1g Lions Club Beer License CITYOF
7700 Market Boulevard
PO Box 147
Chanhassen. f:,iN 55317
Administration
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Fa',.: 952.2271110
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P?.o~e: 952.227.1180
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:. %2.227.1t40
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Fa':.: 952.227.!1!0
2310 Ccc',ter
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!59i Park Road
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MEMORANDUM
TO:
FROM:
Todd Gerhardt, Acting City Manager
Karen Engelhardt, Office Manager
DATE: July 2, 2002
SUB J:
Approval of Temporary Beer License, Chanhassen Lions Club,
August 2-4, 2002
Attached please find an application for a temporary beer license from the
Chanhassen Lions Club. The Lions would like to sell beer at the Regional
Softball Tournament that will be held at Lake Ann Park on August 2-4.
RECOMMENDATION
Staff recommends approval of the Chanhassen Lions Club request to sell beer at
Lake Ann Park on August 2-4, 2002 for a fee of $1.00. This approval should be
contingent upon receipt of their liquor liability insurance certificate.
g.\uscr\karen\liquor\!ions.doc
The City of Chanhassen · ,:: _:":,', ir:~: ;::~':":~rn~{y ',','[th OX'a:' :Z:eS. ;Ua:'ti' *:""'O'X'~ '~ ~hF. rmifin d ...... O%,FL thrMng b.,Ynesses, v,,indino trails, ''''~ her-U? f ii parks. A '-'=.~? p!a.'.":e to ih, e. ,,,,nr~ and cay.
PS-09079-01 (8/85)
PHONE 612-296-6159
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
LIQUOR CONTROL DIVISION
333 SlBLEY · ST. PAUL, MN 55101
APPLICATION AND PERMIT
FOR A I to 3 DAY TEMPORARY ON-SALE LIQUOR LICENSE
TYPE OR PRINT INFORMATION
NAME OF ORGANIZATION
STREET ADDRESS
DATE ORGANIZED }_ NO. OF MEMBERS
TAX EXEMPT NUMBER
ZIP CODE
BUSINESS PHONE I HOME PHONE
DATES L,~IQUOR WILL B.~._E SOL~D? ~1 TO 3 ,D~AYS) -- .~ J OOES~0RGANIZATION HAVE A CHARTER I GENERAL PURP( OF ORGANIZATION
c~-~u~Z_~.-~/-z/, -___~_~'~z-~..4.~ ~ ~Yes ~No ~,. ._ , . ,
ADDRESS
Location where license will be used. If an outdoor area, describe.
, /, / '
Will the applicant contract for intoxicating liquor services? If so, give the name and address of the Liquor licensee providing
the services.
Will the applicant carry liquor liability insurance? If so, the carrier's name and amount of coverage.
(Note: Insurance is not mandatory)
APPROVAL
CITY OF
CITY FEE AMOUNT
DATE FEE PAID
SIGNATURE CITY CLERK
DATE APPROVED
LICENSE DATES
APPROVED LIQUOR CONTROL DIRECTOR
Do not separate these two parts, send both parts to the address above and the original signed by this division
NOTE:
will be returned ss the license. Submit to the City Clerk at least 30 days before the event.
ACORD CERTIFICATE OF LIABILITY INSURANCE
,. o5/z3/zooz
PRODUCER (952)893-9218 FAX (952)893-9402 THIS CERTIFICATE IS ISSUED AS A MATTER OF NFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CORPOEATE 4 ZNS AGENCY, ZNC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
7220 METRO BOULEVARD ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
I EDINA, MN $5439-2133 INSURERS AFFORDING COVERAGE
IINSURED INSURERA: General Star Indemnity
Chanhassen Lions Club INSURERB:
PO Box 484 INSURER C:
Chanhassen, MN 55317 INSURERD:
.
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
~1"?1~ TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE
COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire)
I CLAIMS MADE ['~ OCCUR MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/Op AGG $
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident)
ANY AUTO
ALL OWNED AUTOS ............ C .... ~' ' i ~' , '" (- ~ ..... BODILY INJURY
HIREDAUTOS I.!NES INSURER BU'i' iS HO ' Oi'HFRWI$I~ BODILY INJURY
NON-OWNED AUTOS LICENSED iJY THE STATE OF '41HI"IESOTA. Ii I (Per accident) $
[ _~ ...... (Pal acc~der, I) $
I GAaP, GE LIABILITY , ~ r AUTO ONLY - EA ACCIDENT $
i ]~ ANY AUTO SURPL'b:~" i['~S 'r,~,.?: .................................... OTHERT,AN EAACC$
AUTO ONLY: AGG $
AC'
$
__~ - E'L- DISEASE - POLICY LIMIT $
~--om-b--~--~---~ '~~ '06/30/2002 06/30/2003 $1,000,000 each common cause
t Liquor Liaui~i~y $1,000,000 aggregate
FICATE HOLDER [~ ADDITIONAL INSURED; INSURER LE'I-I'ER:
CANCELLATION
Chanhassen Lions Club
PO Box 484
Chanhassen, MN 55317
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY W1LL ENDEAVOR TO MAIL
~ DAYS WRI'FI'EN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Jane Johnson/MB