1i. Approve one Day Beer License Request, Septemberfest Celebration, September 23, Chanhassen Lions Club1
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CITY OF 1 °
CHANHASSEN
690 COULTER DRIVE • P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317
(612) 937 -1900 • FAX (612) 937 -5739
Action by City Administrator
Endorsed ✓ t�tJ�
MEMORANDUM WNW
TO: Don Ashworth, City Manager
Date Submitted to Commissbrt
FROM: Karen Engelhardt, Office Manager
Dato Submitted to CoUWA
DATE: September 6, 1995 // 9 S
SUBJ: Request for On -Sale Non - Intoxicating Liquor License, September 23,
Chanhassen Lions Club
Attached please find an application for an on -sale non - intoxicating liquor license from the
Chanhassen Lions Club. The Lions plan to sell beer on September 23 during the City's
Septemberfest Celebration in City Center Park. Attached is a copy of their liquor liability
insurance that is in effect for that date.
RECOMMENDATION
Staff recommends approval of the application as submitted and recommends a license fee of $1.
PS- 09079 -01 (8/85) MINNESOTA DEPARTMENT OF PUBLIC SAFETY
PHONE 612-296-6159 LIQUOR CONTROL DIVISION
333 SIBLEY • ST. PAUL, MN 55101
APPLICATION AND PERMIT
FOR A 1 to 3 DAY TEMPORARY ON -SALE LIQUOR LICENSE
TYPE OR PRINT INFORMATION
NAME OF ORGANIZATION
Lions Club of Chanhassen
STREET ADDRESS
P.O. Box 484
NAME OF PERSON MAKING APPLICATION
Gary Boyle
DATES LIQUOR WILL BE SOLD? 0 TO 3 DAYS)
September 23, 1995
ORGANIZATION OFFICER'S NAME
Roman Roos, President
ORGANIZATION OFFICER'S NAME
Robert Siegel, Secretary
ORGANIZATION OFFICER'S NAME
Curt Robinson
DATE ORGANIZED NO. OF MEMBERS TAX EXEMPT NUMBER
1988 50
CITY STATE ZIP CODE
Chanhassen MN I 55317
BUSINESS PHONE HOME PHONE
( 612) 540 -7529 (612 ) 934 -7617
DOES ORGANIZATION HAVE A CHARTER I GENERAL PURPOSE OF ORGANIZATION
R Yes 0 No Service
ADDRESS
1727 Greencrest Drive, Victoria
ADDRESS
411 Highland Drive, Chanhassen
ADDRESS
202 West 77th Street, Chanhassen
Location where license will be used. If an outdoor area, describe.
City Center Park
Will the applicant contract for intoxicating liquor services? If so, give the name and address of the Liquor licensee providing
the services.
Locker Bros. Distributing, Green Isle, Minnesota
Will the applicant carry liquor liability insurance? If so, the carrier's name and amount of coverage.
(Note: Insurance is not mandatory) Yes. Transcontinental Insurance Co.
APPROVAL
CITY OF
CITY FEE AMOUNT
DATE FEE PAID
SIGNATURE CITY CLERK
DATE APPROVED
LICENSE DATES
APPROVED LIQUOR CONTROL DIRECTOR
NOTE: Do not separate these two parts, send both parts to the address above and the original signed by this division
will be returned es the license. Submit to the City Clerk at least 30 days before the event.
PRODUCER
CORPORATE 4 INS AGENCY INC
7220 METRO BOULEVARD
EDINA MINNESOTA 55439
Lions Club of Chanhassen
P.O. Box 484
06/19/95
THIS CERTIFICATE IS ISSUED AS A MATTER 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.
COMPANY A
LETTER
. ....... .. ........
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANIES AFFORDING COVERAGE
TRANSCONTINENTAL INS. CO.
Chanhassen, MN 55317
COMPANY E
LETTER
CO R G ... ,;; : :.:..:::::.:...:
...............
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REOUIREMENT, 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
TR DATE (MM /DD/YY) DATE (MM /DD/YY)
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR.
OWNER'S & CONTRACTOR'S PROT.
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
LIQUOR
LIABILITY
GENERAL AGGREGATE
$
........ ...................
PRODUCTS - COMP /OP AGGR.
...............................
$
PERSONAL & ADV. INJURY
: $
EACH OCCURRENCE
.............................
$
FIRE DAMAGE (Any one fire)
$
MED. EXPENSE (Any one person)
: $
COMBINED SINGLE
$
LIMIT
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURENCE
$
AGGREGATE
...... .............. ..............
$
STATUTORY LIMITS
EACH ACCIDENT
$
DISEASE - POLICY LIMIT
$
DISEASE-EACH EMPLOYEE
$
LLP2660268 06/30/95 06/30/96 SEE BELOW
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES /SPECIAL ITEMS
LIQUOR LIABILITY: BODILY INJURY:$ 1,000,000 ea.person /$1,000,000 ea.occurrence;
PROPERTY DAMAGE: $1,000,000 ea.occ; LOSS OF MEANS OF SUPPORT: $1,000,000 ea
person /$1,000,000 ea. occ; ANNUAL AGGREGATE: $1,000,000
CERTIFICATE HOLDER
Chanhassen City Hall
Attn: Todd Hoffman
690 Coulter Drive
Chanhassen, MN 55317
ACORD 25 -S (7/90
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 1 0 DAYS WRITTEN 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 R E " O f
........ : s :: >;:;:
:A CO RD CO RATION i0