 SHERMAN STREET DENVER CO 80261 COLORADO LIQUOR OR 3.2% FERMENTED MALT BEVERAGE RETAIL LICENSE APPLICATION O NEW LICENSE [TRANSFER OF OWNERSHIP ❑ LICENSE RENEWAL • ALL ANSWERS MUST BE PRINTED IN BLACK INK OR TYPEWRITTEN • APPLICANT MUST CHECK THE APPROPRIATE BOX(ES) • LOCAL LICENSE FEE $ .STS 60 • APPLICANT SHOULD OBTAIN A COPY OF THE COLORADO UQUOR AND BEER CODE(Call 303-3214164) 1. Applicant is applying as a ❑ Corporation ❑ Partnership (includes Limited Liability and Husband and Wife Partnerships) 2. Name of Applicant(s) If partnership, list artners' names (at least two); if corporation, name of corporation �}-�- Sf cud- P/lei / r DO NOT WRITE IN THIS SPACE ❑ Individual `. Limited Liability Company ❑ Association or Other 2a.Trade Name Establishment'(eic c 3. Ad r ss of Premis ai (specify exact location of premises PC( gC-G JAS G C City f 7-- 4. Mailing Address tuber and Street) 32Z ri; c(C 5. If the premises currently have a liquor or beer license, you MUST answer the following questions: t Class of License Cournty�c City or Town State Sales Tax No. ofsttf syooDo State &do/2400 Business, _nc (l[7L to Present State License No. `7/73 00� ❑ Late Renewal Application Fee $500.00 ❑ Application Fee for New License 650.00 ❑ Application Fee -New License Concurrent Review 750.00 g Application Fee for Transfer of Ownership 50. z:` `SECTION B . , _ �,8;2'xir`H�ER i�CENSEf"EES:)` • Retail 3.2% Beer On Premises - (city) ❑ Retail 3.2% Beer On Premises - (county) ❑ Retail 3.2% Beer Off Premises - (city) ❑ Retail 3.2% Beer Off Premises - (county) ❑ Retail 3.2% Beer On/Off Premises - (city) ❑ Retail 3.2% Beer On/Off Premises - (county) $71.25 92.50 71.25 92.50 71.25 92.50 2210-100 (999) 1980-100 (999) 1970-750 (999) No Fee No Fee 1l ❑ Retail Warehouse Storage Permit $75.00 ❑ Addition of Optional Premises to existing hotel/restaurant $75.00 x Total Fee ❑ Managers Registration (hotel & restaurant only) ... $75.00 ❑ 3.2% Beer On/Off Premises Only Delivery Permit ❑ Retail Liquor Store Delivery Permit ZIP Code 8dco"' ZIP Code re re Present Expiration Date 21 ttrION D,. ,° El 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) H & R License ❑city gcounty ❑ H & R License w/opt Prem ❑ city El Club License El city ❑ county ❑ Tavem License ❑city ID county ❑ Arts License ❑ city ❑ county ❑ Racetrack License ❑ city El county ❑ Optional Premises License ❑ city ❑ county ❑ Retail Gaming Tavem Lic ❑city ❑county ❑ Brew -Pub License El Other DO NOT WRITE IN THIS SPACE - FOR DEPARTMENT OF REVENUE USE ONLY AlIONw;i" lcerlse ActoaittNwnber,, 7 TOTAL 2-2-,.1998 $202.50 287.50 202.50 287.50 326.25 411.25 475.00 ID county 475.00 283.75 475.00 283.75 475.00 475.00 475.00 725.00 L -Q 0 032- 971924 DR 8404 (06/97) Page 2 APPLICATION DOCUMENTS CHECKLIST AND WORKSHEET Instructions: This check list should be utilized to assist applicants with filing all required documents for licensure. All documents must be properly signed and correspond with the name of the applicant exactly. All documents must be typed or legibly printed. Upon final State approval the license will be mailed to the local licensing authority. ITEMS SUBMITTED, PLEASE CHECK ALL APPROPRIATE BOXES COMPLETED OR DOCUMENTS SUBMITTED I. APPLICANT INFORMATION • A. Applicant/Licensee identified. • B. State sales tax license number listed or applied for at time of application. • C. License type or other transaction identified. ❑ D. Return original & 2 copies to local authority. • E. Additional information may be required by the local licensing authority. II. DIAGRAM OF THE PREMISES • A. No larger than 8 1/2" X 11". IN B. Dimensions included (doesn't have to be to scale). Exterior areas should show control (fences, walls, etc.). • C. Separate diagram for each floor (if multiple levels). • D. Kitchen - identified if Hotel and Restaurant. III. PROOF OF PROPERTY POSSESSION ■ A. Deed in name of the Applicant ONLY (or) • B. Lease in the name of the Applicant ONLY. ■ C. Lease Assignment in the name of the Applicant (ONLY) with consent from the Landlord proper and acceptance by the Applicant. • D. Other Agreement if not deed or lease. IV. BACKGROUND INFORMATION AND FINANCIAL DOCUMENTS • A. Individual History Record(s) (Form DR 8404-I). r] B. Fingerprints taken and submitted to local authority. (State authority for master file applicants.) • C. Purchase agreement, stock transfer agreement, and or authorization to transfer license. • D. List of all notes and loans. V. CORPORATE APPLICANT INFORMATION (If Applicable) ■ A. Certificate of Incorporation (and/or) • B. Certificate of Good Standing if incorporated more than 2 ago. years ■ C. Certificate of Authorization) foreign corporation. • D. List of officers, directors and stockholders of parent corporation (designate 1 "principal person as officer"). VI. PARTNERSHIP APPLICANT INFORMATION (If Applicable) • A. Partnership Agreement (general or limited). Not needed if husband and wife. VII. LIMITED LIABILITY COMPANY APPLICANT INFORMATION (If Applicable) • A. Copy of articles of organization (date stamped by Colorado Secretary of State's Office). ■ B. Copy of operating agreement. • C. Certificate of Authority (if foreign company). VIII. MANAGER REGISTRATION FOR HOTEL AND RESTAURANT LICENSES WHEN INCLUDED WITH THIS APPLICATION ■ A. $75.00 fee. • B. Individual History Record (DR 8404-I). DR 8404 (06/97) Page a 6. Is the applicant (including any of the partners, if a partnership; members or manager if a limited liability company; or officers, stock- Yes No holders or directors if a corporation) or manager under the age of twenty-one years? 7. Has the applicant (including any of the partners, if a partnership; members or manager if a limited liability company; or stockholders or directors if a corporation) or manager ever (in Colorado or any other state); (a) been denied an alcoholic beverage license? (b) had an alcoholic beverage license suspended or revoked? (c) had interest in another entity that had an alcoholic beverage license suspended or revoked? If you answered yes to 7a, b or c, explain in detail on a separate sheet. officers, __,/ • L7 ■ Ba. Has a liquor license application (same license class), that was located within 500 feet of the proposed premises, been preceding two years? If 'yes; explain in detail. Bb. Has a 3.2 beer license for the premises to be licensed been denied within the preceding one year? If 'yes," explain in denied within the ■ detail. ❑ .1W - 9. Are the premises to be licensed within 500 feet of any public or private school that meets compulsory education requirements of ❑ 0 Colorado law, or the principal campus of any college, university or seminary? 10. Has a liquor or beer license ever been issued to the applicant (including any of the partners, if a partnership; members limited liability company; or officers, stockholders or directors if a corporation)? If yes, identify the name of the business financial interest in said business including any loans to or from a licensee. or manager if a ,/ and list any - ■ L� 11. a. Attach and current Does the Applicant, as listed on line 2 of this application, this license will b iss ed by virtue of ownership, lease in of have legal possession of the premises for at least 1 year from or other arrangement? the date that - • ■ Ownership atLease ■ Other (Explain Detail) expiration, EXACTLY as they appear on the lease:11 f leased, of landlord and tenant, and date }list 1name ` la� kf U t� ye anq t .gc,y.(-.(1y�_ef}" �Jj",tp� I� ( I I Ing pyres r r 2 44 Unjto W C.1 a diagram and outlin he yea to be licensed (including dimensions) which shows the bars, brewery, walls, partitions, entrances, exits dimensions) what each room shall be utilized for in this business. This diagram should be no larger than 8 1/2' X 11". (Doesn't have to be to scale) 12 Who, besides will loan or give money,e ns, irms, partnerships, d lity companies), nvliento in fumituhis re ortion (including equipment to or forusef in this business; or who wl corporations, receive monleyflrom this business. y ry. Attach a separate sheet if necessary. NAME DATE OF BIRTH FEIN OR SSN _ INTEREST Attach copies of all notes and security instruments, any person (including partnerships, corporations, this establishment, and any agreement relating of advice or consultation and any written agreement, or details of any oral agreement, by which limited liabi ity companies, etc.) will share in the profit or gross proceeds of to the business which is contingent or conditional in any way by volume, profit, sales, giving 13. Optional Premises or Hotel and Restaurant Licenses with Optional Premises A local ordinance or resolution authorizing optional premises has been adopted. Number of separate Optional Premises areas requested Yes No 14. Liquor Licensed Drug Store applicants, answer the following: (a) Does the applicant for a Liquor Licensed Drug Store have a license issued by the Colorado Board of Pharmacy? COPY MUST BE ATTACHED. Yes ht • ❑ 15. Club Liquor License applicants answer the following and attach: (a) Is the applicant organization operated solely for a national, social, fraternal, patriotic, political or athletic purpose not for pecuniary gain? (b) Is the applicant organization a regularly chartered branch, lodge or chapter of a national organization which operated solely for the object of a patriotic or fraternal organization or society, but not for pecuniary gain? (c) How long has the club been incorporated? (d) How long has applicant occupied the premises (Three years required) to be licensed as a club? (Three years and ❑ d is ■ required) 16. Brew -Pub License Applicants answer the following: Has the applicant received or applied for a Federal Brewers Notice? (Copy of notice or application must be attached) O O1(a) & Restr. Lic. 17a. Name Manager (If this is an application for a Hotel number. Date of Birth Hotel Yes No U o of and Restaurant License, the manager must also submit an Individual History Record (DR 8404-I). 17b. Does this manager act as the manager of, or have a financial interest in, any other liquor• licensed establishment in the State of Colorado? If yes, provide name, type of license and account Yes No L/J a 18. Tax Distraint Information. Does the applicant or any other person listed on this application and including its partners, directors, stockholders, members (LLC) or managing members (LLC) and any other persons with a 10% or geaterfinancial in the applicant currently have an outstanding tax distraint issued to them by the Colorado Department of Revenue? If yes, provide an explanation and include copies of any payment agreements. officers, ` , Yes No interest• R 8404 (06/97) Page 4 19. If applicant is a corporation, partnership, association or a limited liability company, it is required to list by position all officers and directors, general partners, managing members, all stockholders, partners (including limited partners) and members who have a 10% or greater financial interest in the applicant. All persons listed here or by attachment must submit and attach a DR 8404-I (Individual History Record) and provide fingerprint cards to their local licensing authority. NAME HOME ADDRESS, CITY & STATE I�k1 Liw t. di w ,dk- C,, DATE OF BIRTH POSITION OWNED Additional Documents to be submitted by type of entity 0 ❑ CORPORATION 0 Cert. of Incorp. 0 Cert. of Good Standing (if more than 2 yrs. old) ❑ Cert. of Auth. (if a foreign corp.) PARTNERSHIP 0 Partnership Agreement (General or Limited) 0 Husband and Wife partnership (no written agreement) 2 LIMITED LIABILITY COMPANY 21Articles of Organization ❑ Cert. of Authority if foreign company) ❑ Operating Agrmt. ElASSOCIATION OR OTHER Attach copy of agreements creating association or relationship between the parties Registered Agent (if applicable) Authorized //Sigg{{�tat //ure ___Q7. Date application filed with local authority 7- /4-9. 7 Address for Service 61WAJLWC_ Date 2- 7-2 7 Date of local authority hearing (for new license applicants; cannot be less than 30 days from date of application 12-47-311 (1)) C.R.S. ?-a/-97 Each person required to file DR 8404-I: a. Has been fingerprinted b. Background investigation and NCJC and CCIC check for outstanding warrants conducted c. The liquor licensed premises is ready for occupancy and has been inspected by the Local Licensing Authority. If 'no", the building will be completed and ready for inspection by (date) The foregoing application has been examined; and the premises, business to be conducted, and character of the applicant are satisfactory. We do report that such license, if granted, will meet the reasonable requirements of the neighborhood and the desires of the adult inhabitants, and will comply with the provisions of Title 12, Article 46 or 47, C.R.S. THEREFORE, THIS APPLICATION IS APPROVED. uthority for UNTY COLORADO 4 4a e ut at 6� within , e oval should be signed by the mayor and clerk, if in a county, then by the chairman commissioners and the clerk to the board. If, by ordinance or otherwise, the local licensing authority is some other official, al should be given by such official. Yes No Et O la CI 0 ❑ Telephone Number 970 356-4000 x4225 Title GEORGE E. BAXTER, CHAIR, WELD COUNTY BOARD OF COMMISSIONERS Title WELD COUNTY CLERK TO THE BOARD ET TOWN, CITY COUNTY Date Date 07/21/97 07/21/97 cv O PS Form 3800, June 1985 P 387 472 371 RECEIPT FOR CERTIFIED. MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) Sent to Colorado Dept of Revenue P Liquor Enforcement Div. 1375 Sherman Street Denver, CO 80261 Ci SI Restricted Delivery Fee Return Receipt showing to whom and Date Delivered Return Receipt showing to whom. Date. and Address of Delivery TOTAL Postage and Fees $ Postmark or Date gay -97 'sown NIItooH wound 6upn io nob( Amyl m5 m o m N o G N Ce O3 II? Cw N o d am 0 m \)_❑ is form so that we can return this 8 m 2 1 z Cc 0 0 0 iR 0 0 0 O m 0 m 0 Ill r — O) Co 7 LL( o f_0 y � � 'C z a E a C 6C1 as: U 10 O0 o C U d .o a w L r ¢ E¢ R so y m m R! as e o ° CC CO o LIJy V 3 1H LePiS MEMO' mil uo pouNdwoo SS3HOOY NHn13H iooil III c Return Re m E 0 0) .0 m OA5 Puki gircrik-m. 6 e DR 8404-I (02/94) COLORADO DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION 1375 SHERMAN STREET DENVER CO 80261 INDIVIDUAL HISTORY RECORD To be completed by each individual applicant, all general partners of a partnership, all limited partners owning 10% (or more) of a partnership; all officers and directors of a corporation, all stockholders of a corporation owning 10% (or more) of the stock of such corporation; all limited liability company MANAGING members, or other limited liability company members with a 10% (or more) ownership interest in such company and all managers of a Hotel and Restaurant license. 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 of the applicant. 1. Name of Business cod-(- Py IG7 L-I� bet., ci b- ' x1 \ W46rs LA -Cc 1-. Date 6-2-5'1 Social Securit Number(s) 2. Your Full Name (last, first, middle) py-t " Tim -€t- .5-c-4.77- 3. Also Known As (maiden name/nickname, etc.) s C 4. Mailing Address (it different from residence) /V/7/ CA/co/4 cR tAm/fA4O„I Co Zo≤o/ Home Telephone (go3.)6S2 lied 5. Residence Address (street and number, city, state, ZIP) /517/ &t o" (.J cat- C,,..,iq ,..tie.,./; Ge 7trere-/ 6. Date of Birth $ Place of Birth Lib%) . okej CI C -o \ tai CM--tCM--tc, 7. U.S. Citizen? .‘„,...-- AMYes F-1 No If Naturalized, state where I4(Pr When k)I k- Name of U.S. District Court N( (^- Naturalization reitificate Number Date 7,:feit ifica e If an Alien, Give Alien's Registration Card Number Permanent Residence Card Number 8. Height (D `C Weight 7...0 S Hair Color 73ea-i Eye_ Color t t-.),1 Sex !A Race V.) 9. Do ou Have a Yes current Drivers License? If yes, jjve nu,er, 8 state No \S% Name of Present Employer je.\F £.�p(9./ 11. T e of Business or Employment nsac.rt-c sifr12. Address of 1Business Where Employed ' (street number, city, state, 1ZIP) 1 \1 ` LA``L O L1 tAt-- , `A:7. ••-sc-t 1N-01�1"v C %"*. Business Telephone \3 42.'-.4 °ti\Z-4S9 13. Present Position 14. Marital Status P1/4,tikerr...c..z 15. Name of Spouse (include maiden name if applicable) N : ca\ , C . CY 16. Spouse's Date of Birth 1O. s Place of Birth u...LiWeJk- C-•• for pc�. . 17. Spouse's residence address, if different than yours (stree and number, city, state, ZIP) 5 ca,r-\ 1 Spouse's Present Employer � I - / KOLAC1 µChv.1Tli11t (A ,r .. Occupation Plir�!`e� 19. yFsgf ro s Employe_ I -\ j^/ U (List (t I^'n , ^ yr //fit ,,/j/7'//4�L� ^ IN a ' / 20. the name(s) of all relatives working in or having a financial interest in the liquor industry. NAME OF RELATIVE RELATIONSHIP TO YOU POSITION HELD NAME OF EMPLOYER LOCATION OF EMPLOYER NONv 21. Do you now, or have you ever held a State of Colorado Liquor or Beer License, or loaned money, furniture, fixtures, equipment or inventory, to any Colorado Liquor or Beer Licensee? If yes, answer in detail ❑ Yes %No • CONTINUED ON REVERSE SIDE DR 8404-I (2/94) Page 2 22. Have you ever been convicted of a crime, or received a suspended sentence, deferred sentence, or forfeited bail for any offense in criminal or military court? (Do not include traffic violations, unless they resulted in suspension or revocation of your driver's license, or you were convicted of driving under the influence of drugs or alcoholic beverages.) It yes, explain in detail. El Yes L'1 No 23. Have you ever received a violation notice, suspension or revocation for a liquor law violation, or been denied a liquor or beer license anywhere in the U.S.? If yes, explain in detail. ❑ Yes (t No 24. Miliq ervice (branch) r 4 From To Serial Number Type of Discharge 25. 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 atOrutu xt 26. List all former employers or businesses 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 27.0hatrs your re i applicant? (sole owner, partner, corporate officer, director, stockholder, member or manager) r'1}1 /C/� nshi toa Percent of outstanding stock owned 28. If sto kholder, number of shares owned beneficially or of record 29. If �p�gGs ate whether ❑ General ❑ Limited parr 30. Total amount you will invest in this business, including notes, loans, cash, services or equipment, and operating capital. (Reg. 46-106.1 and Reg. 47-107.1) Amount'$t{I ici6 int 31. Identify the sources of all funds you will invest in this business as listed in 30 above. List all bank names, account numbers and the amount derived from such source. Also identify all persons authorized to sign on, or who are part owners of said account. (Attach copies of all your notes or loans used in or for this business.) Names on accounts or person who can Percent of Partnership Owned If Limited Liability Company (percent owned) Amounts Sources - Account Numbers sign on this account $SaakThaeS. $ $ $ Oath of Applicant I declare and r penalty of r'ury in the second degree that this application and all attachments are true, correct, and complete to the best of my know dge. Authorized Snature/ Title Date 7-7-F7 7-14-1997 2:39PM FROM THE MTG ARCHITECTS 415 431 4665 P. 1 FETING RCHI 1'hCTS MEETING & INCENTIVE PROFESSIONALS TO: Colorado County Attorney (970) 352-0242 fax FROM: Jill Orrantia RE: Thomas Scott Pyle "Wags Place" Liquor License DATE: July 14, 1997 To Whom it May Concern: I'm writing this letter in regards to Thomas Scott Pyle's application for a Colorado Liquor License. I have known Scott for more than 13 years and have admired not only his responsibility but his work ethics. Scott was a very devoted bagel store owner in Texas and I feel that with his dedication and supervision, his new restaurant "Wags Place," will be a great success. Additionally, I am certain that Scott will treat the liquor license as a great privilege and will honor the rules and regulations that it requires. 479 Ninth Street • SOMA San Francisco. CA 94103 Tel (415) 431-0236 Fax (415) 431-4665 319 Highway 66 Longmont CO 80504 July 7, 1997 To Whom it may Concern I would like to recommend Scott Pyle for consideration for a liquor license. Having known Scott for over seven years, I find his work ethic and professionalism to be outstanding. I believe he would handle this responsibility with sincerity and conscientiousness. I level aswell, only worked with Scott, but have known him on a personal finding him trustworthy and extremely dependable. Bud Cash DATE: July 14, 1996 TO: KIM FLIETHMAN, SHERIFF'S DEPARTMENT FROM: OFFICE OF WELD COUNTY CLERK TO THE BOARD SUBJECT: LIQUOR LICENSE CHECK In accordance with the new procedure established by you and the County Atorney, please run a records check on the following establishment for any associated incident reports during the last year. Your report should be returned to the Clerk's office within two weeks to be used by the Board of County Commissioners in considering renewal of liquor license. PLEASE RESPOND NO LATER THAN July 23, 1997. Thank you. 23- g ESTABLISHMENT: WAG'S PLACE 10' (new owner) Thomas Scott Pyle (522-43-5005) 4322 Hwy 66 Longmont, CO 80504 Call 356-4000, ext. 4225 IF QUESTIONS. No violations/incidentss on record. BY: INCIDENT REPORTS (PLEASE LIST OR ATTACH) _ BY: Please notify 66-7>m g" - Lst,! the Board of Commissioner's renewal hearing. c71> /iic4_TvC' go COI / zoo ge.,; 8,„ i�.U15/ ex? it2395" N0 L,L CMAee cog - DP Tr> i.tiL TuJJl6-e'te,-)T at Extension 'Qt& of the date and time of /JU Cc p_.)y 5 5"A, (5i)e-me,4_,0b/2. /),22��; ,ti /Igo Addresses in last five years: 1471 Lincoln Circle Longmont, CO 80501 12163 Ella Lee Lane Houston, TX 77077 May 1997- Present December 1997 -May 1997 7311 Timber Lake Dr Sugar Land, TX 77479 December 1995- December 1996 813 Twin Creek Mansfield, TX 77063 March 1995 -December 1995 5722 Bramblewood Ct Arlington, TX 77077 March 1994 -March 1995 6500 Arbor Lane Fort Worth, TX 3501 Wind Way Fort Worth, TX August 1993 -March 1994 August 1992 -August 1993 Former Employers or Businesses engaged in 5 years Bagel Barrel Inc 13711 Westheimer B-1 Houston, TX 77077 Sept 1995 -May 1997 Justin Boot Company 813 W. Dagget Fort Worth, TX Sources of Investment of Funds Personal Note David Pietrangelo(previous owner) Personal Note Robert J. Cash Note Harlon Wagoner(previous owner) $115,000.00 $50,000 $15,000 Personal References: August 1992 -Sept 1995 Robert Cash Salesman Ruddock Shirt Co 0319 Hwy 66 Longmont, CO 80504 (303)776-9708 John T. Gordon Teacher Longmont High 333 23rd Ave Longmont, Co 80501 (970)593-1674 Brent Johnsten Banker Southwest Bank Texas 3414 Broadmead Houston, TX (713)661-8115 P.1 .CC .. tit d)35a -i a1 -la:-.- ,`'5Qru3)1f of 3d , -,tr a.a v c e v�►iNfil,sla t cti� . 7Th - cmimq . a. v1. AL 14 '97 03:25PM MILLER I (1 .. ....... T _.. _ rax NO a awe ! .ems ., _ . tifet July 14, 1997 To • m it May Concern: Dept Chip Call I am writing this letter on behalf of Thomas Scott Pyle to be approved for a Colorado liquor lice t . I have (mown and been friends with Scott for over 15 yen We grew up together in Longman and ve shared many of the same friends and bobbies throughout the yen Scott is a very responsible and aneet individual with an amazing work ethic. He always puts 100% into any project or business he is on and I always see the results of his hard wodt. I can only imagine how much Wags Place will char - and grow due to Scott's dedication and supervision. I think Longmont is extremely fortanate to have strong member Mille community interested in making his restaurant the best of the best Rest gaids, olio . Gordon WALLACE H. GRANT DANIEL F. BERNARD RICHARD N. LYONS, II JEFFREY 1. KAHN H. WILLIAM SIMS, IR. JOHN W. GADDIS BRADLEY A. HALL STEVEN P. JEFFERS CAMERON A. GRANT WENDY S. RUDNIK SUZAN D. FRITCHEL KARIN RANTA CURRAN Scott Pyle 1471 Lincoln Circle Longmont, CO 80501 Re: Scott Pyle, LLC Dear Scott: GRANT, BERNARD LYONS & GADDIS A PROFESSIONAL CORPORATION ATTORNEYS AND COUNSELORS July 25, 1997 515 KIMBARK STREET POST OFFICE BOX 978 LONGMONT, CO 80502-0978 303-776-9900 FAX 772-6105 DENVER 571-5506 DENVER FAX 571-0939 E-MAIL info@gblg.com I am sending this information since I have been unable to reach you by phone over the last few days. Please find enclosed a revised copy of your Articles of Organization for Scott Pyle, LLC. I also had a chance to speak with Bruce Barker, a Weld County Attorney, regarding you application for a liquor license. According to Mr. Barker, if you change the name of a business holding a liquor license you must re -apply for that license and pay the associated license fees. We spent some time discussing this and it seems that there is no way to simply amend the name on a license when a business name changes. Therefore, if you apply for your liquor license as Scott Pyle, LLC and then change the name of the business to Wags Place, LLC it will cost your $1,000 + to get a new license. I suggest that rather than changing the name of the limited liability company that you simply apply for a trade name. You can then own your business, lease the property and hold the liquor license in the name of Scott Pyle, LLC but you can also operate under the trade name of Wags Place. In other words, you would be Scott Pyle, LLC d/b/a Wags Place. This allows you to change the name of the business to anything that suits your purposes without reorganizing the underlying business entity. I discussed this option with Mr. Barker and he agreed that it would be the simplest and cheapest method to accomplish your goal. In order to finalize your liquor license application under the name of Scott Pyle, LLC you need to do the following: 1. Change the name on your application to Scott Pyle, LLC, 2. Provide Mr. Barker with a copy of a sub -lease agreement sub -leasing the property from Thomas Scott Pyle to Scott Pyle, LLC, and 3. Provide Mr. Barker with a copy of a letter from me indicating that you intend to operate you business under the name of Scott Pyle, LLC and do not plan to change the name to Wags Place, LLC. I am enclosing that letter. In addition, Mr. Barker suggested that you verify that both your sales tax and business applications state that the name of your entity is Scott Pyle, LLC, not Wags Place, LLC. GRANT, BERNARD LYONS & GADDIS A PROFESSIONAL CORPORATION ATTORNEYS AND COUNSELORS Scott Pyle August 14, 1997 Page 2 If you need any call. Otherwise, week to ten days Enclosures assistance with this or have any questions please do not hesitate to give me a I will send you a draft Operating Agreement for Scott Pyle, LLC in the next \WNW\DATA \ CLIENTS \TPYLES\L SCOTT PYLE RE LLC AND LIQUOR LICENSEDOC Very truly yours, GRANT, BERNARD, LYONS & GADDIS, a Professional Corporation By Cameron A. Grant ADDENDUM TO LEASE EFFECTIVE DA1E E JULY 1, 1997 BETWEEN THOMAS SCOTT PYLE & LONGS PEAK EQUIPMENT COMPANY INC. It is hereby agreed to by both parties that said lease shall be assigned from Thomas Scott Pyle to Scott Pyle LLC. Scott Pyle LLC. hereby assumes all responsibilities of said lease. 7LS Q omas Scott Pyle Kevin R. Olson Secretary Scott Pyle LLC by Thomas Scott Pyle MUST BE TYPED FILING FEE: 550.00 MUST SUBMIT TWO COPIES Please include a typed self-addressed envelope s9 Cv I/We the undersigned natural person(s) of the age of eighteen years or more, acting as organizer(s) of a limited liability company under the Colorado Limited Liability Company Act, adopt the following Articles of Organization for such limited liability company: FIRST: The name of the limited liability company is: Scott Pyle, LLC SECOND: Principal place of business (if known): 4322 Highway 66 Longmont, CO 80504 Mail to: Secretary of State Corporate Section 1560 Broadway, Suite 200 Denver, CO 80202 (303) 894-2251 Fax (303) 894-2242 For office use only 77111 217 C 50.00 Sti, tie+ ARTICLES OF ORGANIZATION"u7-24-77 or DIAic 12:30:ii THIRD: The street address of the initial registered office of the limited liability company is: 1471 Lincoln Circle Longmont, CO 80501 The mailing address (if different from above) of the initial registered office of the limited liability company is: SAME The name of its proposed registered agent in Colorado at that address is: Thomas Scott Pyle FOURTH: The management is vested in manager member (circle one) The names and business addresses of the initial manager or managers or if the management is vested in the members, rather than managers, the names and addresses of the member or members are: FIFTH: SIXTH: NAME ADDRESS (include zip codes) 1471 Lincoln Circle Thomas Scott Pyle Longmont, CO 80501 The name and address of each organizer is: NAME ADDRESS (include zip codes) Cameron A. Grant �vt -� igned: Organizer P.O. Box 978 515 Kimbark Street Longmont, CO 80502-0978 WALLACE H. GRANT DANIEL F. BERNARD RICHARD N. LYONS, II JEFFREY I. KAHN H. WILLIAM SIMS, JR. JOHN W. GADDIS BRADLEY A. HALL STEVEN P. JEFFERS CAMERON A. GRANT WENDY S. RUDNIK SUZAN D. FRITCHEL KARIN RANTA CURRAN Scott Pyle 4322 Highway 66 Longmont, Colorado 80504 Re: Scott Pyle, LLC GRANT, BERNARD LYONS & GADDIS A PROFESSIONAL CORPORATION ATTORNEYS AND COUNSELORS July 11, 1997 515 KIMBARK STREET POST OFFICE BOX 978 LONGMONT, CO 80502-0978 303-776-9900 FAX 772-6105 DENVER 571-5506 DENVER FAX 571-0939 E-MAIL info@gblg.com Via Hand Delivery Dear Scott: Please find enclosed a photocopy of the Articles of Organization for Scott Pyle, LLC. The Articles were filed with the Secretary of State yesterday. I expect confirmation of their approval within the next several weeks. Also enclosed is an Application of Employer Identification Number for the limited liability company. Please complete the blanks in this document where marked and sign and return the Application with our courier. Once she has the document back in our office we will fax it to the IRS to expedite the process of issuing a tax ID number for the LLC. As we discussed on the phone yesterday, I will also prepare a Withdrawal of Trade Name for the prior owner of Wags Place to sign. This document will officially relinquish his rights to the trade name Wags Place. Once the document is filed the Secretary of State imposes a 90 day waiting period before anyone else can use that same trade name. Once that 90 days elapses we will file an amendment of the Articles of Organization changing the name of your company to Wags Place, LLC. Lastly, I will begin drafting an operating agreement for your limited liability company. I expect to have a draft ready in the next two weeks. At that time, I will mail that to you for your review. Once you have had a chance to review the draft we should then schedule a meeting to discuss any questions or comments you have and to finalize the terms. If you have any questions please don't hesitate to give me a call. I will get in touch with you as soon as I have heard from either the Secretary of State or the IRS. CAG:jcg Enclosures 0:ICLIENTS'PIPYLESICLIE NT-LOOC Very truly yours, GRANT, BERNARD, LYONS & GADDIS, a Professional Corporation amero n A Grant`<1—Sm- 07/11/97 10:11 AM -JOG MUST BE TYPED FILING FEE: $50.00 MUST SUBMIT TWO COPIES Please include a typed self-addressed envelope Mail to: Secretary of State Corporate Section 1560 Broadway, Suite 200 Denver, CO 80202 (303) 894-2251 Fax (303) 894-2242 ARTICLES OF ORGANIZATION For office use only 97 JUL in J I/We the undersigned natural person(s) of the age of eighteen years or more, acting as organizer(s) of a limited liability company under the Colorado Limited Liability Company Act, adopt the following Articles of Organization for such limited liability company: FIRST: The name of the limited liability company is: ' Scott Pyle , LLC SECOND: Principal place of business (if known): 4322 Highway 66 Longmont, CO 80504 THIRD: The street address of the initial registered office of the limited liability company is: 1471 Lincoln Circle Longmont, CO 80501 The mailing address (if different from above) of the initial registered office of the limited liability company is: SAME The name of its proposed registered agent in Colorado at that address is: FOURTH: The management is vested in manager embers(circle one) FIFTH: SIXTH: The names and business addresses of the initial manager or managers or if the management is vested in the members, rather than managers, the names and addresses of the member or members are: NAME ADDRESS (include zip codes) Thomas Scott Pyle The name and address of each organizer is: NAME Cameron A. Grant c," igned: Orgahi 1471 Lincoln Circle Longmont, CO 80501 ADDRESS (include zip codes) P.O. Box 978 515 Kimbark Street Longmont, CO 80502-0978 ADDENDUM TO BUSINESS LEASE Addendum to Business Lease dated March 7, 1996 between UniWest Equipment ( The Lessor) and Harlan Wagoner ( The Lessee). It is understood by all parties that said lease has been assigned by UniWest Equipment to Longs Peak Equipment Company Inc. effective April 1, 1997. Longs peak Equipment Company, Inc. hereby gives permission to Lessee to assign said lease to Thomas Scott Pyle effective July 1, 1997. Thomas Scott Pyle, hereafter referred to as Lessee, agrees to and accepts all conditions of aforementioned lease and to the following additions: A: Lessee agrees to release Lessor from any obligations should Lessor not exercise its option to purchase said premises prior to the expiration of lease. B: Lessee agrees to pay additional rent for said premises should the hours of operation increase. Additional rent will be determined on a pro -rate basis. Lessor: Kevin R. Olson Secretary- Longs Peak Equipment Company Inc. Lessee: 3-9 Date 7-3-9 Date ti - Harlan Wagoner gAR .�� Date BUSINESS LEASE This lease is made this 07 day of March, 1996 between UniWest Equipment (the "Lessor") and Harlan Wagoner ( the "Lessee"). In consideration of the payment of the rent and the performance of covenants and agreements by the Lessee set forth below, the Lessor does hereby lease to the Lessee the following described premisedsituate in the County of Weld, in the State of Colorado; the address of which is 4322 Hwy 66, Longmont, Colorado. The legal property address in 4322 Hwy 66, and the legal description is: PT NE4 NW4 LOT A RE 123 SEC 26 T3N R68 NORTH. The leased premises are shown on the drawing attached together with non-exclusive use of the parking lot and shared bathrooms in the hall at the Lessors property. Togehter with personal properyt listed on exhibit "A" TO HAVE AND TO HOLD the same with all the appurtenances unto the said Lessee from twelve o'clock noon on the 01 day of April, 1996 at and for a rental for the full term of 5 years at $131,100.00 payable in monthly installments of $2,185.00 , said amount being due on the FIRST of each month. The Lessee, in consideration of the leasing of the premises agrees as follows : 1. To pay the rent for the premises above described. 2. To keep the improvements upon the premised, including sewer connection, plumbing, wiring kitchen equipment, glass etc. in good repair (Please see attached list) and at the expiration of this lease to surrender the premises in as good a condition as when the Lessee entered the premises, loss by fire, inevitable accident, and ordinary wear excepted. To keep all restrooms clean. To keep all entrances and/or sidewalks on and around the premises free and clear of ice and snow, and to keep the entire exterior premises free from litter, dirt debris and obstruction: to keep the premises in a clean and sanitary condition as required by the ordinances of the state and county in which the property is situated. 3. To sublet no part of the premises, and not to assign the lease or any interest therein without the written consent of the Lessor. 4. To use the premises only as RESTAURANT & BAR and to use the premises for no purpose prohibited by the law of the United States or the State of Colorado, or of the ordinances of Weld County in which said premises are located, and for no improper ore questionable purposes whatsoever, and to neither permit nor suffer any tendency to annoy or disturb any persons occupying adjacent premises. 5. To neither hold nor attempt to hold the Lessor liable for any injury or damage, either proximate or remote, occurring through or caused by the repairs, alterations, injury or accident to the premises, or adjacent premises, or other parts of the above premises not herein demised, or by reason of the negligence or default of the owners of occupants thereof any other person, nor to hold the Lessor liable for any injury or damage occasioned by defective electric wiring, or the breakage or stoppage of plumbing or sewerage upon said premises or upon results from freezing or otherwise; to neither permit nor suffer said premises, or the walls or the floors thereof, to be endangered by overloading, nor said premises to be used for any purpose which would render the insurance thereon void or the insurance risk more hazardous, nor make any alterations in or changes in, upon or about said premises without first obtaining the written consent of the Lessor thereof, but to sign upon the leased premises at any time after sixty days before the end of this lease. 6. To allow the Lessor to enter upon the premises at any reasonable hour. 7. To hold harmless lessor from any damage to contents of premises and if insurance is desired, to seek out separate renters insurance for contents of premises. IT IS EXPRESSLY UNDERSTOOD AND AGREED BETWEEN LESSOR AND LESSEE AS FOLLOWS; 8. No assent, express or implied, to any breach of any one or more of the agreements hereof shall be deemed or taken to be a waiver of any succeeding or other breach. 9. If, after the expiration of this lease, the Lessee shall remain in possession of the premises and continue to pay rent without a written agreement as to continue to pay rent as such possession, then such tenancy shall be regarded as a month -to -month tenancy, at a monthly rental, payable in advance equivalent to the last months rent paid under this lease and subject to all the terms and conditions of this lease. 10. If the premises are left vacant and any part of the rent reserved hereunder is not paid, then the Lessor may, without being obligated to do so, and without terminating this lease, retake possession of the said premises and rent the same for such rent, and upon such conditions as the Lessor may think best, making such change and repairs as may be required, giving credit for the amount of rent so received less all expenses of such changes and repairs, and the Lessees shall be liable for the balance of the rent herein reserved until the expiration of the term of this lease. 11. The Lessor acknowledges receipt of a deposit in the amount of $ to be held by the Lessor for the faithful performance of all the terms, conditions and covenants of this lease. The Lessor may apply the deposit to cure any default under the terms of this lease and shall account to the Lessee for the balance. The Lessee may not apply the deposit hereunder to the payment of the rent reserved hereunder or the performance of other obligations. 12. If any part of the rent provided to be paid herein is not paid when due, or if any default is made in any of the agreements by the Lessee contained herein, it shall be lawful for the Lessor to declare the term ended, and to enter into the premises, either with or without legal process, and to remove the Lessee or any other person occupying the premises, using such force as may be necessary, without being liable to prosecution, or in damages therefor, and to repossess the premises free and clear of any rights of the Lessee. 13. In the event of any dispute arising under the terms of this lease, or in the event of non- payment of any sums arising under this lease and in the event this matter is turned over to an attorney, the party prevailing in such dispute shall be entitled, in addition to other damages or costs, to receive reasonable attorney's fees from the other party. 14. In the event any payment required hereunder is not made within ten (10) days after the payment is due, a late charge in the amount of five percent (5%) of the payment will be paid by the Lessee. 15. In the event of a condemnation or other taking by any governmental agency, all proceeds shall be paid to the Lessor hereunder, the Lessee waiving all right to any such payments. 16. Lessee shall have the right to apply for a Bar and Restaurant liquor license under the Colorado liquor code in connection with its use and possession of the premises as a restaurant. 17. Upon Lessee's vacation of the premises after, the term of this lease , or any extension thereof, Leaser shall have the option to purchase the trade fixtures used by Lessee either from Lessee or Harlan Wagoner, either of whom may own such trade fixtures at the time of exercise of this right of first refusal, at the price paid by Harlan Wagoner for the aquistion of such trade fixtures at the inception of this lease. 18. If Lessor wishes to install at his sole discretion an electric meter and gas meter, at that time rent will become $1,750.00 monthly, with Leasee responsible for all said utilities. 21:112141 UNIWEST EQUIPMENT CO. 4322 HWY 66 LONGMONT, CO 4322 HWY 66 LONGMONT, CO " LL1 11U, 141 IA BY: PRESIDENT BY: OWNER � fall / /9 . . DAT HARLAN WAG NER fllalt, l -J - 19 cite DATE 19. Lessee's obligations under this lease shall be conditioned on Lessee purchasing the business "Peter Angelo's Restaurant" by April 2, 1996 or this lease shall be null and void. 20. Lessee is not obligated to maintain the HVAC or the sewer, plumbing or wiring in the bathrooms shared with Lessor or its other tenants, if any. Lessee is not obligated to maintain the parking lot or exterior grounds. 21. Provided Lessee is not in default under this lease, Lessee shall have the option to renew this lease for an additional 5 year term. 22. Lessor to pay all real property taxes and utilities. Lessee to pay all personal property taxes on Lessee's equipment and the Lessor's personal property leased hereunder. 23. Provided Lessee is not in default under the terms of this lease, Lessor, Nick Sekich and Butch Sekich agree not to construct a restaurant, or lease any commercial buildings to another restaurant within the area known as Sekich Business Park and/or the lands lying within 1 mile of the intersection of Highway 66 and Interstate 25. RESTUARANT EQUIPMENT LIST AND PRICE 18 - 4 TOP TABLES $200/EACH 2 - 8 TOP SQUARE TABLES $350/EACH 30 PADDED CHAIRS SILVERWARE FOR 50 PLATES FOR 100 BOWLS FOR 100 CUPS FOR 100 GALSSES FOR 100 CASH REGISTER STAINLESS MILK MANCI-IINE STAINLESS POP MACHINE STOVE AND GRILL l - FRYER 3-FREZEERS 2 - REACH IN COOLERS 1 - AUTOMATIC DISHWASHERS STAINLESS STEEL SINK BOARDS 1 - MEAT SLICERS 1 - OVERHEAD RANGE HOODS WITH EXT. SYSTEM 1 - ICE CREAM FREEZER $3600.00 $700.00 $1920.00 $400.00 $500.00 $350.00 $200.00 $100.00 $1000.00 $600.00 $1000.00 $600.00 $500.00 $3000.00 $4500.00 $2500.00 $800.00 $600.00 $150,00 $23,020.00 ADDENDUM TO LEASE AGREEMENT The lease agreement dated march 7, 1996 between Harlan Wagoner, lessee and UniWest Equipment , lessor is hereby amended to read Wag's Inc. federal number 84-0959537, lessee. The change in lessee name is effective May 1, 1996. This addendum does not change any existing lease terms or conditions nor in any other way affect the aforementioned lease. Addendum agreed to Hil 9th day of May 1996. Lessor: UniWest Equipment Co. By Nick Sekich Jr. President Lessee: Wag's Inc. By Harlan Wagoner President Harlan Wago MUST BE TYPED FILING FEE: $10.00 MUST SUBMIT TWO COPIES Please include a typed self-addressed envelope Mail to: Secretary of State Corporations Section 1560 Broadway, Suite 200 Denver, CO 80202 (303) 894-2251 Fax (303) 894-2242 CERTIFICATE OF WITHDRAWAL OF TRADE NAME For office use only Wag's, Inc. , a corporation, limited (exact name as shown on records of the Secretary of State) partnership or limited liability company organized under the laws of Colorado transacting a portion of its business under an assumed or trade name as permitted by 7-71-101, Colorado Revised Statutes, hereby certifies: The corporate, limited partnership or limited liability company name and location of its registered office in Colorado is: Wea's Tnc., 9004 Walker Road, Lononont, Co 80503 2. The name, other than its own corporate, limited partnership or limited liability company Waa's Place. Tnc. name, under which such business is carried on is: 3. Hereby withdraws and cancels the trade name it has been using in Colorado. Limited Partnerships or Limited Liability Companies complete this section Corporations complete this section By Signature Its (Manager, Member, General Partner) Wag's, Inc. By W. Harlan Wagoner Its President Title DEPARTMENT OF THE TREASURY INTERNAL REVENUE SERVICE OGDEN UT 84201 DATE OF THIS NOTICE: 06-20-97 NUMBER OF THIS NOTICE: CP 575 A EMPLOYER IDENTIFICATION NUMBER: 84-1411318 FORM: SS -4 2916906373 B THOMAS SCOTT PYLE WAGS PLACE 1471 LINCOLN CIR LONGMONT CO 80501 FOR ASSISTANCE CALL US AT: 825-7041 LOCAL DENVER 1-800-829-1040 OTHER CO OR WRITE TO THE ADDRESS SHOWN AT THE TOP LEFT. IF YOU WRITE, ATTACH THE STUB OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER (EIN) Thank you for your Form SS -4, Application for Employer Identification Number (EIN). We assigned you EIN 84-1411318. This EIN will identify your business account, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. Use your complete name and EIN shown above on all federal tax forms, payments, and related correspondence. If you use any variation in your name or EIN, it may cause a delay in processing, incorrect information in your account, or cause you to be assigned more than one EIN. If you're required to deposit for employment taxes (Forms 941, 943, 940, 945, CT -1, or 1042), excise taxes (Form 720), or income taxes (Form 1120), we will send an initial supply of Federal Tax Deposit (FTD) coupon books within five to six weeks. You can use the enclosed coupons if you need to make a deposit before you receive your supply. Based on the information shown on your Form SS -4, you must file the following forms(s) by the date we show. Form 941 If the due date has passed please complete the form and send it to us by 07-07-97. If we don't receive the form by that date additional penalties and interest will be charged. If you weren't in business or didn't hire employees for the tax period shown, please file the form showing that you have no liability. If you need help in determining what your tax year is, you can get Publication 538, Accounting Periods and Methods, at your local IRS office. If you have any questions about the forms shown or the date they are due, you may call us at 1-800-829-1040 or write to us at the address shown above. Thank you for your cooperation. IOU lJrnStreet 19 `Denver,;060261-0013 COLORADO:BUSINESS REGISTRATION �. PLEASE PRESS FIRMLY AND PRINT CLEARLY _ 3 RECEiVWIa 735 THIS FORM WILL BE REVIEWED FOR 1. REASON FOR FILING THIS APPLICATION Q JUN 0 4 1997 s UNEMPLOYMENT INSURANCE (UI) LIABILITY ❑ Original Application ED Change of Ownership • If trade name registration with the Department of k Revenue is required, the Information marked with a Do you have a Dept of Revenue Account Number? ❑ yes p no IF YES, Account # diamond will become public record. Do you wan this.number assigned to new location? D yes ❑ no _ COIO. D o' •t eve nue ♦2. INDICATE TYPE OF ORGANIZATION ! individual t , Q tale ❑ Other Non -Profit ❑ [J • -Limited Liabili limited er General Partnership Panner5hl LP ❑ Other ❑ p 1 cint enlur DO NOT WRITE IN THIS SPACE SIDE A REVENUE REGISTRATION ACCOUNT NUMBER , ) �,� Z ,/ limited Partnership ❑ Corcoran t "Limited Liability Company (LLC) x ❑ 'S' Corpor Non prolit 501 (C)(3) Limited Liability Partnership (LLP) Association"7_ ❑ (Please enclose copy of the IRS letter of exemption.) ORGANIZATION INFORMATION 1. Taxpayer Name (owner, partners or corporate name) (last, first, middle) ' 2a. Trade Name/Doing Businesp As (if applicable) • 1;\ •(11.\, •, I" I 1.t /., 1, 2b. Federal Employer Identification Number (FEIN) 3a. Street ♦'l Address' of Princip Place 1, - J of Busir4ss in Coioradq I I- Ill ,`t ,'.\ AC- City' • ( Slate ♦ ,. ZIP " .: (: �I 3b. CQunly { / I • A 1 If business is within limits of a city, what city? Telephone l { 4a. In Care Of (do) Ilc4-i.,t{, i t �� 1 4b. Mailing Acdress ♦ II. ()f differ nt from above) (include unit t1 11))1,.(il #) • { .t;f:_ City • i i.. is \ ) i ., I I Slate ♦ i i.` ZIP I " ` • I, �L M Telephone •i l I �� (.I 1) if ',.' • " ` 5. Bank Name (it a%/ailable) , i•I!I.(•!{ .1; I' I ' (ii1I.,Iill ; Bank Address 1 I I ' lir Bank Account Number 6. First Day of Payroll (MO/DAY/YR) I! • • ;` f• f f 1 Payroll 1 Records,Localion(list ) f I address 1 i i ( } f.: ) , jt i, i I I t 1 if( ;' Payroll Records Telephone ( r, ",' ) l (' 1)\' 7. What products and/or services do you provide? (cornptete section •I ') • t Do you rent out items Do you sell woodstoves for 30 days or less? ❑ Yes D No or fireplace inserts? Q Yes in No 8a. Owner/Partner/Corp. Officer • Title • Social Security # 1 Federal Employer Number (FEIN) : i I S 8b. Address (residence or P.O. Box, street, city state, ZIP) • 1?- 1 ( ! J " I! , ( { I I i i + 1 i 1. •� I t - l l` r' . Telephone I f ) I I f + ) ' ! 1 ". J (If/ 9a. Owner/Partner/Corp. Officer • 1) 1 IN Title ♦ I•..( Pk. Social Security # ti t fl.- Federal Employer Identification Number (FEIN) N1 9b. Address (residence or P.O. Box, street, city, state, ZIP) • r 1 .1 l I:\( Telephone ) 'r- 1 I J /-•\ If you acquired the business in whole or in part, complete the following: 10a. Prior Taxpayer Name 1 i`'\ •r \ i t- "r1-' 4 i �'. &.,`—• ,, \ k (L Date of Acquisition . ,. ( t ., - r) `7 Prior Taxpayer UI i)e.'1' -7 Tax Account Number -1 ? c- o lob. Address Lt '.. 2 Z_. 1 t .•,. 4 a , l l!) Fy City 1�,. 0 1 , } { Slate I Y i • ZIP ' '1.1 1, O II Seasonal, mark O JAN ❑ APR ❑ JULY ❑ OCT OFEB ❑ MAY ❑ AUG [T]NOV each business month. ❑ MAR ❑ JUN ❑ SEPT ❑ DEC PERIOD COVERED FROM: Mo/YR TO; MdlYR FEES FEES a 2a. FILING FREQUENCY: II sales tax collected is. I2b. First Day of Sates (MO/DAY/YR) ❑ $15.00/month or less • Annually I I i (0280. Trade Name 750) Registration (999) $ I-- w O Under $300/month - Quarterly /} , . $300/month or more • Monthly I J t) f�j C 1 I : , ( t Wholesale only • Annually 0020 ( State Sales Tax 810) Deposit (355) , 8 -�, Q I (0080- co 3. Indicate which applies to you: ❑ Single Event - Period Covered ❑ Wholesaler ❑ Charitable 750) License s Tax se(999) $ (MO/DAY/YR) El, Retail -Sates O Multiple Event ❑ Retailers -Use Event Location (1000 Wage 750) Withholding (999) $ 0.00 0 1. FILING FREQUENCY: If wage withholding amount is p$1 - $6,999/year - Quarterly ■ $50,000+/year - Weekly 2. OIL/GAS ■ Withholding O $7,000 - $49,999/year - Monthly Must file by Electronic Funds Transfer Make check payable to Cob. Dept. of Revenue THE REVERSE SIDE OF THIS PAGE TOTAL $ ; MUST BE COMPLETED, AND BOTH WHITE PAGES RETURNED.- I declare under penalty of perju�)he_second degree that the statements made in this application are true and complete to the best of my knowledge. SIGNATURE o1 Owner, Pa ner r r rtire Officer REQUIRED .1--' •_ �r�i Title ,/7 r 4 . /it."( 'L- 1. Date ; ' {� - OFFICE USE ONLY Account Type Sic Org LC LD OD SC IA Sig O N TR-1 Date Tech Sig (corrlinue on reverse Side of this pope.) Form SS -4 (Rev. December 1995) Department or the Treasury internal Revenue Service Application for Employer Identification Number (For use by employers, corporations, partnerships, trusts, estates, churches, government agencies, certain individuals, and others. See instructions.) ► Keep a copy for your records. EIN OMB No. 1545-0003 Please type or print clearly. I 1 Name of applicant (Legal name) (See instructions.) Scott Pyle 2 Trade name of business (if different from name on line 1) Scott Pyle, LLC 3 Executor, trustee, "care of" name 4a Mailing address (street address) (room, apt., or suite no.) 1471 Lincoln Circle 5a Business address (if different from address on lines 4a and 4b) 4322 Highway 66 4b City, state, and ZIP code Longmont, CO 80501 5b City, state, and ZIP code Longmont, CO 80504 6 County and state where principal business is located Weld, Colorado / 7 Name of principal officer, general partner, grantor, owner, or trustor—SSN required (See instructions.) II - . Be Type of entity (Check only one box.) (See instructions.) 0 Sole proprietor (SSN) • ❑ Partnership ❑ REMIC 0 State/local government ❑ Other nonprofit organization (specify) ► ❑ Other (specify) 0- 8b If a corporation, name the state or foreign country (if applicable) where incorporated ❑ Estate (SSN of decedent) ❑ Plan administrator-SSN Personal service corp. ❑ Other corporation (specify) ► Limited liability co. ❑ Trust ❑ Farmers' cooperative National Guard ❑ Federal Govemment/military ❑ Church or church -controlled organization (enter GEN if applicable) State 9 Reason for applying (Check only one box.) ❑ Started new business (specify) ► ❑ Hired employees ❑ Created a pension plan (specify type) ► Foreign country ❑ Banking purpose (specify) ► El Changed type of organization (specify) ► inPurchased going business ❑ Created a trust (specify) ► ❑ Other (specify) ► 10 Date business started or acquired (Mo., day, year) (See instructions.) 03/14/96 12 First date wages or annuit'I[Ras were paid or will be paid (Mo., day, year). Note: If applicant is a withholding agent, enter date income will first be paid b nonresident alien. (Mo., day, year) ► Closing mont of accounting year (See instructions.) eyCOAA (12Q (k - 13 Highest number of employees expected in the next 12 months. Note: If the applicant does not expect to have any employees during the period, enter -0-. (See instructions.) . 0- 14 Principal activity (See instructions.) ► Restaurant 15 Is the principal business activity manufacturing? ❑ Yes No If "Yes," principal product and raw material used P'- 16 To whom are most of the products or services sold? Please check the appropriate box. X Public (retail) ❑ Other (specify) ► 17a Has the applicant ever applied for an identification number for this or any other business? Note: If "Yes," please complete lines 17b and 17c. 17b If you checked "Yes" on line 17a, give applicant's legal name and trade name shown on prior application, if different from line 1 or 2 above. Legal name ► Trade name PI - 17c Approximate date when and city and state where the application was filed. Enter previous employer identification number if known. Approximate date when filed (Mo., day, year) City and state where filed Previous EIN Nonagricultural Agricultural Household ❑ Business (wholesale) 0 N/A ❑ Yes ER No Under penalties of perlury, I declare that I have examined this application, and to the best of my knowledge and belief. it is true, correct, and complete. . • Naine aria Attie (Please type or print clearly. u Scott Pyle, Member Business telephone number (include area code) (970) 535-4575 Fax telephone number (Include area code) Date ► L - 1 '" Note: Do not write below this line. For official use only. Please leave blank ► Ind Class Size Reason for applying Cat. No. 16055N Form SS -4 (Rev. 12-95) DR 01e1101/94) COLORADO DEPARTMENT OF REVENUE .1375 SHERMAN STREET DENVER CO 80281 WAGE WITHHOLDING LICENSE THIS LICENSE IS NOTTRANSFERABLE USE ACCOUNT NUMBER for all references LIABILITY INFORMATION ISSUE DATE 24-51454-0000 03 206 5812 L 040197 JUN 04 1997 WAGS PLACE, LLP THOMAS SCOTT PYLE 1471 LINCOLN CR LONGMONT CO 80501 A DETACH HERE GENERAL INFORMATION 1/4.147tptLvNeetei. Executive Director Department of Revenue Please keep the attached license in a safe place; it will be valid as long as you are doing business under the same name and ownership as shown on the license. Unless you are filing by electronic funds transfer (EFT), you will receive coupons with which to file in a few weeks. Tired of filling out coupon forms, writing checks and mailing payments? Tired of worrying whether your payment arrived on time? FILE YOUR WAGE WITHHOLDING BY TELEPHONE For information on Electronic Funds Transfer, call DOR at (303) 832-6139. Filing withholding tax by EFT can be as easy as picking up the phone! alin$46I OPARTM(NT SST DEN..ERN CO Hoe I Must collect taxes for: STATE COLORADO SALES TAX LICENSE USE ACCOUNT NUMBER for all references LIABILITY INFORMATION ISSUE DATE LICENSE VALID DECEMBER 31 =.w,..{ „I* ,wyn. I ',PI I ',add,'',add,' d". ma,u I e•.. I r" 24-51454-0000 03206.5812 L 060197 JUN 10 97 1997 THIS LICENSE MUST BE POSTED AT THE FOLLOWING LOCATION: 4322.`HWY ,66.1 LONGMONT ,C0 1 WAGS PLACE, LLP THOMAS SCOTT PYLE 1471 LINCOLN CR LONGMONT CO 80501 THIS LICENSE IS NOT TRANSFERABLE 1/4.14api et Executive Dire ah'or • Department of Revenue A DETACH HERE IMPORTANT NOTICE from the Colorado Department of Revenue Please VERIFY that all information on your new sales tax license is correct. If your mailing address is incorrect or if you discontinue making sales from this location, notify the Department of Revenue by calling (303) 232-2416 or by writing to: Registration Control Colorado Department of Revenue 1375 Sherman Street, Room 86 Denver CO 80261 Preprinted reporting forms with your Colorado Account Number and other information will be mailed within six weeks to the address shown on your license. You may experience costly delays if materials are returned by the Postal Service to the Department of Revenue because they could not be delivered. Tax reporting and payment of fees and taxes due are your responsibility, whether or not you receive your returns before the filing deadline. In order to avoid late penalties and interest, when you mail your return with your remittance, the envelope must be POSTMARKED on or before the due date. You must file a return even if no taxes are due. This license is to be used only for purchasing items tax free for resale. If no tax is remitted on this account for twelve consecutive months, the account will be closed, except for wholesale accounts. If you have any other questions, please contact the Taxpayer Service Division, (303) 232-2416. NEW BUSINESS ASSISTANCE SERVICE CENTER 1625 Broadway, Suite 805 Denver CO 80202 COLORADO SPRINGS REGIONAL SERVICE CENTER 3650 Austin Bluffs Parkway, Suite 188 Colorado Springs CO 80918 FORT COLLINS REGIONAL SERVICE CENTER 300 E. Foothills Parkway Fort Collins CO 80525 GRAND JUNCTION SERVICE CENTER 222 S. Sixth Street, Room 208 Grand Junction CO 81501 PUEBLO SERVICE CENTER 310 E. Abriendo Avenue, Suite A4 Pueblo CO 81004 TTN: APP ATTENTION: WELD CO SHERIFFS OFFICE COLORADO BUREAU OF INVESTIGATION - CRIME INFORMATION CENTER 690 KIPLING STREET, #3000, DENVER, COLORADO 80215 303/239-4208 THIS IDENTIFICATION RECORD, FOR LAWFUL USE ONLY, SUMMARIZES INFORMATION SENT TO THE csr BY FINGERPRINT CONTRIBUTORS IN COLORADO. WHERE THE DISPOSITION IS NOT SHOWN OR FURTHER EXPLANATION OF A CHARGE OR DISPOSITION IS DESIRED, CONTACT THE AGENCY THAT FURNISHED THE FINGERPRINTS. ONLY THE COURT OR DISTRICT ATTORNEY IN WHOSE OFFICE A FINAL DISPOSITION OCCURRED CAN PROVIDE A CERTIFIED COPY OF THAT DISPOSITION. STATE LAW GOVERNS ACCESS TO SEALED RECORDS. UNLESS FINGERPRINTS ACCOMPANIED YOUR INQUIRY, WE CANNOT GUARANTEE THIS RECORD RELATES TO THE PERSON IN WHOM -YOU HAVE AN INTEREST. BECAUSE ADDITIONS AND DELETIONS MAY BE MADE AT ANY TIME, A NEW COPY SHOULD BE REQUESTED WHEN NEEDED FOR SUBSEQUENT USE. NAME(S) USED: PHYSICAL: DATE(S) OF BIRTH: PLACE(S) OF BIRTH: PYLE, THOMAS SCOTT W M 601 200 BRO/BLU SKIN: CONTRIBUTOR / ARREST# NAME / DATE CHARGE / DISPOSITION PD BOULDER ARREST # B0004426 PD BOULDER ARREST # B0004426 PD BOULDER ARREST # B0004426 PYLE, THOMAS SCOTT DATE - 03/18/90 MNU:OA-A000004970 PYLE, THOMAS SCOTT DATE - 03/18/90 MNU:OA-A000004970 PYLE, THOMAS SCOTT DATE - 03/18/90 MNU:OA-A000004970 ASSAULT 3RD DEG MISDEMEANOR OFFENSE DATE: 03/18/90 ITEM #001/003 FAILURE TO APPEAR -SEE MIS TRAFFIC MISDEMEANOR OFFENSE DATE: 03/18/90 ITEM #002/003 PUBLIC PEACE BRAWLING OFFENSE DATE: 03/18/90 ITEM #003/003 --- END OF PAGE # 1 --- ATTN: APP PAGE # 2 ATTENTION: WELD CO SHE*t `S OttCE F PAGE # 2 --- ---- END OF RECORD MEETING DISSEMINATION CRITERIA 07/28/t 1536MT Hello