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Home My WebLink About20192247.tiffJune 13, 2019 CLERK TO THE BOARD PHONE: (970) 400-4225 FAX: (970) 336-7233 1150 O STREET P.O. BOX 758 GREELEY, COLORADO 80632 www.weldgov.com ATTN: JACKIE MERRILL RLF, INC. DBA CJ'S LIQUORS 3907 STATE HIGHWAY 119 LONGMONT, CO 80504 RE: REFUND OF COUNTY FEES FOR RENEWAL LIQUOR LICENSE APPLICATION - RLF, INC., DBA CJ'S LIQUORS Dear licensee: Please find enclosed Check Number 16807 in the Amount of $137.50 for refund of your liquor license renewal application fees due to your request to withdraw the application. If you have questions or need additional information, please do not hesitate to contact me at (970) 400-4213. Very truly yours, , R.,., Chloe A. Rempel Deputy Clerk to the Board crempel@weldgov.com Communications cc: SO(RS/JN/AC),CA(BC),LED 06/17/19 06/13/19 2019-2247 LC0020 REQUEST FOR REVOLVING FUND CHECK FROM: Esther E. Gesick DEPARTMENT: DATE: 06/13/2019 Clerk to the Board's Office CHECK TO BE ISSUED TO: CHECK AMOUNT: REASON FOR ISSUANCE: CJ's Liquors $137.50 The applicants have decided to withdraw their renewal liquor license application. CTB is refunding the County renewal fee. APPROVED: (Elected Official or Department Head Signature) ACCOUNTING OFFICE USE ONLY CHECK WRITTEN: Cp / ( ?, CHECK NUMBER: CHECK AMOUNT: 6( 3-] .5O PAYEE: STATEMENT SENT: PAYMENT RECEIVED: FORM: 807-79-024 #tC.08'O7 C. -1"s c- ic3oors CTB(M:)\TEMPLATES\FORMS\Revolving Fund Check Request Form MEMORANDUM TO: ACCOUNTING DEPT June 13, 2019 FROM: CHLOE A. REMPEL, DEPUTY CLERK TO THE BOARD SUBJECT: REVOLVING CHECK REFUND REQUEST Please see the attached request for a refund from the revolving check fund. The check should be made payable to CJ's Liquors, in the amount of $137.50. This refund is requested due to the renewal liquor license application being withdrawn. A copy of the original receipt from payment is attached. - FOR SECURITY PURPOSES. THE BORDER OF THIS DOCUMENT CONTAINS MICROPRINTING WELD COUNTY GOVERNMENT REVOLVING FUND 1 150 O Street Room 107 Greeley, CO 80631 AY TO THF? ORDER O1 's DOL. lic pity MEMO: i WELLS FARGO BANK, N.A. GRAND JUNCTION, CO ( 'tom.;It.s 23-7/1020 DATE 67171ei b J 4 /00 • _ " 16807Tr $ 137 ID' Dousxs a sr AUTHORIZED SIGNATURE Chloe Rempel From: Sent: To: Subject: Good afternoon, Chloe Rempel Wednesday, June 12, 2019 4:28 PM jckmrrll@gmail.com RE: Affidavit for Surrender of Liquor Licenses Please respond to this email confirming if you wish to allow your license to expire on August 5, 2019, and that you would like the renewal application and fees returned to you. Sincere regards, Chloe A. Rempel Deputy Clerk to the Board Weld County 1150 O Street Greeley, CO 80631 tel: 970-400-4213 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Chloe Rempel Sent: Friday, June 7, 2019 11:28 AM To: jckmrrll@gmail.com Subject: Affidavit for Surrender of Liquor Licenses Good morning, It was nice speaking with you both this morning, and it has been wonderful working with you over the years. I have attached the Colorado Affidavit for Surrender form to this email. When you are ready to officially close the business and surrender your liquor licenses, please complete the attached form and mail it, along with both your Colorado Liquor License and your Weld County Liquor License, to me. If, before you surrender your licenses, the property owner finds a new lessee, you can transfer your liquor license to them. Let me know if this is the case and I can walk you and the new applicant through the process. Please let me know if you have any questions or concerns. Sincere regards, i Chloe A. Rempel Deputy Clerk to the Board Weld County 1150 O Street Greeley, CO 80631 tel: 970-400-4213 Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. 2 DR 8400 (Revised 08/01/18) COLORADO DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION SUBMIT TO LOCAL LICENSING AUTHORITY RETAIL LIQUOR OR 3.2 BEER LICENSE RENEWAL APPLICATION CJ'S LIQUORS 3907 HWY 119 LONGMONT CO 80504 RECEIVED MAY 072U9 WELD COUNTY COMMISSIONERS Fees Due Renewal Fee Storage Permit $100 x 312.50 Optional Premise $100 x Related Resort $75 x Amount Due/Paid Make check payable to: Colorado Department of Revenue. The State may convert your check to a one-time electronic banking transaction. Your bank account may be debited as early as the same day received by the State. If converted, your check will not be returned. If your check is rejected due to insufficient or uncollected funds, the Department may collect the payment amount directly from your banking account electronically. PLEASE VERIFY & UPDATE ALL INFORMATION BELOW RETURN TO CITY OR COUNTY DBA CJ'S LIQUORS LICENSING AUTHORITY BY DUE DATE Licensee Name RLF INC Liquor License # 14-39883-0000 License Type Liquor Store (county) Sales Tax License # 14398830000 Expiration Date 08/05/2019 Due Date 06/21/2019 Operating Manager r31 E-- �c Jec u.2 1-OeacQ . O© r5' --t?- Manager Phone Number 30:3-1-7"S - -17 Email Address , 1 JC� 1 KM Kr-- 1 1 1 . CO Or)Street Address J Phone Number 3907 HWY 119 LONGMONT CO 80504 3037768359 Mailing Address 3907 HWY 119 LONGMONT CO 80504 1. Do you have legal possession of the premises at the street address above? 4 YES ❑ NO Is the premises owned or rented? ❑ Owned [ Rented* *If rented, expiration date of lease - 1- DO 5. Since the date of filing of the last application, has there been any change in financial interest (new notes, loans, owners, etc.) or organizational structure (addition or deletion of officers, directors, managing members or general partners)? If yes, explain in detail and attach a listing of all liquor businesses in which these new lenders, owners (other than licensed financial institutions), officers, directors, managing members, or general partners are materially interested. ❑ YES Ei, NO NOTE TO CORPORATION, LIMITED LIABILITY COMPANY AND PARTNERSHIP APPLICANTS: If you have added or deleted any officers, directors, managing members, general partners or persons with 10% or more interest in your business, you must complete and return immediately to your Local Licensing Authority, Form DR 8177: Corporation, Limited Liability Company or Partnership Report of Changes, along with all supporting documentation and fees. 3. Since the date of filing of the last application, has the applicant or any of its agents, owners, managers, partners or lenders (other than licensed financial institutions) been convicted of a crime? If yes, attach a detailed explanation. ❑ YES 0 NO 4. Since the date of filing of the last application, has the applicant or any of its agents, owners, managers, partners or lenders (other than licensed financial institutions) been denied an alcohol beverage license, had an alcohol beverage license suspended or revoked, or had interest in any entity that had an alcohol beverage license denied, suspended or revoked? If yes, attach a detailed explanation. ❑ YES a NO 5. Does the applicant or any of its agents, owners, managers, partners or lenders (other than licensed financial institutions) have a direct ' or indirect interest in any other Colorado liquor lice se, including loans to or from any licensee or interest in a loan to any licensee? If yes, attach a detailed explanation. ❑ YES NO AFFIRMATION & CONSENT 1 declare under penalty of perjury in the second degree that this application and all attachments are true, correct and complete to the best of my knowledge. Type or Print Name of Applicant/Authorized Agent of Business Title li \jnC r -e I r 01"r, 1 ( 1(;CY\C�CfPv r�t��,lp J Signature /� �f�, n /) ct Date l �} 1 REPORT & PPROVAL OF CITY OR COUNTY LICENSING AUTHORITY The foregoing application has been examined and the premises, business conducted and character of the applicant are satisfactory, and we do hereby report that such license, if granted, will comply with the provisions of Title 12, Articles 46 and 47, C.R.S. THEREFORE THIS APPLICATION IS APPROVED. Local Licensing Authority For Date Weld County, Colorado Signature Title Barbara Kirkmeyer Attest Esther E. Gesick Chair, County Commissioners Clerk to the Board RECEIPT DATE 05Io7L0419 NO 90464 L � IT) L U 0 m C U o — a5 au 1lt it 4 1 r Ik3 PO Box 758 Greeley CO 80632 RECEIVED FROM G cT '5 Liq,cjors ADDRESS 3'1O7 3+ck+c {-iC.Ue ( 19, LOR9MOn-1- CO g050tJ -Three Hundreck st"weA vG .t• S°/goo— s 316 6 0 FOR cS7'ct T�, RhnGcAda., ( belt ?5tce.nic, Fe.G HOW PAID CASH CHECK 3i 50 MONEY ORDER 3t0c03 f%uor Store. BY CaQK RAAtt Ar_•!l.At91 - NIIlA.' aft •h. � -.___ _ . f - - .d�iSl1.._a�,r-J a�-�![lY�l�l�.�'�s :11IQLrx.,.a...• _, a� �1 _.. -S—mrshu..•it� ate' :t .;.et na.[`7i CJ'S LIQUORS RLF INC PH. 303-776-8359 3907 HWY 119 LONGMON a • CO 80504 PAY n TO THECOtcY?'kOLO ORDER OF DATE ie3is -AdL1Cee, hu,nc�rP�A -WaSli2 SD/c0 t GUARANTY BANK AND TRUST COMPANY' Customer Service (877) 609-5500 FORLA pl alle %ca:I* 1Li $3981c300%) 00 3 L0630 30 1:10 2000966i: 23-96,1020 DOLLARS »rfy =wtwr. `.ntaiy an ilaCY �� _��C +ill/•"'tea''•• {L�h4Ydrnsni.. twastancr 90465 RECEIVED FROM C.;3" S%uor5 ADDRESS 0907 StoitG 1--(wt 19 , L09+,co $1'KOy One Hundred Yhir-cj-sevtn * $°Ylno-s t 3—t • SO FOR GOUhTy d%oor C:tiv_Loadt Fife HOW PAID CASH CHECK 1_ 37 e0 MONEY ORDER - -4 Azt 3L0& -c BY i R)cJ or Soct 1 ect �_��•ntr..:rx.•.!+�S�t �aa—lrt_�aa`L11fai_._;/�ttris7—_at1_..--__---iradata aathagigialk-sa itintara.._tfrc•:r„vss,ifSr_a�_„.�t_�IrflLet_ .:,•T!rLea..aw_eI isinerari 4 PAY TO THE ORDER OF CJ'S LIQUORS RLF INC PH. 303-776-8359 3907 HWY 119 LONGMONT. CO 80504 DATE 14,1a31 t ct Med& -Aro 4-LiL BOO- rd nnJ'-- LS -•1 1C SCA '-\ek'`-C(-k-rd r�010-Dik fi Ste! I Can GUARANTY BANK AND TRUST COMPANY' Customer Service (877) 609-5500 FORL CSI(i CCviSC {? )a )4511g4Saxto 0031064e L064e 1:10 20009661: 52000 ' S" Bowl '11JTS- --- -��+Reu\xn![ 23-96/1020 'Z) DOLLARS :et,ty nukes', igiMDf M Bb NP 6/13/2019 FedEx Ship Manager - Print Your Label(s) C) O C CA 00 vo M C.) 19019££9 17911 213AVS SS321dX3 d0C P Nflf 8I - 3f11 m J191019010701uv o zo G w �mWO -13d1A13db3 co y C/1 --I-I C) m c0 565W ID21023AD 0 L C-) m m ✓ Z m m �m Cn� m0 Woo Cn, a3ON3S 1118 After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning: Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges, along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees, costs, and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented loss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. https://www.fedex.com/shipping/shipmentConfirmationAction.handle?method=doContinue 1/2 6/13/2019 FedEx Ship Manager - Print Your Label(s) ■ ed Shipment Receipt Address Information Ship to: Ship from: JACKIE MERRILL CHLOE REMPEL RLF, INC., DBA CJ'S WELD COUNTY LIQUORS 3907 STATE HIGHWAY 119 1150 O STREET RM 166 LONGMONT, CO 80504 US 303-817-5547 GREELEY, CO 80631 US 9704004225 Shipment Information: Tracking no.: 775463367067 Ship date: 06/13/2019 Estimated shipping charges: 5.55 USD Package Information Pricing option: FedEx Standard Rate Service type: FedEx Express Saver Package type: FedFx Envelope Number of packages: 1 Total weight: 0.40 LBS Declared Value: 0.00 USD Special Services: Pickup/Drop-off: Drop off package at FedEx location Billing Information: Bill transportation to: COUNTYOFWELD-483 DEPARTMENT NAME: CLERK TO THE BOARD SENDER NAME: CHLOE A. REMPEL ADDITIONAL INFO: CTB DEPARTMENT ORGANIZATION CODE: 10400 Thank you for shipping online with FedEx ShipManager at fedex.com. Please Note FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non -delivery, misdelivery, or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including Intrinsic value of the package, loss of sales, income interest, profit, attomey's fees, costs, and other forms of damage whether direct, Incidental, consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented loss. Maximum for items of extraordinary value is $1000, e.g., jewelry, precious metals, negotiable instruments and other items listed in our Service Guide. Written claims must be filed within strict time limits; Consult the applicable FedEx Service Guide for details. The estimated shipping charge may be different than the actual charges for your shipment. Differences may occur based on actual weight, dimensions, and other factors. Consult the applicable FedEx Service Guide or the FedEx Rate Sheets for details on how shipping charges are calculated. https://www.fedex.com/shipping/shipmentConfirmationAction.handle?method=dOContinue 2/2 Hello