2l. On-Sale Liq Lic for Chan Lions Club Septemberfest CITYOF x .
CHANHASSEN
690 COULTER DRIVE • P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317
1 (612) 937 -1900 • FAX (612) 937 -5739
Action by City Administrator
E n d orse d ✓ Dom&
MEMORANDUM 111odified
Rejected
TO: Don Ashworth, City Manager DatR 9 -
1 Date Submitted to Commission
FROM: Karen Engelhardt, Office Manager ► ' T -- ---- --
Dete Submitted to Council
' DATE: September 7, 1993 9-/3 -13
' SUBJ: On -Sale Non - Intoxicating Liquor License Request, Chanhassen Lions Club,
Septemberfest Celebration (formerly Oktoberfest), September 25
1
Attached please find an application for an on -sale non - intoxicating liquor license for the
Chanhassen Lions Club. The Lions would like to sell beer at the city's annual Septemberfest
celebration on September 25, which is held in the lower parking lot area at City Hall. The Lions
organization has sold beer at this celebration for the past four years.
Also attached is a copy of the liquor liability insurance certificate which will cover this event.
' RECOMMENDATION
This office recommends approval of the on -sale non - intoxicating liquor license application of the
1 Chanhassen Lions Club for the Septemberfest Celebration on September 25, 1993, and that the
fee for said license be set at $1.00.
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PS 09079 -0, Isie5) MINNESOTA DEPARTMENT OF PUBLIC SAFETY
PHONE 612-296-6159 LIQUOR CONTROL DIVISION
1 333 SIBLEY • ST. PAUL, MN 55101
1 f.
APPLICATION AND PERMIT
FOR A 1 to 3 DAY TEMPORARY ON -SALE LIQUOR LICENSE
I TYPE OR PRINT INFORMATION
NAME OF ORGANIZATION DATE ORGANIZED NO. OF MEMBERS TAX EXEMPT NUMBER
LIailS flub c C_V- ia,6Mse,\ l`t8f 91 41- tb`), (ow1.
' ST ET AD SS CITY STATE ZIP CODE
Y o CI X y b y C RY\ 5S�31')
N OF PERSON MA APPLICATION BUSINESS PHONE HOME PHONE
.D � t WG &LAVQ* s� '1 S'a:°t (6)21 q 3�2 -
I OA E LIQUOR WILL BE SOLD? (1 TO 3 DAYS) DOES QRGANIZATION HAVE A CHARTER ENERAL PURPOSE OF ORGANIZATION
� � � 5 1 1� Yes 12 Nor1 - U10
GANIZATIO i FFICER'S NAME ADDRESS
' ORGANIZATION OFFICER'S NAME ADDRESS
S fl c V \ S �� ucl 1 c3 . ' 1' {�ISn1 �e� it.. &\4'
ORGANIZATION OFFICER'S NAME ADDRESS
1 Location wher icense will be used. If an outdoor area, describe.
C,� �A),
1
I Will the applicant contract for intoxicating liquor services? If so, give the name and address of the Liquor licensee providing•
th e services.
1.--cC1 -- Ci.- ` 015\; A)1/41 t — CiLec -A Est e
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Will the applicant carry liquor liability insurance? If so, the carrier's name and amount of coverage.
I (Note: Insurance is not mandatory)) /E
)AI ai \ A C4 S , Cl- t�i� 41 5ab � aaa PS) g. 060
APPROVAL
CITY OF DATE APPROVED
CITY FEE AMOUNT LICENSE DATES
1 DATE FEE PAID
APPROVED LIQUOR CONTROL DIRECTOR
1 SIGNATURE CITY CLERK
I NOTE: Do not separate these two parts, send both parts to the address above and the original signed by this division
will be returned as the license. Submit to the City Clerk at least 30 days before the event.
f
COMMERCIAL INSURANCE POUCY - COMMON POUCY DECLARATIONS USF&G•
INSURANCE 1
Policy No. LLC 139629260 00 Renewal of LLC 127864077 00
1
1. NAMED INSURED AND MAILING ADDRESS: 0 United State: Fidelity and Guaranty Downy
(No., Street, City, State, Zip Code)
I
CHANHA LIONS CLUB ❑ Fidelity and Guaranty insurance Underwriters. Inc.
I P.O. BOX 484 ❑ Fidelity and Guannty Insurance Company
CHANHASSEN, MN 55317
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(Each a Stock Insurance Company)
The issuing company is designated above by
I
the letter X.
2. POLICY PERIOD: Branch Office: Minneapolis
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Agent: Hadtrath & Associates, Inc.
From 9/28/92 t 9/28/93 Address: Coon Rapids, MN 55433
12:01 A.M. standard time at your mailing address
I
shown above.
Agent's Code: 47 -4163
3. BUSINESS DESCRIPTION: Countersigned By:
I
Fraternal Club ' 4 ,/°-- 'd '
July 4. In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide I
the insurance as stated in this policy. This policy consists of the following Coverage Part(s) for which a premium
is indicated. This premium may be subject to adjustment. The Policy Writing Minimum Premium is$ I
Coverage Part(s) Premium
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Liquor Liability $ 400. •
$ 1
$
$
d, Total Policy Premium $ 400. I
ry
•d . Premium is payable: At Inception $ 400.
i 1
I 5. FORMS AND ENDORSEMENTS APPLICABLE TO ALL COVERAGE PARTS: CL /IL 108 08 89
CL /IL 211 07 89, CL /IL 210 -1 07 90, CL /IL 154 07 90,CG 00 33 11 88,
II
CG 28 06 11 85, CL /IL 00 21 02 88
CL in Ina na ao
USF&G®
1 LIQUOR LIABILITY COVERAGE PART - DECLARATIONS INSURANCE
Policy No. PLC 13962926000
1
LIMITS OF INSURANCE
1 $ 500,000 Aggregate Limit
$ 500,000 Each Common Cause Limit
I FORM OF BUSINESS:
i Individual ❑ Partnership ❑ Joint Venture ❑ Corporation
Other Fraternal Organization
LOCATION OF ALL PREMISES YOU OWN, RENT OR OCCUPY:
I ❑ Same as shown in Item 1 of the Common Policy Declarations.
I Various
PREMIUM SCHEDULE
I Classifications Premium Advance Code No. Bases' Rates Premiums
Manufacturers, wholesalers and distributors selling
alcoholic beverages for consumption off premises 50911
Package stores and other retail establishments selling
I alcoholic beverages for consumption off premises 59211
Clubs 70412 Flat Flat $400.
I Charge Charge
Restaurants, taverns, hotels, motels, including
• package sales 58161
1 Temporary Licensees 58168
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I 'See Description of Terms Used as Premium Bases.
TOTAL ADVANCE PREMIUM FOR THIS COVERAGE PART: $ 400.
I AUDIT PERIOD: ® Annually ❑ Semi- annually ❑ Quarterly ❑ Monthly
FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART: COIL 00 21 02 88, COIL 211 07 89
1 CL /IL 108 08 89, CL /IL 210 - 1 07 90, CL /IL 154 07 90, CG 00 33 11 88, CG 28 06 11 85
RETROACTIVE DATE: (Applicable only when coverage is provided by CG 00 34 Claims Made.)
I (Enter date or "None" If no Retroactive Date applies.)
This insurance does not apply to "Injury" which occurred before the Retroactive Date, if any, shown above.
I COIL 211 07 89