1j. Temp Beer License for 4th of July, Rotary CITYOF
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690 COULTER DRIVE • P.O. BOX 147 • CHANHASSEN, MINNESOTA 55317
(612) 937-1900 • FAX (612) 937-5739
1 MEMORANDUM
1 TO: Don Ashworth, City Manager
FROM: Jim Chaffee, Public Safety Director
DATE: June 7, 1990
SUBJ: Three Day Temporary On-Sale Beer License Chanhassen Rotary
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Please find attached an application for a liquor license permit to
' be issued to the Chanhassen Rotary for June 29, 30, and July 3,
1990. The Rotary Club will again be serving beer as they did the
two (2) previous 4th of July celebrations.
1 There is an attached copy of an insurance policy that runs through
July 1 , 1990. We are renewing the insurance policy for 1991.
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MANAGER ' S COMMENT: Approval is recommended .
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II PS-09079-01(8185) MINNESOTA DEPARTMENT OF PUBLIC SAFETY
PHONE612-296-6159 LIQUOR CONTROL DIVISION
1 333 SIBLEY • ST. PAUL, MN 55101
I at _ =
'- APPLICATION AND PERMIT
A 1 FOR to 3 DAY TEMPORARY ON-SALE LIQUOR LICENSE
ITYPE OR PRINT INFORMATION
NAME OF ORGANIZATION DATE ORGANIZED NO.OF MEMBERS TAX EXEMPT NUMBER
CG,'n4,4-11e,. CG'e b 4-1-4--) 3
I STREET ADDRESS CITY STATE ZIP CODE
69P �••LTe/e. d2 C/f4A,./L.i-De..I filN S3ji7
NAME OF PERSON MAKING APPLICATION BUSINESS PHONE HOME PHONE
IOI ,,. CarrPFe-e— (GiL ) 5'37 -(Svo ( G/t )J�') y- 707
DATES LIQUOR WILL BE SOLD?(1 TO 3 DAYS) DOES ORGANIZATION HAVE A CHARTER GENERAL PURPOSE OF ORGANIZATION
Jr1Ne.. .2 iCi Ict(,, 3 ? /990 g Yes ❑No C.l�Rt746�e
I ORGANIZATION OFFICERS NAME 7 ADDRER
MA&o w 4-62-Eo 1/44, Pt eM4'7` ✓r ei 01 'Lt-sJe•^)
ORGANIZATION OFFICER'S NAME ADDRESS
W\tIce_ rP_.Aq$ tf o37 C► a•Yen1N'e. 4) N,sh44r.62..,)
I ORGANIZATION OFFICER'S NA E ADDRESS
J(.00, C f- .�.. S73( K,L,..4_ ha 44477c,51-
ILocation where license will be used.If an outdoor area,describe.
ZA-g€ AA, C,d,G Ce.✓r-eA AA talc S
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I Will the applicant contract for intoxicating liquor services?If so,give the name and address of the Liquor licensee providing
the services.
IN/A-
I Will the applicant carry liquor liability insurance?If so,the carrier's name and amount of coverage.
(Note:Insurance is not mandatory)
See A-1—'141-A-col .
IAPPROVAL
ICITY OF DATE APPROVED
CITY FEE AMOUNT LICENSE DATES
IDATE FEE PAID
APPROVED LIQUOR CONTROL DIRECTOR
ISIGNATURE CITY CLERK
Do not separate these two parts,send both parts to the address above and the original signed by this division
I NOTE:
will be returned as the license.Submit to the City Clerk at least 30 days before the event.
This Program Covers •
g Club Meetings • Youth Programs I
• Fund Raising • RYLA
• Parades - • Youth Exchange
•Sale of Food
• Social Gatherings • Non Owned& Hired Automobiles
Automobiles
• Incorporated Foundations • Non-Owned Watercraft Up to 26'.
• Spectators at Athletic Events • Liquor- Sold or Given Away I
Club Limits: I
$3,000,000 occurrence/$4,000,000 aggregate Bodily Injury&Property Damage
$3,000,000 occurrence/$4,000,000 aggregate Products&Completed Operations
$3,000,000 Non Owned & Hired Automobiles '
$3,000,000 Personal &Advertising Injury
$ 50,000 Fire Legal Liability
--4----5,000 Medical Payments - -- . --- -- - -- ---- --.--7.--------- _ I
Company: Rnval Insurance Company of America, Charlotte, N.C. I
(Kest Rating A+ XI)
Term: Jul N I. 1989 - ,1ul■ 1, 1990
Rate: S l.9ui pc] member.
1>>( sated from effective date of addition to Jul} 1, 1990
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Additional Coverages Directors&Officers$1,000,000 + additional premium quotation tntingent nn
Available: completed application. '
Insurance Terminology: Commercial General 1,1,11,1111)
'Volunteers as additional utsuicds
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Club Members as additional insurcdk
Exclusions: Athletic Participants
Fireworks I
Mechanically Operated Amusement I)e\lc( ,
Asbestos 8: Pollution i
Territory: United States, its possessions, and Canada
Insured: Available only to Entire Rotary Districts including all U.S Clubs
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To Order:
complete attached application and mail
with attendance list and check payable to:
,:Northern Insuring Agency, Inc.
1_P.O. Box160 = I
Additional - f Plattsburgh, New York 12901
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Information Needed. '
.contact:
Deena Gilt McCullough, Account Executive or
-Laurie Mere, Account Executive Assistant
j l8.561.7000 FAX 515-561-0210 = - . '
In some stairs A A a Rid C.ilu of Rodrru(..(.iiu Insuranrr Agrnn -w Iwdii i to,a,lual.nnuat i w a-. i I
oAnc anJ aau yo n iunu.