1k Edina Realty Foundation LiceCITYOF
CHAN SEN
7700 ........
PO Box 147
0~?ha5%2. M!,! 55317
Administration
Phsns: 952 227.1100
Fi>:: 952.227.1110
Building Inspections
c~ .... -G5,272711S0
'?:: 951 227.i i99
Engineering
F? 952 2271!70
Finance
...... r.-~ 9~='
:7. "_'_£ ~Z¢.
Park & Recreation
F~ :::~: ~52.227.1120
?p:cc 952227.i400
9522271404
Planning &
Natural Resources
Ph3~e: 952.227.!!30
Fz;, 952 227 i!10
Public Works
i'59i ?~ri,:,: Road
Fa,:: 952.227.13i0
Senior Center
R~::~,e: 952.227.!i 25
F¢,-c.~? ?97 ~1~q
MEMORANDUM
TO:
FROM:
DATE:
Todd Gerhardt, City Manager
Karen J. Engelhardt, Office Manager
August 19, 2002
SUB J:
Approval of Temporary Beer & Wine License, Edina Realty
Foundation
Attached please find a request for a temporary on-sale beer and wine license for
Edina Realty Foundation. The Edina Realty Foundation was established in 1996
for the purpose of assisting in housing related issues. They are planning a charity
ball that will include food, music, and beverages on September 20, 2002 in the
gymnasium at St. Hubert's Church. All proceeds from the event will be donated
to the Carver County Crisis Nursery and OMEGON, a residential treatment center
for troubled teens in Minnesota.
Attached is a copy of the liquor liability insurance certificate covering this event.
RECOMMENDATION
Approval of the request from the Edina Realty Foundation for a temporary beer
and wine license for a charity ball on September 20, 2002, is recommended.
g:\userXkarenXliquor\edina realty foun.doc
The City ol Cflanhassen · ..z. :.'c,:,r:_~ cc,,'n."~,';,~:,' v,./m clear., i~:~,s., .... 'it,: sc,hoots, a chaining downtown, thrivfng businesses, winding trails, and beautiful parks. A gear place to live. work. and play.
Minnesota Department of Public Safety
LIQUOR CONTROL DIVISION
444 Cedar St./Suite 100L
St. Paul, MN 55101-2156
(612)296-6439 TDD (612)282-6555
APPLICATION AND PER.MIT
FOR A 1 TO 4 DAY TEMPORARY ON-SALE LIQUOR LICENSE
(Organization or location limited to 3 permits in a 12 month period)
TYPE OR PRINT INFORMATION
oF O AN Z^TIg
DATE ORGANIZED
TAX EXEMPT NUMBER
ST)~TE
ZIP CODE
NAl~x. OF ,PERS ~(~ MAKING APPLICATION
I)ATES LIQUOR WILL BE SOLD (1 to 4 days)
BUSINESS PHONE
TYPE OF ORGANIZATION
IHOME PHONE
ORG,A,,.NIZATIO,N OFI4CER'S NAME ADDRESSf.
.ORGANIZATION OFFICER'S NAME ADDRESS
ORGANIZATION OFFICER'S NAME ~' ADDRESS
i.ochlion v~-here license will be used. If an outdoor area, dcscribe
CLUB ~'CttARITABLE Iq RELIGIOUS ~ OTHER NONPROFIT
Ct5
Will the applicanl contract lbr inloxicating liquor scn-'ices? If so, give thc namc and address of the Liquor hcense providing the sen,ice.
/ ! i
Will Iht applicant can3.- liquor liabilit)' insurance? If so. the carrier' s name and amount of coverage.
(NOTE: Insurance is no/mandalory) " ' ' ' ~
APPRO fAL
APPLICATION MUST BE APPROVED BY CITY OR COUNTY BEFORE SUBMITTING TO LIQUOR CONTROL
CITY~COUNTY
CITY FEE AMOUNT
DATE FEE PAID
SIGNATURE CITY CI,I/RK OR COUNTY OFFICIAL
DATE APPROVED
LICENSE DATES
APl'ROVED LIQUOR CONTROL DIRECTOR
NOTE: Do not separate these m'o parts, send both parts to the address above and the original signed by this dh'ision
will be returned as the license. Submit to the City or Count3' at least 30 days before the event.
PS-09079(8/95)
AUG-14-~00~
10:~3
CERTIFICATE OF LIABILITY INSURANCE -
P. 01/01
-.
· ' :" -'. ' ..... '. 08114/02
,ADh Risk Services, Inc. of Nebraska
Insurance Services CA License
11213 Davenport
Suite 201
Omaha NE 68154 USA
~E (402) 697-1400 FAX-(402) 697-0017
Homeservices of America, Inc.
% Edina Realty Inc.
6800 France Ave, South,Ste 600
Edina MN 554350000 USA
TtlIS CERTIFICATE IS ISSUED AS A MAT~ER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
__
INSURI~RS AFFORDING COVERAGE
FNSUR~RA: Great Northern Insurance Co.
INSURER B:
INSU~R C:
~S~R D:
~S~ E:
'intended'~ndorSem~ntS~onditions and;exclmions:df th. eLpoliciefshown ...... .:.....: ~.: .:
OF ~S~ANCE LIS~D BELOW HAVE BEEN ISSUED ~ ~ INSU~D N~D ~OVE FOR T~ POLICY PE~OD INDICAT~. NOTW~S~A~
, '~ OR CONDITION OF A~ CO~CT OR O~R ~C~ENT WI~ ~SPECT TO ~CH ~IS CERT~ICA~ MAY BE ISS~D OR MAY
THE ~SU~NCE ~O~ED BY ~ ~LIC~ D~CRIBED HE~IN IS SUBJECT TO ALL T~ TERMS EXCLUSIONS AND CONDITIONS OF SUCH POI,ICIE$,
L~ITS SHO~ ~y HAVE BEEN REDUCED {IY PAID ~IM$, '
TYPE OF INSURANCE
GENERAL LLSBILITY
COMMERCIAL GEI~Ep,~I. LIABILITy
El_AIMS MADE~ OCCUR
GE.~L AGGREGATE LIMIT APPLIES PEg:
POt. ICY
JECT ~ LOC
AUTOMOBILE LIABILITY
ANY AU]X)
ALL OWNED AUTOS
$CI4EOULED AUTOS
HIRED AUTOS
NON O%¥.'NED AUTOS
GARAGE LL-X~ILITY
ANY AUTO
EXCESS LIABILITY
OCCUR [---] CLAIMS MAD{
DEDUCTIBLE
RETENTION
WOR. KEi~ COMPENSATION AND
EMPLOYER.~' LIABILITY
OTHER
POLICY NUMBER
3S3~-~2-32
'~-RgPTION OF OPERATIONSA. OCATIONf, TVEH[CLE$/EXCLUSiONS ADDED BY ENDORSEMENT/SPECiAL PROVISIONS
POLICY EFFECTIVE POLICY
DAI'E(MM~DD%YV) DA'FE(MM~DD~yy)
04/01/02 04/01/03
' ~ACH OCCUF~Z-~C~ $1,000,000
FIRE DAmAGE(Any one tim) $ .~, 000,
M~D EKP fA.nv one uerson]
PERSONAL & ADV IN.E/~Y
O£N 6g, AL
PRODUCTS - (:OMWOP AC;(}
$1,000,000
$2,000,
$2,000,000
COMBINED SINGLE LIMIT
(Ca accident)
BODILY INIURY
( Per
BODI[.¥ INJLnRy
(Per accident)
PROPERTY DAMAGE
(Per
AUTO ONLY - EA ACCIDENT
OTb~RTNAN EAACC
AUTO ONLY:
AGG
EAC~OCCURRENCE
:AGGREGATE
wc
EL. EACFI ACCIDENT
E.L. DISEASE.POLICY LIMIT
E.L. DISEASE-CA £MPLOYEE
SIIOULD ANY OF TRE A/~OvE O£SCRIRED POLICIES BE CANALLED BEFOaE TH5 E~I~TION
City of Chanhassen DATE ~E~OF, THs: ISSUinG CO~ANYWILL E~EAVORTO MAIL
B~ FML~ TO ~ SO .SHALL IMPOSE NO OBLIGATION OR LIABILITY
Cnann as sen, ~ 553 ~ V USa ~' ~Y KI~ UPON ~ COMPANY, ~S,~GEN~S 0K ~P~ENTATtV~,
A~N"~ED ~P~SENTATi~ ~~~ -
570003672166 ' ' ' : ........ '" ~" ' 'T'~'~~9
;.{f~cato. Nn :
I~older Identifier:
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