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Home My WebLink About2010 01.19 City Council Regular Agenda PLEASE FILL OUT A"R^JEST TO SPEAK"FORM IF YOU WISH TO ADD(. ;S THE COUNCIL AT CALL TO THE PUBLIC OR ON ANY NON-PUBLIC HEARING i EM. Pg-xcH a GO a pache junction U Z NOrle o,"tl)e ,Superstition,,�loitiiteiiii.r �PtZOIA APACHE JUNCTION CITY COUNCIL CITY COUNCIL CHAMBERS 300 EAST SUPERSTITION BOULEVARD ( 1 APACHE JUNCTION,ARIZONA 85219 REGULAR MEETING AGENDA January 19,2010 7:00 PM A. CALL TO ORDER. E• INVOCATION AND PLEDGE OF ALLEGIANCE. C. ROLL CALL. D. CONSENT AGENDA. The Council may,at this time,take single action on any or all items listed as consent agenda items.These items may include,but are not limited to,acceptance of agenda,acceptance of minutes,appointments,acceptance of resignations and adoption of certain resolutions and other items which do not require a public hearing.The Consent Agenda is a timesaving device of which the Mayor and City Council is to receive documentation on these items from the City Manager for their review prior to the meeting.Any member of the Council may remove any item from the Consent Agenda for discussion and cause a separate vote on the matter later in the agenda. 1• Acceptance of Agenda. 2. Approval of Minutes of Regular Meeting of January 5,2010. E. AWARDS, PRESENTATIONS AND PROCLAMATIONS. Awards,presentations from other organizations,proclamations issued by the mayor,and acknowledgement of distinguished guests and visitors,and staff presentation of receipt of grant or donated funds are permitted at this time. None. R ANNOUNCEMENT OF CURRENT EVENTS. The Mayor or any member of Council may at this time present a brief summary of current events. However,no discussion shall take place on such items except for clarifying comments related to substance,time and location. G. CITY MANAGER'S REPORT.- The City Manager,,members of.City staff or those individuals designated by the Manager may present information pertinent to items-under consideration or information related to the operation of the City.There shall however be no discussion at this time except for clarification inquiries. 3. MANAGER'S REPORT. 4. PRESENTATION AND DISCUSSION ON THE UTILIZATION OF VOLUNTEERS IN THE APACHE JUNCTION POLICE DEPARTMENT. Jerald Monahan, Police Chief,will provide an overview on the utilization of volunteers in the City of Apache Junction Police Department. H. PUBLIC HEARINGS. Public hearings required by applicable law shall be conducted by the Council and any person shall be given the opportunity to speak.All remarks shall be addressed to the Council as a whole and not to any member thereof.Such remarks shall be limited to five(5)minutes unless additional,time is granted,by the Mayor:This limitation shall not apply to applicants and their Its appearing before the Council. 5. APPLICATION FOR A NEW LICENSE,CORPORATION,SERIES 10 LIQUOR LICENSE FOR WALGREENS #06333. This public hearing is the next step in the application process required by state law. The city council is required to give a recommendation of approval or denial to be forwarded to the Arizona Department of Liquor Licenses and Control:. �• OLD BUSINESS. The Council shall consider any business that has been previously considered and which is still unfinished to include those items previously postponed or tabled.No member of the public shall be permitted to speak on these items unless invited to do so by the Mayor after first submitting a written request-to-speak form with the City Clerk. None. J- NEW BUSINESS. The Council shall consider any business not yet considered.No member of the public shall be permitted to speak on these items unless invited to do so by the Mayor after first submitting a written request-to-speak form.with the City Clerk. 6. PRESENTATION,DISCUSSION,AND POSSIBLE CONSIDERATION ON FISCAL YEAR 2009-2010 PROFESSIONAL SERVICES AGREEMENT WITH APACHE JUNCTION COMMUNITY DEVELOPMENT CORPORATION FOR ECONOMIC DEVELOPMENT AND BUSINESS EDUCATION SERVICES. Presentation,discussion and possible consideration of a professional services agreement with the Apache Junction Community Development Corporation to continue services as outlined in their program activities. 7. PRESENTATION,DISCUSSION AND CONSIDERATION ON FISCAL YEAR 2009-2010 PROFESSIONAL SERVICES AGREEMENT WITH APACHE JUNCTION MAIN STREET FOR ECONOMIC DEVELOPMENT SERVICES. Presentation,discussion and possible consideration on a professional services agreement for Main Street's continuation of events to ,encourage business in the downtown and support for local businesess. K- COUNCIL DIRECTION TO STAFF. This item allows the Mayor and City Council to direct staff on specifically listed matters. None. �• SELECTION OF MEETING DATES, TIMES, LOCATIONS, AND PURPOSES: 8• EXECUTIVE SESSION AT 5:45 P.M.AND WORK SESSION AT 7:00 P.M.FOR MONDAY,FEBRUARY 1,2010. 9. EXECUTIVE SESSION AT 5:45 P.M.FOR TUESDAY,FEBRUARY 2,2016.OTHER MEETINGS IF NECESSARY M. CALL TO PUBLIC. At this time the public has the privilege to address the Council with requests,communications,comments or suggestions relating to City business that are not listed on the agenda.All speakers must have already submitted a writterf"Request to Speak"form to the City Clerk no later than the conclusion of the City Manager's Report portion of the agenda.If there is a group speaking on the same item,they should select a spokesperson.All such remarks shall be addressed to the Council as a whole and not to any member thereof.The Mayor is authorized to ask a speaker to stop speaking and leave the podium or to adjourn the meeting if anyone becomes disorderly,uncivil,makes personal attacks or continues to speak about items that are not within the jurisdiction of the city after being warned such issues are beyond the jurisdiction of the city to act.The Council may not answer questions of the speaker,discuss the matter with one another,but may,at the conclusion:.1) respond to criticism by a speaker;2)ask the City Manager to review a matter;3)ask the City Manager to place the matter on a future agenda. Each speaker must approach the podium,speak into the microphone,provide their name and address.There is a three(3) minute time limit per speaker. N. ADJOURNMENT. Copies of this agenda and additional information regarding any of the items listed above may be obtained from the City Clerk's office: 300 East Superstition Boulevard,Apache Junction,AZ Monday.through Friday,8:00 aim.to 5:00 p.m.,excluding holidays If any person with a disability needs any type of accommodation,please notify the Human Resources Office, at CITY COUNCIL REGULAR MEETING JANUARY 5, 2010 The regular meeting of the City Council of the City of Apache Junction, Arizona, was held on January 5, 2010, at the Apache Junction City Council Chambers pursuant to the notice required by law. row*) CALL TO ORDER Mayor Insalaco called the meeting to order at 7 : 00 p.m. INVOCATION Councilmember Wilson gave the Invocation. PLEDGE OF ALLEGIANCE Vice Mayor Eck led the Pledge of Allegiance . , ROLL CALL Councilmembers Present : Mayor Insalaco Vice Mayor Eck Councilmember Barker Councilmember Coleman Councilmember Wilson (Councilmembers Dietz and Serdy were absent) Staff Present : City Manager George Hoffman Assistant City Manager Bryant Powell City Clerk Kathleen Connelly City Attorney Joel Stern Public Safety Director Jerald Monahan Public Works Director David Fern Economic Dev. Director Steve Filipowicz Others Present : Public Works Manager Shane Kiesow Police Records Supervisor Rhonda Wise REGULAR MEETING OF THE CITY COUNCIL JANUARY 5, 2010 PAGE 1 OF 7 Program Coordinator Heather Patel ACCEPTANCE OF CONSENT AGENDA ) ) Vice Mayor Eck MOVED THAT THE CONSENT AGENDA BE ACCEPTED AS PRESENTED; AND THAT RESOLUTION NO. 09-59, A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, AUTHORIZING CITY STAFF TO SUBMIT AN AMENDED WASTEWATER DESIGNATED MANAGEMENT s� AREA BOUNDARY, BE APPROVED. J Councilmember Barker SECONDED THE MOTION . VOTE: Unanimous . The motion carried. AWARDS, PRESENTATIONS AND COMMUNICATIONS Department of Public Safety Director Jerald Monahan presented Police Records Supervisor Rhonda Wise with her 25-year service award. He gave a brief summary of the highlights of her career. ANNOUNCEMENT OF CURRENT EVENTS Councilmember Coleman announced that the Arizona Republic named Apache Junction High School defensive lineman Si Maugmer to the All Arizona Football Team. Mayor Insalaco announced there is a citizens' group that is requesting donations for the July 4, 2010 city fireworks display. AWARDS, PRESENTATIONS AND COMMUNICATIONS (continued) Department of Public Safety Director Jerald Monahan and Apache Junction Drug Coalition Vice Chairperson Christa Rizzi gave a short presentation on recommended social host and unruly gathering .regulations . CITY MANAGER' S REPORT REGULAR MEETING OF THE CITY COUNCIL JANUARY 5, 2010 PAGE 2 OF 7 n � None . PUBLIC HEARINGS None . OLD BUSINESS None . NEW BUSINESS RESOLUTION NO. 09-61, APPROVING THE SUBMISSION OF A RURAL ECONOMIC DEVELOPMENT AND PLANNING ASSISTANCE GRANT ) Program Coordinator Heather Patel briefed the council on the item. Councilmember Barker commented the last time they had discussed grants she had stated if the grant was divided it would make it more difficult to get . She asked if this is a different type of grant . Program Coordinator Heather Patel stated it is a different type of grant . They all, to a certain extent, work together. They are all GIS based projects, there are just three components of it . This would be a different thing. Councilmember Barker asked A where they are coming up with the $5, 000 for leverage. Program Coordinator Heather Patel stated the $5, 000 is already in the development services budget due to the loss of our GIS staff position. Mayor Insalaco closed the discussion with no more comments and called for a motion. Councilmember Coleman MOVED THAT RESOLUTION NO. 09-61, A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, APPROVING THE REGULAR MEETING OF THE CITY COUNCIL JANUARY 5, 2010 PAGE 3 OF 7 SUBMITTAL OF A GRANT APPLICATION TO THE ARIZONA DEPARTMENT OF COMMERCE FOR A RURAL ECONOMIC DEVELOPMENT AND PLANNING ASSISTANCE GRANT, BE APPROVED. Councilmember Barker SECONDED THE MOTION. VOTE: Unanimous . The motion carried. ; l RESOLUTION NO. 09-52, AN INTERGOVERNMENTAL AGREEMENT WITH APACHE JUNCTION UNIFIED SCHOOL DISTRICT TO PROVIDE A USED BROCE BROOM STREET SWEEPER AND OTHER FUTURE USED VEHICLES AND EQUIPMENT ) Public Works Manager Shane Kiesow briefed the council on the item. Vice Mayor Eck asked what he would consider to be its value. Public Works Manager Shane Kiesow commented since he has been around this equipment, he would estimate it would be worth $1, 000 to $1, 500 . It is hard to say with 25 years of use. It has a considerable amount of hours on it . It is at risk for having a major breakdown. Vice Mayor Eck commented he knows that Doug used to run that equipment to its end. Public Works Manager Shane Kiesow stated they want it for its capacity to do the parking lots . Mayor Insalaco commented it will work for what they need it for. They are not doing miles of streets . He then closed the discussion with no further comments and called for a motion. Vice Mayor Eck MOVED THAT RESOLUTION NO. 09-521 A RESOLUTION OF THE MAYOR AND CITY COUNCIL REGULAR MEETING OF THE CITY COUNCIL JANUARY 5, 2010 PAGE 4 OF 7 n r� OF THE CITY OF APACHE JUNCTION, ARIZONA, AUTHORIZING THE CITY TO ENTER INTO AN INTERGOVERNMENTAL AGREEMENT FOR TRANSFER OF CITY OF APACHE JUNCTION USED EQUIPMENT TO THE APACHE JUNCTION UNIFIED SCHOOL DISTRICT, BE APPROVED. Councilmember Wilson SECONDED THE MOTION. VOTE: Unanimous . 1 1 The motion carried. FISCAL YEAR 2009-2010 PROFESSIONAL SERVICES AGREEMENT WITH APACHE JUNCTION MAIN STREET FOR ECONOMIC DEVELOPMENT SERVICES/FISCAL YEAR 2009-2010 PROFESSIONAL SERVICES AGREEMENT WITH APACHE JUNCTION COMMUNITY DEVELOPMENT CORPORATION FOR ECONOMIC DEVELOPMENT SERVICES ) ) City Manager George Hoffman recommended staff work on additional refinements to both of these agreements with the staff and boards of Main Street and Community Development Corporation and that they return to the council at a subsequent meeting for consideration of these two agreements . COUNCIL DIRECTION TO STAFF None . SELECTION OF MEETING DATES, TIMES, LOCATIONS, AND PURPOSES �l Councilmember Coleman MOVED THAT AN EXECUTIVE SESSION AT 5 : 45 P.M. AND A WORK SESSION AT 7 : 00 P.M. BE HELD ON TUESDAY, JANUARY 19, 2010, IN THE CITY COUNCIL CONFERENCE ROOM AND CITY COUNCIL CHAMBERS, RESPECTIVELY. Councilmember Barker SECONDED THE MOTION. VOTE: Unanimous . REGULAR MEETING OF THE CITY COUNCIL JANUARY 5, 2010 PAGE 5 OF 7 n � The motion carried. CALL TO THE PUBLIC: Mr. Elliott Fisher, 547 E. Quail, Apache Junction, addressed the council regarding Lost Dutchman Days being privatized, his difficulty in getting a booth, the unruly gathering ordinance, and the Main Street Program. ADJOURNMENT ) Mayor Insalaco adjourned the meeting at 7 : 30 p.m. Consent Agenda Items are as follows : 1 . Acceptance of Agenda. 2 . Acceptance of Minutes of Regular Meeting of December 15, 2009 . 3 . Consideration of Resolution No. 09-59, authorizing the submittal of an amended wastewater designated management area boundary. ACCEPTED THIS 19TH DAY OF JANUARY, 2010, BY THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA. SIGNED AND ATTESTED TO THIS 19TH DAY OF JANUARY, 2010 . n JOHN S. INSALACO Mayor ATTEST: KATHLEEN CONNELLY City Clerk REGULAR MEETING OF THE CITY COUNCIL JANUARY 5, 2010 PAGE 6 OF 7 CITY COUNCIL MINUTES CERTIFICATION I hereby certify that the foregoing minutes are a true and correct copy of the minutes of the regular meeting of the City Council of the City of Apache Junction, Arizona, held on the 5th day of January, 2010 . I further certify that the meeting was duly called and held and that a quorum was present. n Dated this 7th of January, 2010 . KATHLEEN CONNELLY City Clerk I REGULAR MEETING OF THE CITY COUNCIL JANUARY 5, 2010 PAGE 7 OF 7 i ROLL CALL VOTE NOTES: ITEM # MEETING OF l 1 MOTION BY: V SECONDED BY: YES NO ABSTAINED COUNCILMEMBER DIETZ COUNCILMEMBER BARKER J VICE MAYOR ECK COUNCILMEMBER COLEMAN COUNCILMEMBER SERDY COUNCILMEMBER WILSON MAYOR INSALACO ,�► UNANIMO S IN FAVOR OPPOSED ABSTAINED TOTAL r r CONSENT AGENDA ITEMS NO. 1-2 I MOVE THAT THE CONSENT AGENDA BE ACCEPTED AS PRESENTED. PpACHf✓G � n 4 j - GO oj'A- _pacbe Ju.nction 0 HOW 0f the Superi'fdt?(1n AlDLlIPtCIln gRlzptSl' 8 Print TO: City Manager's Office FROM: George Hoffman, City Manager ^ DATE: January 19, 2010 r I Agenda Type : Regular Agenda Council Priority Focus Area: TITLE OF AGENDA ITEM: MANAGER'S REPORT. ACTION REQUESTED: DISCUSSION/BACKGROUND INFORMATION: FISCAL IMPACT: OPTIONS/ALTERNATIVES: RECOMMENDATION: ATTACHMENTS: Click to download No Attachments Available d� 4 t x - C'i o 1cae Ju 2ctiDZ ♦� , z, o V .,,k .: Z Home ?"the Su�essfif?on A ountains aPIZ014� 8 Print TO: City Manager's Office FROM: Jerald Monahan, Police Chief DATE: January 19,2010 nAgenda Type : Regular Agenda Council Priority Focus Area: TITLE OF AGENDA ITEM: PRESENTATION AND DISCUSSION ON THE UTILIZATION OF VOLUNTEERS IN THE APACHE JUNCTION POLICE DEPARTMENT. ACTION REQUESTED: DISCUSSION/BACKGROUND INFORMATION: Jerald Monahan, Police Chief,will provide an overview on the utilization of volunteers in the City of Apache Junction Police Department. FISCAL IMPACT: OPTIONS/ALTERNATIVES: RECOMMENDATION: ATTACHMENTS: Click to download No Attachments Available n n PUBLIC HEARING n 1. For APPLICATION FOR A NEW LICENSE, CORPORATION, SERIES 10 LIQUOR LICENSE FOR WALGREENS #06333 2. Will CITY CLERK KATHLEEN CONNELLY speak to the Council? 3. Will the applicant or spokesperson please speak to the Council on this item? 4. Is there anyone from the public who wishes to speak on this item? (Are there any "Request to Speak" forms?) 5. If not, this hearing is closed. 6. Is there any discussion? 7. Call for a motion. 8. Call for a second. 9. Roll call vote. GO oj*A 'pache junction Hone gl'the .S upewit9on Ill ounhaih P120 8 Print TO: City Manager's Office FROM: Kathy Connelly, City Clerk DATE: January 19,2010 Agenda Type : Regular Agenda Council Priority Focus Area: Required by Federal Law or State Statute TITLE OF AGENDA ITEM: APPLICATION FOR A NEW LICENSE, CORPORATION, SERIES 10 LIQUOR LICENSE FOR WALGREENS#06333. ACTION REQUESTED: Recommendation for Approval DISCUSSION/BACKGROUND INFORMATION: This public hearing is the next step in the application process required by state law. The city council is required to give a recommendation of approval or denial to be forwarded to the Arizona Department of Liquor Licenses and Control. FISCAL IMPACT: Budgetary Approval Not Required OPTIONS/ALTERNATIVES: RECOMMENDATION: I ATTACHMENTS: Click to download ❑ cover memo ❑ application part 1 ❑ application part 2 0 application part o 0 application part 4 ❑ notice ❑ applicant letter ❑ department memo ❑ planning recommendation ❑ police department recommendation ❑ fire district recommendation ppCF1,E (� C� P G2 Home of the Superstition Mountains '9RIZON� t Y JANUARY 7, 2010 MEMORANDUM TO: HONORABLE MAYOR AND CITY COUNCIL MEMBERS THROUGH: GEORGE R. HOFFMAN, CITY MANAGER THROUGH: KATHLEEN CONNELLY, CITY CLERK \LC�/ FROM: JAN MASON, DEPUTY CITY CLERK-,�t,- "* ` SUBJECT: AGENDA ITEM,FOR JANUARY 19, 2010: APPLICATION FOR A_LIQUOR LICENSE FOR WALGREENS #06333 An application for a New License, Corporation, Series 7 Liquor License has been submitted by Mr. Randy Guse for Walgreens #06333 located at 2440 S. Ironwood Drive in Apache Junction. Correspondence has been received from Department of Public Safety, the Planning Division, and the Fire District, a copy of which is attached. The next step in the procedure .is for the City Council to hold a public hearing on the application and make a recommendation for approval or denial to be forwarded to the State Department of Liquor Licenses and Control. •Voice(480)982-8002 •FAX(480)982-7018 •TDD(480)983-0095 •www.aicity.net 300 E. Superstition Boulevard, Apache Junction,AZ 85219 n n ARIZONA DEPARTMENT OF LIQUOR LICENSES& CONTROL "_'_ `= r:: i't• = QIi Mshington 5th Floor Phoenix AZ 86007-2934 (602) 542 141 APPLICA'T> OR LICENSE �tIa :WI1a1n Nn Natice; frffectiva Nov.1,1997,All turners Ast tits !'aiirre s toe°tc5�ld¢ �fft of X na r act[wol irnratva tf in tho da to rfa o •ratios of the_business must aEterid a tDopartme ntapproved liquac lav rntn 7 f l rQof vF aQten dance within;the last five yaars. Sea page 5 of tho-UquerLicensing mquiramo Ms. f -' /° SECTION 1. This application is for a: � ��t � ��, 1:{CTION 2 Type of ownership: 1 1 INTERIM PERMIT Complete Section 5 � 4 slrsr2 1 0- J,T,S/V_R.0,8_ Complete Section 6 0 NEW LICENSE Complete Sections 2,3,4, 13,?4, 15 � 0 INDIVIDUAL Coinplate Section 6 El PERSON TRANSFER(Bars&Liquor Stores 0 Y) V Q PARTNERSHIP Complete Section S Complete Sections 2,3,4,11,13,15, 15 N CORPOPA110N Complete Section T 0 LOCATION TRANSFER(Bars anA Liquor Stores ONLY) 11 LIMITED LIABILITY GO. Corriplete Section 7 Complete Sections 21 3,4,1Z 13,15, 15 11 CLUB Complete Section& 0 PROBATErV11LLASSIGhIMENTID[VORCE DECREE Ea GOVERNIMENf Complete Section 10 Complete Sections Z 3,4,9, 13,16(fee not required) 1_ TRUST Complete Section E 0 GOVERNMENT Complete Sections 2,3,4,10,13,15,16 0 OTHER Explain SECTION 3 3 Type of license and fees tJCENSE 9: ° ( N t 'eGny 1. Type of License Series ip Qeer sr'414r}- erase ?.Total fees attached: s ll+m APPLICA710M FEE.4iilf31NTERIM P.ERAV,r•FEES-(iF APPL1CR�NOTREFGit4DABLE. The fees allowed under A R S.44�7-6�52 wi be r:harged for all dishonored checks. $EG'rtON 44 Applicant 1.Crwrier/Agent's Name: rss, Randy fallen_ ;fuse t one rrame ot•iLY to appear on ilwriwL) List First Miidcle 2. CorpJPar1znersNp1L_LC-: Walgrean AFizona E)rtlq 00. ti�zartiy as it�pp�ars oc,FtirhCa_s zfFtr�o.c�`Ar:ic;lc�of ri}zc�.) S_ Business Name:_ . . Walclreens'0633^ tExarity;r i!ar pears eta ttr wxletie of p aft tses) ill!" 2440 South ironwood Drive. Apache Junction; Mefk, 55220 4. Principal Street L�'�_t ion e p �. -- (Dc-%riot LrA PO Box Plumber) citj county �IP 5. Business Phone: 480-288-0428 —.— Daytime Contact-. 623-215-0407 - - -- B. Is the business located within the incorporated limits of the alcove city of tulm? DYES EINO 7_ Mailing Address: PC BOX 801, Deerfield, IL 60015 City state zip 8_Enter the amount pall for a bar,beer and:vine,or liquor store license$_ —(Price(Price of License only) _ DEPARTMENT USE ONLY Fees/ � Appricativn Interim Pemlit Agent Change Club Finger Prints$_/C � t" TOTAL OF ALL FEES Is Arizona Statement of "7enship&Alien Status For State enefits.complete? YES E�IO Accepted key.- ' Date uc o10011912059 `Disabled individuals requiring special accommodation,please call(602)542.9027. ��_. SEGTi lgN "a interim Permit: N/A 1. if you intend to opr-ota business when your application is pending you vAtI need an Interim Permit pursuarft to A.f?S. 4-203.g I- 2. Tnare MUST be a•.valid licenva of the same type you are applying,for currently issued to the location. 3. Enter the license number Currently at the location.._ • ti 4. is the l➢ciense currently in use?IJ YES C7 NO if no,haoi long has it been out of use? r:.f ATTACK THE UCENSE CURRENTLY ISSUED AT THE LOCATION TO THIS APPLICATION. t.1 declare that I am the CURRENT OVVNER.AGENT,CLUB MEMBER, PARTfV,E iFr�Tt it:tf narF_} „� MEMBER.STOCKHOLDER, OR LICENSEE(cfrrcfe the titte,,*hich applies)of the slated license and location. „I State of .nc;mty The foregoing insfn Invent was acknowledged befo;a me this _--jay of M Commission expires Gn: 7ay Month Year (Sionah!te t;`ti?TAtTi eP JBLV) SECTION 6 individual or Partnership Owners: N/A EACH PEKS'G`N USTED MUSTSt BNWACQAtPLE r' D QU_3TIONNAIRE(POWA LIC61C1t,.AN-APPtr.ANT-TYPE_F:NGERP:RINT CARD,AMD S24 PROCESSING FEE FOR EACH CARD. 1. Individual: t.Sti t First Aliddla 4G C4A)r--d U110ng Addris:s Q1 V 'skate Zip Partnership Name:(Orly the first per;trier listed Will appear on lien.=c) -- -- tibn'te+a3•iir7lit-x3 La a t` &t '.ks;tlkF 74 Oasx•d h93itin Adt1K•s ---,.__. CiN 1 0,a tin I Q f EJ El (>'i ACH A.EiG`( OW4 L:HEET IE NECE ty) v 2- Is any person,other than the above,going to share in the profitsAosses of the bus:n ss'i YES El NO If Yes,give name,^k.>mnt address and telephone dumber cf the pemcn(s). Use ac?diticnol sheets if neoe;ssary. Last Frit hfidi,As 1-1,fliroAdtlre« c,i,+ SPate.r'ia is 2 SECTION CorporationfLIMited Liability Co.: EACH MRSONUMM M1J5TSUWAT A009PLETED QUE51101 WRE(FORM=101),AN"APPLICANT-TYPE FINGERPRINT CARD,AND$24 MMES'5410 FEE.FOR EACH CARD. CORPORA-171ION Complete questions 1,2 3,5, 6,7,ancL 8. Ll LUG1 Complete 1,4 4, 5,6, 7. and 8. ,:i. DW, 1. Name of CarporafloNILL.C.. Walareen Adzarn . Drug Co. fllxactt-az ito ws cn Mclas of or Xrdtitaz of Orgaritzadun) 2. Data IncofriomtediOrganized-. 01/22JI954 State severe Inc wporatadOrganizzed: Arizona 3. AZ Carporation Cor-nmiss-kon J-11a No,: 016195-1-8 Date authocized to do business Irk AZ: 01/22(54 4- AZ LL.C-Fife No, NIA Date authoft cad to do bu5in:ess io AZ N/A 5- Is Corpil-L-G,Non.-proflt?El YES SNO 6. List aft(Twectois,officers a Members in Corporabioni'L-LC.: Last Rst Tvtt3nie T 41e MWEng At4- a5s Pity &-at-- Z:D See attached Corporate Rider. (A-MCM AOUT1044 SiiFi---T 2F NEC 5SSAPY) 7. List ztockhakioF5 who are controiling pe-isons orvOio oovrt'10%ormor;j: Last Middle Maiflng Mfrp-,ss C>tv si.Me zip Not one person owns as, much as 5% of corpGiata stock. (ATr,&.C�AC iA Iflh";Cz?rPc-ra1;Go4k.L-C.is owned by another e-witf,atlach a percentar4e of orvnershiip shad, and diJ-eQtOV1vft-;Cedvnernber disclosure for the parent entity. Attach additici-I-al sheets as needed in order to disc-lose p-erson2l identifies of all C".%mef-S, SECTION 8 Club Applicants: N/A EAckF--9R$4N UST513MUS-T SUP-111TACOMPLEMED TYPE Rbi3ERPFMIT CARD, kNO 32-1 PROCESSING FEE FOR EACH CARD. Warm of CIUh- .......... Date Chartered: ds iiapp-mrs on C.'Ub Charlar Dr B}47ws) ?,At4ich i (,,F Clut,U-hartr-or 2. Is club non-profit? El YES CJ NO 3. L,Ist offirer aged directors: Liat First Mddl,- rJe Ma-'ma AW-L-G, Oizv Sujt= :,:,p to TrACH ADDITIONAL SHEET IF NECESSARY) WALG14EEN ARIZONA DRUG CO. f'ifir_.ers& Directors Social Security l�umber Name Title �csidcr r� Address Place and Data�C Birth 'Mark Anthon Wagner president 1127 S. Ridge Road Covington,KY l Lake Forest, IL 60045 'Dana tone Green ['resident 739 Forest Ave Chicago, IL Evanston, 1L 60202 f 'Oren Bentle Azar VLce President 3937 Proctor Clrcte Israel Selretar), Arlington Heights, IL G-0004 l�t Rick,John }-airs Vce Ptesldenl 328'Woodland Road Watertown, W1 Secretary Lake Bluff, IL 60044 -owl riot eo Meda Silvcrrnan Vice President 1421 Coral Pa.rkwil} � hrc,�go,a4 Norttrbr00k, IL 0062 fvta arita Evelyn Keilen `l'reas,urer B45 Wagnerr� Y agr� Road Chicago, IL Glenview, IL 6002- }' r John Anthony Many) ,rice presiuerrl -I4,09 Royal Oak Lane Flint, MI Glenvio,;,1L 6002E'' {3ar Michael Maitlra Acsistant Treasurer 1 309 mad son chic a o, IL Buffalo Grove, I+600a-9 � '} Susa n Lynne DeVries Ass isiaiit`I'rer Surer 1056 F rernont Ct . East Chicago. IN Buffalo Grove,, IL 6DO89 l Michael nominik Felisll ksistant TrOD. t.rer 219 91h Street Clak{park, 1L Wilmette, IL(30091 � . , i - . `Ita.rrrlit R rpui7d Crawford (...rl..c;oa 20742 4"J hf gtarrir_,e f~ci xlt+irt,TIC , -- Kildeer, IL 60047 'Indicates Director r � . E 1 l ) ECTION 9 Probate,Will Assignment or Divorce Decree of an existing Bar or Liquor Stare Licensq, NjA 1. Current Licensae's Name. (F=gdly as it appears on litensu) Last First 2. As ggnee`s Name. f.aFE �i�t tr3ic�r113 3. License Type: License Niimb(-:r. Date:of Last Renevml: 4. AT iiACH TO THI A€'PLICATEDId A CERTIFIED COPY OFTi-IE WILL,PROBATE RtSTRI51 1TION INSTRUMENT,CEO DIVORCE DECREE THAT SPECIFICALLY OFSTRI13LITF-8 THE LIQUOR LICENSE TO THE AS.S GNEETo`fH(S APPLI ATION- SECTION1U Gov,�rr.ment,(far cities,towtn,;,orcounfleY%only) 1. G©verrinerital Entity: %_ Parsc.viidesEginee: Lasi Fij-.t m t:lidrdle GGnt3 t Phor,-_D14at7rw Y A SEPARATE LICENSE MUST BE OBTAINED FOR F=ACFI PREMISES FROM WHICH SPIRiTUOUS:LIQUOR Is�FRVF=D SECTION `f`6 Person to Person Trartsfer: N/A �. Questions to be completed by CURRENT LiCENSEE(Bars and Liquor Stoney ONLY-Series 06,07,and 09). 1, Current Licensc�a's Name: _ Ea%,: ;Exac'y as:i F<r s on Last First 1i�u;u fl fi°r..ApaRt, tc,l L. CorporatioWL.L.0.Name: (E:actfy 33 it appears an I;r_xu-c) CUT rent Bi.lsines Name: (±=t ilU 34 It:�j}3ar C43 l tr'1159,r __ 4. Ph,Eical Street Location of Busines',.Satreat rity.State,Zip 5_ License:T3ype: LEcanG ie NurribeE: 6.CusTcni Nlailing r-`ddlrr,, ; S'Teet (C#ttterUian busirisss) w r iri.State,Zip 7, hl eve�,li t;i editor�,Ilan hctdere>,intcrG�t holder ,e&C.teen nctr`Ier3 sE th irrna Y? 'YES C NC? 8. Bees the appl€dint of nd t-D Operate file business while this application i s pendir q? �'r;—:S El PI0 li}rev, cmpl[te Se. r nr? of tins application,attach fee,and current i.ice.nse to this:appl(caUon, 9. is _ he_mty uthokvn she depeftent to process this appii--ition to L-ar,$f;e the (picotfuli nzrr...) privilege of the license tD the applicant,pmvided that all and condition i of;±alp are rnet. Based on the€ultilirrnent of Muse conditions l cei ffy Iliat ttW applicMt rtow cs ms or-41 ovin thia pF-oper1y righIs of the license by Lh¢da.te of issue.. declare that t am be CUt RDIT 01AIINER, AGENT,MEMBER,PARTNER (6xint full name STCxsKHOLDER,or LICEN,5E4 of tie stated License, l have read the above ve Section 1 t and cofffrm that ail staternents are vine,cUrrec;t,and complete, X State of ____Ccluitty of (Sk:nakwe et CURREUr LICENSEE) Tt,p Foregoing instn im_nt,vas arknf,saa{frs=ri r ot.;rc r y rhie Cray MQrAh Year My cernrnissian expires on.- (Skirrawri.of t G`I.yaf;Y PUBL C) 4 MCTION�12 Location to Location Transfer:(Bars and Liquor Stores ONLY) N/A 3 A_ APPLPCPX'r3 CANNOT OP11E�TE UNDER A LOCATION TRMSFER UMIL ITIsSAPPnoveD BTP� T 1. Gunre-nt Business: Name (Exactly as it appeam,on IkAaRSQ) Address 2. New Business: fame (Rhys,ical,Sireet Lorzlion) Mdves,- .3. Ucensa Type: —License Number: 4- What date 1710 NfOU Dian to movi-.0 VJhal date do yvau ptan to open? SECTION 13 Questions for all in-state applicants axeluding thane ynDlying for goyernment.hot Wal jje €serjas 5,11,and 12): A,R,13,§2,207(A)and(B)state that no retaller's licensa Shall be is< for any pmrt7Aseswhich are at the tirre se 1)�ns--ar4Ar-qt`,Ti Is ceceived by Irp-d.iredor,within diree,hundred(30G)horizontal feer of a church,w hin thrm hundred f3Uj)horanotai feet of a pubRc or,*jata school btje-,ft g*Ah kindargarteri programs or grades i)np T*he above p3ia-graph DOES NOT�Q 1)throLyjh(12j c r with h M ree-I hundred- (309,1 hodai ml feat if.a fenced rectaa tonal area adjaceill to 4uch scluiol built irt g #j to: 3)Res urant license 4-205.02) r,)Govemro-4nt11;Gn nsc-j§4-:2, -KIS.03) b)Hotevrn-aial 1"-vnsa �412MV) d)F-jnced play ing area of golfi curse(�4-207 L Distance to nearest school: 528 fL Name uf school Apache Junction High School -L-,,&iress 2525 South Ironwood Drive, Ac)ache Junction, AZ 85220 City, ;tat .-7jj) 2, Ofstapl;�f2D nearest churclh: .12t r1a .orhuFch b � t 'ir_1 h ;t pf Lat+ Da, Saints A 'Ujr'_tLQJ-1Aa 0,5220 City,State,zip 3.E @,-n the: LesseeEl Subfesse-e, Cn-a i e.r [I p urchaser(.--f premisas) 4. if the premises is leased give ies=B:Name'Nbert & 13[6lie Thomas Family LLP nq Address P.Q. Box 1336, ApachqjtLj)qt City,Stater Zip 4a, httonthly,-ent2-.blease rate; 4,606.25 —Wh&t is the remaining lenpof the lease Llyrs. 7 mos. 4b- Vvbat is Tie Penalty If the lease is not AlAfilled? S or oti-,er We Would go into default (_q iv deta.rls -attach oddilional thmet 7f inde-btedness for th;s aicenzk-ftration excluding he lease?S 0 Please list cfebtors bolmv if applicabk-- Laqt Fir-a Nrklola An-nunt Owed Ma0hiqAddrf--zs --City SUN Zip N/A fA-TITAC1 f ADDMIONAL SHEET IF NEGFSSARY) 6. What tLyp--of business will this iice-nse be toe:d for(te spedfr;)'7 Retail Orug Store 5 SECTION 13-contin-00-d 7.Hasa license or-a transfer license for the premises on tbiaappliCation been denied by jhe5tata wfthin the past one'71)Year? UYES 5 NO lfjes,attach explanation. a-Does any spirituous Uquor manufacturer,wholesaler,or emplayea hzve any'interest in your business? DYES M NO R,Is the premises curfeently licensed with a liquor lictw5e? nYES ONO lryes,give license number and licensee's name, UoDnse (Exactly as it appears on lic-ense) Name SECTION 14 Restaurant or hatalfirnotel license applicants: N/A 1. Is there an eAsting restaurant or hotalmotel liquor ijcen.5e at the proposed location?' [I YE$ 0 NO if yes,ghte the I I name a,licensee,Agent or a company narne, sad ficen 4: Last Frzt Middle -)ur application i p -1ding; 'OSUR 2- if the answorto Question I is YF-S,you mayqualify-mrarl Interim Permit tag operate whileyt A.R.S,§4-203.01;and complete SECTION 5 of-this application. :3. All restaurant and hotelim otel applicants must complete a Restaurant Operation Plan(Form LIC0114)provided by thp-- Depaitment of Liquor Licenses and Control. 4.As stated in A-R.3,§4-205.02.G.2,a.restaurant is an establishment which de-Oves at least 40 percent of its gross rovenue from the sale of,food, Gross revenue is therevenue derived from all sales of food and spirituous liquor on tVe It premises, By applying for this El botellmotel it restaurant li:cense, I cartify that I understand that I must maintain;a,a rrvinimuni of'40 percent food sales based on these definitions and have included the Restaurant Hotel]klotel Recor8fi- Required for Audit fform LIC 1013)with thi-s,npplicatfon- applicants signature As stated in A.R3§4-205.02(13), 1 under_,;tanjjJt is my responsibility to contact the D,?partment of Liquor Corittd to schedule an inspectior,when all tables and chahm,are on site,kitchen equipment,.and,ifaipplicabin, patio 1-mr-riors are in plo—ce on the licensed promises- With the oxcetpffon of I the paU6 barriers,these items are not required 10 be properly ittistalledfbr this jneper-tiaii. V allure to schedule an in;.;p c mion,will delay issuance of the I ict�n se y - sior. Inspection 90 days after filing your application,please,reques'tan eAension in%witing, specify why the e-ten. -is x and thn me�vin?pection d2te you are reqijc—.tiri-g, To schedule your site in5padion vi:it v.,mP.v.azliqucr.gov and click bnthF-, "Information'talb. applicants initials SEOTION 15 Diagram of Premises'.(Blueprints not accepted,diagram must be on this form) 1.Check ALL boxes that apply to your business-' EntrinceWEAts Liquorstorageareas patio: 11 ContlguOus El Servicewind::s M Drive-immndmvz Non Contiguous iT Pharmacy Only 2. Is your licensed premises currently dosed due to construction,renovation,or redes5gn? OYES 11,No If yes,what is your estimated opining date? montWdalj,hjear 3. Restaurints and hotel;matef applicants are required to draw a detailed floor plan of the kitchen and dining areas in�jvdincz the locations of all kitchen equipment and dining furniture. MLgram paper is provided on page 41- is 5sclose only the area(s)'where spOtous Ilqurjr is to 156' The d�arg ram 'a detailed floor plan)you provide I requirortto, sold,served,consumed, dispen-sed,possessed,or stored on Me pi-emises unless it is a restraurant.(see 9:3 above)'"["'" 5. Provide the square fcoUige of outside dimensions orif thelicensed premises. Please do not include non-licensed premises, such as parking lot.5, li-ving quarters,et". As stated in A.R.S.§4-205.02(F),I und6rstand it is my responsll�ijlty to notify the Department of Liquor Licenses and Control when there are changes to boundaries,entrances,exits,added or deleted doors,w1adveits or aw.ice windows,or increase or decrease to the,square footage after submitting this initial dirwNing. applicants initials ;�_ .e iy o uiagram cat°Pr9mis6s Total Store Square Feotageis e. �— ,' is 4 Ir Cj -:—�— ,:L I . I _T°�.—�-� •_...l�fi�": --I bt';s to be sold,served, consumed, `iTr I '�_ -r_ ,._ . , i ,! interior walls, �bars, tybar #s�tnc� tE/ , y�C {. �,'� e_ stage,-an{� 6i'' 1,11 room. Do-not z i i I i .�" mt Nara 4. vmises is attached to this ox provided below. i Fts is - - rv---. } .. G-S� _ - •� . T-T � � ;1. cslr3 ! E v � IHN r 7 ".' ,� l. s � ti. m ^ ��._. "'"�'fT-x' j�3-r � _._- _-- _•.�- - j �f:Jam- �.,.'� SECTION 16 Signature Block �a f. ...3gndyr Allen Cure hereby declare that I am the rJVIMERAGENT filing this l , trjrirt,kill harm,Gf apt rttj A application as stated in Section 4, Question 1, l have read this application and veriPy all statements to be true, correct an Corp lete. X i siCna;,i�c1 tp�iu�,3��t Ia.tad Ir S�cft��n=1,Uu2 a•�IY 1) j��^¢ !1 f�+� �y A V /'/� Arizona u`yttnip�)' (Aaricopa -1 he fore oing instrum n awas acknovviedged befqre die this nt Vi day h,?anv' Y+0ar' MY comMissiorr C-xqi.=e~;on"0(16 a Day Month Year sI u ;f NOTARY PUSUG r- >_ C1 €��,�r�c,rr�, .- "Er ! Lic DEPARTMENT OF LIQUOR LICENSES&CONTROL ED �-'z 800 W Washington 5th Fliaor Phoenix AZ 85007.2934 UIJE9110NNAIRE Attention all Local Governing Bodies: q0Cjal SeCLirity anti Bir�dftL-In'fdrrb'ation is Confidential, 'this information r4y be ji kfb local law enforcernc-nt agencies for Uha purpose of back. I ra.tj[.id.1 c.h.ock.s'only: hufffiust bo blocked to be unreadable prior sin o"'iny public:if ' - ..' -,\ r view, Read carefully. This instrument is:a Type or print with BLACK INK, An extensive inve0gation Of YoU�'4a.Gkqfo6hd will be,coriducted, False or incompliete answerML cvWd result in criminal prGSQCWtj0n:and the derilai or stibs6�I:kent revocation of a license or perm! TO BE CON-'I 1_E:TEFI Py__AC�'-cnj'rRq.LIJV!G R AC5E Jj r OR MA14AGER,.- EACH PER�-�3N C,_'%`PLE71NG THIS FOR%-I r',IUST SUBN117 AN . .A.. ... -- -APPUCANT TYFF FIN(7.-FRPRINT CARD V,.--iICH MAYS;-:014TA3,14K)AT DLLIC. ONE BY A 60:.��A FIDE UNW 1FqG_PJv'R3NTIN0%1LJ5T PE D� ENFORCEMLZWAGL�,CYCIRA Rrqi3FRPRJ'471v- SERW.E.4L-07P'-)v'F_Q BY bffFf R-,KIEN Wrlii PROVIDE Ti 13 sEF:V!f3E. kfftj�.fivlGf�I.W hQre is a S24-00 12rGaossing fee for each fingerjorhit card sular ter Ll uor Liqqnse qL The fees allovied bv A.R.3,S 44-6862 will be .Qll dishonored checks. I che( L-1 Controlling Person Agent Pilanager(Only) aapropraate (Complete Questions 1-19) r (Complatia All Questions gy,".F�21.#14,14a 21) 1 uux cot-arolling Pi?rson or Agent must completa,#21 for a Manager 1 Controlling Person or Agent must complete#21 2 wane:Ouse Y Randy Allen Middle (NOT i Pubtk,Rocdr.d) r'-C131 Se'-uv:tv Nu i AZ Uc:5�,n State (NOT a pu4jfr_record} mot a public record) C. -1 1,1 Z c�_•c f e,r h f-A o n t 4F�o V i e MN U.S. I So bows,Height: H�*. Country -int cL)un-.y'1 60 2 5 Ll Sir,---fle L ) -214-6281 �'JQ �_ Da-',,timL Contact Phone 6 of C�j_'_'. muse Karla :cur Johnsort P _nt Sr Zi�o? "r.51j!la of B3V 1 'ddle .1aide public"bl, Mma,11 fti*t J ot If n,.c Q,&5:a(�q) 1.?S1 n .311 for;aM'.5 yeam-i S��additianal qbn -r� ""f vvhal stat�"?A7 'Arizo, C1.1 1963 u are a I I" ia.date of rc-�idenrv' 602-214-5281 -3 T3!ephore to you'lu'-Jr(rj hours fur at-.yqueatic.ns req2r6ng this do,_.I mint. yo i b een an A.izcinH residert'1'0,-lvss than tfvee-(3",Inunths,S."!bmit acopy of your Arizo5a driver's kyeanse or voter re,3istFation cz--,,d ft 06333 480-2839-0428 Premises Phone. 2440 Ironwood Drive Apache Junction 852'-.)G 1 Py-si�,q,Lrj�:z,'or,o"D-zensed Premis� d-R 12 ist yo,jr it or i'-if L)tjsine�,s d!j ring'the pa $,,e f 5'1 y��qrs;.it"unemployed pare of the time,fist?Aosp dF tes. List mast recent I st FROM TO 0-SCRIBE POSITION EMPLOYER'S NAME OR NAME OF BUSINESS MQ11I10Ye.41 OR BUSINESS Ira rily-stlta&zp 6197 CURRENT i District Manager VValgreens, 207.5 Pinnarle Pnok Road, phoenix qz 85027 Al"TACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTICINt (I. Ind irate Your;a::-idence adci;ess IJr10e 0 st Five ti7i yeam: I FROM To RESIDENCE Street Address I WY I "'.n uh additional �hpqtMi 1 1 name, hr--jenumber�if 1011�10rd G i,V01VT11Y03i'110,P1, ear ntea,atziu on V addre.,�s�Lnd 04)97 Cupj; 'n 1897"VV.Lark.Drive Chandler AZ 85248 LIC 0-101 M24.12009 Disabted individuals r"Wring speciat accommodations,please call the Department 662)542.9027 tf you checked the Manager box on the front of this fomi skip to#15 14,As a Controlling Person or AgenL krill you be physically present-and operating the licensed premises? 7EIYESEINO If you answered YES,how many hrslday?_ ,and Llz—f}1da belovl- If NO,skip to#15. 14a.Have you attended a DGLC-ap€iroved Liquor Law Training Course vrithin the past 5 years? (Must provpde proof) If the answer to#14a is"hfO",course must be completed before issuance of a new license or approval on an existing license, 15.Have you been detained,cited err wed indicted or summoned Into court for violation of ANY law or El YES IZI NO ordinance, regardless of the disposition, even if dismissed or expunged,within the past ten (10)years {include cnl}`traffic violations that were alcohol andlor drug related)? 1.5.Are there ANY administrative law citations,compliance actions or consents.,criminal arrest, indictments or Summonses:PENQiHc-,ariabst you oi-MY entity In which you are.now Involved? C�YES El NO 17. Have YOU of afry entity in which you have held ownership. been an officer, member,director or manager YES []No r EVER had a business, pre:€essio4-ml or liaucr application or rejected,denied,revckt-' SUS et -- t7f t 1e In ihls or rin't`oth,_.r;Tate? i u. Has any-orie ,E'vEH. hl-:d suit ar*,btainofl a iudanlenr;�c€�rn5,(,j ou,the subject of which involved rraud or DYES (grit anisrrF.,-e =-nt.atir.rl ?S-. Are you or Prave v,Du EVEE held ownership,been a cr FZtiing person,been an ntffijc_.f.men)t-_; 10YES 0, NO direcinr or nlaliauer on.. �L tl1e_r liluor fieense in this or any other state? If am an::,wtar to Questions 15r throtlg;1 19 is "YES"YC'�t1 PattWT attach a signed statgmerit- rivE crmnl=tom~ i tills including _ .r7 g dr3tes, agencies involved, art-d cispoc-itir.ns. StJB_s-fvNTIVE CHANGES TO HIS�{PPUC",TI N '',kill-L NOT BE ACCEPTEDr(-'�� ,�JJ Guse hereby dezlare the€I efts the r,PPLIC N T REPRESENIATl' r;,:,neC�iul r,Qri1C or r�Fp-0�s,n�j _'• Tiling this yu� f;:�nnair.� I It.:• e read this queFE.Ur.•rmaire and all statewients are true, correct and corn lete. fr - - X County of --_-..•"-iS�gnahFr„oi.a,:P4ir�an'1 -Cote foregoing in&tivment YiaS ao,.nawEpegc,,j nr-fi L,m t,i L+.f t.f"dYEt'7$f Jt�JI�}�t t ,i�,r� tJr,Y lGI L. SeAL" S it> Ent tar}+ant 'f�:° _,. fulori Year h diatyr.;rr4+F}�ti5it'FF17f3n. 18 11 f� r I,J3 a n zi'tyj r a D''" f,�onlh Year r I SFL rt71 i�lcnstre of NJy :'f COMPLETE THIS SECTION ONLY IF YOU ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 2-1. The applicant hereby authori es the person named on this questionnaire to act as manager for the named liquor license- The manager n 3med must be at least 21 years of age. Sfate f _ County of f TIr3 foregoing instrmment was acknowledged t tfom me 11 day of Signature of Comro,ling Person otAgent(rirdle one h�rnut Ysar Fins Namem f.�tng;ure_of NOTARY PUBLICI T- My rommi sion expires an; Day Marsh Year r 8 W wa,shirigton,5t1� F1o0 Congress .ISQ Fhoert_ix AZ 85003-293 - Tt?rwrt. AZ 85701-1352 (602) 54275141, (5 0) 628-6595 CERTIFICATION CAP COMPLETLD ALCOHOL TRAINING PROGRAM(S) Y. OS FAIN CRIG4 AL-'j QF TMS FORM FROM i+iLr--D UCST PROT+OCOPY,00tUMENT IS tChtpt€t ft S hbENEt7. TWE of-,PRINT VCH St'.c F W-k _ALCOHjOL TFZAINING PROGRAM NDIVIDUAl.INFORMATION� ' ti,�iwi�f�gl,ttom_(PrSnE� •�-t` _ r,/'�- IFititri!�U.i]t.�'itt�!:3lJCa TYPE OF TRAININQ t MPt E s ECt ,�._. �TRAINEf;�MUST CHECK YES OR NOF�Jrr P, EACH T'fi PE tf.� (4i � NO -[i. _if!- I YYF.a NO ON:SAUE t 42lte I `ttrtitY�Fv 7fF5p+�t ti, y Pd� t�,F. 1:lfiEM`` $I` I�� '*'_. 1. t;tJ +�: ,-SALE.: a 'ry_� j�} Pds�l E�t�T { � 'ri=5 nO OTHER, IF TRAINEE IS EMPL0YED EY m{LIi-ENSEE: x r ,T r �_ -r- l„F.�u..t.q[ `1-�r' E f _i NAM OF YHE LI IENSt:E_ stj Ir'tczs `E ..mE E_IQUr F,Li Et4 =NUMBER ?LCOHOLTF°A.[NING PRrvCIRANI PROVIDER INFOPNII"tTION Anzo a usin--ss Council for A co.bol Education (ANY) company or tndivir ual Nam,i 00 East Thomas l oaci 9-1.00 phoenix" Arizona 85012 (602) 1-95-1 90 Cihq �__... Sttta Zip Phor- I Cer*y the ataove czar ed Individual has s cG 8sdull j cmnp6etad thp- srpe dficd prorgraa)(:s). T. J. Kuhn TPdinzt t`a�R'— m�n8 T 2in Sirg73Cu€ {)3 to Y�itir ,qiv_vri❑-seat,!corrpletad tn`m to Trainee, i,.hctut--,pY and maintain sompieied document -for your re=atd,. itnartuatvcy Uquvi Low Training Tor aii hew apfYlir.3'kjQns suommad esker No•t-i, i`, 7, n.t.a-w=Cti;m a- e.2(G)(2), Completion of t1-c Uquor Ucenl:e Tlaitti ig.Courses is.mgjired at diL issuance of a License_ Th¢pc(son(;)required to attend told)tie Basic Likluw Law and Managtiment Tr�i(ung,(either on-sale or off-saEep,w4l inrf,.de all of t*>n_laaowrinq: y„nP,(�I,Iicz(srafayent of manager(n)`,""lHC)ARE Ar,'.TIVELY INVOLVED Itf THE DAY TO DAY QPEt kA IQK€r THE 81JS1.'lLSS: rPfl-lot of atUmdarre writhitt'fiG last fivic rear,,fw th,*required couf5rn;must bt,subnittrd to ti!c Uepaitmettt be,`are tho huur!ss app!ca5c-1 is con 'I'ved ca;nale{e_ Hefare screptance of a Manager's Que tionitaire andrar Agent Change fa a;existiN license,pri3of of attenrjance ror the Basic r i uce lavr amti hiana,4eocnt Tra4;in0(ahlitm a,-s3le or off-sale)YyA be require— Ltc liar w-mot Ri5 bled'tr!c*A& is€,�-Auidng spe-ml accommadau4nq pEerie-call(602)S42.9t51• 1 4rherinacy America Trusts•Sinte iWV October 26,2009 Arizona Department ofLiquor Lki ease &Control Phoenix,A.Z 85007-29,34 E'F: jtktt4ll7+k:?t..[..t iir(11C`t Wato:1Lei?.`urizcmgDmgC_o- Dear Sir or Madam: Wulgp..im Nxizona Drug C:t). [,Ij��il,„1Jv u53'nf{ 11#7 itl[iiry'i [i alS'.ret'n('o._ %'yF.11M17LC: Co- ties operated f'''• retail nh3rma-cic.s since 190 t saa eurn.ntly oj) ates 7,d_t00 store and pliartriacies na.ti+anv,,ide, ffidividua.l Wat�:reens stores and distri?[_itium C,tmL rti;:f 'subjlea to Potential adruitli5fra lG'e actions by various f�d[_rtal atYt1 it, to Sgelcis.s that regulate still}r>ki`d i>.s"tic wid ilia practice of phormaoy. - NV tgrec-11 Co. iq iIi°tok,ed in Various ?egal proceedings im id+fatal to the llGnnat coursE:of busiaes.`+and is 13hje;.t to 'v`ariou;;aufio nt,by ,oi`ernniei-aaL a nitho hies responsible for el-if-+rcing the la-. s and rt�Llp itit?l; oa =ahioh the;o-rnpaay is 5uhJlei.l- r" aterial actions arcs required to be 3,:,L.lt;..r1?o this U:iit.ed Statos ietlilritie3 an� l,:�cli Inge t'ommi,-.;il iii S�Fi'i. Any information regaFdirtg T:3t?tenal civil,criii-kinat, iiCCI11IAE.1it:l.iV rWtTJlat+)PJ Or dI:SC17ilIT12CY i,3COOIIS ",vo ild he di db.sed 3t'i.i}fe conlil?11y's 33T_iblic1','cal 31E.ibliF T1r:4;,1?BTI.t' filr�l W t"-,the M'tl-,k ee.[I ,L ri .t�C11a 1111 ":-0, t;;[rrt;ntl r Ei,ltl:; _t1 r 4',i) _.,hep liiinit ix: `1 ti 13ti)i 1icLT1MC int1's State of .fir_otia_ A,,.-i?U_,,a Departt3wnt nt 1,i l2or i_icui:-sL xiidl Conte.—,I i;idli--ateF that W li=reen ,Ajizoii: D {Co. paid 41, fines from the,Mate `ii-orn 1991 to 2.00 1.as del hill. rt dic attached s;,rea shot t. 1.o iitdicate. that`k�?Isjre�ti�'.r7.=_�tia Uru.�Cc. :r.cz:l r�; i try°t�l,rl ct�d."�t�'a� icY of Vi ilaflons 1f;.m 194;' to 1997 as{k Lailed in take kfll oij�,i X..Valg;ree,n Ariw,'.a Dlurl Co.and Walgre:en Co, take Quiff-pliance'~Hith all federal,state and local laws seriously. i1.11 (FuiptuyeLs i'rivolk'ed in alti,lihol;ale-:s undere o t-rai ling not 4 rdy in Arizona liquor lnw ,but alsta Walgreen Co, licluorrili�,_ �lilGea""e1.4', � 1 ;r i� Randy Zc'us'e District Nfanager 'a'i'alg rtfxni Arizana DiLig Co. Walgreen Go. 2075 W,Pinnarte PaiX Rd.fate 130 • Phoenix,AZ 85027 _ 1 v''d��I-G-=tCEN"""0. LEGAL CONFIDENTIAL ALLE13ED VIOLATIONS WITH THE ARIZONA DEPARTMENT OF LIQUOR LICENSES AND CONTROL Alleged Violation License 4 AGENCY ALLEGED VIOLATION STATtJ� 1 S. State or Arizona Depanir^,�-nt of LfFlaa:�r �+sU;t�iu<s,i.nnr_,t�ur;tilr�ra w:�w�l.fr �:h ahral i r r 124199`ij 'ar07ol-I F3k L uen es and Control j State of Anzon Lit p artr aa.rit of Liquor iquor u .. r `_ _'.. -_ -- ._.. -II.._4 _ - tox---- - ----_..�'_ - sore! _-- Violation 9129/1992 9 a3itt fib. I_i €E7 ur d r rralkrc I ab rn lie,,.rur to on intoxicated „r eta�urrt r1 traGaar �1gt:cE of State oe Arizona DE,,partruflot of U._luc ,s"'ll, yiVe. li.rrfliSh ea3'at'erage per on Irrl Lh aIcohc I 711/1993 9100091 t icenses and Contral ;lrlotice of Violation-- -.._ w._.. _. State of Arizoii a D fs rhr7eaas.��f Lir.;u„r r etur�a,o t i.t, s lip from undeaige buye-r, self, rgrvc, 7121)1994 91000941License end Control 'Flue Paid:$500 ,rk ! State of Arizr.'ina, Dupurtmont of Li;.tcrur 'WILJFL to rec:utst :U from underage buyer; sell, £�f211995, 1 0800.-01 Ltc;ens s and�ont>.rJs" gar , furnish i 3dora��aot's:on mth alcohol_— _ Fine Paid, $590 -- ------ --- -- I . State of keizona Department ent cat I i(JU(ar 1 J ,rrt,tG re t uu t 11) from underage tar ye?.r,:3re'f, 1 4119119961 91000751 Licenses and Camtrol c r'Mu furnish Untie rDc e person with.alcohol Fine Paid:$500 State of Ar zone, Department of 1-iq or ,l aiiurc Ai-)rr;i L1e!:t ID frurrr Ufld sragQ buyer.sell, 7125119961 ''J97067 3. Licenses and Control !&e. f anti`h uncrA�ra [a rs n w irn a4fco of jFine 'aid $1,000 910fi0rt�7j .� '.fq cyf,+`�rizr{i{� Department L,��aa:�, rail�.�re n_ut_� �0 "rcr��underage buyer; sell give, 1ttr16r1'396 hF Lirt-�rr r and irnish�+.altdora^� e r�or� ,,ikh al a37o1 kne Pairt t$500 r State of Arizona Depa tlfle It of Liqiior jfuilur--to r<njlau st Eli from underage buyer; s�I6, 10125119961 9070285 Licenses arid'C or.tr& ' ++e:, hi,r .r,uu de alp pe'son wit,,air-ohul taee r�'Ji�fat on Late of Arizoria Departrneiit caf I qurar fa0ure to r ttue st ID from underage buyer stall 1012511996 307 30'v� t if-,,ns s and Control give,e, furn,.•ah underage person viiih alcohol 'Notice~of Violation 9 State of Arizona, Department of Liquor ` lure to request'ID frorn unctur.age buyer;sell, /012511996 91001791 1-,census aqd Control ti:+e, furnistr uneJ rage f rson +,'rt r aloollol J fine Paid, 500 I Stare,at,lei:orba, Department of Liquor 10125/1996 e Lic 9100094' nse,and�ontro. sell, dive lur„first,urstJer� e a rtlr �3ue3hr7 -- ---- E fine Farb.�1,51�U __ _� __ __ _ 1 _ Mate taf Arizona Department of Littucar failure to ruquest III frorn under age buyer;sell, 1/9119971 C0070281 I iee::n,+,-,:anti C ontrol 'qi�.�e:, furnish u,icte raoe�orrgn�P,+It:h al�crtrol Notice gat Violation. _. - d _ . �__ __ LEGAI.-CONFIDENTIAL 5.ab� of Ar u'�. Dt-)arlumml of!Jquor if(LI r I :Sl` )`,jC IN"111 Zkollol 21i 9119971 91 0 0'114 eo ,13' Ucse.� and Control Notice of Violation Stato,of Arizona, Department Of UNUOr f-,)iIGFQ 10 I'D frorri,u.1dQr�qe[-,wyer: 71241-19971 9f,170573'i Liccw-S'c-,-s and Cowrol fLI-111A01 nden-ige person wdh al; onoi Fine Paid-$1,000 of funish uyidlerugf, p rx,,n with alor111(il 7;'2 4/19 9 7 9 1 o c,15 rIvl,! C0111rUli ;fine Paid $500 State of Arizoi Lie,,f,-artnibro of furnish Ljmjera�gfj vvith aicohol 81.21 2J 19 9 7 9100126, Liu ensp.s and Contro? Fine Paid: $1,000 ---------- State of Arizona, M prtwi(inl of Litioor I :a elf 1, givo,fumish uriderage.person%?vitn alcohol 111311997 i 91070261 Licons.a an d nd Control Fine Paid $1,000 State of Ar.izona, Department of UCsLlQr furnosh inderage person v4lh alwhol 'Fine Paid:$1,000 11/3119971 9C170,2921 Liuc,-n-ses and Control State of Departi-Titra of Uquo, Ali,givo,furni!Ji i-mclima-ge voUi olcoho� 1.,'21119961 S407031Z Licenr ,�and(.,.Carom-1 lFirke Paid: $500 .Mate ul Arizona, Dep4�jrt.irieril of Liquoi 'i I aay:ure toseqkjH�A ID from undefage buyer;sell, -112811 9498 91070078 Licenses and --ontrul give, furnish uncle rage pei�sw vMh almhot Fins Paid: $1,000 St;Ae of Arizona, Dop'i0keMef)l Of UUMIr ;t., ' ', , give, furru-';I I riderage p pir-an wi-th aluobol 3W 998 91100,156 Licerisr", and Control IFIne Paid.,$1,500 ................ -StMe of Arizomi,Departrnent of Liqu(,f fmiure to rew-lest ID(run)Underage buyer,sell, 908OC1401 Licenses and Control ive, lurnish ut def-arje ip�erson with alcohol Fifle Paid: $1,000 slatu,of f Ejepartn)erit a,Liquor 5/1511998 9100179 Licenses and Control sci Furnish und�rage pe,*joii wltl i alcohol �Fine Paid: $1,500 kit Arizaro, Departi-nefit of Ljqkjt.)r 812911998 9070673: Li rasp and ContrcA sell, pve, furnishundera jiorsan-vith atcohol 1 Fin e Pa i d., $500 State of Arizona, Depactment of Liquor fZ1iI1Jf0'1U 10 ff0fil Uridewzig'e lbuwer sell, 9129/1998! 90706'('31 Ucen.sus and C,tntro.i aive, furnish widtraue erblari vwilh alcohol Fine Paid: $1,000 State of Arir,:ona, Clepartruorit of Liq..ior controi sell,gjvv,.,, alcoho 'Fine Paici: $1,500 Stat(t of Arizona, Department of Liqucir i ifliflure to rorluesi 10 frorn t"liver"sell, 2.Q411 09 9 c90705, 3 L.Juen-qos and Coritroi rum sh uridt fucj with alcul-lol I-Ipe Paid- $1 5UQ ;Ir iL jF(EEN C',O LEGAL-CONFIDENTIAL - �� 5,tata;caF.';r!zunl. Ds,�arUiT�:n;oz Litl�•JI— -- ._._ 25. c 7 Lx; enses rand Controi : 3,�b,199J �JiJ,056�f ti :cll• cti ,� I..Irrilsll r.ncti_rCtgs?j.;c-:r�grt t�rilh �i:`t��hal Fine Pair:: 'S5GG `J.! Since of t';i.ors,,, G�upa Frr,,e ni c,f L cju r , _ r�! ,Ilt;c to c,,iu � If)rrr;m Lrrrrir�caa e, Drayt-r;sell, °;Iar9/'stgyCJl {}('G2i� t.it: n5+.°5 cif nl Contr03 Paid:ll,(r, fUfTllot'.r,ril r':licC ( JLrs�: , r�w.ltll c31,ofiol FntliS0,25 I'1J .... E_ _. _ . . __� StdtC or Arizona,I'L:1, [7Cpcff nit,la of L,cluor nll:r� to FffluC ? lD rr m undCra0es buyer sell, 81Ef11999 9070078 I_icensr s and Control mist', (l per`5c with -. l t,. rl.l� _tt un�lt �, �rl v alcohol Fine Pirfj, $2,040 ' State of Arizona, Departnae nt of Lgtja i 9i151.1999'. 9100 9 Licenses and Control t:rrdG �.Io ,r'r ann vw+Itl ralCr�ru,rd � Fine Pad:$2,00C, -: -- StatC of Arizona, De;arff�"Ic lil �f Lis Lll i f,., buyer: 1 i Ilr,r.: h�rk (l,l[ 1 J t fr-im underage sell, 9/27/1999 i 9010 0564 Lic cnsr-; and Control r person r �r ___ _, t n,l,,ri ur Jr r itle per, n with al-ohol lFina Paid $2,250 S1, at(:of Arizomt Deparlmtrrit of Lic;,lor . '111,10/19991 90703063 Licen;-!s no o rcl c , un �, furnish, _mde aae _Lra( t 4,Itn a Irrahul Fine Paid: $1,000 - i State o1 Aai oral i t eoattlmil nt:.°t l.tf;i,o fG t 5 rULJL!et HI ror"i i Lis,T urLdc a c buyer- c 1213011999 9070287! Licenses and onlrol ` Urdtrage With LdCO€ u Pine Paid $1,125 `Mate;of Arizcrri r, L.epartrmeni,of Liquor 'Ill 512000 911f7003i Licenses and Gr�ntrr,. 11 rit�u. furr__-h u,-idcr.ge,pur,,con ;.pith alcohd Fine Paud '12,000 --- __' I Stater oaf Ar unEs, Departrt eat of Lcluor failure to reques ID from undcaage buyer; sell, give,l 2:2/2000, 9070063 Licenses and Control furnish wider age f7t:r £)tt with Acg1-101 Fina Paid: $1,125 l Stabu UI Arizona, Department of Liquor i 11/2000 91a1)1 157 Licens ,riot Coritral sell give.. r`urnish undesag,p iyon vratfl alcohol !Pima Puld $2 000 State:of Arl on r Deprti)-iertt c,f I,IgLar,l !r riuri, t°> rs rgucst ID from ujirllwage buyer,sell 311012000;_ 908Cio 0:1 _ License-sand Con;rrl �5i e., furniF,'ll underage persort with 21Co1101 is ine Paid:$1,250 tate of , irons, Dr-,pnrtrn, nt of Lic-uor l urn tD request ILl from undert;;e buyer;sell, 3M/2000;-- 9070 8t Lic:en!5es and+,wantr;al - . gkF--. lur ish underage person with alcohol Firle Paid $3,000 S 511 +20i�4] 90 [)? 't u cat wrizor.,a, Departuicn,of LigLl 1 iiyilu;F SriII=k friarrl unilarage buyer: L:ceris s and Control _ f lrrlisl'I ori4s r 'e erson vw+nth alccboi f lre Paid: $1,2 3ti 6/6/2CQC1 9070287 Sl4,tri Cif AfizrnEt, Department t} I_r-'lu.Car lciill,'e 110 VCC]OES( ID Sroro underage buyer: :swill, L icenses and Control tl+e fnrnisl and rage person with alcohol 'Fine Paid ,2,J00 Stdtc:of Af z�na, Lup@rtmcrit of Licluor ,II, li i , furl i.4w L<airJ [,•tlr Will'I ai,wftltul 714112{?OlJ 9t�5QU20 Licenses- ;end Contrrai iFne Paid: $500 Stall of Arizona Depat rrent of Laqui..:sr Jjilure to from urdE n-ige buyer- sell, 8,+212000> 9070294 LI•ena e;and C ont o4 fqive, fLI niSl").uidt fage person with alcohol Fine Paid: $625 '-A`r;LGREEi'J CO. LF-C,`AL CONFIL ENTIAL State of Arl o ia, Dupartrnent of Liquor:se. , r;Yr, Purr ,ti ilmlerage,+rnitl `ilCGtroi'n� i 11J3012000 9100179 L,co si,—, �in(7 I-c;nlrol t-irle.Paid:$2,000 rn r_ �, , Ern nt t,i:l,.lor Ir tr qur , ICE f.olrt urluc r9t�r k7 �y�tr, sr�3a, 12161 2 a 0 �'y i31.70-40b: I is enSr arvA (;,;., Itroi �.il',��, fU,r4,'sh underage ��'rson vAth a!�h�ho! Fine Falb:$2,000 Jt;,,ne of At.1:,.ti71�«l, Dr17i;vrnurit Gt Urluor ,f@iILIN-'tO fOQU4. ID frUrrt UndnsrEKjo_bup�.r, ,;e11,. l,J 4124)2002� 907061, 3 Lcense anal Cali c I give; `. r h ;Jnd r Ige persan,v.-It:l fine Paid:_$625. . ._- ;atpte of Ar rjl•, Lir;uar sell. gi ,urnisn u.I� rage pGrscn with alcohol t;128;20031 J070'173 L ..ense.,j �ir.d Control 500 _..--- •~ Fuss P�at�i,$ . Sti le of Ariii:lna, Dop jrun iltof L1r.: ur tF_711LIrG'f_ r 1 C;<Il"it ID.EI'4"trrl l�I,,ieCc:<Jk I)U}e r, sell. '�' ... .._.- _J _.. __. .... .. i�l_._. ........._.. �._.�4 _'i ith t ......._ ._......_.__- 3r68t199 7� t170�r� :afnl�:of�,r t�ri;s s�and tnr�t�-ri I;;e Li,,;;;tx failure t;,f•r�fctu�:�t{G rFr:�rYt unciorac;�� bLw,{lUl�i;;ll, I il�e Paid-.�1,0Gf1_, r,•,r 10 29,'1990 9_0-7057 t{' �l 3t� Uf 3rl v it �Jranit„aGriururc:rio;l o` . Ptt;ee �rLi�l:tianJIV . F-7 7 � - eagcpr acoto Liquor - 71 4'1997i 9-1000051 Lu c rl.;r;,card contrr, lsell, give. fair nt;h underage parson wile wcoho! -- - n _ ARIZONA DEPARTMENT OF LIQUOR LICENSE—s&CONTROL 800 11V VVa hington 5th Floor 400 W Conclress i,2 a Ph,ti ari AZ� 85007-292,4 Fur 1(1 H / 8571?I-13� l (6 21)42-5141 QC18 qit 5All6 RE (520)628-65 Attention all Local Governing f3odles: Social Security and 6trth6ts lnf€j,:Vattvtt is CaTtfideotital. This infontcaticl&,, ay r*-�9`van to local lave enforcement argencies for the purpose cif 6ac@tVr,dund cficc S eniy bat roust Eye blocked to toe rititeu<i�l�1e ritr 3tirl�' 1 r;ny putailc vle�u. �� / • Read carefulty. This instrument i,;�s.srorrt`r�acifrxtent Type or print with BLACK flfl{_ An r�tensi bG ina eSftg 3tiQn of yra+Ir tlacl r r�unii will tie ccardvu-tAct. 1 a6e or incomptate ansnrer� could result in criminal prosectttton'3r€d the.deniei orsluhseg6en(revocation of a Ncense orpern1i' -0;'4E CQNJPL=TEG By EACH COPITRCLLINIG"SE4'_rvt rr3LPlT #�`t��t'u t? Chl ,:-�S t1 r'tSF L`c113E r H.3 FO.10 MUST .1JP%A1- N, 'ARPUCAN-F T`'PE FildG}=R=RINT CARD'NH] H i1; Y EE 05fA NE.i'AT LC HNGERtFAxit TING'.9u_1 3€_DONE LY A'St;,':V-.'iG1=LAN ET=FClt+CEt 1..:i`i AGE€G`t'CR r Fltl yE 2 plidTfPdC' ',tI ;E!�PFt C1iEC5[ L11.T..TH'E Di iHSSER:'cE' T : SPd?< FJL Effective IM1107 there is a .q lresr trlc fie fUr each Ei ncrecv+ihi card submitted_ Lit or License The fraes_a!Lo_vy_ tsv l,i,St§4d-E852 will Lie ci�arueal fen all vrsllorEcrec cttec s f �,+ i ) (If 01v Inc.tion iv cw gfltly i4eot%ed) 1.Chcc`r. MContrulfing Per.-on ❑,Agarat _ Manatger(Only) aappropriato 1 (Complste Qu€rstion. M9) fCompiote Ali Quer.ticiniS imgggpt P,14,i4a 9,211 box _;p. ? Controlling Person cr&gent mustcomplete#21 fear a 143nager Controlling PGripri or Agent.roust complete 0 21 2.Name: ..EVel}+'rt: -oate 0 Bir°h.: Ld;t Fir,l Middle INOT a Public Record) n t:,ial ti-arr..:r•i,,ri�8 .: r Dri°n-�"_h,t,�rl 3 � ' •� ;-to: Illinois 117 ,i p{ah1Er.r^rnrdl, (MUr z fsulslic raecr<l) — --- 4.PlI ce is 3irUi: _ C l� __1- Illinois------I 1 A —.. Height: 9" ighL _€4 ,r„Clue Hair 8lr.�nde --- _ _ �_----,-- _ - 5 y i. ��Itd -d Lu R8 f G_ ar-,E rf rent Ner n Kellen Kevin, at E � ia.; %( � Z K7 , ; ggg Lrst WEfor,oyt: yews Use,adufinna snce.it ^ ` 1g _� p!U8cs record) r (c a;arc, :2 r fc :3t4jd.r«-.f 1':11n+ois if AhZiDra. J `e_f ras:dlenc : 8 T( rapc-,_Ffv nun lter is contai:["vou during businjess fmurs k-r ijny quezz,titris rc.ga x i;ig Uii.,5 T•_;.ir 1+1nt .,_� ?� .',-2l-4��i =3. I;pu 11,4vi..L..:a:(1 !e,-.ri m;p',.si lent':Ir li s;M4,a 1:hroo(3)!non i,3.`=ubrrlit a copy of your Airzura drr.&s iIC_.er ot-vG._r negg:vr ajcjn t_lyd, tJ. i d tr t 1 t f'L, i_;i r �r Pir,,i5n Pho ie: 9 7 ' LJt3 T,1 �1��ica:L1 tie:r o`Li t ns d ri=mi=,es rclo- ss {3t 1ltlr q ,T t' l qs (Do;,,-A uiie P!J x)x t i 1 C,c,nt} zip 12 ListvL cstdrthla _1� '.es ,�n�m irz�ri�f �firr 33 dates. Ls€na�truuent$ t. l'€'CON1 TO E}ESGR B—=POSITION � EMPL 4YER S NAME OR`•LAME i?F BUSINESS 10-y"'h ryUr OR BUSINESS i i t..,.<i:Jr r._.,a,a ,ie"'a ztr.i r Q_ ( ;_txFnElll r - 9 f-c " z- t V i "" , 01,1 0 Treasurer yt al l een Co- t.t1. � Omat load Deerfield, EL 6D 15 ATTACH ADDITIONAL`tHEET tF NECESSARY FE R E i IE.R"•ECTICrltp, 1:; h iclic;;3l ,tar qt&i.,r1„e a:trlrv;s for tha last true(51,ears: 1 1 FRGNI TO Refit or RESIDEFICE StrEe-,Addr:sss 1 t f lr_a.thfY'c-zr I Mc Whi leas turn. 'If rarlWa,a1121�1 addibo,,al ShM tvb,1amc,adds s alp},jhoi...,,urntc�t d lawflorr1 i Gi!Y St.9tr= _i 1 611198429 .,� S i 61 f198 {. 9REHT 0'Nll 845 Wainer Road i lenview l IL 6002 t n 1 n LIC 01 al tavpl209 PJisnbtr d indlylctia.3l requidng Fi acial acconlnigdEtrons,please call tha Dvpartmr.nL(G 2)542-1U2T i If you checked the Manager t ox on the front of this form skip to#15 14.Asa Controlling Person Or Agent,vAl you 6e phyfiiva,lfi,,preaent and operating the ficensled premises? r�YESDNO I P you answered YES,haw many hrsId3y?_ .and If NO,skip to. �15 14s.Have you atteTded a DLW-apWoved Liquor Law Training Coursewithim the past 5 yeprs? (Must p.-ri.ivide pre-of) []YES L7jN0 It the answer to#14a is"NO",course must be completed beforo issuance of a new ficenss or approval on all existing license, 1. Have you been oonviu.ed. figed.ordered to i2eoosit bail.imprisoned,olaced on crob@tior or parole, El YES M NO fi-Rid to.2ost tx-ind or had sentence suspendl�d for any v olatmn of_.ALl.'�law,br of dLirajnce w, t6in dje past t,erl (101 y�-ara(1rclude only tfa-.,fic violariorzs that%fvore afloahal andlor dk�lq releated}? 16.Are there ANY adminiFtrative law citar-;ons, ccwipliance actions Drr-onsents, criminal arrest, indictments jJD m -J Or summonses E,E [N(; against you or —Y entity in-which.you arkt nog lrpvcalv��d- DYES M ND 17. Have yr,u or ziny entity i, J1 you,have 1'0,rjl ownersh,p, b!mi an C7jj,,u3r,marn�'--,T, lirector i.-x maiiat f-;r jYES Fj NO EVER had a busines,5, profes5ional cr liquor amlicaboor or liognse relcv ted,denied revoked. susgend'ogn ,QT-2 in this of any other state? H,.Is zlhyone ELr 2�2V�w't cr obtained a thie Subject of which irw-Aved fragd or o,(�.5 FA t"(D 19. Are ,-ou FyLM ri"have you EVER held o,,.vnerL=;Nu, been a controlling gersor., been an officer,mernbe Ll r-.10 EEMR ti•rr or,:ul—1 rmg,at'n-n gra—mJqgLr I LiL;oF 11 cjei-,a i n th i-or any other St.te`? 11 arly rlskm�r io QuestionT, 15 IhT-cugh 1 19 is"YEA'yQ_[tLyj LQT o_ iete rj&taiis i- :��vs corno lck-ld6lg ihctes, agerldes sSUB-STANTIVE: CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED 2�0- k a VF_tL_E_jt,in Kc- __ R SF� "�,drfl rz:avt ur AppEc--ml) Pir-;gt th;s I havEi read this n :ill stq'p-ner-ts are tru�a.corrct, i,-d *mple'e c . U'�)Si11 4-1�- ---- - F i. uII f --------- -m- iAppk -37 7fI'2 e wvirt i<-rt ver-3 U0,Lmij r-f,,L I'l�5 _QqLQber Zr Lo 41 -is ox),My c-ommis-sion p irc 4 .atMor-1111 year COMPLETE THIS SECTION ONLY IF YOU ARE A TROLLING PERSON OR AGENT APPROVJNG A MANAGER'S APPLICATION 21. ThL-appzit.artl.herebv;vulnor-1,zes the perz-io-q na-med or,this ouestionnaire to aCt FS Fna�2ger fOlf'he, 'itj lice-,ise. The manager naa-!,ed 11-illst b 5 ut feast 2", yr:ir, ,f Stato cf county of x (%y of Signature of Controlling P rsclf)or Agent(clruk� y -S' fiatwe of H'OTkRY PU 8 DC) r1nint My rommif,,,-,ion expires on: Day IMC-111111 YE-W r.... f J Arizona Dep attment of LigL-,,)r Lic t es Control 800 W "'asirtyj 5 'RM)r tie.: Statement p e,arding,'Walgeen Arizona Dmg Cn, Ci ;ir tiir or N'lawufl: r' l men,adona Dmg s a , h ll onucl.su[ idi'ar-, sat 1N'al r Co. w r Co.i `4 .:� t .• � a.l? �Ea+�tr:.:ui Co. re-taR pha1rtc:.i.; S ;h e 1`_01 Mid ..li,r;`ildy opc!rn� is ,i.NN)SICI S And li}t€oF:Ia.3.i's naLiOTVO d [ndi ii.I.l.al Wall`-Trti'•WS MUMS FI TId diSCrih-UtiOn a.if:suhj?ct i0 Fit-3C�_Rti:il..:'.�TTI.9n l.5CILYLT�'".actions by various federal imd tall;agencies that regulate avail r a d issues and the practice of pharma, v il'reen Co. is Ttlk&elm. in various le-gal proceedings ":ncidt(ital to"h ,n Irnal t..§.rs'u,,of b-us €i4::5 and (S subitci to vanous actUms by zi7'SCCt3t'ianul :illt[oRic's ?Or--tIfOrC tit, [IX.- (;VWS ,'into FC:TLIl tllo S co which the conipny is Si.ibjixt, Z'I.wd ) nc rE(11.lfmd w be l3i.s xsW to we Unit4d Sums rtiti 1 '+:. h yc':A.im _ .,t (SECT Any M;rimjl:,I' ii%ts3fl[;yy( ?6m. regulatory-«. Llis iplltma v ac-O ttisi ii oulu be disdos,cv in the conl[3 RY'.S. a-,, i;t 71C do umxvnts tiicd with the SEC ''�'= i.l,g,ee.n :;rizcna Dmg C;J_ ::!.tria3i ly }?oWs an't ownership inie �`t in .:•l iiLuor Sri i'.,att. t.iono 1_}.prlunent of Uqun:' License and t_ Itrot tU?s_ iC s drat Wn] nt,-ni , k:fuFTl:l Dn-,?Co Pa!,t 44 E nes Kom Gila Sme .:4 m i Q9, i'o 20),I.as chCtaiiCd in thS,auaCll-Ll Rcc orily:ils indicate tftlt Wal�[.',eTS .'ir(`ICi[=1 Dma C-Y imv, `t:ti G9 tcittil ;,if Si.t( ) ir''[r;iti..5 of ', :oltlt(trIIS t isT7] 191--j3 to i 997 i.s Cic t tii.'.i.l iii lh,ti a(tt &f.'l1C'i.l Wal green'Vizon,1 Drug Co. and fir'' al trt_ n Co. We t.tYPistihmStir;i4 ith all ic.fjt•r]S1, and Ix cal, i t''' rit}ti4l�'. t..l 9i1}�l Srva. jn,&Ij`K.,_l in ill'c_hul j35Cs Uttil:gu wainI g t1(51 udy in Wi;t) a }:qtltir hoc hu ,dso W:dgrt:e,n C_, liquor policioS. C11 tI'- I' `l rcasiir r 'i` z lg;reen Arizona Chug Co. I i 4'ALGREEfq 00, LE GAL->J t''It=if EN IAL ALLEGED VIOLATIONS WITH THE ARI ONA DEPARTMENT OF LIQUOR LICENSES AND CONTROL bate Alleged i V>otatlan1.1-11cense# AGENCY � ALLEGIr[?VtCtL+4TItlIV STATUS Stag of Arizona, Department of iqu(lr sell,give,furnish uj tenage vr:ith alc;uhol 4 1'1� P1�� 90 r 4119 t Licenses and Control Fine PaCr9;$1,000 I State of Arizona,Department of I lquor 9,r29,r19921_ 91:�10016i Licenses end Contfal Sell,rur liqvor to as intoxlcatead or disor�s Notice of Violation State of Arizona:Department of Liquor sell,give furnish underage person with alcohol 7r1/1993 9100091 Licenses and Controf _ Notice of Violation State of Arizona,Department of Liquor falure to reques t st D from underage buyer;salt,give, 712111994 3100094 Licenses and Control ftarnlSh Urirjeraars parson t^.ith afcrshal �Fine Paid:$500 State of Arizona, Depar meat of Liquor faiture to ra quest lD from un..deregQ buyer;.sell, 8/2119951 9080020 Licenses and Curatrdl c1 ve�furnisfi underage person with alcohol Pine Paid:$1,250 I j State of Arizona, Department of Liquor !failure to request Ili from underage buyer;Se i[, 4i19,+1986€ 91000751 Licenses and Control Ictive,furnlsti underage person w0h alcohol Pine Peald;-$':00 C State of Aft ova,Department of Liquor fallure to request IF)from underage buyer;sell, 7.125/1996 9070673 Licenses and Control give,fudnish underage person with alcohol [Fine Pr13d;�0a�{1 r II Stale of Arizona,Department of Liquor failure+to requet Cif from underage Guyer;soft,give, I i 10/16A 996 91000097 Licenses and Control ftunIsib undema ar person with alcohol Fine Paid:$500 State of Arizona, Department of Uqucr failure to request ID from underage buyer, sell, 1012611996 9070285 Licenses and Control glen,turnfufi und_ r ee persrsn avifil atrtih€zl Notice of Violation ''S a eta et of Arizona,Department of Liquor ,failure to request ITS from underage buyer;sell, i 10125119951 9070305, Licenses and Control ;dive,furnl,Uh underage person with alcohol :Notice of Violation State of Arizona,Department of Liquor failure to request ID from underage buyer:seal, 1012511996 9100179 Licenses and Control give,furnish underage person with alcohol Pinar Patd $500 State of Arizona, Department of liquor � 10l2511996 9100094 Licenses and Coratro3 lnell,give, furnish ands ago whth alcohol rFine Paid.p1. 00 State of Arizona,Department of Liquor failure to request ID from underage buyer;sell, a 1/9/1997 9070281 j Licenses and Control rive furri!0 unclrara •e person with alcohol �Notice of Violation VIALGF EEN CO.LEGAL-CONFIDENTIAL State of Arizona,Department of Liquor ,sell, give,furnish underage with alcohol I 2/19/1997 9100148 Licenses and Control _ lNotice of Violation �� ~^ State of Arizona Department of Liquor failure to request ID from underage 4 uyer; sell, 7/2411997 9070573 Licenses and Control ^ give,furnish Underage person with alcohol _ Ffne Paid.$1,000 } I State of Arizona, Department of Liquor sail,giva, furnish underage person vdth alcohol 712 +1997 91001a5i Licenses and Control Fine Paid: $500 State of Arizona,Department of Liquor (sell,gig,+e,furnish underage with alcohol 8122J1997 9100126 T A Licenses and Control _. .-w r� __— Eno Paid: $1,000 Stsite of Arizona, Department of Liquor cell,give, furnish unriaraye.person with aiGot7ol 11/3/1997 9070281I M _ Licenses and Control _ � _ _ _ _ iFine Paid: $1,000 State of Arizona,Department of Liquor Isalr,give,furnish underage person with alcohol l 1 1/311 997 1 OW0292 Licenses and Control I Find Paid:$1,000 State of Arizona.Department of Lfquo�" rsell,91vo,furnish underage ^rith alcohol 1r"21f1998 90708i2 _ Licenses and Control _ Fine Paid:$500 .j.� .:� State of Arizona, Department of Liquor Ifailure to request ID from underage buyer,sell, 1124/1998, 907007$f Licenses and Contmi 13tve,furnish underage person rrith alcohol Fine raid;$1,000 State of Arizona, Department of Liquor tsell,give;,furnish underage parson with alcohol 319/1998 9100155 Licenses and Control i iFin Pafd-S1.600 State of Arizona,Department of Uquor failure to request ID from underage boyar;sePl, Licenses and Controt , _ 319r'1'996' 0800�f0 _ dive fura�ish under�ga parson with aloohof v Fine Pall: $_1�hIJt1 ✓ State of Arizona, Department of Liquor 5115119981 9•1001791 Licenses and Control Isell,give,furnish underage person rrith alcohol Fine Paid:$1.500 I State of Arizona, Department of Liquor 5 III 8/2911998i 9070673. �. Licenses and Control _i so gi e,furnish underage person with alcohol (Fine Paid:� 00 State of Arizona, Department of Liquor faller-[�to request ID from underage buyer;self, I 8129/1998 9070673 Licenses and Control iva,furnish underage person with aicohof III'Fine Paid:$i 000 Stain of Arizona,Department of Liquor 1OJ30/1996 9070673 Licenses and Control sell,give,furnish undera ith alcohol Fine Paid:$1,500 .,..,_ , - �__.... State of Arizona, Department of Liquor 'failure to request ID from underage buyer;sell, V2411999I Q070573 Lirrerrsds and Control iOtu®,furrrl h uncial e orsan with alcohol Poe Paid;$1 500 WALGREEN CO. LEGAL-CONFIDENTIAL State of Arizona, Department of Liquor 312511999 90(1564� Licenses and Control e furnish underaqe parson with alcohol ,Fine Paid:$500 sell, give f 'I State of Arizona,Department of Liquor failure to request ID fromunderage buyer:sell, 1999 Licenses and C011trot _glve, furnl h undRrage person with alcohol fRie Paid:$625 State of Anizona, Department of Liquor fajljfCI to request ID from underage buyer; ;ell, 816/19991 9070078 Licenses and Control !give.furnish underage person with alcohol Fine Paid,$2,000 State of Arizona, Department of Liquor I 9115/1999 9100179 LjQenses.and Control �, we,,Jrfnih Undera(le p6mon with alcohol Fine Paid: $2 State of Arizona,Department of Liquor failure to roqueM ID, from-underage buyer;sell, 9127/1999 9070564. Licenses and Control give,furnish underage parson with alcohol Fine Paid:$2,250 State of Arizona,Department of Liquor 11/10/1999 90703061 Licenses and Control sell,giva,furnish underage person with alcohol Fine Paid: $1,000 Satre of Arizone. Department of Liquor failure to requa!10 from underage buyer;sell,give, 12,'30119991 90702871� Licenses and Control furnish alcohol IFine Paid: $1..!25 State Qf Arizona. Department of Ur,,juor 1 1115;'200£1i 9110003 License-,and Control .sell. rive, furnish underage person faith alcohol ;Fine Paid:$2,000 State of Arizona, Department of Liquor :!ailure 14�feques ID from underage buyer,sell,give,' 212,122.0001 9070063 Licenses and Control furnish underac Fino Paid:$1,125 ge person alcohol State of Arizona, Department of Liquor 31V2000 9100157 Licenses and Control give,wrfliSh underage person with alcohol Fine Paid:$2,000 State of Arizona,Department of Liquor failure to request 10 from underage buyer;sell, 3/10112000 9080040 Licenses and Control iVe,1L)MiSh underage person with alcohol Fine Paid: $1,250 State of Arizona, Department of liquor failure to request ID from underago buyer;sell, 3/28/2000 90700781 Licenses and Control IQKr6,furnish underage person with alcobot Fine Paid:$3,000 State of Arizona, Department of Liquor 5MV111000 9070734 Lloenses and Control jaillure to requesi ID from underage buyer",sell, give,furnish uridera22_p "I�:Ine Paid.$500 arson with alcohol State of Arizona,Department of Liquor 6/6/2000� 9070287 failum to request ID from underage buyer;sell, Licenses and Control give,furnish underage person with alcohol IFines Paid:$2,000 State of Arizona,Department of Liquor 742000 90800201 Cleanses and Control sell,Uive,furnish unde,rage with alWI01 Fine Paid: $500 Stata of Arizona, Department 0 UqiFur_5aFUr_G_F0 request ID from underage buyer sett _ - 8/2/2000 90702941 Licenses and Control giva, furnish uridoraqa person with alcohol Flne Paid: $625 VVALGRhF •1 CID- LEGAL-CONFIDENTIAL State(at ri ona De oaatrtaent of Liquor un Control , sh cee with al rag 'cchGl 1 t�`30�"'�SQLI ;319rJ1i'9! LIt��.n;�oG ena give furn jFirte Paid: $2,090 I state of Arizona Department of Li+iuor `�aarum to necluest ID from underage buyer;sell, 1216 qp'Qj 90703,00 Licenses and Control �� e,furnish underage person with ulcohcp rile Paid: $2,000 State of Arizona, Department of Ligr_arir Ift ilure to request ICE from underage buyer; sell, I alcohol Fine Paid-. 25 !? +'ACaCa2; r i'0{373 Mate or Arizona, erf Liquc.r r furnish ah $6 pi rni h underage person sill, Haiti wa,furnish underage person with alcohol 6/28/2003I 90705731 Licen,�es and Contr-ol Fine Paid_$500 State of Arizona, Department of Liquo?_ railure to request ID morn,underage buyer: sell, 3128119971 90705791 Licenses and Control lg_ive i irnisrt underage ttersw with airohol Frncj Paid,$1,000 i State of Arizona, Diapa tment of Liq,Uor torequesil ID from,underage Buyer;sell, 10+291199 i 9070579' Lioerrses and Control ,calve, furnish underage person with a.l.chol � Notice of V lot aticr, f State or Arizona, Departr•nen of Liquor isedl give, rurnish underage person with alcohol 7l2411997a 9100t_'a95j Licenses and Control Fine Paid $1,000 ARtZORA DEPARTMENT OF LAQUOR LICF-NSF-S CONTROL soo 5th Floor 400VV Congross,41-521 Phoenix AZ 85007-2934 rucson A7 85701-136 15,42-5141 QUESTIQNNAW (:52G)628-6-5-25 Attention all Local Governing Bodies: Social Security Arid Bjrtfidar6(nforinatign is Confidential- This fifforrrizi lilt)I Y e f-I -pt agencies for the PLJFp0$�-09� `6 %. local law anforcemG backgrovInd checks only iftlftlustbe hiocked to bp unreadable P�� a 6,19 oranypublic le, Read carefully, This Instrument is Type or print with BLACK INK, An extensive investigation of your background rrAf ho'con'dUcted. False or inaorripleta answer: coWd result in criminal prose-cation gridthe denial or sobseit.6ent revocation of a license or permit. TOB E COM PI-=-T�Erp 9 Y E,V-,H C0NTPQt,L1Ni3 PSR'3014 ASEN F t.)R MAi-AG. �14 E c.f PER ON C3MPL E7'NG THIS FORM 11ALIS T SU-2,10 I T NEDiT DI-La'1`11;.iGEPP ihtING MUST SE DONE BY A 601,A FIDE LzWt DnES iJrlTPROVPDE THIS SEPVICE. Effoctive 10101/OT there is.3 324.00_proces--inq jeejp U r cqm Tho fees allowed by,A faft h,i�rqed for all difthon5rc-d check--- Of the lacaunn if'-wm"fly 1.Check Controlling Parson A,",n t I Manager(OR[Y) apprGpriato (Complete Questions 1-113) (Complete All Questions excaot#14.14a 2 V] ) IDOX —> CoEitrotliog P2rson or Agent must complete#21 for zi.Manager controlling Person or Agent must complete#21i 2..Name: laroll Michael Coat gas Eiirth: Last Wql a-Public'Reci,re),- (,NOT a public racordl a PU fe rer I r I ac e,o B G h I c,a ao Minois USA 6' 190 - es ;,(P-e F3 q -I . D 0 rwi!=:rfep,,!EJ 0 847 , 527 4779 Narn.e of Cu¢renl or i 4t fqeiaam Martin Judy Ka, E,hinehait =rate cf Bint (Ust aill f"r last 5 yeats-Use additional sheet if necessar}) 7-i�nt Fr� M i dd _dc n 'NO, pulil Ic 4-euo Vd) Vou are a r1 iin.fid Illinois, . A64or.,da, ✓f rdmef 8 Telophofle numb-F,r io conjacL,;ou during bdsiness h.::ajj�ot-znv quesUons regarcing Lhis document. L��7 4779 it YOU lfArti-or.,a re&kjoT)t for Tan thcuthecae('11)nr; �5u,r1ni,a copy of your Afa,.,)r.pi&i,,ers Icense or vo,-2r rcgisiraflon c2 d, rr i Mare of Li(7on,,vid Pf Walgleens 4063 33 Phona:(_.4..§,O 2C7 042 1.Physic.I Loc-aiion of Lk'erjsrxd Prnmiscs Address,_2440,S0jjV0CQf1W'Q d ache Junction P—DCIVP Apache UZ20 iv ors_If un-arnpIf-;yQd paft cf!ho tirne.1�st those daez,, List most i-�-cerlt tat.12.Llstraur ewsptrjym�z�-m c r -i�,,a c f bc-siness d!ff.rg the past five F:RO.M TO DESCRIBE POSITION FMPLOYFR NAPA2 OR NAME 052 EWSWEss OR RUSINIES8 (simel 2&lres', Ap), CURP.Ellf-) j:L1 9791 Assistant Treasurer Walgreen CO- 300 Willmot Road, Deeifield, L 60015 AIT ACH ADDiTIONAL S-HE-E-1 F- NL E�SARY FOR EITHER SE-CTIONA, 1 a. Indic-ate your re,,--i4ierce�jddrass for U-,f--last five(51yex-s.- FRom To Rokilor RESICTFOCrt Street Addro!;q i Stag s 19 IIFNT Own 1309 Madison Buffalo Grove IL Disablu-j illdividu;ils foquifing spacial please call thu Dttpartaiunt(11102)542-9027 (010) If you chocked the hlafiagDr box on the front of this form skip to#It 4,AZ a Cantrelfing Person Cf Aaenf,Ml you bn'physioalty pFesernt and operating the R(-or.. od r -f,�? ]YES NO If ym ans-were'd Y E-3,how Mal �iy hrshlay? and answer#14a befow, if No .i*Jp to#15, 14a,Have you attended a DUC-approved Liqux Law Training Course within the pasI.5 years? (Must provOa proof) []YE8[JNQ If the answer to#,14ais"NO",course mustba,comp[oted before issuance of a new license or approval on an existing 0:Uime, 15- Have you been convictp-d,�ried=da-m—dio—daposl, bail,imori�uned,olaced on rrobation or unrole., []YES NO J fo r 12- any violation of ANY I-,;,N or ordinance w Min the past Len(10)year--,(in-ClUde only traffic violations that were Nca%lol an6l?'Or drug related)-? 1s Are there k ,.N_yadrnjnjstrj!i%,t�I-.w citations, compliance actions L,,,,consents, criminal arrest,,-ndictrnens C j-Y L-` a NO or surnFro.noes PEP40ING apinst yoL or AN.y entity in which you are now involved? 17 Have you Gr any entity in wnich you t-tave l-se9d ownership,been an ufficer, mi-,rrber,director or manager BYL-S 7 NO EVEP had a business,p.,efesssional or Qr_,Un-d to N5 or any statra? 18 Has anycna I iudgmgmt PagirIM vou, 1"Iff subi�--Ct Of vA-1ich involvpd ��j f,;[L -S NO n, _ .0-% L I -r: - - -�y F -3. Ate you NOW or have you EVLF hed 2,ynershio,beeq, a cantr?lling it Lrsoq,befan an offcer, rnernben YES L],No djL-s-,L�0-f or on am y—ok-ff- _ _�(-in this oT any olht?i 5tam? 1'-r-y F.risvwer to 1 tfuOugh 19 iL-'YES' )(rQU MU',S T--anach -a 5,iq;-,p-cj s,�74t,. -.1. Give cnrnoete,deI83-iS VIC,Udinq dates, aganp-es invoiveo, and this osalicris. S U[3 STA N T 1 V E- CFTIANGESTO TH!S,�PPI..IC.AT10I`,1 WILL NOTBE ACCEPTEE Z, _Garr Michael Martin h,3,eny de,-.J r n, fil rtI thus I have re.lid this ar-d all stat rrients i:re true,curred. <A.nd con"plet-a Z 111incis Ci.mly,5f L a sk 1�4.vjivowi�t nJ Appi(:�j,11t oFPCIAL St:A s CK1.1 U C K�A v PUBUC STA OF Uif`� %IV LIE.4-C'j COMPLETE THIS SECTION ONLY IF YOU AREA CONTROLLING PERSON OR AGENT APPROVING A MANAGEWS APPLICATION 2 1, rain z-Li pp!;-:@ n t i-.,e reb y auta:cj nze s the!:o9 F5on r-a,med on t,,,1 s q Ll P-SdOl-,112i r9 tcl ac' as r.1 al i age t ro r I h c ria.m ed liclu x it c3l�r. "he rnarageclaf-f.er-i nut be :3t least 21 years C.t age. of Thp"forpqnin.g m-mirnp.01 x d3-j of rrt live of CotOldling pers, or Agrtnl,(610--nne) Pkjr-alumnf rK.)TARV-:1U8UC) Fl&lt fAy con-migsion expji�.,on; Day M-xjih yoar Thrx P�arma;;y Aii�?ric€7 fRr�4•Since 7�;9' October 26,2009 fl Arizona Dcpartment of Liquor I'Jcetns��s&Control goo W. 4`lsriia�gton,5�,Ploor l 1 P'hocTiix,AZ 8500 7-2934 Fie: Statement RegardingWalgree.n s-riz:onal Di.ig Co, Ocur Sir or Madam: Vv'alga-;en Arizona Drug Co- is a wholly awned suhFidia:y ofWalgr een Co. Walcreen Co,ha,c?uerated rciail phtlrintcies since 001 aTId CUrrtntly operates 7,000 stores and phyriiacies.s.at.lonvilde. Individual Walgreens stores and distribution C;Mtcr-Q'ure su jtct to potential adminisvative actions by Various federal and state agencies that.regulate read n hied issues and the pract)'ce o£pharmacy, Watlgrccn Co. is irwolved in tar ous lep] proceedings.incidental to the normal, .:i'wsc.of business and v; wiubj act to:carious auionT 3 by>oveTn,ilru:i autho i.6ts rez;po* i le f(W anforc ng thy: laws and regul.Liion ;n which the r,-Timpan is sut7j[7(i, .IMWM 4�1:xtiuns are r quircki to l),t`disclosed Ica the United States :?ENLI'�itLP9 i1nd I:'€lead€?s;Cumrrns_.?on I S 4_'1, t�4Fk '1nfC7FiI7'z2tYtaR rr =r{1tng matcrial ,^_.t�.'Il, ;. €SIt3l, administrative,regulatory ar di:s iplinan,,a3criviis v ould be disclosed in the compaltv',s publicly available documents tt.ted Lvith the SEC. l alzrc n;s,Tzzona thug Co.cemc;ttt�� n¢}di_�an wv; nership ili.terest Ila 51 liquor lic{z st s in die.Seat.c;i Ari on,a_ Arxzwia Dcpartmcn4 o 1'.,igtlor l.icc.nS�and C onti-ol indic�itcs that katlffeen Ai-ir c a Brig Co, paid 44 tines from the.State from 1991 to 00+,as detailed in the attached spreadsheet- R?--cords also indicate that Walgreen Arizona Dug Co,received a total ol"s :(7)Notices oFVioiatiisns flom 1992 U) 1997 m detailed in the attached spreadsheet Walgrect—i Arizona Ian g Co,and Wal r e n Co. take compliance«-ith all federal,stag:anti local Jaws ;; r'-)lilt All uI pl oyev a in G"(Axed i i a1C')hbol:;,Iles undergo traiving lot only R:fir zona liquor juvvs.but A elso walf-r en Co. liquor polici(s l J Sirietrcly, C::aa`y�iv.tii:hae:k P.dart=rt Assistant[ieasurer Walgreen ttrirrinat Emig Co. 'fatgrren rn. 3rjr V'Vi`mIDt:goad MS 3301 + Dearfie;d, IL 60015 f ALLEGED VIOLATIONS WITH THE ARIZONA,DEPARTMEN'T OF LIQUOR UCENSES AND CONTROL . Date — 17 Alleged Vlolation Lioen€ae.it AGENCY ALLEGED VIOLATION STATUS State of Arizona,Department of Liquor Sell,give,iurrnlwi underagewitt1 alcohol 12/4/'1991 9070118 Licenses and Carrtrol ;Fine Paid:$1,000 ! State of Arzona, (Department of Li'gpor 9,r2911 992 �13t)O i�a Llum3n,+xs and Control liquor to an intoxicated or di.sordarly person l Nolica of Violation State of Arizona, Department of Liquor isell,give turnfsh underage person with alcohol � 7/1/19931 91000911 Licenses and Control I Notice of Violation State of Arizona,(Department of Liquor iifaiture to requss ID from undera.99 buyer: sell, give, 7/21/19941 9100094, Licenses and Control ;tUrnl5r6 uriroraga person with alcohol Fine Paid.S500 State of Arizona,Department of Liquor 1failure to request 10 from urrdu;raoe buyer,sail 812/1995 90800201 . . Licenses and Control �. mire, furnisri underaq,e parson witft alcotfol _IFine Paid:: 1 250 State of Arizona, Departrmlant of Liquor failure to request.IQ from underage buyer,;yell, +'19/1996 9100075 License, and Control give,furnish underage person with alcoho? 'Fine Paid:$500 State of Arizona,Department of Liquor falure to request iD from underage b,,uyer;sell, l 7/2511996 90 0673 Licenses afld Control chore,furnish underage person tenth alcohol W� Fli10 Paid;11 000 State of Arizona, Department of Liquor failure to requet ID from underage buyer.snA,glye, 10116/1996 9100DO97 Licenses and Control furnish G�ncta�ra e arsors ti^�4t1�alc+�hol dine Paid:$500 t State of Arizona.Department of Uquor ffaiiurM to request ID from underage buyer:sell, 10/25119951 9070285: Licenses and Control ; foe,fitmrnivlt t;nderape ptarsDl��v th alcohol Notics Cal tirio9rttlort mq ,__._ l State of Arizona,Department ref Liquor failure to request ID frorn underage tauy'er;sell 10i2511996L gwo.m L leenses and Control jivq,turni ht underage person vdth alcohol oNotice of Violation State of Arizona.. Department of Liquor failure to request ID from underage buyer;;fell, 10I2911996 9100179 Licenses and Contra] give,furnish underagee person,! 10 alcohol Fine Paid:$500 State of,Ariwt na, Dopartrrmor,of Liquor 10?'25/1996 9.100094, Licenses and Cor:aroi soil,gNe-o,furnish underare wth alcohol Fine Paid:S1,500 State of Arizona,Department of Liquor failure to request I[D from underage buyer,sell, 101997€ 9070281 Licenses and Control lye,l'umish undera a person with alccmhni rNotice of Violatfcan WALGREE f CO.LEGAL-DOMMENTIAL Stag o3 Arizona,Department rt¢11Ent of Liquor silt,giINe,furnish underage with alcothol 2119a18 7 9100948 � Licenses and Control Control Notice-of Violation State of Arizona, Department of Liquor !ifailure to request ID from underage:buyer;self, 7,/24I1997 9070573 Licenses and Control give, furnisn underage person with alcohol Fin�a Paid;$1,000 State of r'ria+an 5:a, Departrkrent of Lfguor li,giva, furr,,ish underage person with alcohol! 7:'2=t11997 910015S Licenses and Control Fine Paid:$500 { `state of Arizona,Departmect of Liquor Merl.give,furnish underage v,ith alcohol � 8YMIS97� 9100126i Licenses and Control _ ;Fine Paid:$!,OaO �..�.. �__.._.w._...State of Arizona,Department of Liqu+�r° s with _.�.� _ .��.,...,.�,. sell,give,furnish underage person ,fifth alcohol y 11/3/1997 90702B1 Licenses and Control f ;Finer Paid:$0,000 I • u State of Arizona, Department of Liyaor sell,give, furnish underage person with alcohol 1113/1997 l 90 02,92 Licenses and Controf Finn Paid:$1,000 i State of Arizona;Department of Uquw sefl,give,furnish underage with alcohol 1121/1998i 90'0312 Licenses and Control Fine Paid:$500 i.State of Arizona, Department of Liquor lfa;lure to request ID front underage buyer,, sell, 112611998 9070078 M Licenses and Control igive, furnish underage person vdlh aicoho'l IFlna Paid:$1,000 $fate of.Arizona, Department of Liquor !sell,give,furnish underage persor,a h1i alcohol 3f911998 9100155 O.er'nses and Control [Finn Paid:$11500 Staten of Arizona,Dapartim,ent of Liquor falfure t{ request ID fre7r11 underage b1r}+er;sell, Licenses and Control 3P911&9Jb 9020040; dire,"urrpf�h unrtertac +iaarson with alcohol Fine Palci, 1,000 Slate of Arizona, Department of Liquor W1.511998 9100179 Licenses and Controla�ivc;,furrri h underaRr�oorsori with alcohol _Fine Paid;$1,500 State of Arizona,Deparlmena of Liquor 81'29/1998 9A170673 Licenses and Control sells gave,furnish undeEa_9e(:person with alcohol w IFirle Paid:$500 Stale of Arizona.,Department of Liquor failure to request 10 frorn underage buyer;.sell Licenses and Control 5�2�11`�9fi 90iigb7;� give,furti,istt underage Person v,rlttr alcohol �Fine Paid:5i1,000 r 1f}/3011998( $tale of Arizona,,Department of t iq-Uor 9.10 Q6.73 4� Licensees and Control Isell,give,furnish under$ e With alcohol !'Fine Paid:$1,500 x State of Arizona,Department of Liquor failure to request 10 from underage buyer; if (r 2124/1999 9070573 Licenses:and Control lvee.furnish underage arson with alcohol. i=fno Paid,$1 500 WALGREEN CO.. LEGAL.-CONFIDENTIAL State of Arfzoma, Department of Liquclr /2�+11999 90+'O:+a 1. Licen es and Control setl, IV,-,Furnish urlcictra+jq nn�uikli alcol7c tFine Pain$500 State of Arizona,Department of Liquor failure Ors raquasf ID front underage buyer;soil, � ^_ 4/9.11999 90702,951 Licenses arid Control _ caiv� furnish unclerac��parson with alcohol Fine f'al,d.$625 �VState of Arizona,Department of Liquor failure to raq,uest ID frorn underage buyer; scsl, 8/6i1999; 907008 LioL;msrrs and Control give furnish underage person with alcohol fine Paid', $2,000 State of Arizona, Department of Liquor 9115/1999i 91K001'n Licenses and Co trolySel, afurni;h umdera _ d: �2,000. 3 fa i State of Arizona., Department of Liquor fr:ilt.rre to request ID from underage buyer;sell, 9/27/1999 _9070 0c504 Licenses and Control �lave,furr°rish underagc person ,,ir th alcohol Fine Paid: $2,260 State of Arizona, Department of Lfq or 111'10/1999 9070$06 Licenses and Control sell, give,furnish underage person with air,oho+l Flre Paid:$1,000 State of Arizona,Department of Liquor failure to requet ID from underage buyer; sell, give, 12/30/1999 90r'0287' Licenses and Control furnish underage persnxi with alcohol Fire Paid: $1,125 Mate of Arizona, Department cat Liquor i 'I/15120001 91100 _ Liranses and Control i,;cat_givf.,,furnish undortge person olh alcohol j inre Paid:$2.000 Stage of Arizona, Dep artment of Liquor ;faiiu:re to reque;;ID from underage buffer,.sell, give'! 2i1212000 9070063` Licenses and Control Ifurnigh undp araon with alcohol tFine Laid: $1,125 State caf Arizona, Department of L giiGr o __ 3/1/2000 9100157 Licenses and Control Iscall cri h,fgrrri:h underage poi; on with alc;ohol Fine Paid:$2,000 State of Arizona,Department of Liquor failure to request ID from underage buyer sell, 3/10/2000 9080040 Licenses and C'ontrof _. ._ giv'r ,furnish under person with alcohol r Fine Paid:1 250 State of Arizona, Department of liquor failure to request ID frorn underage buyer;sell, 3i28/2000 90 007&!; Licenses and Control cifva,frrtniSh uncisrage person�rrith alcalto Firt�Paid $3,000 5/18/2000 90 07$�I( data of Arizona, t epartm nt of Liquor JI::Iure to request ID from underage buyer;sots, Lloensas and Control _ iqr�'e,furnish undera a arsurt w1th alcohol - ,1=lne Paid:$500 , State:of Arizona,Departmert of Liquor ' 6/6120001 9070267 failure to request ID from underage buyer: sell, Licenses i:mC Control ,r i e furnish runderage erson ltb alcohol Fine P,afd.$2,000 State of Arizona,Department of Liqu-w ; '7.W2400d 90B002t0 _ _ Licenses and C,,ontrol t*lf,9xva3, furr�istt underage rti�go with alcohol Fine Paid:$500 I -partme t of Liquor laiiuie fc,request ID frrarn Underage buyer;sell, 8/2,12000 047029 E Licenses and Control dive,furnish undara_ o person with alcohol Fine Paid:$625 "oVAt GREEN:C20-LEG"L-CONFIDENTIAL �t,te ref Arizona Department of Liquor s e`t,giv-:, furni'Sh underage%6M ak ohol 11 301200,0 9I UO179 Licenses and Comral fine Paid: $2,000 State;of Arizona Department of t_.igUQF ifailure to regLJQsL ID fr0m undo aga duyar;sell, 121612000! 9070 U6 Licenses and Control g v fu r-sh Rinde'age��r�;�ar�with alcohol !FIr��P�,i�t ��Gr�O — _._ -.- __ _.._ ... 1 Star of Arizona Departrnont of LgUor ifailure to request ICJ from underage Meyer;sell, 4124/2002: 907W7 f Licenses and Ctsntrol give furnish underage person with alcohol f Fine Paid: $625 Stagy:of Arizona,Department of Liquor � -,ell,giVO, f�.arr ,511 Underage per:;on with alcohol �� 6,12 ti2003, 9070 73'.. ., Liuvnses and Control, �Fine Maid: 5GO I I SIa e of Arizona, Eropartment cif LigU o r f�i16r-e tu?'req`ue,st[(J 1?rorr a a n—de--rase sett, 3,128}19971 90705791' Licenses and Control give furnish u-nderarg e pefson,vith alcohol Fine Paid $1 000 State of Arizon a, DeparlMent Of LittuOr failure to request EIS fro-ni underage buyer: self, 1-0 29,'1996 90705791 l lcenses and Convol give furnish underage person with atrohol Notice of Violation St to of Ariz na, tJapdetm: nt of E.i uvf sell, givo, tu,nIsh underage person with alcohol 7f2 /1997 1 9100095 Licenses and Control Fine Paid $1,000 ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL 800 t1'e4•Washington 5tf'i Floorr 400 W Congress ri521 Phoenix .AZ 85007-29 4 Tucson AZ 3570 1-135 ( 2)5 ? 51 t IJ STIQNNAIR (52 )r2u-s3ryv5 fist ration all Local Governing Bodies: Social Security andtrtttt�ate Infarttt;ost L5 Qanfid rtttal. This informs#ia r 35 fa "q�� cn t local lavr e nfcrcem,ent agencies for the purpose of basl�grbflg3 check ert!y=Esut rirust bed blacked io be unreadable � iar,tcr tstia or!,}v r gbria Vitt v. s Rmad carefully. This fnstrr.ime, 1-�a yWt3rti doeuiiisiat eype car§mint vrith BLACK.INK. An autansivn irwLst":gation of your faackgr1.Quric3 will be"re�rduated, False or incoml to altsvrer could rosalt in criminal prosecutio and the denial cr ftrsE�uent revacation of a license or patvi f r: 1 t�3 L--TED b.'EACH t.0 NT—RC LwrPI; ER SON,A ENT.OR 0 A '9=R �.� " � 1t3�^�v1S L e s lidG i tis t_?R.'i h.(tl.7 S10a"4 -.ri. . C "TYPE FINGER P!NTCARD: D WHICH LV-Y FE C.c,. '"f ED AT[LLL 1EPz Fll. Rltf( C,Nl INLIST SEE ?e� 1P IANT` r,Y A r501,:y=,T,E L41'V E irCiKi t_':fEEf7:ACE'SC' OF,ia=1WGFRF'RNT,NGSSRVICE; df4,110vE6gYnLL,_.TIIE OtPARTIVIEW7DOCSfffzj pkCariLrE`TH'Is S=R`:i wr e-tiw,10101i€l'there is a S2#[PQ s�rocesstnzt f €or carp fsriaerrtPcn#card ai tjUlk tr Liiq or Li cegse�� Tta_fees,atlo`r ed by A_R.&&�6852 will be charga Ld fGF slt.a�r � z ,f the location i:s r_xsrmnfly ir-ef:a#{il !.chack Controlling Person 1 4gent _ h'lanncger(Oniy) appropriate (Complete Quegtiona 1-19) i ;Cornpiet€Ail Quas ioP5.r,-xp�vt 14.64a 211 box -- a Contra Hing Person or regent must complat'e#Fi for a Manager Controlling Person or Agent must campl?tR 729 r3 e t Cate or Bifil; 11 i �iCJI rt.. _ _ L 1-r _-._. t_n;t First 49tr�jit; _ocial Se:urity ''umbur Lri er;Licence ° !1` iµ `t f. : Millais iNOT a.public racordP (NOT A public mccrd) F 1.;•i: 7. .,ut,: Chiqag liflnoi USA ri icsht: 5'9"... ode-i•]ttL 185 Er_s.BI'0"rn;+iw: Black t ^i.y ",furl Counhy Snot c m n y.) i:,riial a::r.Lv C:uncle 0 Nla ed iI- 7: yr.w:c[] ,1 r.! 'A'3; :v1 rY ,r nflt.;,Phone.i; 47 ' 315 - 45574 f8st, F n tt , w pi lei :,uitS t ,:. `,;,Iverrrlai1..._.._. ._Lv!iin.._El`ien Abra s r^gieii'iLtr (L all "r kart yw ,., v".e ddit ran it ia4t:+.i#iii c :,,,i, j t..:•t kfid 1,tL0 _f pu is r?cact3J,? You zi_ bona etdG re4sideni Gi Y.iiai stale sl{InGiS tf Angora,date-M 3 T ei�M,ta.rr�r;i", f _, ,_:,<:ir,t�t.G'r'7tf!;urnrw t..t.zute._ hrt�S M1 CSr .s•�_lut,stifat�s rr_r�arcirti{tiai...te...ue,:ii?z. �.��I_f��"i -��3� _"_ r1. it t;t.dJ P'd'rn FC•Qii�^.4t"tZOn3 r4SiG..lit-_r I�_.>�+.hen Yrt'v I,.�}r:V'i l}7c,.SiJ t3f"il 2i CGf7� G('yrr1,'r C�n?4.•nS��11L'+�a'S Ilr'`'rY�@[7F"r'Gt!3C Ce=3��,tYztlun i�tr�. fo• l'dam .+i!_icea7s' 1.rrirtt _i e : i 1ta reen� `0 33 r.smi.;c Phone:t 480 t 88 0428 o Ir etfrt { f� t us=s.Nr7 �i. rthf n'}r yip 2 Ust 2tlr�re.:6�ra';rrrn:n-i?'tpe cr ut.,,imi: durin:'I t!"'o Past:c:c ,5; r ar .If Ut10rrr,lc, cd pilrL of P it *,lint tP is dates List most mcept 9 st Fl<OU DESCRIBE POSITION 1 t?PLOYE? f S NAME OR NAME OF SLISINE-18 `1':tn i f 1r„hFr :at C4R RUSINES5 i 01/2004 + DiVisional .'ice President t VV2Lgreen (,'o,104 Wilmot Road, Deerfield, IL t,0015 ! Corporate and Transaoti na{ Laird i ATTACH ADD); SHEET IF}d-_.1_SSM"'Y=L?r;t I t iiari t-..G.j0,1'1 Sadie l j�. e�ti Jr:,�•Si�{'r:Gu'.3Cldrr?e5 tOf el:t7 1r`3>>ii'x'G I��j j's-'Ffe S: r ttP eTyi 5 I[5 i Rent or RESiUEHCE StTeet 3ddmss Ii � i+'frni'iu rear k.t.nth.,1'1..ar J;wa If r '7:r.' ,aklacta� d.'.Ii�r.Jl fi i i'r lh name.,: re.s',S•rd rh{a'ts:n:.r�,b�r c.r d.ajiarr5 1 C;ty S:a"o t ?io 05106 $CUtRRENT iQ,�,.rn 1421 Coral Parkkr g 0.� _ _ � Northbrook ^€_L 6C�J�2 05191 05M Own 1400 Kingsport Court Northbrook IL 60062 I t L!C mal ttaCii a,09 Disabled individugis requiring spacial accommodations.please calf ttu!Department.t$62�542-902' If you chacked the Manager.box on,the front of this form skip to#15 14 Asa Contsoffinq Person or Agent,vAl you be phydCarly j'restill and operzing the licerned If you answered YES,hcw many tvsidar- and answrg-#J� D 4 t L, kip to..I s. 14a-H2ve you attended a DILI-C-approved Liquor Law Training Course wiLhir,the past 5 years? (h4ust provide proof) OYFI13 01 If the answDr to, 14a is"NO",CourSe 4 must be ODF11plated bofare issuance of arj4w or appro,,(aj oil -111,10 an existinq license- 15. Have you been convicted. Fined,cirdered to deposit ball.irnwisoned,Dfaced on probation or OaLaiq� FE-1 YES FJ Ito had tci oost bond or had sentence susDended for any vidajon ofANY law or ordinatcewithij,'i the t�75,L tort(10)yairs(.Int luc e only traffic violations that were alcohol andAx d-ug related"? 16.Are adiministrative law c1ations, cotnpliarce acfi ns or consents. cninniflai arras�,0 Lj YES :Vjj N(-) exsumi-nonses PENDING against you orAN'Yenflty in which you are now involved" !?, Have yuu or any enhk'T,,in kvhich you have hdri been ain officer,,weiniuer,tiimqt�cjr o,--nanager EVER�iad a.bij��iires5 DrT)fusj- anjd cg liguor�:jr)rjjjca[iof1 ur firerlse reie.G I ted,denied.vevokeff, EYES []NO or fj wr-,d.in this of any ather state? 18 Has ariyoner EY'-E- led the;subject of which involvr.-,�i f1FDL WE 13, Are-yrau -tIA or haves you LYM held vL��tnors j.!,baen a ,4en :in car, nnetrib8 MYES "tgj_jlq on any othe, liCTLIQF license-in this ar any offier state? If nnsvver to 15 throuqh 19 is Q M UZ abre"!srat,�Ment- ��S"Y 3 sttpch 3n dis a7i Ions 47.14jd,ng d?tes. ig enc:p s p, SUBSTANTIVE CHANGES TO THIS APPL11CATIONVill-L NOT �E ACCEPTED F �o -Rrt,)ert evierip Sidverrnari li�irei:v dec;nre <W, the APP! r5. i have realJ this ald all stxlefrelltf,af- ttuv,::Clfe-ut Hfid comP70-z! -t 0 X — ----- Lak r-,alUm .,f Applk.='1111) Thb goirtg fi^-, this fja-�of 1�r 22� - — - M r AINN:�'P-KULICH .;ion 0.'pires or., iki-N z IYA 2 I :11, DT ful"alu N- COMPLETE THIS,SECTION ONLY IF YOU AREA CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21. T f-;ippfiCInt j1jr;[-CGy ai,jthcnzes tha person rarnf-d on ilh�s que-z-flonnaire to act as man.ager;or thF-na-med liquor 1jr-er-,sEj m,-ira b '2 ag,�. Z.f7r n.��m�-rj t t I ast1 of R j j try€r,errr-this x n;3 t f r--A o ri ti t r c I i n P i, t i n r A g n t(r,.ff r.1 0 r 10 Year (Skjriv hire of NOTARY PUBLIC) Prinf D.,.ty Month Year ;l Tte TZ - ?q.9R, Sr �i ica 333t' C_kc(ober 26, 7009 Arizona Dopaitxmnt of Li;gwr Uci4 uses&Control ; 800 W. Washingtan,5,Flc}c7r Pho-ellix,Y\Z 85007-29 34 Re: S[s3 emT--m R ga€ding Wa.lgm! n.Arizona Drug Co. - Dear Sir or Nladam: Walvm4ea Arizona Druc,C o Iw`i st'hoil (1wned subsidiary of Wal„rc-m Co- Waiort:en Co. has oF.'rrted ttlti td hllarn7 ic-:8 slnc,J 1901 and curm fitly op.-t'ate,`s 7,000 stome-.3,.i d ph,:1miacies naLin 7 vide. 1x di;ridua.1 4 algr,Z Ons:St01-4.5 and distribution sublecl ro pt'ricatial adlnisV>trativt ac.tis}ns by various, Cc&tal and statt agencies that rugulate retail relatud issu(s arld the nmctice of pharrrrac- . Wc l_rt.en Co. is inw.-lved in various legal pEC'C c�'tding`_ iiFt'idenu,1 to the norm'i i:.t•�.�rC e o busi�fc-ss and is .sub ect Lo Eras`ous actions by oovernmental authorities responsible for enfijFcillg th1 iaws mid ! zuk—LiOnS to which the t_or-r1pany i8 sub e.ct. Ivlatrr ial a tit^_rnS are regUired to be disclosed to Li L United States Securilie-s and I xc h ngt tC,,7 nrnls-ion L_SEQ-1. Anv information regarding Material cis*i's; criminal. tilrllltliti(riii?ti'e_, C:'' t l t.trtr or disct[lllliir( iii C;.7tt,> '.VilLilGj j,t Cll`? 14� C j in the C4,Si7t)tt7}' public dt'<t¢l 15i `t rciIIII.R S fil,cd -,v,,(P7 rIic�S EC, Wah'� een Arizona Druvg C_t7. cult lily li:Ns :I ?i'i crShip v,(:.. .1 i77 I iiv.l-vr lice i'w", I l lilt' `I.it o r7 oRa. :triZCrnaCic.r?1rtsT7al?i E'af L.IqI_tOC I-? eC.'sc_!nd Cop ri l indicatc lh it �'Y`,Iigreecn Armyria Drug C o� laid 44 fiti :_from L67.4 St..tt-;rota 1)91. To 01-),33 afi dexai.nd in the auach :J snre-adshett. Rc;c- ,fds also I;1d A(,,:Lh..t Wal-r-Emn -Vi'zorm Dru, C(.Y C t:t'i''L.il a mml o six i r'J'Notict-s of Violations from 199 1tj 1997:ti dt;tailed in the attached spreadsflu'l. ' aIgieen Ati7.ona Dru C t). a I i Wtlgraen.Co take.compliance with all Federal, state and la<ua1 la <s soriousl t. All :frkplo es invoived in alcohol.a ll: 4la rk_o r-ahiitig., 11 x o1`I.1y tt1 Arizomi liquor lav,:�, but also Waltirve.n CO. hgtior l7c�ll:ses, ID:"XI '•:,{ ^OA rt NwtI,Flc SIM"UTWin VX,E Presider walucen Arizona Dru YLIgre,e[t Co_ + 300 Wilrriot Rears MS Pt3301 . Deerfield,L 60015 WALCREEN DO, LEGAL-CON IDENT11,1%., ALLEGED W OLATIONS WITH THE ARIZONA DEPARTMENT T OF LIQUOR LICENSES AND CONTROL Date A.f Alleged Violation License P C AGENCY ALLEGED VJOLATION STATUS State e of Arizona,Department of LigUor sell,give,.#urriish underage vif?h a.lcohc 122411991 9070118 Licenses and Control Pine Paid:$1 000 Stater of Arizona,Department of Liquor 9l ,Q(19 2 9100016 Licenses and Control i ^ o os�n ;VotBre of Violation � State of Arizona, Department of Liquor self, give furnish underage person with alcohol l 7/1 ill M^ 9100001; .. _.._. Licenses and Control Notice of Violatlon . State of Arizona, Department of Liquor failura to reques ID from underage buyer;sell, give, 7121""199 9100094 1 _ Licenses and Control Mnistx urirlerasfe person with al�;ohol � i4 kne Paid:$500 Stave of Arizona,Department of Liquor failure to reque94 I0 fray€r undwa e buyer;5.00, 612/1996 9080020 1. crr7ses and( cantrol r~ix� furnish Underage person with al;oFroi IFlne Bald;$1,250 State of Arizona,Department of Liquor failure to regQasl 10 from underarge buyer; sell, j 411-19/1996 9100075 Licenses and-Cnntrol give.,turnish unae:a q per on nfth al ctrof 'dine Fail;$500 State of Arizona,Department of Liquor ifallure to request ID from underage buyer,sell, 71'2511996 90706731 Licenses and Control icai�e turrrt4h underage person with alcohol Fine Paid: 7,QQ ....,»....,y..n....a_..,..,�,.r - .. ...,,.,...,..-.y....A,�a....,,...aid:,L1, s: State of Arizona, Department of Liquor �faifure to requet ID from under buyer;sell,gilve, 10.f16J19961 91000097 Licenses and Control Iturnish undarrs22 parson}with alcohol Fine Paid.$500 State cif Arizona, Department of Liquor failure to request ID from underage Guyer;call, 10J25f1996 90770286 Licenses and Cor7#rol t7ive, ftr�ru h under erson wfi a.lcotioi Ncitice of Violation State of Arizona, Dapartmerit of Liquor failure to request ID from under go boy r; wall, i 10/25/1996I 9070306 Licenses and Control ;ram,lurnish u7derrag l.,ch.I No ica of Violation State of Arizona, Departmant of Liquor failure to request Its from un ierage buyer,sell 14125,"1996 3100179 I i oases and Control' give, furnish underage person with alcohrul Fine Paid: $500 ! State of Arizona,Department of Liquor 10125t`199 1 n. 910001 Licenses and Control turn i h urnl rye%yitr� lcohol µ iFIrie Paid:V 500 w Mate of Arizona department of Liquor failure to fequest ID from underasfe buyrer;sell, 1/911997 9070281 Licenser and Control !c�aue Eurr�#r to#i tandorag e person i-; � � er on with alcohol Notice of olatlon WALGREEN M.LEGAL-f~C4NFfi,~7ENTIAL, State of Arizona, Department of Litlaavr ve,furnish underage with alcohof 2/11/1997 91001 461 Licenses and Control _ Notice of Violation --- - ' Mate of Arizona,Department of Liquorfailure to request ID from underagebuyer;soil, 7i24,11997 9(r05731 Licenses and Control ;:rlfve, furnish underage person with alcohol _ line Pairs:$1,000 y� State of Arizona, Department of Liquor sell,giva,furnish underage person with alcoholmm�� M2411997 91130155 Licenses and Control Fine Paid: 500 ! State of Arizona,Department cf Liquor I sell,give, furnish underage with alcohol i 9100126 812Z/1997 Licenses and Control I _ Fine Paid:�;1,� 0 State(if Arizona,Department of Liquor � sell,give,furnish underage persmi with alcohol 11f811997 9070281 Licenses and Control Fine Paid'$1,000 State of Arizona,Deparfrrern of Liquor Iscit,clf.e,lurmuh underage person with alcohol i 11f3l1997 90'70292 Licenses and ControlFine Paid:$1,000 State{01'Arizona Department nt of Liquor P p 1 eel,r;i.vd,,fatrrilskt u:trirsrage v)ith alvolloi 112111998! 9+070312 Licenses and Control fine Paid: 500 Mate of Arizona, Department of Ld u�r !failure ro request ID fro r-underage buyer;sell., 1r #3f18 f8� r 0700r 3 _m_... Licenses and Control uivr f�lmr sh undo rage person with alcohol Pine Paid"$1,000 State of Arizona, Depar ment of Liquor sell,Five,furnish underage person wi h alcohol 7319t,99E3 J1(1015, L oanses andCanCroi � F1ne F'ald:Sl,�;t7f7.._.7_� ... _. � . Statcr of Arizona.Department of Liquor i fall;re to request.11D from underage L)uyer,sell, 3:19�1998i 9080040 Licenses and Control ��7iw�� furr��sh aj alcohol Fln+�t a1J �1 000 State of Arizona, Deiaartrrent of L,ix jar 115/1998 ^_9100179 Licenses and C onl.rctl ise4,five, furnitih Lmdera, a Gerson with alcohol Five Paid: $1400 State of Arizona,Department or Liquor _ 812911998 90?0674 Licenses and Control tl rt+u~, turrai eft F,a7tleraq rs�An� iti�alcr�,rol Fine Paid:$500 i State of Arizona,Department of Liquor failure tie rfrquosl 0 frorn underage buyer;sell, 8/2`�11998 99i'Of 73 Lice.nses and Control ct;ve far+nrsif underacla pursor kth atcohoi Fine Paid'. '1,000 Slate of Arizona,Department of L gUor 1 W30 1995 9070673 Licenses and Control furnish underage with aidohof l Fin€ Paid:$1,500 I� State of Arizona, Dapartment of Liquor failure to request ID front underage buyer,sell, Tine Licenses anti Control ri' furnish underage ttkrso� viith a1cehvl Paid:$1 500 Mate of Arizona, Department of Liquor � $f25/1999 90 0564 Llcenves and Control sell, give furnish underage person with alcohol iFina Paid:$500 ' State of Arizona, Department of Liquor I p failure to raquest]D from underage buyer;sell, 4/9,119991. 90702851 Licenses and Control � vivo,furnish underage person with alcohol fFine F`ald: State at Arizona, Department of Liquor (failure to request IC from underage buyer; sell, 8/611099 9070078 Licenses and Control �dive, furnish underage person with alcohol Fire Paid: $2,000 State of Arizona,Department of Liquor 911511999 91001791 _ Licenses and Control se ti Ivan`ttrrlI h Fine.Paid:$2,000 State of Arizona, Department of Liquor failure to request Ifs from Underage buyer;sell, W27I1999 9070564 Licenses and Control "give, furnlsh underage person with alcohol �Fine Paid:$2,250 State of Arizona, Department of Liquor 11/10.11999 9070306 Licenses and Control sell, rla,furnish underage person with alcohol Fine Pala:$1,000 State of.Arizona,Department of Liquor failure to requet ID frorn underage buyer; sellr glue, 12,G011999i 9070 1.87; Licenses and Control fumi.sh Underage person with rtcohol Fine Paid! $1,125 State of Arizona, Department of Liquor r . 11115,12000 9110003 Licenses and Control l —._........_..._......�.... ,sell urge,furriisn underage l.�erson with Fine Paid:$2,000 State of Arizona, Department of Liquor failure to¢ecc.,es ID frorn underage buyer-,sell,give, 212/2000 9070063 License$and Control furnish unaar:age person with alcohol Fine Paid:$1,125 I State of Arizona., Department of Liquor 3/112000 9100157 t Licenses and Control sett, give, fiumish underagg parser; wilh.afcolnol iFine Paid: $2,000 I State of Ar(zona,Departrrtent of _fquor failure to request iD from underage buyer;sell, 3,f10/2G00t L 9080040 Licenses.and Control give,furnish wnrterac�e a�rsc�rn+�vitln alcc�tnel Fine Paid:$1,250 State of Arizona, Department of Liquor failure to request ll)from.o n€erage buyer;sell, 3.120120 907 0076f _ _ Licenses and Control. e=furnish underage person v,ithn alcohol Fine Paid: $3,000 5118/2000 90 07'3�i State of Arizona, Department rnt of Ltqu r failure tc vaguest lD from underage buyer:saki, Lloen es and Control ( -� i— I Ive, furnish underage person w1th alcohol Fine Pald:$500 6/6120/00 9070287; State of Arizr na, Departmernt of Liquor Ifaiture to request ifs from underage buyer;sell, Licenses and Control r _ _ give,fLrM;sh underage 1zerso-r with alcohol Fine Pald:$2,000' — State of Arizona,Dapartmem of Liquor - - _ 714I200 Uc'anses and Control 0 9080020 sell,give .'urniwh underage with al�cohnf IFlne maid:$500 _ State of,Arizona, Department of#. quu4F ifaitu,c to request ID frCrrE1 undat�t��=:I�'e1 +5611, 8/212000 90702941 Licensers and Control givq..furnish undera ,e person with alcohol Fine Paid:$625 J VVAI,.GF EEN CID. L-GAL- State of Arizona, DPI.arlme It of l.;quor :!s, ell, gi�v�:, turnk h underage with alcohol 11;30r2000! a10U1 7: Licenses and Cos3trtrt Tine Paid-, $2,000 St¢te of Arizona Department of Liquor ;failure U.)request ID from underage buyer, scsl, 1 F- 2000; 9w D106, Licenses and Control Igi^ve furnish underage Forson vvith alcohol IFIrm, Pail: $2,000 Stake of Arizona Department of Lir•IuCrr :failurer to request tD from underage buyer; sell, 4114,(2002 9070673i License's and Contra l jive,furnish undcragu persur:vvit11 alcohorl �Fir1a Peed; lit 5 State of Arizona, Daparlment of Liquor sell, givw�, furnish underage person� �Ith t,lcohol. di'�:�;'aUL.'i JC1TG`i`r;1; Lr�en.�es and Conaral IFine raid $500 i State of h€t=ona Department of Lirluo, failure to request ID From underage buyer,sill, 3128/1997 9070579 Licences and Control give n)rnisr+ untlrrar e Fer5on v pith alcoliol lFine,f�aidc $1,000. 5t�rtr of rrzun�, Dapactrnent of Li�lucr faiiar lcr re was( It) from underage buyer sell, 1OY29,19961 9070.379 Licenses and Control give, furnish underopo porsa+ with alcohol Notice of Violation l - Slate of Arizona, Department of Liqu;.rr sett,frr4r.,1'urrissli undorage Giecsan with alcohol 7i241199r + 910009`i LicFonses and ControlFine Paid: $1,000 J P ritFdTm _A_RIZONA qqq Ai T�ENT OF LIQUOR LICENSES&�CONTR9 - - ' 'Vb(g V'Vliashington 5t;t Flog Phoenix AZ 85007-2934 i602)542-5.141.. QUEST{C?NNAIRE , tJ`4 Attention ail Local Govarning Bodies: Social Security and Sirthda' lrtforinatign is Confidential. This infotmati Way ,qi ''to Kcal law enforcement agencies for the flterl>nGe of 62ackgtouitd checks 6nty&0t rrltlst be btcsa;Ked to be urtreaCfatr� �. r itt posting or any P011C vie.i. _ k Read carefully. This instrument is a sworn'docutmeiit.rType or print with BLACK INK. 1 / An exte usive Investigation of your bachrarouffdwill bo conducted. Falso or in.completo w ansoes'\ 1 i:oWd raskilt in Criminal Prosecution and the denial or subsequent rovoration of a licanse or permits\, tD GF i' d.i�=i T��1�'t _ti�� ^-c11:1 a<ti;: Fi+.S{.`1, .it :( _i''.fAA1 IAGElR:.'EAG,H�PER30N{:O� 1-1 r`Ihas TH15 i:,Fi:�A tv11.1:i�€ ,,:RLiI i.4t i f F LiI_:r;i•1'I" T IPF 1 1r•1;, It:'T Cr'.RO 1°;NIt.H tv1A''iiE 4]? 1 !°tEL .I tt!I.0 rlr:! E A Ili il}•T4!i IL,T 8.(iC}FdE 8'{r l3Cr !A.=1I3F rL'i =NFOR Eir1Li•T, GE;4f-'(CHAFItI I1RPRT%1TiN .*ERVICE.SVIP'ROV17D.BYQt3C. TiS0>-PAp'-1-vtEt4r[,i:t=s '•TPRovoLI*1i1S Ertw,tl e 10t01 07 thira is a a24.40 proeessiatet fee fare r.sfiktg�rpritlt card siri�cttitted. L Uor LIC ..r1S� �} c11r,� nE±d L,�A R.S §4448S_%viit be charged for all dishonored cl*cl:g. J -- {i{the location is currenfiy€iccn;e p i Check Controlling Person �L1Atgent (y Manager(O;0y) apprnpriate I (Coir,plete Questions 1-19) I (Complete All Questions except#14,14.&21) 1 tfax -• — Controlling 'n-rson or Agent must complete 921 for a.Manager 1CQtwtrrsilircJ Person nr tl r.w:'`Itst,�t,k rhn.stclpher Paul bated. r,E Firsi Middle (h(L Record) a.r!'Ul .i .,r...•aI tns+r NU _L1:';'•.� �r�c`ei � '. ':.,ac � '--- a (N'OT a public racordi (3t'_JF a parbftc record) ,v c •[:r1 :_s!; i al��._' -- _ AZ T U.. He!yht S 1 y1G 'S Blue gr c7':Jn .. -t C� C.,J IJld is 1 ji•].a�C tF 1 ,_..___..-_..�_ DaOrne Ctw,2ct Phone;•1v(�' £;3-il i,s t? AIt>tf_t;;k A,rl`+iJ - .. i oxuer I ou'tit t _ a public recordl ar-_: ol'ra-J7,t ...., r : r:!3t ?7r;•,4L 'f,'=rizoi-i , cute f residenc�, -- -- :i i 78 Tr', raj. r, .tlrt, ,.F..yg2e.l 4(iri rr ro4q r 480-288-04_2S -- -- ant_=.ttons r-�•a�n t,`r�1.i:is ou�,.r:cr!i li`;'c;6,.,.. .tl.,rt it _:na tes;deni fzr 1e55 thin thre, r;,t7i Ie i_i.SWYPI. of.vow Ar,r, a;;ri1h?f'`-iice t (�i ;SPY I a n5e or:cr.err-gl_i.rat.on;:3rd i0 t,i 4 Ci-2P,8-Q428 -i" FY`''r�u�J1 L�r`ailn _ _.__riser t'f?s:ISZS gib.",.yrvSG_.24A0 n11 h Inonvvood Dnvt3 Aparho Ainction Pi;ial -E.52_0 j2.1y - 12, _I_t v% if e s 15!ter 3f8.If na,C f r Sr_ 15t root ❑3it' L.st I�t6�t reC211?13t. FROM � TO DESCRIBE POSITION � EMPLOYERS NAME OR NAME GF PUSINESS { ^lh;r� l ;to r- :u' ON ETr)SWCVESS is t adArils,rry 41 fe�?;p} '2DG5 rt t: tr StCrB Manager YValgreens, 22440 B- !ron. rood Di Apache Jurr,icn.A: i37 !� ILT iC � iVf c� `{fit( li Lrl♦t] Y!d'ei' ? irm J A i fA -1 A 1DITICi1KL',SHEET 1F NECESSARY Fi,R EITHER�ECt l ;pl',• `•t I FROM TO Rearo:1 RESIDENCE StriatAddisss .ir. ;.,,r �.r 61;r;!;elvY;trir l Own 1l1 r:;ntea ,a'c.l':dditic•:±zl shy !Willi name.aJdrea;and pnoue nuinber ur ianuturd i e yt�tg= i 1v12C0.= _rrr FNT f)V'n I 994 E, Maddison ��- � Queen ;reek ,Az na210 12i2oall 1t 0005 Rent 1279 S,Vine Ct. �{ Gilbert AZ 85233 � i 1 LIC 0101 91241Zi309 Disabled individuals requiting special accomtmod,tlons,p!Lase call the Department 1602)642.9027 ,I 1 ) If you checked the Manager box can the front of tth15 form Skip to 4 15 14.A>s a Contro I I In ja Pcr,,-,on or,A,gent x3i11 yat:be physically rr-€som end dpm:�-rat€ng the licensed pfamiscs? [DYES EINO 4(tirou arr s4erd` E:3,how itl any hIday3 and s�su 'M1da#rdri if No. ;! fy 1oki , � 1da.:`Pve you at9e Eded a DLLC•approved L rucr Law Tr-aming Couese within the Past 5 years? 1;11aiust pfavi€,e pra'd) I ^]1 E 1[INC) if the answer to#'14a is"NO",course must be Gornpteted before issuance of a na',v license or a,pCoval on an exiztlag license. 1 3'rs y;�.a been t nn� rlrt t Raa ti1� . r2 i k fir? ��,1 1�' { i Ord tr h _yr Pgrc,la. El YES KNO. had to rout bond or had sentc rfc:c-:suspemded,or piny violation of iNW law,or t,JrlirIance, ,vit'mn axle past ter:(10)yp-ar%(indudQ only traffic violations lhat wera<alcohd anvior drug rc.:t ted) n18.Are there ANY adml nisLrat ve law fit bons, compliantactions or s~onsent%Ecr r,6nal a.re,�t, indi meats `E3 P Cy nr sumr ons,..—PENDING aaainst you or ANY entity in Fihich you are now lnvuly&d? 7, 1-fuva you or 4rny entity Gn 'thtt fYOU i13Je hVir VXI -,:5il{.1 boon n an c4ffiuv,murzrber.d x u'or Gr F-nanager :.YC8 -ri NO Eu`ERN r aol ti bu5ir u.5s, ..r{(li(a 7taryc i rJi d()r,^K))'I i t.. t7i 2�'�15t [E jai it _{tE ll C a F k S' .SL1SL c�ilCli ' or p;ed iTi (hi";or any other sWu? W 18. Has arlyoiie EVER rhinfi st,it or€:t:pir h a aims 5�t,1, fhe sutjat;t afv.hdch invOlv'ed iza ld Cr FY Eti i [10 nlisrem,esei t tior-1? 19. Arc-,oU t Qt_or have you t`5ER el,oyynersh. ,be n d con. IIE7 cursr_-i, te,n flri * v r lenn-r, r NrE director or ma<tager or, antic other lid.ucrr i t e se,in thi;OF a11Y other stata? r; If any art 4.- r tJ l,t.es`.armi 17 flhrol igh i a ,a E 7 .t.�Jt t 1LtS T agilch Cl�,t3 S Al I gLn t. Gilye Compl 1p i3?talls irn'Ju 1 cl at€s', ignt1 es in votive de Pad SUBSTANT,zVE CNr'iIN TO THIS + €'LI :'1TIt N 'aL'ILL NOT T BE A C; P r 1) 7 cl. 1; _ `k g tx ftfL r' v4 1{t 1 3 !(, --._ hereby deci.r, tnat t in-,the.1PPI_ICAN11 pE:!-'RESE lTA T WE tprni Si,li a:yre:e Ul ru,li an; ` ?II I CJ tlE'S �t_'Fst'F t tnEi?rP, 1 nave,rt ?d tl.-v L�ii£ 1 .,lItfe=1r, ti(!St1€? fir; atE fG;v.correct Ct 3fi r_;;JR1Fyl t�. JI J/ •- r t J f.�41,�Gt�i t{sl5 i Ig fF -lL14C}(•s: ljn f.d<ft�C i11:S 9�d-„4�r-1,tl,,.,i[tr'e.<d:!Faz orE: ...__...._ j rCie h.r,.tttl r`r �,yx z t t' Nlfifl; turoafNrtIA.nYclaLlt; tip" `�C e^fslt'�ap s.lti:ae3s73Jttr: COMPLETE THIS SECTION ONLY a('YOU ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION c 1 The aPp iG3nt hereby by 8l r:ar{zes the £'{t7n n t -d rtn t ri.i G dl sfornaire Cl tCt Els m2nc;clur f r the tl rTl rj Ilcl der :'t at}a t`l: rnat'isgar narrt d mi t ' :1.`Fc.' i ',';,ar_ )1 i,l , f�y/d Lit--• {oupty of �f Jar day of Signrtwe of:m1 c E m�F'na=r t. iert' rife o R- IVA/ a`ear My oarrdd'rils,;ion expires Drj: is i 1 1 I 29512 Ari.Qnu Departmmt of LiCivar Licenses and Control 800 West Washington,5th Floor -- - ' Phoenix,Arizona 85007 ,vww,azliquor.gov 602-542-51 1 { CERTIFICATE OF TITLE 4 TRAINING COMPLETION y Igo M)t DuI'-) r_`ite This Fr}rrri Cc-rilricate.5 must be r=Gmpl.etEd bX a state-a prc)ved Craiiik g cca.i e pro idE.r,!n black ink,an an origjnal fL'Drm. Full Nzi I:} re �1�_- T faln:nt7 for 1plfit.in(,,ate lam? Type W ,rlining C or pleted,zzhecn Ye� - r-; L J `o ?7�:•.IhIA .r.;.{i:r lT ,�Ye; C r,i,.: OF1 :.l..F r rl;li;t:Ff r: u,:piratiLn Dail 't I J +�� ..,. 1 t1A.G r T- , ?as,>rr;, i Y' ` r•;o BOTH f I OTHE.- (3ASI... 3 Yeats h'orl, l Tr ine?I__ mpjpvQQ,%art I_.Tej-,Z`„' 11� I,. ------- ��. ------ Alcohol Training Program Provider InflO ration ARiZ0NF,:BUSINESS C 01.)NC:IL FOP Al-C-011C.,L EDU t "10N IIABCs C�rnl.any r�r�'sriiaritii inl s°:,�„nt.aa,�s>?r;rnBi ..�,,,..,.�• I rstr?iP it;,�at,t7v=n.ert=.d ind`ovsc u:d h:u:;unesslullt -.(4r ,. ":rr;,t ;-i;. n,:t. ;•t ins;y c` r.: uri._L..),i,. �. •!b>r(r_Do artm�:W.r,r-oi - fjff,ifd1 1 FEAGLES ID,I I i�i-tr5�,lant:7�.a:�. 4 1�;ijii L,rr+�n:la r n �li'e :lit±.npr 1,�•:Crarnt^g i",r`rr Saifrd r;rl'.,r tit tl,e L::U'} �;.. .%di r�rat•.la.r t;��IiCan_:z:�}-)pliCn tGrc,.,u'?t i'r.i C!tiJ Th, r r:.cnt lrs;uir i roe s; ru;l1'>nrts I-{ ! ; i'.i l er Itrd,h„ri.in ..J, ur..;r I 1 ! A..1[; rl,ar.i'� :�.). :11"idT TitY?: }4-.,.Si t r. l fiy•r ._ .C.i n u.p::�.; ti valid;no'expl(ed)Certificate of Title 4 rraininq Completion must be submitted,a the Depaitment r.,#Liquor.Licensrs ar`d Cat m-oi b-fc>r a!iqucr ,iPfofe ac(ept,lnce o a mangger'gue_ti:xnnaire andrejr.sgent c iange for an e+.z!tOF,rt liquor acenso,prodof ar-tcn:Eance for th^8A51C.and N11.6- ! GiEPAUIT Title-4 liquor iaw training i.on-f)r'i rf-.`r.7lQl li I 8l�QG9 D s[+b!cd ifidividi.:als r<-quirlrig sp->c!al.-Xc:0mi.-tudations,please rat! VU21 542-9WZ i eoi* Home gf'the Superstition iWountains 17-0 NOTICE The attached application for a New License, Corporation, Series 7 Liquor License submitted for Walgreens #06333 located at 2440 S. Ironwood Drive, Apache Junction, Arizona, was posted on the 29th day of December, 2009, at 2,30 p.m. Any person who is bona fide resident of the age of nineteen (19) years or more, residing, owning, or leasing property within one-half (112) mile radius fron) the proposed premises to be licensed may file written arguments in favor thereof, or objections thereto with the City Clerk at City Fall within twenty (20) days after the date of posting. Arguments for, not objections against, shall be filed thereafter. A public hearing will be held Tuesday, January 19, 2010, at the City Council Chambers, 300 W. Superstition Blvd., Apache Junction, AZ at 7:00 p.m., at which time any objections filed will be heard. 1 Kathleen Connelly City Clerk ' j rm DO NOT REMOVE THIS NOTICE AND/OR ATTACHMENTS. REMOVAL OF THIS APPLICATION MAY JEOPARDIZE CITY COUNCIL RECOMMENDATION. •Voice(480)982-9002 1 FAX(480)9,82-701 S•TDD(480)983-0095-w wl .aicimnet 300 E. Superstition Boulevard, Apache Junction.AZ��2izl 4ACHF 0 nh' 'XI flo C'40-';t E5 " Home of the Sunei stition Mountains ' ttrzv � December 29, 2009 Randy Allen Guse Walgreen Arizona Drug Co. P.O. Box 901 Deerfield, IL 60015 Dear Mr. Guse: Please be advised that the application for a New License, Corporation, Series 7 liquor License submitted for Walgreens #06333, 2440 S. Ironwood Drive, Apache Junction, Arizona, was posted on December 29, 2009, in accordance with State law. The Apache .function City Council will hold a public hearing on January 19, 2010, at 7:00 p.m. in the City Council Chambers, 300 E. Superstition Blvd., Apache Junction, at which time the City Council will consider a recommendation for approval or disapproval which will be forwarded to the Arizona Department of Liquor Licenses and Control. Please note that the City Council frequently has questions for the applicant. It is strongly recommended that you attend this meeting in order to avoid any delays in the preacessing of your application. There is a $50 ricn-refundable application fee that you have -already submitted to us fer this application to be placed on the City Council agenda. If you have any questions concerning this matter, please contact my office at (480) 474-5068. Sincerely,. l ,r Kathleen Connelly ' City Clerk - f, 1 • Voice(490)982-8002 • FAX(,490)9$2-71118•TDD(480)983-0095•wtivw.ajcity-net 300 F.Superstitim Boulevard, Apache Jufledon, AZ 35219 r ��V V im^0/ /0 ,,. T10me qfthe 5tepel"Stition Xfoulitaini . `�7 fZOP D ECEMBER 29, 2009 MEMORANDUM TO DEPARTMENT OF PUBLIC SAFETY, ADMIN_ SGT. PLANNING DIVISION APACHE JUNCTION FIRE DISTRICT a THROUGH: KATHLEEN CONNELLY, CITY CLERK,z`--� THROUGH.- JAN MASON, DEPUTY CITY CLERK FROM- SUZANNE HENINGER, SECRETARYz SUBJECT: APPLICATION FOR LIQUOR LICENSE FOR WALGREENS 406333 Mr. Randy Allen Guse has submitted an application for a New License, Corporation, Series 7 L iquor License for Walgreens #06333 located at 2440 S. Ironwood Drive, Apache Junction. Please conduct the necessary inspections and submit your recommendation by email no later than Wednesday, January 6, 2010, in order for this item to be on the agenda for the City Council Meeting of January 19, 2010. • Voice(=480)982-8002. • FAX(<80)i)82-7018•TDD(480)983-0095 •www.sjCity.net 300 E. Superstition €oulevard, Apache Junction,AZ 85-219 I Janet Mason From. Suzanne Heninger Scent: Wednesday, December 30,2009 19:39 AM To: Janet Mason Subject-, F'W: Application forliquor license for Walgreens#06333 on Ircrrwood Here is planning's info back. From:Todd Kennedy 1 ' Sent: 'Wednesday, December 30, 2009 IG:28 AM To Fred Baker Cc: Suzanne Heninger Subject: RE: Application for liquor license for Walcareens 06333 on Ironwood Pkannino 11cz,5 no issue s'vith thir application. Todd C. Kennedy Assistant Planner City of Apache Junction 00 E.Superstition Blvd. Apache Junction, AZ 8 219 (480)_74.5093 t-k.er i3 dY'r'�`?ici ee From: Fred Baker Sent:Tuesday, Decembaar 29, 2009 3:47 PIA, To: Todd Kennedy Cc: Suzanne Heninger Subject: RN: Application for liquor license for VJalgreens+0633a on %ronwood Todd: Please review and respond to Suzanne by January 6, 2010. Fred l 1 From: Suzanne Heninger Seat:Tuesday, December 29, 2009 3-32 PM To: Fred Baer Subject- Application for liquor license for VValgreens7906333 on Tron,-void Attached is a copy of the memo and liquor license application for'Afalgreens on Ironwood. Please,et recommendations to us by January 6, 2010_ c[�ft_Yi NA€',,�fzfd:riy_•t :F 7Ui1 CfC ,1{i(?C l.4rf GPHP{:p!fi:f1 cc 11 r;: f ticl ElYf a—jt��l' i Apache Junction Police artmej Interdepartmental Memo DATE.- 12/31/09 TO: Kathleen Connelly, City Clerk THROUGH: Sergeant Allision FROM: Corporal Saldana SUBJECT: Walgreens liquor license applications In review of Walgreerris's liquor license application, it appears that Apache Junction High School, 2525 S. Ironwood Dr_ xill be the closest sGhool to Walgreens, Walgreens is located 528 ft. away from the High School. This exceeds the 300 ft limit_ Inspections vvere rude at the store and the ,Apache Junction Police Department has no objections with the issuance of the liquor license. CC: Chief Monahan ff r I n � Apache Junction Fire District �„�o� ,,,� 565 North Idaho Road, Apache Junction,AZ 85119 Phone (480) 982-4440, Fax(480) 982-0183 www.ajfd.org MEMORANDUM TO: Kathleen Connelly, City Clerk City of Apache Junction 300 E. Superstition Blvd. Apache Jct., AZ. 85219 FROM: Dave Montgomery, Deputy Fire Chief/Fire Marshal DATE: January 5,2010 SUBJECT: Application for Liquor License -Walgreens#06333 2440 S.Ironwood Drive,Apache Jct.,AZ 85120 The Apache Junction Fire District has reviewed the documentation and prevention files for the applicant as noted above. Our records of their annual fire and life safety inspection show no major violations. We therefore would recommend approval of this application. Thank you for your notification on this matter. If you have any further questions regarding this inspection, please feel free to contact the fire n prevention bureau offices at 982-4440. Thank You. ROLL CALL VOTE I NOTES: ITEM # MEETING WF MOTION BY: SECONDED BY: YES NO ABSTAINED COUNCILMEMBER COLEMAN COUNCILMEMBER DIETZ COUNCILMEMBER SERDY COUNCILMEMBER BARKER COUNCILMEMBER WILSON VICE MAYOR ECK MAYOR INSALACO UNANIMO S IN FAVOR OPPOSED ABSTAINED TOTAL f ITEM NO. 5 I MOVE THAT THE APPLICATION FOR A NEW LICENSE, CORPORATION, SERIES 10 LIQUOR LICENSE FOR WALGREENS #06333, SUBMITTED BY RANDY GUSE, BE RECOMMENDED FOR (APPROVAL) OR(DENIAL) TO THE ARIZONA DEPARTMENT OF LIQUOR LICENSES AND CONTROL. GO } f _pacbe Junction Nawe oj` he ,Stype rlifionAl ouni a n s• 'tRl2Q�� S Print TO: City Manager's Office FROM: Kathy Connelly, City Clerk DATE: January 19,2010 Agenda Type : Regular Agenda Council Priority Focus Area: Economic Development TITLE OF AGENDA ITEM: PRESENTATION, DISCUSSION, AND POSSIBLE CONSIDERATION ON FISCAL YEAR 2009-2010 PROFESSIONAL SERVICES AGREEMENT WITH APACHE JUNCTION COMMUNITY DEVELOPMENT CORPORATION FOR ECONOMIC DEVELOPMENT AND BUSINESS EDUCATION SERVICES. ACTION REQUESTED: Recommendation for Approval DISCUSSION/BACKGROUND INFORMATION: Presentation, discussion and possible consideration of a professional services agreement with the Apache Junction Community Development Corporation to continue services as outlined in their program activities. FISCAL IMPACT: Budgeted Expenditure OPTIONS/ALTERNATIVES: ' 1 RECOMMENDATION: ATTACHMENTS: Click to download ❑ cover memo ❑ 09 agreement part 1 ❑ 09 agreement part 2 ApAC�f '��J " Rf7o JANi_ARY �. 2010 '�tI titC I iDli11 6O: HON(.RABL) M:}`s.YOR AND CITY COt NC'1L MEMBERS THRC)t.'C3I-I: OFORC E. R.. HOI''C''MAN. CIT`.' 4AINAGER I'R.t:} "1: KATI-1I.-,EEN CC?NNELLY. ( [A' C'I..FRK ,r S(-;;BJ1 CI': AG E N DA ITEM FORJANI-'AR`Y' 19, 2010 'PRCIEFSS'10N �L SLRVIC E5 AUI:L]✓ I ` T WITH C 01\11MUNITY DEVELOPMENT CORPORATION) f"'t vour.kranuaCv 19, 20tO mectin '. _Gou !'q't1I have the. C1ppr.rtwiitO to Jissckis�5 ihQ continuation of a pro"Lssional s .r`iicL!i a-rl'c file 11 f6t' Fy 0-1 i! 111 tl?c' re'JUCCLI ilttiOLHA Ot S fj.!„10. 1 11iS 20',„ reduction from FY 08-09- This item was on'nmally piaced 011 01C Ja11=1ary 5. 20I0 a1 u11d) but Was ptistpe+tlt�d to allow additional time to prepare and review the agreement. it.ached is a revised agreement and Exhibit �. The services provided, bt the. Community Development Corporation "CDC."i would provide a resource Rif-business ownen-s and city staff, Asa -50106 entity, the CDC 11as financing -uid A donation options that are not otlier+ise available it) existing and new bUSInesse.s. ( J PIC-USC e_i 1taCt IM'. it VOLT h 'wC tit' Cll� t1i1114_ . Voice(480)982-840' FAX(48G)982-7018 •TDD(490)983-0095+kvw% ,ajcity.net 300 F.Superstition Boulevard.. i pac;lie Junction,AZ 85219 PROFESSIONAL SERVICES AGREEMENT FOR ECONOMIC DEVELOPMENT AND BUSINESS EDUCATION SERVICES WITH APACHE JUNCTION COMMUNITY DEVELOPMENT CORPORATION THIS AGREEMENT is made and entered into this day of 2010, by and between the CITY OF APACHE JUNCTION, ARIZONA, an Arizona municipal corporation ("City") and APACHE JUNCTION COMMUNITY DEVELOPMENT CORPORATION ("Consultant") for the .project eintitled "ECONOMIC DEVELOPMENT AND BUSINESS EDUCATION SERVICES" ("Project"). WHEREAS, pursuant to Arizona Revised Statutes Annotated, ("A.R,S.") §§ 9-493 and 9-500.11, City is authorized to appropriate monies from its general fund for the purpose of improving or enhancing the economic; welfare of the inhabitants of the city, encouraging immigration, now industries and investment in the city, and to print and distribute boo ks,.pam ph lets and maps advertising the advantages of the city; and WHEREAS, City desires to retain a consultant to provide economic development and business ness education services and to make payment for the same in accordance with the terms and conditions set forth in this Agreement, including all attachments and addenda. which are appended hereto by mutual agreement of the parties; and WHEREAS, Consultant has the specialized resources, facilities and skills to perform such work. NOW, THEREFORE, City' agrees to retain and does hereby retain Consultant and Consultant agrees to provide the services required according to the terms and conditions and for the consideration set forth below: 1. TERM: This Agreement shall commence retroactively from July 1, 2009 through June 30, 2610, and shall remain in full force and effect for twelve (12) months, with options to continue the program. 2. CONSULTANT'S DUTIES: Consultant agrees to perform the following professional services in connection with the Project, all to be performed in accordance with all city codes, ordinances, regulations, policies and procedures: A. Consultant shall provide assistance and services outlined in the Apache Junction Community Development Corporation Program Objectives 2009-2010 attached hereto as Exhibit A. Page 1 of 11 13� Consultant will provide a speaker to explain the Project to local business groups, publicize the program, and generally encourage participation in-the, Project. C. Consultant will maintain a database that will include but not be limited to industry-specific reports, community-wide property and business reports and demographics. D. Consultant will provide technical assistance to city staff and city consultants, including but not limited to, development and retention of businesses in downtown and redevelopment areas. E. Consultant will provide business education and development program to include a series of workshops held within the community. F. Consultant shall not expend any city funds on the development of a Community Development Corloration-created microenterprise such as the Apache Junction Mercantile unless specifically approved in writing by the City Manager or his designee. G. Consultant will actively seek private donations and grant funding that will further provide opportunities for real estate, development, economic development and business 'education, H. Consultant will provide information and services listed above on an impartial basis and in conformance with state and federal non- discrimination regulations. 1. - Requests for specific information regarding city government operations and City services shall be referred directly to City officials. J. , Requests for business planning and other basic business tools shall be referred to Service Core of Retired Executives, the Small Business Development Center, or other non-profit group. . 3. COMPENSATION.- In accordance with the terms and conditions of this Agreement, City shall compensate Consultant for its professional services as follows: A. An aggregate sum of up to Seven Thousand Six Hundred Dollars ($7,600) for Fiscal Year 2009-2010 provided Consultant meets the reporting requirements described in Section 3(B) of this Agreement with payment to be made as follows: (1) One Thousand Page 2, of I I Nine Hundred Dollars.,($1,900) upon execution of this Agreement; and (2) three additional payments of One Thousand Nine Hundred Dollars ($1,900) disbursed at equal intervals over the term of the Agreement. Exhausting the total amount payable for activities described in Section 2 above shall not relieve Consultant of its obligations to perform such services. Should City request additional services beyond those specified in Section 2, Consultant's Duties, Consultant shall charge, and City shall pay, an hourly rate of $60, plus appropriate expenses authorized by the City. B. Within ten (10) business days following thelast day of each fiscal year quarter, Consultant shall submit to the Apache Junction City Clark ("City Clark") detailed reports accounting for the expenditure of City funds. Consultant shall submit a separate, concise summary of all expenditures within each report. The summaries shall be subject to public disclosure as public records in accordance with A.R.S. § 39-121 at seq. Each report shall be typewritten or prepared on a word processor and shall include the status of Consultant's progress on the scheduled work items as referenced in Section 2 above. It shall include a description of all work undertaken and all findings and coriCIUS'OnS. In addition, it shall include documentation supporting these.expenditures. These reports shall also contain the information required in this Agreement, and in doing so, shall demonstrate the value of work and its impact upon economic development within the corporate boundaries of the City. Documentation for actual expenditures shall include a summary page detailing all quarterly expenditures made in accordance with this Agreement and all relevant bills, receipts, and statements with the relevant expenditures highlighted. The Apache Junction City Manager or designee ("City Manager") has the sole discretion as to whether the above-referenced erenced reports-contain adequate specificity. Should the City Manager desire additional information, such information shall be produced by Consultant within ten (10) business days from receipt of such request. The City Manager may withhold any and all payments due until such time as all concerns on the reporting have been resolved. The books and records of Consultant shall be subject to inspection and audit by City during the term of this Agreement and fora-period of three (3) years after expiration of this Agreement for the purpose of verifying Consultant's performance as well as the thoroughness and accuracy of the reports Submitted hereunder. Records of Consultant shall be provided to City and/or made available for inspection and audit within three (3) working days following a written request by City. Page 3 of 11 Consultant will monitor and seek other sources of public or private community and/or economic developm6nt funding which becomes available to Consultant or other community entities, and will advise the City Manager in writing -of these opportunities. A summary of all contacts andlor correspondence regarding these funding sources and Consultant applications for the funding shall be provided to City on a quarterly basis at the time of submitting the quarterly reports required in Section 3(B) of this Agreement. D. Consultant shall design and use a business report that describes any and all progress made in the categories listed in Section 2. Consultant's Duties noted above. Consultant shall substantiate the information contained in the report, Such report shall be provided to City on a quarterly basis at the time of submitting the quarterly reports required in Section 3(B) of this Agreement, E. Consultants Scope of Work, Program Objectives, attached hereto as Exhibit A is adopted in conjunction with this Agreement and made a part of the Agreement by reference. F. Any funds not expended or disbursed by Consultant shall be reimbursed to the City. Any funds expended or disbursed by Consultant in violation of Ordinance No. 659, attached as Exhibit B, .or in violation of this Agreement shall be reimbursed'to the City. Should Consultant seek funding for fiscal year 2010-2011, it shall comply with the filing deadlines set forth in Ordinance No. 659 and shall submit a work plan substantiating Such request no later than March 30, 2010. 4. CONSULTANT'S BILLING; For additional services as negotiated in Section 3(D) noted above, Consultant shall bill City on a time and expense basis in a total amount, not to exceed the negotiated amount. City shall pay such billings within thirty (30) calendar days of the date of receipt or as otherwise negotiated. 5. CONSULTANT''S STANDARD OF PERFORMANCE, While performing the services, Consultant shall exercise the reasonable professional care and skill customarily exercised by reputable members ' of Consultant's profession practicing in the Phoenix metropolitan area, and shall use reasonable diliaence and best judgment -while exorcising its professional skill and expertise. Consultant shall be responsible for all errors and omissions Consultant commits in the performance of this Agreement. Page 4 of 11 n � 6. NOTICES: All notices to the other party required under this Agreement shall be in writing and sent ,by,.first class certified mail, postage prepaid, return receipt requested, addressed to the following personnel: If to City: City Manager. City of Apache Junction 300 E. Superstition Blvd. Apache Junction, AZ 85119 And to: City Attorney City of Apache Junction 300 E. Superstition Blvd. Apache Junction, AZ 86119 If to Consultant Executive Director Apache Junction Community Development Corp P.O. Box 6296 -Apache Junction, AZ 85178 7. TERMINATION: This Agreement may be terminated by either party upon fifteen (15) working days written notice. If this Agreement is terminated, Consultant shall be paid for services performed to the date of receipt of such termination notice. In the event of such termination, Consultant shall deliver to City all work in any state of completion at the date of effective termination. a. SUBCONTRACTORS., Consultant shall, within ten (10) calendar days after the execution of this Agreement and before awarding any subcontract, furnish City with a list of proposed subcontractors, if any, and shall not employ any that City may object to for any reason Consultant agrees that it is as fully responsible to City for the acts and omissions of its subcontractors and of persons either directly or indirectly employed by Consultant. Nothing contained in the Agreement shall create any contractual relations between any subcontractor and City, 9. INSURANCE, A. Required Lit-nits 1. Commercial General Liability Consultant shall maintain Commercial General Liability insurance with a limit of not less than $1,000,000 for each occurrence with. a.$2,000,000 Products/Completed Operations Aggregate and a $2,000,000 General Aggregate limit. The policy shall include coverage for bodily injury, broad form Page 5 of 11 (7) property damage, personal injury, products and completed operations and blanket contractual coverage including;but not limited to, the liability- assumed under the indemnification provisions of this Agreement which coverage will be at toast as broad as Insurance. Service Office, Inc. Policy Form CC 00010196 or any replacements thereof. Such policy shall contain -a severability of interest provision, and shall not contain a sunset provision or commutation clause, nor any provision which would serve to limit third party action over claims, The Commercial General Liability additional insured endorsement shall be at least as broad as the Insurance Service Office, Inc.'s Additional Insured, Form B, CC 20101185, and shall include coverage for Consultant's operations and products and completed operations. If Consultant sublets any part of the work, services or operations, Consultant shall purchase and maintain, at all times during prosecution of the work, services or operations under this Agreement, a Protective Liability insurance policy for bodily injury and property damage, including death, which may arise in the prosecution of the Consultant's work, service or operations Linder this Agreement. Covorage shall be on an occurrence basis with a limit not less than $1,000,000 per occurrence, and the policy shall be issued by the same insurance company that issues General Liability Insurance. 2. Workers' Compensation-Insurance Consultant shall carry Workers' Compensation insurance to be provided by an insurance company which is authorized to transact insurance business in the State of Arizona, to cover obligations imposed by federal and state statutes having jurisdiction of Consultant's employees engaged in the performance of the work or services; and, Employer's Liability insurance of not less than $10,000 for each accident, $1100,000 disease for each employee, and $500,000 disease policy limit. BY execution of this Agreement, Consultant certifies as follows: 7 "I am aware and understand the provisions of A.R.S. § 23.900 of seq. which 'requires every employer to be insured against liability for workers' compensation or to Page 6 of 11 n undertake self-insurance in accordance with the provisions of this chapter, and I will comply with such provisions before commencing the performance of the work of this Agreement." If Consultant has no employees for whom workers' compensation ,insurance is required, Consultant shall submit a declaration or affidavit to City so stating and.covenanting to n obtain such insurance if and when Consultant employs any employees subject to coverage. In case any work is subcontracted, Consultant will require subconsultant to provide Workers' Compensation and Employer's Liability to at least the same..extent as required of Consultant. B. CERTIFICATES OF INSURANCE Prior to commencing work or service under this Agreement, Consultant shall furnish City with Certificates of Insurance, or formal endorsements as required by the Agreement, issued by Consultant's insurers), as . evidence that policies providing the required coverages, conditions and limits set forth by this Agreement are in full force and effect and remains so for the duration of this Agreement. The form of the certificates of insurance and endorsements shall be subject to the approval of the Apache Junction City Attorney. In the event any insurance policies required by this Agreement are. written on a "claims made" basis, coverage shall extend for two (2) years past completion and acceptance of the Consultant's work or services and: as evidenced by annual Certificates. of Insurance, to-be filed with the City.Clerk. n If a policy is expired, canceled or materially changed during the life of the Agreement, such notice must be sent to City thirty (30) calendar days prior to such action. The cancellation clause on the. Certificate of Insurance shall state the insured party shall send notice of such cancellation at least thirty (30) calendar days in advance of such cancellation. The Certificate of Insurance shall include an original signature of the insured's representative. Photocopies will not be accepted and failure to provide timely notice as noted above will be considered a material breach of contract_ Policies or certificates and completed forms of City's Additional Insured Endorsement (or a substantially equivalent insurance company form acceptable. to the City Attorney) evidencing the coverage required -by this section shall be filed with the City-Clerk Page 7,of 11 and shall include City as an additional insured party. The policy or policies shall be in the usual form of a public liability insurance, but shall also include the following language: "Solely as respects work done by or on behalf of the named insured for the City of Apache Junction, it is agreed that the City of Apache Junction and its mayor, council members, officers and employees are added as additional insured parties under this policy." 10. RIGHT OF CITY TO CONTRACT WITH OTHERS: Nothing in this n Agreement shall imply City is obligated to obtain the services descried herein with only this particular consultant. 11. DEFAULT EXCEPTIONS: City and Consultant shall exert all efforts to perform their respective responsibilities under this Agreement. However, neither party shall hold the other party responsible for inability to render timely performance if such inability is a direct result of a force_ beyond its control, including but not limited to the following strikes, lockouts, embargoes, failure of carriers, inability to obtain transportation facilities, acts of God or the public enemy, or other events beyond the control of the other or the other's employees and agents. 12. INDEMNiFICATION: Consultant shall defend, indemnify, and hold City, its agents, officers, officials and employees harmless from any and all loss, damage, claim for damage, liability, expense, or cost, including attorney fees, which arise out of, or is in any way connected with the performance of work under this Agreement by Consultant, or any of Consultant's employees, agents or subconsultants, and from all claims by Consultant's employees, agents and subconsultants and agents for compensation for services rendered to Consultant in the performance of this Agreement, notwithstanding that City may have benefited from their services. This indemnification provision shall apply to any and all acts or emissions, willful misconduct or negligent conduct, whether active or passive, on the part of Consultant or Consultant`s employees, agents or (� subconsultants. This section shall survive the expiration or early termination of the Agreement. 13. WAIVER OF TERMS AND CONDITIONS: The failure of City or Consultant to insist. in any one or more instances on performance of any of the terms or conditions of this Agreement or to exercise any right or privilege contained herein shall not be considered as thereafter waiving such terms, conditions, rights or privileges, and they shall remain in full force and effect. 14. INDEPENDENT CONTRACTOR: Consultant shall at all times during Consultant's performance of the services retain Consultant's status as independent contractor. Consultant's employees shall under no circumstances be considered or held to be employees or agents of City, and City shall have no Page 8 of 11 obligation to pay or withhold state or, federal taxes or provide workers' compensation or unemployment insurance for or on behalf of them or Consultant. 15. GOVERNING LAW AND VENUE: The terms and conditions of this Agreement shall be governed by and interpreted in accordance with the laws of the State of Arizona. Any action at law or in equity brought by either party for the purpose of enforcing a right or rights provided for in this Agreement, shall be tried in a court of competent jurisdiction in Final County, State of Arizona. The parties hereby waive all provisions of law providing for a change of venue in such proceeding to any other county. In the event either party shall bring suit to enforce any term of this Agreement or to recover any damages, for and on account of the breach of any term. or condition in this Agreement, it is mutually agreed that the prevailing party in such action shall recover all costs including: all litigation and appeal expenses, collection expenses, reasonable attorney fees, necessary witness foes and court casts to be determined by the court in such action, 16. OWNERSHIP OF RECORDS AND REPORTS: All of the files, reports, documents, information and data prepared or, assembled by Consultant under this Agreement shall be and remain the property of City and shall be forwarded to City at any time City requires such papers and files in accordance to the limitations within this Agreement. 17. LICENSE: Consultant represents and warrants that any license necessary to perform the work under this Agreement is current and valid. Consultant understands that the activity described herein constitutes "doing business in the City of Apache Junction" and Consultant agrees to obtain a business occupational license and sales tax license pursuant to the Apache Junction City Code and keep such licenses current during the term of this Agreement. Any Consultant activities or programs within the corporate city liMitS will invoke the same business occupational license and sales tax regulations. All participants in these activities and programs will obtain any required business occupational and sales tax licenses. Any activity by subconsultants within the corporates city limits corpora will invoke the same. business Occupational license and satles tax regulations on any .subconsultants. and Consultant ensures its subconsultants will obtain any required business occupational license and sales tax-license. In the event any subconsultant fails to pay required license fees or taxes due, Consultant shall pay to City such amounts within ten (10) working days after notification from City that such amounts are due and payable. 18. NONASSIGNMENT: This Agreement has been entered into based upon the personal reputation, expertise and qualifications of Consultant. Neither party to this Agreement shall assign its interest in the Agreement, either in whole Page 9 of 11 or in part. Consultant shall not assign any monies due or to become due to it hereunder without the prior written consent of City. 19. ENTIRE AGREEMENT; This Agreement and any attachments represent the entire agreement between City and Consultant and supersede all prior negotiations, representations or agreements, either express or implied, written or oral. It is mutually understood and agreed that no alteration or variation of the terms and conditions of this Agreement shall be valid unless made in writing and signed by the parties hereto. Written and signed amendments shall automatically become part of the Supporting Documents, and shall -supersede any inconsistent provision therein- provided, however, that any apparent inconsistency shall be resolved, if possible, by construing the provisions as mutually complementary and supplementary. 20. SEVERABILITY: If any part, term or provision of this Agreement shall be held illegal, unenforceable or in conflict with any law, the validity of the remaining portions and provisions hereof shall not be affected. 21. CONFLICTS OF INTEREST: The provisions of A.R.S. § 38-511 relating to cancellation of contracts due to conflicts of interest shalt apply to this contract. 22. POLITICAL ACTIVITIES: As a community service-teased. organization, Consultant is a non-political organization, Consultant's employees are prohibited from engaging in any partisan political activity with respect to candidates for political office beyond the private expression of personal opinion, registering as a member of a political party, signing nomination petitions and voting in any special, primary or general election. No board member, officer or employee of Consultant shall solicit any contribution in-cash or services from any Consultant employee to support any candidate for public office, No board member or officer shall use the name of Consultant, or use their affiliation with Consultant, to engage in any partisan political activity of any kind or to solicit any contribution in cash or services to support any candidate for public office. If a board member or officer should engage in said activities, they shall make it clear that they are doing so in their personal and private capacity, r and are not associated with Consultant in any way, while engaging in said activity. The functions and activities of Consultant are non-political with respect to candidates for political office. Therefore, all board members, officers and employees will refrain from engaging in any partisan political activity, of whatsoever type or nature, while attending or participating in Consultant function or event. This includes the circulation or signing of nomination petitions or soliciting any contributions in cash or services from anyone to support any candidate- for public office. Page 10 of 11 MN, JOT .. Tltld� or T i pity APPROVED AS T CORM.. g � clay o.rney :of Il ........: r- EXHIBIT A 1, Build con-mittees ofreqidents and but iqe.,ises.dedicated u? Qreafincr -and impl;�me.rtfing Com I'll uni ty projects Collaborate vfth City Housing Coordinlator to obrairt granE ti-toncy for rehab adi.d afTordab[c LOUSI'[1--PTOgMMS Parti-i, r svilh City to cxplorkc outcomes and possible irtipbmicntation strateglos utice the CDBG funded DownLovvii R�!developrnent Plan is completed Solicit private dlonatIC1113 Create a don.ation brodware DiStribute brochures vo Aix-Ache Junction rik sideats and 1-LlShl(CSSCS Solicit doliations from Corporations and foundations Q J(']:-)C' t-i-ij,'ogh u publi ,s p kin— ReqLJQ.'St Sj)e�Aijj eff eMs W is c--it 011urches, Ctubs and oL, --a b,.afions Conduct -, series of�vo.rkshops.on hov.,to Mar,'. opeclate cor cxpmid i business ;M kpache Junctimi. -9itt wor'-shop timeline will be June throw-yin septe-mbor. EXHIBIT B ORDINANCE NO. 601 AN ORDINANCE FF THE MAYOR AND MY FUMIL OF W CITY OF APACHE JUICTIOU, ARIZONA, "MA YMS CITY ORDIUANCE Wh 631 AND ADOPTING ORDINANCE NO, 651 IN LIEU THEREOF, ADOPTING AND ENACTING REPGRTING REQUMEMENTS, PE`Q1IRr0 WCUMENrAVOK AND VROMURES FUR M-PRorn AGENWES RKEMNn CET Y FUNDS; REPEALING CONFLICTENG PROVISIPM 00VIDIN; FaR SEMABILITY', AND DECLARING AN MERGEN&Y, Bk 5; OR DA!NE9 9f THF Af;'L' C I 1'f :J"Wtii'* 1 Hr.- I I y VT VACHE JIMT&N, AP17QNA, AS FQQ41: ill GEI-iERAL _01 O No. 11 �0 rpp—a 4 wt Q1 0 nyTq N� 'a Kon 1h?rwqf ti call 3� fokow: yreuv V JKv WK; ohn' : wV'I Lc f 4? c i i? ipar if ic ln�qnov %n- Wn V judin, hat 7 1 i -1101 1C. 'Vy Qjlo�iqql A om D' ? mant raccri FKant Wl �tnt-n-it : owuenonurp swevanL- A wavion lot i 1 lo 1 0 011 4-0 PC". i co - on ywr�w an! amowl qt Wdirl -�ttize� ircm all mW o uryt% ny,q, h�. 1410wrnh ; fvw� coo diso, im : jrPPE �rw: 'Van a, 71 anplin.. K wide&o of W My of Ausm jwHaKon. pro-f of non-profk_ status aF determined by the intornil WFriun Spruicej pruf of Wisrat? S5105 to W 'Jr wnic. nF mplaas W articles w., Worpuniin; via source arK anum of funding received fror n1hur goverpmental igunnin: the nanen and Wdrasses of cur-wt Ward members; apd any other janowntsioN as way he Mew! necessary by M cKy. I WORT 1 qy!jEMjjjA: Anv on-Oro"1 C on jr jr 1ho Of . i i 0 ai . i A� . a i lo 1 o.cc-, i n 0 E nend we ri :AKIqm - '4 10 vrryn"Ti 1- ! , �nor! �qrnli n V 11,n 140 lrnra z WOK nAt 10 ;n thp 1- wn,rictor '! 31rencypt V ty the 1i f V T. Apinh; 3inoiijv. amaq wbor c,p wwaylvion as mey be we"M wussdry by tho oitj in or Q WerMine We dgelQ 1 COW i arre wi th the troy i s i w of the owl,art WE DIE OF THTEE COHMACT REQUIRE& RD EBURE FOR DISTRIBUTION OF FUNDS tt A-.'i'i i_i ty funds a I I ci ca ted or gran W to any non-profit agency stall he by means of a written coqtracL based upon nervicw to be provided lu or wM tin be pyl&umed on behif of City of Ap5che junction and its residents in compliaw witir; the provisions of Arkya Revised St te dlus regarding tOe use of public funds. P. All city funds Plumed Jr qraotod under Une arovisions Rf this ordinance shall to relsaW in equal qUarterly inst.01- mEnt5 or qu3rt2rly payments Wind upon. * schedule.of anticipated expenses which has been aDproved by the Mayor dnd City Gunoil , No nukequpit quarterly all Lion or ordrit Sall On relo,20 Mil w. time that the Wely% bency has pro0dad oil of the raWred ter o . rovizbn in! his S"O' 'dej minnnar, of complianco "Ill. the yvpe CC WW sti;ulltov K UP- rentran with 09 rii ". All Tandirl rcizzi :q7711VII D nor PrM, j�wk f; 0110catioN Cr gra= at U11, lords 0111 to out-ittac ve Lk Uivy Ourk 's uffict d ,r'rl lay waritr n, Japuary of "onr yox. '111VO 1"Prq4no '!50 ! 00 FT Q , 14 'Cqj or any Varr of rpe ccan MorrY We& by rpWrarn; a-, ! I PRUVIDENG FOR SWERABILIK,' a:!y jonjg670, Acqns, Kra, o- portion K On PrTnew a, any ps-I PF the MwO ho: :K 41 refcrmrs Q, f-r ari,-,- Y a 1;Wn ho 10 M; ho lnva: in D- W any Uoi-I Y zsMaQvent ;or !odiut ion, w" do- i_sir.. .4111 ;D, Wo�" Wily Y too r,w;Ir': 1! of Aprich- AM ijir� PriTnro, 1h it thin ardinjuny Wuns &K J a 1.t= y n a me r qP P n v in Sclor-I ;- PriK an! this PrVriii, � n� to A votive 00011101Y upon pas wo and alopl IWI P D in F� INIANCT INI5,c.-9 PAGF T1,40 OW THRU A%D A.D0717HI A'F'. f ITi 7F.',: f_]TV V-T N ILD D A T L'P LL Tl- ROLL CALL VOTE NOTES: � I ITEM # I i / MEETING OF MOTION BY: / SECONDED BY: v YES NO ABSTAINED COUNCILMEMBER SERDY VICE MAYOR ECK COUNCILMEMBER DIETZ COUNCILMEMBER WILSON COUNCILMEMBER COLEMAN COUNCILMEMBER BARKER MAYOR INSALACO UNANIMO S IN FAVOR OPPOSED ABSTAINED TOTAL i ITEM NO. 6 z. I MOVE THAT APPROVAL BE GIVEN FOR THE PROFESSIONAL SERVICES AGREEMENT FOR FISCAL YEAR 2009-2010 BETWEEN THE APACHE JUNCTION COMMUNITY DEVELOPMENT CORPORATION AND THE CITY OF APACHE JUNCTION FOR ECONOMIC DEVELOPMENT AND BUSINESS EDUCATION SERVICES IN THE AMOUNT OF $7,600; AND THAT AUTHORIZATION BE GIVEN FOR THE MAYOR TO SIGN THE AGREEMENT. g GO ofrcheucia Notre of the ,S i.pe x ition A os�trkiih.s �+412Q �' ` Print TO: City Manager's Office FROM: Kathy Connelly, City Clerk ^^ DATE: January 19, 2010 Agenda Type : Regular Agenda -Council Priority Focus Area: Economic Development TITLE OF AGENDA ITEM: PRESENTATION, DISCUSSION AND CONSIDERATION ON FISCAL YEAR 2009-2010 PROFESSIONAL SERVICES AGREEMENT WITH APACHE JUNCTION MAIN STREET FOR ECONOMIC DEVELOPMENT SERVICES. ACTION REQUESTED: Recommendation for Approval DISCUSSION/BACKGROUND INFORMATION: Presentation, discussion and possible consideration on a professional services agreement for Main Street's continuation of events to encourage business in the downtown and support for local businesess. FISCAL IMPACT: Budgeted Expenditure OPTIONS/ALTERNATIVES: n RECOMMENDATION: ATTACHMENTS: Click to download ❑ cover memo ❑ 09 agreement part 1 ❑ 09 agreement part 2 161W f-Ifwne af'the Srrt)vrvition ;1lfnttrrtains 1 o�' ' %IFEL\fORA1i DL'iM TO: IIC)1`Gfi,'.1:3 ,E NNIA OR AND CI`i`i' CG'tl �IC'fL �'f��trsLleS THROi,ltii-I: GEORGE R. f I(1I:'E'i� AN,CITY MANAGER FROM: KATHL E.N CMS,.\,TLL` . CiT i CLLRR ;',. SUBJECT: ACYENDA iTENM FOR JAN! A.RY I9 2010 (PROFESSIONAL SE?R w`IC:i S AORI;I=MEitiT WITH ''PACHE' Jt1NCTION iulAIN STREET PROGR-.-h-i.) In CO juilCb)n ',vitlt the: F Y 2009-10 Wgct,council atiborked an expendi[LIVC of$3Z.000 to LOntW Be agrteMe.itt "IT tI;2. Apa&L illi:i' 01) Main Street Program Cor viirious cconomic development sm ices relative to increasing activity. development vmd redevelopment in ik downtown This amnum represents a t'!.lriciirtg mduction of 20"'10 trom FY 080% Ile proposed program Or dis Rscal.}'ar reflect a.practical lifilltt;or, approach to partntring, ',vitli till' Ci[) ',with the. d-fared g,.oals o C ot}Jlancinp, our exisgng bud tosses and encour7"-ging n(V%v ones a hi tiem mms originally placed on Be janwwy },20I 0 agenda but vms postponed to allow-additiot.M time to prepare and review the agreemmV. Attached is a revked agn4ement and E-Nhihit A. A Nease comact me ifycm nce d additional inliOrnlaLiOn. ' 1 • Voice(480)982-8002 • FAX(480)982-7018•TDD 14SR)983-0095 •ww-k .ajcity_nL:t 300 E.Superstition Boulevard, Apache Juntion,AZ 8:219 PROFESSIONAL SERVICES AGREEMENT FOR ECONOMIC DEVELOPMENT OF APACHE TRAIL AND DOWNTOWN AREA WITH APACHE JUNCTION MAIN STREET PROGRAM, INC. THIS AGREEMENT is made and entered into this day of 2010, by and between the CITY OF APACHE JUNCTION, ARIZONA, an Arizona municipal. corporation ("City") and APACHE JUNCTION MAIN STREET PROGRAM INC. ("Consultant") for the project entitled "ECONOMIC DEVELOPMENT OF APACHE TRAIL AND DOWNTOWN AREA" ("Project"). WHEREAS, pursuant to Arizona Revised Statutes Annotated ("A.R.S.") § 41-1505.02, a state Main Street Program is established, to provide for the revitalization of central business districts in rural communities based on the development of progressive marketing and management techniques as an economic development strategy for local governments; and WHEREAS, City desires to retain a consultant to provide economic development services and to make payment for the same in accordance with the terms and conditions set forth in this Agreement, including all attachments and addenda which are appended hereto by mutual agreement of the parties; and WHEREAS, Consultant has the specialized expertise to further the state Main Street Program goals and objectives basad on directives from the State of Arizona Department of Commerce and the national Main Street Program. NOW, THEREFORE, City agrees to retain and does hereby retain Consultant and Consultant agrees to provide the services required according to the terms and conditions and for the consideration set forth below: 1. TERM: The term of this Agreement shall commence retroactively from July 1, 2009 to the time of completion of services to be rendered by Consultant, but not later than June 30, 2010. 2. CONSULTANT'S DUTIES: Consultant agrees to perform the following professional services,,all to be performed in accordance with all city codes, ordinances, regulations, policies and procedures: A- Provide services as described in the Apache Junction Main Street Program Objectives 200.9-2010 attached hereto as Exhibits A-1 and A-2 as determined by the Main Street Board of Directors, with the following components: Organization, Design, Promotion and Economic Restructuring. Page 1 of 11 B. Consultant shall provide services conducive to increasing activity And the visibility of the downtown and Apache Trail area, including but not limited to, monthly public events from October 2009 through March 2010. C. Consultant shall provide technical assistance for local businesses to include those currently located in the city and those seeking to locate in the city. D. Consultant shall assist city staff, city consultants and the city's economic development partners in the development and retention of businesses in the downtown and redevelopment areas. E. Consultant may assist with the facilitation. of discussions between members of the business community, city elected officials and staff, other city consultants and city economic development partners subject to board approval. F. Consultant shall not expend any city funds on the development of a Main Street-created microonterprise such as the Apache Junction Mercantile unless specifically approved in writing by the city manager or his designee. 3. COMPENSATION: In accordance with the terms and conditions of this Agreement, City shall compensate Consultant for its professional services as follows: A. An aggregate sum up to Thirty-Two Thousand Dollars ($32,000) for Fiscal Year 2009-2010 provided Consultant meets the reporting requirements described in Section 3(B) of this Agreement and the insurance requirements described in Section 9 of this Agreeme,nt, with payment to be made as follows: (1) Eight Thousand Dollars ($8,000) upon execution of this Agreement; and (2y three additional equal payments of Eight Thousand Dollars ($8,000) disbursed at equal intervals over the term of this Aareement. subject to satisfactory performance in the opinion of the City Clerk of the terms and conditions of this Agreement. B. Within ten (10) working days following the last day of each fiscal year quarter, Consultant shall submit to the Apache Page 2 of 11 i ( ) I 1 Junction City Clerk ("City Clerk") detailed reports accounting for the expenditure of City funds. Consultant shall submit a separate, concise summary of all expenditures within each report. The summaries shall be subject to public disclosure as public records in accordance with A.R.S_ § 39-121 et sea. Each report shall be typewritten or prepared on a word processor and shall include the status of Consultant's progress on the scheduled work items as set forth in the work program in the attached Exhibit. It shall include a description of all work undertaken and all findings and conclusions. In addition, it shall include documentation supporting these expenditures. These reports shall also contain the information required in this Agreement, and in doing so, shall demonstrate, by an appropriate methodology, the value of work and its impact upon economic development within the corporate boundaries of City. Documentation for actual expenditures shall include a summary page detailing all quarterly expenditures made in accordance with this Agreement and all relevant bills, receipts and statements, with the relevant expenditures highlighted. The Apache Junction City Manager or designee ("City Manager") has the sole discretion as to whether the above- referenced reports contain adequate specificity. Should the City Manager desire additional information, such information shall be produced by Consultant within ten (10) working days from receipt of such request. The City Manager may withhold any and all payments due until such time as all concerns on the reporting have been resolved. The books and records of Consultant shall be subject to inspection and audit by City during the term of this Agreement and for a period of three (3) ,years after expiration of this Agreement for the purpose of verifying Consultant's performance as well as the thoroughness and accuracy of the reports submitted hereunder. Records of Consultant shall be provided to City and/or made available for inspection and audit within three (3) working days following a written request by City. C. Consultant will monitor and seek other sources of public or private community and/or economic development funding which may become available to Consultant or other community entities, and will advise the City Manager in writing of these opportunities. Page 3 of 11 � n D. Exhausting the total amount payable for activities described in this Section shall not relieve Consultant of its obligations to perform such services. Should City request additional services beyond those specified in Section 2, Consultant shall charge, and City shall pay for, a rate as negotiated between City and Consultant. • Any funds not expended or disbursed by Consultant shall be reimbursed to the City. Any funds expended or disbursed by Consultant in violation of Ordinance No. 669, attached as Exhibit B, or this Agreement shall be reimbursed to the City. Should Consultant seek funding for fiscal year 2010-2011, it shall comply ,with the filing deadlines set forth in Ordinance No. 659 and shall submit a work plan substantiating such request no later than March 30, 2010. 4.. CONSULTANT'S BILLING: For additional services as negotiated in Section (D) noted above, Consultant shall bill City on a time and expense basis in a total amount not to exceed the negotiated amount. City shall pay such billings within thirty (30) calendar days of the date of receipt, or as otherwise negotiated. 5. CONSULTANT'S STANDARD OF PERFORMANCE: While performing the services. Consultant shall exercise the reasonable professional care and skill customarily exercised by reputable members of Consultant's profession practicing in the Phoenix metropolitan area, and shall use reasonable diligence and best judgment while exercising its professional skill and expertise. Consultant shall be responsible for all errors and omissions Consultant commits in the performance of this Agreement. 6. NOTICES: All notices to the other party required under this Agreement shall be in writing and sent by first class certified mail, postage prepaid, return receipt requested, addressed to the following personnel: If to City: City Manager City of Apache .Junction 300 E, Superstition Blvd. Apache Junction. AZ 85119 And to: Citv AttornAv City of Apache Junction 300 E. Superstition Blvd. Apache Junction, AZ 85119 Page 4 of 11 If to Consultant: Executive Director Apache Junction Main Street Program, Inc. P.O. Box 6296 Apache Junction, AZ 85178 7, TERMINATION: This Agreement may be terminated by either party upon fifteen (15) working days written notice. If this Agreement is terminated, Consultant shall be paid for services performed to the date of receipt of such termination notice. In the event of such termination. Consultant shall deliver to City all work in any state of completion at the date of effective termination. 8. SUBCONTRACTORS: Consultant shall not subcontract any portion of the obligations set forth in this Agreement without City's prior written consent. Consultant agrees that it is as fully responsible to City for the acts and omissions Of its subcontractors and of persons either directly or 'Indirectly employed by them as it is for the acts and omissions or persons directly employed by Consultant. Nothing contained in the Agreement shall create any contractual relations between any subcontractor and City. 9. INSURANCE: A. Required Limits 1. Commercial General Liability Consultant shall maintain Commercial General Liability insurance with a limit of not less than $1,000,000 for each occurrence with a $2,000,000 Prod ucts[Corn pleted Operations Aggregate and a 52,000,000 General Aggregate limit. The policy shall include coverage for bodily injury, broad form property damage, personal injury, products and completed operations and blanket contractual coverage including, but not limited to, the liability assumed under the indemnification provisions of this Agreement which coverage will be at least as broad as Insurance Service Office, Inc. Policy Form CG 00010196.or any replacements thereof. Such policy shall contain a seve-rability of interest provision, and shall not contain a sunset provision or commutation clause, nor any provision which would serve to limit third party action over claims. The. Commercial General Liability additional insured endorsement shall be at least as broad as the Insurance Service Office, Inc.'s Additional Insured, Form B, CG Page 5 of 11 --- --------- .. . ....- I op� 20101185, and shall include coverage for Consultant's operations and products and completed operations. If required by this Agreement, if Consultant sublets any part of the work, services or operations, Consultant shall purchase and maintain, at all times during prosecution of the work, services or operations under this Agreement, a Protective Liability insurance policy for bodily injury and property damage, including death, which may arise in the prosecution of the Consultant's work, service or operations under this Agreement. Coverage shall be on an occurrence basis with a limit not legs than $1,000,000 per occurrence. and the policy ,shall be issued by the same insurance company that issues General Liability Insurance. 2, Workers' Compensation Insurance Consultant shall carry Workers' Compensation Insurance to be provided by an insurance company which is authorized to transact insurance business in the State of Arizona, covering obligations imposed by federal and state statutes having jurisdiction of Consultant's employees engaged in the performance of the work or services: and, Employer's Liability insurance of not less than $100,000 for each accident, $100,000 disease for each employee, and $500,000 disease policy limit. By execution of this Agreement, Consultant certifies as follows "I am aware and understand the provisions of A.R.S. § 23-900 et seq. which requires every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of this chapter, and 1 will comply with such provisions before commencing the performance of the work of this Agreement." If Consultant has no employees for whom workers' compensation insurance is required, Consultant shall submit a-declaration or of to City so stating and Page 6 of 11 cov4nanting to obtain such. insurance if and when C o ns u.Itant'e m ploys any employees subject to coverage. In case any work is subcontracted, Consultant will require subconsultant to provide Workers' Compensation and Employer's Liability to at least the same extent as required of Consultant. B. CERTIFICATES OF INSURANCE Upon execution or simultaneously thereto, Consultant shall submit to the City Clerk all Certificates of Insurance, and formal endorsements as required by Agreement, issued by Consultant's- insurer(s), as evidence that policies providing the required coverages, conditions and limits set forth in this Agreement are in full force and effect and maintain so during the life of this Agreement. The form, of the certificates of insurance and endorsements shall be subject to the approval of the Apache Junction City Attorney. In the event any insurance policies required by this Agreea-ient are written on a "claims made" basis, coverage shall extend for Mor (2) years past completion and acceptance of the Consultant's work or services and as -evidenced by annual Certificates Of Insurance, to be filed with the City Clerk. If a policy is expired, canceled or materially changed during the life of the Agreement, such notice must be sent to City thirty (30) calendar days prior to such action, All Certificates of Insurance. shall include a thirty (30) day pre-notification period wherein insured shall sent City, notice of such cancellation, or material change of the insurance provisions. Policies or certificates and completed forms of City's Additional Insured Endorsement (or a substantially equivalent insurance company form acceptable to the City Attorney) evidencing the coverage required by this section'shall be filed with the City Clerk and shall include Cityq the Mayor, COMIGilMembers, appointees and employees as an additional insured parties. 10. RIGHT OF CITY TO CONTRACT WITH OTHERS: Nothing in this Agreement shall imply City is obligated to obtain the services described herein with only this particular consultant. Pagel of ii F� J 11. EXCUSABLE DELAYS: City and Consultant shall exert all efforts to perform.their r.espectiveresponsibilities under this Agreement. However, neither party shall hold the other party responsible for inability to render timely performance if such inability is.a direct,result of a farce beyond its control, including but not limited to the following: strikes, lockcrt ts, embargoes, failure of carriers., inability to obtain transportation facilities, acts of God or the public enemy, or other events beyond the control of the other car the other's employees and agents. 12. INDEMNIFICATION: Consultant shall defend, indemnify, and hold City, its officers and employees harmless from any and all lass, damage, claim for damage, liability, expense, or cost, including attorney fees, which arise out of, or is in any way connected with the performance of work udder this Agreement by Consultant, or any of Consultant's employees, agents or subconsultants, and from all claims by Consultant's employees, subconsultants and agents for compensation for services rendered to Consultant in the,performance of this Agreement, notwithstanding that City may have benefited from their services. This indemnification provision shall apply to any and all acts or omissions, willful misconduct or negligent conduct, whether active or passive. on the part of Consultant or Consultant's employees, subconsultants or agents. This section shall survive the expiration or early termination of the Agreement. 13. WAIVER OF TERMS AND CONDITIONS: The failure of City or Consultant to insist in any one or more instances on performance of any of the terms or conditions of this Agreement or to exercise any right or privilege contained herein shall not be considered as thereafter waiving such. terms, conditions, rights or privileges, and they shall remain in full force and effect. 14. INDEPENDENT CONTRACTOR:: Consultant shall at all times during Consultant's performance of- the services retain Consultant's status as independent contractor. Consultant's employees shall under no circumstances be considered or held to be employees or agents of City, and City shall have no (� obligation to pay or withheld state or federal taxes or provide workers' compensation or unemployment insurance for or on behalf of t:her-n or Consultant. 15. GOVERNING LAW AND VENUE: The terms and conditions of this Agreement shall be governed by and interpreted in accordance with the laws of the State of-Arizona. Any action at law or in equity brought by either Marty for the Purpose of enforcing a right or rights provided for in this Agreement, shall be tried in. a court of competent jurisdiction in Pinal County, Mate of Arizona. The parties hereby waive all.previsions of law providing for a change of Venue in such proceeding to any other county and right to jury trial. In the event either party shall bring suit-to enforce any term of this agreement or to recover any damages for and on account of the breach of any term or condition in this Agreement, it is Page'8 of 11 n n mutually agreed that the prevailing party in such action shall recover all costs including: all litigation and appeal expenses, collection expenses, reasonable attorney fees, necessary witness flees and court costs to be determined by the court in such action. 16. OWNERSHIP OF RECORDS AND REPORTS: All of the files, reports, documents, information and data re ared or assembled b Consultant under prepared y n this Agreement shall be and remain the property of City and small be forwarded to City at any time City requires such papers in accordance to the limitation within this Agreement. 17. LICENSE: Consultant represents and warrants that any license necessary to perform the work under this Agreement is current and valid. Consultant understands that the activity described herein constitutes "doing lousiness in the City of Apache Junction" and Consultant agrees to obtain a business occupational license and sales tax license pursuant to the Apache Junction City Code and keep such licenses current during the term of this Agreement. Any Consultant activities or programs within the corporate city limits will invoke the same lousiness occupational license and sales tax regulations. All participants in these activities and programs will obtain any required business occupational and sales tax licenses. Any activity by subconsultants within the corporate city limits will invoke the same business license and sales tax regulations on any subconsultants, and Consultant ensuress its subconsultants will obtain any required: business occupational license and sales tax license. In the event any subconsultant fails to pay required license. fees or taxes clue, Consultant shall pay to City such amounts within ten (10) working days after notification from City that such amounts are due and payable. 18. NONA SSIGNMENT: This Agreement has been entered into based upon the personal reputation, expertise and qualifications of Consultant. Neither party to this Agreement shall assign its interest in the Agreement. either in whole n or in part. Consultant shall not assign any monies due or to become dire to it hereunder without the prior written consent of City. 19. ENTIRE AGREEMENT: This Agreement and any attachments represent the entire agreement between City and. Consultant and supersede all prier negotiations, representations or agreements, either express or implied, written ar Nral. It is M—uttualh, understood and --reed il--t ^ It f' - + f lxl �.1WW1 JtN VM 1.i1t- -6 jI V t r.,�� Ylll Ul LQ G`L1V!! VI variation of the terms and conditions of this Agreement shall be valid unless MaCiG ill writing and signed by the parties tfulvtV. VVriften anu signed amendments shall automatically become part of the Supporting Documents, and shall supersede any inconsistent provision therein; provided, however, that any apparent inconsistent shall be resolved if pp y possible, by construing the provisions as mutually complementary and supplementary. i i Page 9of11 --- - ------ -- _ n n 20. SEVERABILITY: If any part, term or provision of this Agreement shall be held illegal, unenforceable or in conflict with any law, the validity of the remaining portions and provisions hereof shall not be affected. 2.1. CONFLICTS OF INTEREST: The provisions of A.R.S. § 33-511 relating to cancellation of contracts due to conflicts of interest shall apply to this contract. 22. POLITICAL ACTIVITIES: As a community service-teased organization, Consultant is a non-political organization. Consultant' employees are prohibited from engaging in any partisan political activity with respect to candidates for political office beyond the private expression of personal opinion, registering as a member of a political party, signing nomination petitions and voting in any special, primary or general election. No board member, offoer or employee of Consultant shall solicit any contribution in cash or services from any Consultant employee to support any candidate for public office. No board member or officer shall use the name of Consultant, or use their affiliation with Consultant, to engage in any partisan political activity of any kind or to solicit any contribution in cash or services to support any candidate for public office. If a board member or officer should engage in said activities, they shall make it clear that they are doing so in their personal and private capacity, and are not associated with Consultant in any way, while engaging in said activity. The functions and activities of Consultant are non-political with respect to candidates for political office. Therefore, all board members, officers and employees will refrain from engaging in any partisan political activity, of whatsoever type or nature, while attending or participating in Consultant function or event. This includes the circulation or signing of nomination petitions or soliciting any contributions in cash or services from anyone to support any candidate for public office. IN WITNESS WHEREOF, the parties have caused this Agreement to be signed by their duly authorized representatives as of the day and year first above (� written. APACHE JUNCTION MAIN STREET PROGRAM, INC, By: Ariel Uhler Title: Executive Dirpntnr Page 10 of 11 n n CITY OF APACHE JUNCTION an Arizona municipal corporation By: JOHN S. INSALACQ Title; Mayp _ _ n ATTEST: KATHLEEN CC7NNELLY City Clerk APPROVED AS TO FORM: t RICHARD J. STERN City Attorney (^1 Page 11 o€11 EXHIMIT A-1 Apache Junction Main Street Program Program Objectives 2009-2010 ,Yrc n, f,)r the pro-g-Tramy'-w"1009 - 2010 SltortTerm Goats 1. Bulid strong-er relationships with local businesses • Onuoinu diStribLlt.'Orl (If SLr%c2',ALI I)LLji11t2S idQnLi I", nIJrKQt ChE s illue .. gafficr siaiistical dat.;, aild , issues or concerns. • Weeki visits to bu, I V iinc.-wses 'n the Apache,runction N ain Streei progran-tarea. it) the local and property wxner-S 2. Expand CLIfrCLIT, pro,,rains io maril",et -Uid Creatc and maintain a busirics-I direclon'. on rUNIS wcbsit-1, Listin- -,%il; be fruc� 0.1 N-fain Street businesses 1"IrDler.,hip v.,11h v,%zR)tIs oro.ulizations to prodUCe nionffikil t-,'CFILS Build Capacity- of X,Iain SM:L�L Progyra-m * Seek gi-arits to provide funding,ofnev4,- prograni-,i * Grain vkilbility for the prog am thmugh press refelts-e-s- �Ii-[Icics and public spe�lklrlll r 49 C011thILIC tO build diverse-boare, b.�' Inviting I.epresenwivcs from \:"Irk-Als hushlG.tis sectors to become board membens 4. prornwic)ris BUild the -prolnutions Committee k. Seek o rants and corporate sponsorships to presetit additional special events Page I of"2 n n EXHIBIT A-2 a Promote 1_I[,wnCt'awn sales events 5._ Stria?Lthen Pirtnership tith the City Develop psr iects in1pleil-ented hi'.-1YNTS and City sta de �. 5igri 111ip 1"i'ts,'ti11i�11i. Prs)gram) o PLIblish newsletter articles contribi.gteA by V,-irio Us' City departrnent;t f Jl CollaI'lon-Atz oil obtaining cxranLs.,, 60r bU SinC-SI; rCLellfiffll and iriculhation Attocnal Cit'S% Council illi:'etir14'a on 1 i�"=L11 r basis • Shrarc Nfain Strcet Business Report frith City Busines Advocste m t ominue. working Sidi le`ttt to inad c.lillpre)' ernents to thl: ,Foc7 efl Point. Long Tcmu Goals t. Work "Adi Inisineus ti, residerim 4'Sir'bus o vanizatlons, it id the City to cl-cate cm oilractive ilti'vntovt n t7u`rim1 s`s Cr.j11irmunily that attr ltt4 touri_,', "Ind ea social iCcfltQr th.' C01111:11,111ity, st I , u i ti t y ati I i i + ,__ ��G;1.('-rla to �a�l -Tt1�.;. l4 piC.r71'il.°' k;[:S' r1.t.`.;El r'1 Program Activitics 21.110 Page 2 a _ i EKMBIT B ORDINANCE NO. 659 An 01RDINANCE OF THIE PlAYOR ANO-CITY COUNCIL OF WE CITY OF APACHE JUNCTION. ARIZONA, REPEALING MY ORDINANCE NO. 631 AND ADOPTING ORDINANCE PIC, 659 IN LIEU THEREOF, AFJOPTrNG %D ENACTING REPORTING REQUIREMENTS, REQUIRED DOCU1`4ENTATION, AND PROCEDURES FOR NONPROFIT AGENCIIS RECEIVING CITY FGNDS; REPEALMIGG CONFLICTING PROVISIONS; PROVIDING TOR SEVER ABILITY; AND DECLARING A4 FMERC-ENCY. BL IT ORDAINED BY THE Mfk,(0111 AND CITY COUNCIL OF I'HL CITY V APACHE JUIRCTIGNI ARIZONA, AS F'OLLEYAS: That OrdiTiance lvi. 631 be repealed and Ullhat. Or(jiriance No. 659 b e ad,-,pted I,-) lieu thereof to rLl,d as fcdliws, 1 , REQUIRED DOCUMENTATION- Any non-profiz, age-ricy s:ibmitting a request fnr an aliocation or grant of city funds sha7l submit to tape city speciNc docum2nta_ tion including, but not limited to, the followimn A copy of the agency's most recent awht rep:r a certffiec; c;apy of t h- —t� a gyz n C y most recent financial statement; ;et6ilec;' ey.penditure statements 'it' order tct prnv1de a detailed accounting of all Wids ureviously received from the City of Apache jurc.tit),); ciimpi(),L an M source and amount of fund fug received irons M i other sources Such an na.g"ennental agencie-s, riemi LEST .hip fees and duzits, .:T-ld private contribotions; Wient service information as it applies to residents of the City of Apache junction; proof of non-profit status as deNrYned by the. Internal Revenue Service; proof of cer,vorate status to incl;ide copies, off by-iaws and crticles of incorporation, the source and amount of funding received from Mar governmental agen;_ies, the nameli and addh-L�ssas of current tt,oard members',. and any other dacuq- .�entiati,nnr as may be de di eme necessary by the City. REP OPTIt4C, REQUIREMENTS, Any non-profit agenC7 re"inng an allocation or grInt of city funds shall b'a required to submit to thQ .,,It}', jr; a quarterly basis, is detailed accountipg of the expa,-,ditvre --it y 11-unds for the prevkius a written repm outlining the agency's performawe and accomplishments within the scope of wark outlined in their c:=�ntractural agreement with the City ;�f Apache junction, and any other dccumentation as aley be deenmd necessary by the city in order to, determirie th=a agency's c�om- pliancQ w0h the corcivisions of the contract. 1WINANCE NO. 659 FAGGE ONE OF THREE J. CONTRACT REQUIRED; PROCEDURE FOR DISTRIBUTION OF FUNDS A. All city funds allocated or- qrantei to arty non-profit agency shall be by means of a written cGntract based upon services to be provided to or work toe be performed onr behalf of Lh!L' City of Apal-he Junction and U5 residents in compliance with the provisions of Ari.zona Revised Statutes regarding the use. Of public funds. R Al I c j ty funds al located or qr ante d under the prov i s i onr; of th It s ordl nance, shal 1 be released =n equal quarterly instal I- m,ents or quarterly payments based upon a schedule of anticipated expenses which has been approved. by the Mayor and City courlci" NO sub's2qurmt fqUirterly al lojrz,,tion or grant shall be released unti I su& time that the r�_Icei VI:ng ,agency has provided all of the required documentation for the previou5 quarter and �a5 provideij satisfactory evidence-, rif cmpliancQ -61th the scope of worlk stipulated in their contract. with thH city, 4, SUMITTAL OF REQUESTS FOR FUNDING: All furid"ing requests submitted by non=proflt agencies, for the allocation or :Iran"' clif r-itv funds shall be submitted to the City (."ie-k's office during the iiimth of Janiiary of eiich year, P,2quest5 so submitted shall not he .ubject to city funding unless apRrovedl by th(e City Council and on]%,, folloming ado,ption of a final budgelt for, the subsequr-rit fiscal Year. IS E C T i ON II RZ-FCALENri Milt (.-ONFLICTING All ordinances and part." of or,,Iinances in (-'onflicTt with the provision-s of this ordinance or any part of the code adopted herein by reference are herehy repealed. SECTtGN ITf PROVIDING FOR SEVERABILl"Y if any seztior , subsertion, s-ritence, clause, phrdse or portian �:)f this P-rdinance or an.y part of the cr Dele adopted her eln by re-fere r nce is, for" any rea'lcn' field to I'le invaiid -n- unconstitutiona! by any court of (:urnpeteint jurisdiction, -Such decision shall lot affect the validitv +?f the remuaninq purtiun5 thoreof. SE"770N 1,L LAUNG AN EMERGE)NCY,11 J _ D EC, i It beinq necc-ssary for the preservation (if thr h=�alth ano Safety of the My of Apache Juriction', Arizona, that this, ordirrance become effec- tive immediately, an emergency is declared to ems", and this ordinance shall be effective. immediately upog its passage and adoption. ORDINANCE NO. 659 PAGE TWO OF THREE PASSED AND ADOPTED 3Y THE M tCrR AND CITY COUNCIL Or THE CITY Or APACHE JUNCTIOlk ARIZONA, THIS 1ST DAY O j;ifEM ER 1988, SIMED AND ATTESTED TO THIS 3RD DAY OF __ raiaVEMSEP: 19SE, NORMAA s. IEII, A VEST:t:it} Clerk 9,,P;PPC,VYD AS TO FORM: AL EX city �i:i urney i ORDINANCE NO. 659 PACE THREE OF THREE ROLL CALL VOTE NOTES: f 1 ITEM # MEETING OF MOTION BY: SECONDED BY: �" i� YES NO ABSTAINED COUNCILMEMBER BARKER ✓ COUNCILMEMBER COLEMAN COUNCILMEMBER WILSON COUNCILMEMBER DIETZ VICE MAYOR ECK COUNCILMEMBER SERDY MAYOR INSALACO UNANIM U IN FAVOR OPPOSED ABSTAINED TOTAL ITEM NO. 7 I MOVE THAT APPROVAL BE GIVEN FOR THE PROFESSIONAL SERVICES AGREEMENT FOR FISCAL YEAR 2009-2010 BETWEEN THE APACHE JUNCTION MAIN STREET PROGRAM AND THE CITY OF APACHE JUNCTION FOR ECONOMIC DEVELOPMENT SERVICES IN THE AMOUNT OF $32,000; AND THAT AUTHORIZATION BE GIVEN FOR THE MAYOR TO SIGN THE AGREEMENT. ROLL CALL VOTE NOTES: ITEM # MEETING OF MOTION BY: SECONDED BY: iLl/W YES NO ABSTAINED VICE MAYOR ECK COUNCILMEMBER WILSON COUNCILMEMBER BARKER COUNCILMEMBER SERDY COUNCILMEMBER DIETZ COUNCILMEMBER COLEMAN MAYOR INSALACO UNANIM US IN FAVOR OPPOSED ABSTAINED TOTAL L ITEMS NO. 8-9 I MOVE THAT AN EXECUTIVE SESSION AT 5:45 P.M. AND A WORK SESSION AT 7:00 P.M. BE HELD ON MONDAY, FEBRUARY 1, 2010, IN THE CITY COUNCIL CONFERENCE ROOM AND CITY COUNCIL CHAMBERS RESPECTIVELY; AND THAT AN EXECUTIVE SESSION AT 5:45 P.M. BE HELD ON TUESDAY,FEBRUARY 2, 2010, IN THE CITY COUNCIL CONFERENCE ROOM. ADJOURNMENT: I MOVE THAT THE MEETING BE ADJOURNED AT P.M. ROLL CALL I ' WS. REG.t t t' 11° SPEC- CITY COUNCIL. P / A P / A P / A MAYOR INSALACO 1// .-... VICE MAYOR ECK COUNCILMEMBER BARKER COUNCILMEMBER COLEMAN COUNCILMEMBER DIETZ COUNCILMEMBER SERDY I COUNCILMEMBER WILSON TOTAL CITY STAFF 1 if 10 City Manager George Hoffman Assistant City Manager Bryant Powell _ City Clerk Kathleen Connelly City Attorney Joel Stern Public Safety Director Jerald Monahan City Engineer Giao Pham Parks& Recreation Director Jeff Bell Finance Director Donna Meinerts Public Works Director ) David Fern Development Svcs Director Brad Steinke Human Resources Director Liz Riley Planning Manager Fred Baker Economic Development Director Steve Filipowicz Assistant to the City Manager Matt Busby OTHERS Date: J 114- City Apache A ache Junction Item No. I D Request to Speak Form o-r- all to The P��a ' iic (One Form Per Item) Please fill out completely and return to the City Clerk prior to the conclusion of the City Manager's Report portion of the agenda. Do you wish to speak before Council on this item? Yes❑ No❑ Only If Necessary ❑ E I am in favor of the proposed Item. ❑ I am opposed to the proposed Item. \ \', 14 -� - SI^ h Name (Print) A dress City Zip Code C )--7-D .) Telephone This information will be used by staff for follow-up, if necessary. Speakers are requested to directly address their agenda item and address their comments to the Mayor and City Council. Please limit Call to the Public comments to no more than three minutes and five minutes for Public Hearing items. 8/18/09