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2012 03.06 City Council Regular Agenda
PLEASE FILL OUT A"RE( 3T TO SPEAK"FORM IF YOU WISH TO ADDR THE COUNCIL AT CALL TO THE PUBLIC OR ON ANY NON-PUBLIC HEARING I i CM. toy ACHE 4,6, City o_f A pache Junction Home of the ,S11pci:cizt1011 AloiilitG1117s 4Thzoto". APACHE JUNCTION CITY COUNCIL CITY COUNCIL CHAMBERS 300 EAST SUPERSTITION BOULEVARD APACHE JUNCTION,ARIZONA 85219 REGULAR MEETING AGENDA March 6, 2012 7:00 PM A. CALL TO ORDER. B INVOCATION AND PLEDGE OF ALLEGIANCE. c ROLL CALL. 0 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. Acceptance of Agenda. 2 Approval of Minutes of Regular Meeting of February 21, 2012 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 3. PRESENTATION OF 25-YEAR SERVICE AWARD TO CARLENA LAWSON OF THE APACHE JUNCTION POLICE DEPARTMENT. F. 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 4 MANAGER'S REPORT. 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 time limitation shall not apply to applicants and their agents appearing before the Council. 5 APPLICATION FOR AN INTERIM PERMIT, NEW LICENSE, CORPORATION, SERIES 10 LIQUOR LICENSE FOR CIRCLE K#3444 LOCATED AT 2933 SOUTH TOMAHAWK ROAD. The next step in the procedure is fk a city council to hold a public hearing on the appl m and make a recommendation for approval or denial to be forwarded to the Arizona Department of Liquor Licenses and Control. 6 APPLICATION FOR A NEW LICENSE, LIMITED LIABILITY CO.,SERIES 7 LIQUOR LICENSE FOR ELVIRA'S MEXICAN RESTAURANT LOCATED AT 1520 WEST APACHE TRAIL. 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 Arizona Department of Liquor Licenses and Control. 7 APPLICATION FOR A NEW LICENSE, LIMITED LIABILITY CO., SERIES 12 LIQUOR LICENSE FOR ELVIRA'S MEXICAN RESTAURANT LOCATED AT 1520 WEST APACHE TRAIL. 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 the Arizona Department of Liquor Licenses and Control. 8 RESOLUTION NO. 12-06, RECOMMENDING THE EXPANSION OF THE APACHE JUNCTION FIRE DISTRICT BOUNDARIES TO ALLOW THE APACHE JUNCTION FIRE DISTRICT TO PROVIDE FIRE PROTECTION SERVICES Ta- EL DORADO MOBILE HOME ESTATES LOCATED AT 202 N MERIDIAN ROAD, MARICOPA COUNTY,APACHE JUNCTION, ARIZONA. This resolution would allow expansion of Apache Junction Fire District boundaries to include 202 N Meridian(El Dorado Mobile Home Estates) This action is authorized by A R S Title 8-462 Deputy Fire Chief Dave Montgomery will be present to discuss this request. 9 PROPOSED RESOLUTION NO. 12-07, AUTHORIZING THE CITY TO ENTER INTO THE PHOENIX METRO HEALTH BENEFIT POOL The City of Apache Junction has been actively pursuing alternatives to combat the escalating costs associated with health care benefits to the City and its employees After months of research on several options,staff feels the best option is to Join the newly formed Phoenix Metro Health Benefits Pool The cities of Avondale, El Mirage and Youngtown are also committed. This item was discussed by city council at the Work Session on March 5,2012. t 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. 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 None K. COUNCIL DIRECTION TO STAFF. This item allows the Mayor and City Council to direct staff on specifically listed matters 10. COUNCIL DIRECTION TO STAFF ON THE TRAIL OF FLAGS CONCEPT IN DOWNTOWN. Staff seeks direction on the frequency and maintenance/replacement options of flags for the new concept for the Trail of Flags at the NW corner or Apache Trail and North Apache Trail After direction is provided,staff will prepare a resolution for council's consideration 11. COUNCIL DIRECTION TO STAFF ON PUBLIC ART FOR THE OLD WEST HIGHWAY MEDIAN ENHANCEMENT PROJECT, Staff seeks direction on the public art alternatives for the Old West Highway pedestals. L SELECTION OF MEETING DATES, TIMES, LOCATIONS, AND PURPOSES: 12 EXECUTIVE SESSION AT 5.45 P.M. AND WORK SESSION AT 7:00 P.M. FOR MONDAY, MARCH 19, 2012. 13. EXECUTIVE SESSION AT 5.45 P M. FOR TUESDAY, MARCH 20,2012.OTHER MEETINGS IF NECESSARY. Pet 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 E Ja All speakers must have already submitted a )n"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. „o , 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 Thursdays, 7 OOa—6 OOp, excluding holidays If any person with a disability needs any type of accommodation,please notify the Human Resources Office,at (480)474-2617 or(480) 983-0095(TDD)at least 72 hours prior to the scheduled time ON CITY COUNCIL REGULAR MEETING FEBRUARY 21, 2012 The regular meeting of the City Council of the City of Apache Junction, Arizona, was held on February 21, 2012, at the Apache Junction City Council Chambers pursuant to the notice required by law. CALL TO ORDER Mayor Insalaco called the meeting to order at 7 : 03 p.m. INVOCATION Councilmember Wilson gave the Invocation. PLEDGE OF ALLEGIANCE Councilmember Serdy led the Pledge of Allegiance . ROLL CALL Councilmembers Present: Mayor Insalaco Vice Mayor Dietz Councilmember Barker Councilmember Serdy Councilmember Smithson Councilmember Wilson /, (There is one vacancy on the council . ) Staff Present: City Manager George Hoffman Assistant City Manager Bryant Powell City Clerk Kathleen Connelly City Attorney Joel Stern Public Safety Director Jerald Monahan Parks and Recreation Director Jeff Bell Development Services Director Brad Steinke Others Present. Senior Planner Rudy Esquivias REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 1 OF 50 emN Senior Project Engineer Emile Schmid Parks Superintendent Nick Blake Revenue Resources Manager Roger Hacker Business Advocate Janine Solley Community Resource Unit Coordinator Constance Halonen ACCEPTANCE OF CONSENT AGENDA Vice Mayor Dietz MOVED emS THAT THE CONSENT AGENDA BE ACCEPTED AS PRESENTED. Councilmember Barker SECONDED THE MOTION. VOTE: Unanimous. The motion carried. ANNOUNCEMENT OF CURRENT EVENTS Councilmember Barker reminded everyone of the Lost Dutchman' s Day Parade, Lost Dutchman Days Weekend and the Get Ready for Teddy event schedule. Councilmember Serdy commented what is cool is that it was all done through donations . No city money was used. Mayor Insalaco announced a week ago from Saturday night he attended the arena downtown to hear the Mormon Tabernacle Choir. AWARDS, PRESENTATIONS AND PROCLAMATIONS Revenue Resources Manager Roger Hacker and Friends of Apache Junction Secretary Laura Dean-Lytle invited the council to the Bad Cactus Brass Band concert to be held on March 10 to benefit the parks and recreation department. The Jazz Laboratory from the high school will also be performing at the concert. A short video from a television program was shown with the Bad Cactus Brass Band performing. Mayor Insalaco commented that this past weekend the weather was beautiful for the Lost Dutchman Marathon. He started all the races except for the full marathon. Former Councilmember REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 2 OF 50 OIN Coleman and Pinal County Supervisor Bryan Martyn participated in the marathon. CITY MANAGER' S REPORT None. PUBLIC HEARINGS APPLICATION FOR AN INTERIM PERMIT, NEW LICENSE, LIMITED LIABILITY CO. , SERIES 12 LIQUOR LICENSE FOR SUNDANCE RESTAURANT City Clerk Kathleen Connelly briefed the council on the item. Mayor Insalaco requested the applicant address the council. Ms. Beverly Keller addressed the council. Mayor Insalaco asked if this is a new license she is applying for Ms . Beverly Keller stated it is . Mayor Insalaco opened the public hearing on the item There being no one wishing to speak, he closed the public hearing and reopened the item to council discussion. There being no further discussion, he called for a motion. Councilmember Barker MOVED THAT THE APPLICATION FOR AN INTERIM PERMIT, NEW LICENSE, LIMITED LIABILITY CO. , SERIES 12 LIQUOR LICENSE FOR SUNDANCE RESTAURANT, SUBMITTED BY BEVERLY JEAN KELLER, BE RECOMMENDED FOR APPROVAL TO THE ARIZONA DEPARTMENT OF LIQUOR LICENSES AND CONTROL. Vice Mayor Dietz SECONDED THE MOTION . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 3 OF 50 Omok VOTE: Unanimous . The motion carried. ORDINANCE NO. 1379, CASE PZ-1-11, PLANNED DEVELOPMENT MAJOR AMENDMENT BY PATHFINDER TRF THREE LLC AND ADAMS CONSTRUCTION COMPANY, REPRESENTED BY BEUS GILBERT PLLC, /S AMENDING THE DEVELOPMENT PLAN FOR "THE VILLAS AT SUPERSTITION MOUNTAIN PHASE 2"/RESOLUTION NO. 12-03, CASE SD-1-11, PROPOSING A NEW PRELIMINARY PLAT TO AMEND AND RESUBDIVIDE "THE VILLAS AT SUPERSTITION MOUNTAINS PHASE 2" UNDER THE NEW NAME OF "APACHE JUNCTION TOWNHOMES"/RESOLUTION NO. 12-04, PRESENTING FOR APPROVAL THE FINAL SUBDIVISION PLAT FOR "APACHE JUNCTION TOWNHOMES" BY ADAMS CONSTRUCTION COMPANY, BUILDER AND PROPERTY MANAGER Senior Planner Rudy Esquivias briefed the council on the item. Vice Mayor Dietz asked if all the documentation still missing will stop them from voting on the issue tonight . Senior Planner Rudy Esquivias stated it does not . The applicants want to have their /'1 administrative approvals done tonight and we can do that tonight. Until these last few items trickle in they cannot record the plat. He continued with his briefing. Vice Mayor Dietz asked if the street lights on Idaho and Plaza will be done through a street lighting district and if the cost will be divided up between all the units and paid off. Senior Planner Rudy Esquivias requested Emile Schmid answer those questions . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 4 OF 50 Senior Project Engineer Emile Schmid asked about Phase 3 . Senior Planner Rudy Esquivias stated they have not done the development plan yet for Phase 3 . Senior Project Engineer Emile Schmid asked if they purchased that property. Senior Planner Rudy Esquivias stated he was not sure if they did. They can answer that when they speak. It was part of the previous ownership group. He is not sure if these people absorbed that section. He has not seen a change of plan for that particular site so he does not have an answer to that question. Vice Mayor Dietz asked who would be responsible if the neighboring property values do drop. City Attorney Joel Stern stated Proposition 207, which is now part of a statute, actually exempts out payments to adjoining property owners . It is not the effect to the adjoining property owners . It is the effect, if they pass a law or regulation, of how that law or regulation affects this particular development and not adjoining property owners . Vice Mayor Dietz asked about the property valuation coming into play with the other property owners . — City Attorney Joel Stern commented they would probably say because affordable housing is being put in next to them their property value has come down. That is not part of the statute. It is how the regulation or act or action taken by the city council would affect this particular development and if their property value would go down. Councilmember Smithson commented page two indicates the internal streets will be constructed much like public streets but they will not be as REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 5 OF 50 wide . He is not sure what much like means He asked if the amount of subbase and base would be the same . Senior Planner Rudy Esquivias stated that is correct . The construction of the street itself, insofar as the cross section, is according to our street standards, the width of the internal streets do not meet our public street standards . Senior Project Engineer Emile Schmid stated he could now answer the question on the street light district . In the past the city has set up street light districts in order to recoup the cost of running or maintaining the street lights . We are one of the few municipalities left in the state doing that . Over the last 5 to 10 years it has been hit and miss with the street light districts Some have them, some do not . There is a question as to the process of setting up a street light district that they have been working out internally with city staff. The question was if this project would require a street light district to be set up. He does not have the answer right now. They would have to consider the cost of three street lights on Plaza Drive and if they would be able to offset the cost of setting up a street light district, including the legal documents and processes in setting that up and how long it would take to recoup the costs . It might not be worth it for three street lights . If it were 30 street lights, it might be a different story. Vice Mayor Dietz asked if there were street lights on Idaho . Senior Project Engineer Emile '"` Schmid stated he could not recall off the top of his head. They might have been installed with the original project 7-9 years ago, but he is not aware of a street light district set up for those. He does not know if they could include these three new ones in that district. Vice Mayor Dietz commented the city would be absorbing the cost for the electricity for these street lights . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 6 OF 50 ` � AZCHH DABDUCTIONRESPONSET EAM AZ CART he Pur . o e A ? To create a pool of specialized investigators and civilians which are available to focus investigative efforts with regard to cases involving missing or abducted children . 4} " r' AZCHILDABDUCTIONRESPONSE E AZ CART History April 2009, 8 year-old girl "missing" after failing to return home from school . Gilbert Police investigate Seven hours into investigation, girl knocks on door of residence near neighborhood . Girl states she was abducted Girl later admits it was a hoax because parents grounded her for stealing candy. � AZCH!LDABDUCTIONRESPONSETEAM AZ cnIr 0.1110.11 S t o ry What did we learn ? Observed deficiencies : > scene management response protocols for patrol and investigators i AZCHILDABDUCTIONRESPONSETEAM __. AZ CART History March 4, 2010 proposed AZCART to Gilbert command staff. May 19, 2010 presented to East Valley Police Chiefs. July 8, 2010 first official meeting with other agencies. September 12- 16 2010 training on how to build a ) CART team . October 25-26 became 17th certified CART team nationally. AZ�HILDABDUCTIONRESPONSETN'.nM Who can use AZCART? AZCART is designed to aid all agencies. An agency DOES NOT need to be a AZCART participant to use the team . Response time and number of > investigators / civilians will vary depending on location �° � AZCHILDABDUC AZ CAR- • • r-Agency Approach Shared personnel resources and equipment. Provides expert resources to increase organized investigative efforts. Assures the victim's family and community that all � resources are used for the successful recovery of the child . 4� AZCHILDABDUCTIONRESPONSETEAM uCRe- l CATMalntéñance Members will attend and participate in quarterly team meetings and training concerning missing and abducted children . Will encourage department-wide training for all agency members from command staff to � communications. `'' "' AZCHILDABDUCTtONRESPONSETFA 1411 AZ CART NC ' E Stats The following statistics are from a one year study: 797,500 children reported missing 203,900 children abducted by family members 58,200 children abducted by non-family 115 children abducted by a stranger "' AZCHILDABDUCTIONRESPONSFTE AZ CART Hour indow H . i , • g will my detectives be gone assisting another agency? AZCART response to an agency assist may be up to 72 hours . FBI and Team Adam should be on scene j AZCNiLnAsnUc1 ioNREsPoNsE'I'En AZCART A gencies Apache Junction PD Mesa Police Dept Chandler Police Paradise Valley PD FBI Phoenix Police Gilbert Police Dept PCSO Glendale Police Dept Scottsdale Police Dept Town of Maricopa PD Tempe Police Dept Maricopa County US Dept of Justice Attorneys Office AZCHIDABDUCTIONRESPONST1AM E AZ CART LETS BE REALISTIC . . . AZCART CONCEPT ) To provide a large team of investigators / civilians and their resources to an agency in the quickest time possible. TIME SENSITIVE INVESTIGATION (According to the 2006 Rob McKenna / Washington study) When an abducted child is killed by a "non-family" killers Percent killed Time 46.8% < 1 hour ) 76.2% Within 3 hours 88.5% Within 24 hours 97.9% Within 7 days 100% Within 30 days ,... - 111.111W Illik:N: i 4001 AZCHILDABDUCTI ONRESPON S ET ILA M AZ CART -....10, T he next step for AZCART . . . .Build regional teams .t.........,.., , 14. • , IOW 064e, CD ) AZCART- West Valley C440,41 • prise 4114r 411 El Mirage $ Peoria la/ 7- Hills tam Litchfield Glendal- ---- ,---- • . I Pan( Park Scottsdale ,..0..... Goodyear "rciieson P enix Apache .,. Avondale Tempe Mesa Junction . Ickeye Guadalupe Gilbert 0 C.:3 \ ) GolO ,, e Chandler Canyon Ii , Queen \\ Creek Sun Lakes San Tan Valley AZCART —East Valley 111111Mmis4 0 Saca*oci ., - icape Bleciewater Florence ..".... 4n Coolidge .... orlitai*mot , illrwill Senior Project Engineer Emile Schmid stated that is an option they are looking at . They are weighing out the pros and cons of that option. Vice Mayor Dietz commented they are voting on this tonight . It is probably something that they should have had. They should have had information on it or knew what was going on with it . illgik Mayor Insalaco requested the applicant address the council . Mr. Paul Gilbert, 4800 N. Scottsdale Road, Scottsdale, addressed the council . He is here on behalf of the applicant . He advised that Mr. Adams, chairman of Adams Construction, was in attendance . He has a lot of experience and is the former head of the Utah Housing Authority. He has a lot of experience with the type of unit we are presenting this evening. This company has a broad base of experience in both Arizona and Utah. Staff has done a good job of outlining the request so he will not go into that . He feels it is important to focus on the zoning that is already there, which is CR-5/PD. They are not changing that; it is the same zoning. The only thing they are doing tonight is reducing the density. It would not set well for his career to lose a case where he comes in and actually reduces the density They are asking for 88 patio homes; the property is already zoned for 197 units . They are not stopping there. They are also reducing the height . Currently two story units are proposed on this property. They are reducing it to one story. They are providing 3 and 4 bedrooms, 2 baths and 2 car attached garage units . He wanted them to focus on that . They will be talking about quality this evening. This is a nice indication of that . They are actually providing 2 car garages for every single unit . He submits they will find very few units, let alone low income housing units, that provide 2 car garages for every unit . Even though these units are duplex, the only place where they have a common wall is the garage itself They can again see the kind of quality they are talking about . They are also providing a lot of amenities on site. They will have a pool area and clubhouse, playground, picnic tables, basketball court and staff has requested that a tot lot be provided and they have done that . To illustrate the extent of how they have tried to REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 7 OF 50 cooperate with Apache Junction, he does not know of a single request that city staff has made that has not been honored. Every change they have been asked to make they have made. They agree with all of the stipulations, including the new stipulations that were added as a result of their very informative and helpful work study session. Their goal, as it is in all of their projects, is to provide an attractive, affordably-priced and healthy living environment . This project will do that . The interesting thing about this project, which ..."N. is very novel, and underscores their confidence in the quality of the project and insures that this is going to be a quality project, is that they are going to allow their future tenants an opportunity to purchase this home . After 15 years, any one of their tenants can purchase this home. That in and of itself is no big shake, but what is the big shake is that they will get a credit towards the purchase price for every single dollar they have spent in rent . If they want to buy their unit at the end of 15 years, they get a credit towards the purchase price of every single dollar they have spent in rent . That is quite a commitment and what an opportunity for the citizens of Apache Junction. This project is roughly a $15, 000, 000 project . If tax credits are awarded, which they have not been as of yet, as one of the conditions of the process is that they have to meet with the council and have this fully entitled as they go into the process If they receive the tax credits, then 70% to 80% of the project will be covered by the tax credits and they will have a permanent loan to cover the remaining percentage. Every year Adams places money into a capital replacement account to cover long term maintenance and repair and capital replacement . The important thing is that this is not a built it and spin it project . This company builds, owns and manages their units . They are not in the business of turning it over to someone else once it is entitled. They build them, they manage them, and they continue to own them unless the tenants, after 15 years, exercise the option they will have to purchase the unit . They have the approval of the planning commission. The vote was 6-1 . He asked the one person who voted against them post-hearing why she voted against them as she seemed to be so positive during the course of the hearing. Her concern was that they did not have separate yards designated for the units . That seemed to be a concern of the council at the study session. They changed that . They have complied with her concern and reciprocally the council concern as well . He is confident in saying that in REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 8 OF 50 effect they have unanimous approval of the planning commission as they corrected the one concern she had. They are not only here in the posture of a recommendation of approval from the planning commission, but from staff as well . Usually you have to envision what the project looks like. They have built the very same project in Arizona. They invited Rudy and another member of city staff to go up and visit the project in northern Arizona. It is built . This is a very close replication of that /► project . Rudy went up and investigated the project and he thinks they liked what they saw. At the planning commission hearing Rudy indicated they were quite impressed with the project . They had a neighborhood meeting with the project to the north and several of the people informed them that they went up and looked at the project and liked what they saw. They stood up at the homeowner' s meeting and stated they liked what they saw. When city staff was at the similar project they knocked on doors, asked residents if they enjoyed living there and if the developer does what he says he will do and they received a very positive response. They are in agreement with all of the staff stipulations . They met with the police chief immediately after the hearing and agreed to do what he asked them to do. It is incorporated into the new stipulations . They have added the rear yards and the individual lots will be enclosed with a six foot cinder block wall . He received a letter from the city attorney asking what they could do in the CC&Rs to incorporate some of the provisions of the lease. They gave him a letter on all of the provisions of the lease that they could incorporate into the CC&Rs . They could not do all of them, but the main points of the lease are committed to the CC&Rs . He believes they have done everything they have been asked to do under the guidelines they have been given. They are Ask careful about who they let come into the units . There is a perception that whoever develops low income housing has to take whoever comes and knocks on the door They believe that is what the government requires . That is not true. This is not Section 8 housing. They are not mandated, even after accepting tax credits, to accept anyone that comes in. They have a full background check done, which includes previous bankruptcy and criminal history, and anything in the background that makes them uncomfortable keeps them from renting any property to those individuals . They have a resident screening company that is expert on this and screens very carefully. They have an onsite manager who lives onsite . They also have an assistant manager REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 9 OF 50 and video surveillance throughout the property. They have full time maintenance and landscape personnel to maintain the quality. This company has built and manages over 900 units . They have a good track record of doing what they say. One of the concerns that came up at the planning and zoning commission hearing and at the council work session was crime. They went to several police chiefs in communities where they have projects and copies of their letters indicating crime is not a problem have been provided They even responded that they like the r. maintenance of the units . He then showed them pictures of some of their units in Hurricane Hills and Cedar City, Utah, and Katherine Heights in Arizona. He promised that if they approve this project and the company receives the tax credits, the council will be very proud of this project. Vice Mayor Dietz asked if that is a maintenance shed in Tract B, as one drawing shows one there and another does not . Mr. Paul Gilbert stated they are putting a maintenance shed there. Vice Mayor Dietz asked if the drainage section in Tract C will have riprap in it or will it just be desert . Mr. Paul Gilbert stated it will have riprap. Mr. Dennis Newcomb, 4800 N. Scottsdale, Scottsdale, commented the one map was the preliminary plat and this is the final plat. This shows a future maintenance building that might have to be put in to store things on site. Vice Mayor Dietz asked if the maintenance building will be made to look like the other units . Mr. Paul Gilbert stated that is correct. Vice Mayor Dietz commented it will be very attractive and not be a metal building. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 10 OF 50 Councilmember Serdy commented he attended the meeting at Quail Creek. He asked if they were able to make contact with residents of Husky Hollow and Chaparral . Mr. Paul Gilbert stated they attempted to but they never made contact . i► Councilmember Serdy commented they had the same concerns, mostly about children overstepping and causing problems in the neighborhood. Mr. Paul Gilbert commented that is correct . There will probably be fewer children in this development than the current approved plan. The current approved plan as double the density. Secondly, they are providing more amenities than the current approved plan. There is no reason for children to leave our facility and go into some of these other facilities . We have better amenities than they do or at least equal to what they are proposing. Plus the city library and city facilities are across the street . They do not foresee them as a problem. Councilmember Serdy commented he thought they were projecting that the maximum amount of children in it would have been quite large but there will be a lot of single families living here as well . Mr. Paul Gilbert stated that is correct. Mayor Insalaco commented this is all ages, too. Mr. Paul Gilbert stated that is correct . Councilmember Barker commented it appears that this entire project is predicated upon getting that tax credit . She asked if that is correct . Mr . Paul Gilbert stated that is correct . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 11 OF 50 Councilmember Barker asked if this project is out the window if the council passed this whole thing and they did not get the tax credit . Mr. Paul Gilbert stated that might be a little strong. They could still consider doing the project, but without the tax credits, as it is now designed and envisioned, it is not likely to come to fruition. They really need the tax credits in order for it to work ,^ Councilmember Barker asked what the likelihood is of their getting the tax credits . Mr. Paul Gilbert stated they are very experienced working in this field. The chairman, Mr. Adams, has a broad range of experience both in Arizona and Utah. They know what needs to be done and the type of project that will qualify. They would not have spent the considerable amount of time and money, including all the engineering expenses of doing a final plat, if they did not have a very high level of confidence that the tax credits would be awarded. They feel pretty good about it, but they cannot represent to them that it is 100% sure because that is another administrative body that has to review it and make its decision. The council can help them to achieve that goal by passing this tonight . They will then write the city a letter inviting the city to make comments on the project . Vice Mayor Dietz asked if all of the properties they have done in Arizona and Utah been done with federal tax credits . Mr. Paul Gilbert stated that is correct . Vice Mayor Dietz asked if they are all low income. Mr. Paul Gilbert stated that is correct. Vice Mayor Dietz commented that is all they have built . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 12 OF 50 Mr. Paul Gilbert stated that is correct . It is a lot of units to have built all with tax credit funds . Councilmember Smithson stated he is quite impressed with the concept of selling the units to the renters after 15 years for what they have paid in. He could not see it in the agreement and asked them to show him where it /"1 is . He could not see that labeled or specified. Mr. Paul Gilbert stated that will be put in as a provision in the CC&Rs. He does not think there has been anything submitted to the city that has it except for putting it on the record here and committing to do that. That is their purpose and they have said it at every meeting and they intend to do that . Councilmember Smithson asked if there is a stipulation that covers that Mr. Paul Gilbert stated there is not. Councilmember Smithson stated if they have made a presentation that is a major provision, which he thinks is fantastic, then he would like to see a stipulation added that it will be included and it will be required. Mr. Paul Gilbert stated they are not afraid of that because that is what they intend to do. Councilmember Smithson stated that will help Mr. Paul Gilbert stated they think it is a great idea. It will help increase the quality of people that will come. They want to do it and they are looking forward to it. Mayor Insalaco commented they talked about the restrictions there would be for people moving in there. When he went through it, he could probably buy a REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 13 OF 50 cruise line or 747 and get away a lot easier. That is what impresses him; they are sticking to their word on how well these will be kept . He then opened the public hearing on the items . Ms . Donna Marquardt, 1770 N. Valley Drive #59, Apache Junction, asked what would be the process if this is approved by the council and the low income housing gets built The council is aware that they have an issue with the development that they are in. She asked how people would get information on this development and how they could apply to be a resident . Mayor Insalaco commented when this portion is through they will ask them. Mr. Elliott Fisher, 547 E. Quail, Apache Junction, stated it is a great project many years too late. He added if council would have approved this back in 1993 when he was advocating for it and more diversity in Apache Junction, maybe there would not be houses all over Apache Junction sitting empty and foreclosed. He is concerned about the timing with the stock of foreclosed housing in the 10-year- old developments He also hoped they would be doing it on the sewer system for environmental He believed no lighting would be an issue . The Gila River Indian Reservation is using solar street lighting that requires no lighting, just pedestals . It may not be as good as powered street lights but it might be an option. They need to memorialize the selling of the properties in the contract . He is also worried about who will be setting the price when the property comes up for sale. It could be an issue. The seller could raise the price to whatever they want . It could become cost prohibitive for the people who have been paying rent all these years . Mayor Insalaco closed the public hearing with no one else wishing to speak. He asked the city attorney if he could ask a question of the applicant . City Attorney Joel Stern stated he could reopen it for the applicant to come forward and answer questions . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 14 OF 50 Mayor Insalaco asked how people will know about this . Mr. Paul Gilbert stated they advertise and market the property just as any other developer would do. They have a waiting list for every one of their projects . They have never had trouble filling them. It is the least of their worries . If they can get underway, they will be rm. very comfortable. A copy of their study has been given to them so that they know they are very earnest about this project . He wanted to readdress Councilmember Smithson' s question. His clients have agreed to put a stipulation in our tax credit application committing them to selling the units after the fifteenth year. That is a commitment They will not qualify for the tax credits if they do not get it . That is pretty airtight . Councilmember Smithson suggested they include a stipulation requiring that in the ordinance . The city will be requiring it and it will also be required in their documents . Mr. Paul Gilbert stated that is fine . They are in agreement with that . Another concern was the timing of the project . Not everything can go as it should as there may be some hang ups here and there . He does not believe there will be any hang ups in Apache Junction from what he has seen. The staff has been great to work with and they have moved things along. Having the preliminary plat and the final plat on the same agenda is a real tribute to how well the staff has worked with them. Assuming things go on schedule and they get through the tax credit approval process in a timely manner, their goal is to start construction in September or October of this year and they hope to be complete by May of next year. They are excited to move forward There was a good question on how the price will be determined on these units after 15 years . Their credit for their rent could be illusory if we simply raise the price of the home by the same price they paid for the rent . As explained at the planning commission hearing, after 15 years they will contract an independent, bonafide appraisal as to the price of the house . That will set the price of what they sell it for. It is not something they can manipulate and try to get back what they have promised by REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 15 OF 50 rr giving full credit for the rent . Regarding the lighting, if they want them to do a street light district, they are happy to do that . Whatever the city wants them to do, they will do. They will abide by what the city tells them to do. They are familiar with street light districts; other communities are pushing for more and more of that in his practice. They will have surveillance cameras throughout the project . The interior streets will be safe and completely lit . r City Attorney Joel Stern stated he probably should reopen it for the public. Mayor Insalaco opened the public hearing on the items . There being no one wishing to speak, he closed the public hearing and reopened the items to council discussion. Councilmember Smithson stated he is very impressed with the project, especially with them reducing the density. He has been in city government for 40 years and he cannot remember anyone coming in and reducing their density before . He pointed out the city council probably would have approved this a long time ago, as someone suggested we should have, if it had been submitted to us . They have to wait until someone submits an application before they can approve it Mayor Insalaco closed the discussion with no further comments and called for a motion. Councilmember Barker MOVED THAT ORDINANCE NO. 1379 BE READ BY TITLE ONLY AND THE READING OF THE ENTIRE ORDINANCE BE WAIVED. p Vice Mayor Dietz SECONDED THE MOTION. VOTE: Unanimous . The motion carried. City Clerk Kathleen Connelly read the ordinance by title only. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 16 OF 50 ON Councilmember Barker MOVED THAT ORDINANCE NO. 1379, AS READ BY THE CITY CLERK, BE APPROVED AND ADOPTED WITH THE FOLLOWING AMENDMENTS: THAT, INCLUDED IN THE CONDITIONS WITHIN THE ORDINANCE WOULD BE NUMBER NINE, THE MANAGERS, OWNERS, OPERATORS AND/OR HOMEOWNERS ASSOCIATION OF APACHE JUNCTION TOWNHOMES SHALL COORDINATE WITH THE CITY' S POLICE DEPARTMENT AND CONTINUALLY PARTICIPATE IN LOCAL, CRIME- FREE, MULTI-FAMILY HOUSING PROGRAMS, NEIGHBORHOOD WATCH PROGRAMS OR SIMILAR PROGRAMS, TEN, THE PRIVATE REAR YARDS OF THE INDIVIDUAL HOME LOTS SHALL BE ENCLOSED WITH SIX FOOT CINDER BLOCK WALL, ELEVEN, THE LEASE AGREEMENTS WITH THE RENTERS OF APACHE JUNCTION TOWNHOMES SHALL INCORPORATE THE SAME TYPE OF LANGUAGE AS THE LEASE AGREEMENTS FOR THE KATHERINE HEIGHTS DEVELOPMENT SUBMITTED WITH CASE PZ-3-11 INSOFAR AS STRICT RULES FOR MAINTAINING A QUALITY DEVELOPMENT AND A SAFE, CLEAN CRIME- FREE NEIGHBORHOOD, TWELVE, THE SALES AGREEMENTS AND CONDITIONS, COVENANTS AND RESTRICTIONS FOR EVENTUAL PURCHASERS OF APACHE JUNCTION TOWNHOMES HOMES AND LOTS SHALL INCORPORATE THE SAME TYPE OF LANGUAGE AS THE LEASE AGREEMENTS FOR APACHE JUNCTION TOWNHOMES AS ALLOWED BY LAW INSOFAR AS STRICT RULES FOR MAINTAINING A QUALITY DEVELOPMENT AND A SAFE, CLEAN CRIME-FREE NEIGHBORHOOD, AND THIRTEEN, THAT THE RENTERS WHO CHOOSE TO BUY THEIR UNITS AT THE END OF THE 15 YEAR PERIOD WILL RECEIVE CREDIT FOR THE RENT THEY HAVE PAID AND THE STIPULATION TO SUCH BE ADDED TO THE RENTAL AGREEMENT. Councilmember Smithson SECONDED THE MOTION. VOTE: Unanimous The motion carried. Vice Mayor Dietz MOVED THAT RESOLUTION NO. 12-03, A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, AMENDING THE FINAL SUBDIVISION PLAT FOR "THE VILLAS AT SUPERSTITION MOUNTAIN PHASE 2", BY APPROVING A NEW PRELIMINARY SUBDIVISION PLAT, PROPOSING TO RENAME AND RE-PLAT THE FORMER SUBDIVISION UNDER THE NEW NAME "APACHE JUNCTION TOWNHOMES", IN CASE SD-1-11, AS REQUESTED BY PATHFINDER TRF THREE LLC AND ADAMS CONSTRUCTION COMPANY, REPRESENTED BY BEUS GILBERT PLLC, BE APPROVED. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 17 OF 50 Councilmember Barker SECONDED THE MOTION. VOTE: Unanimous . The motion carried. Councilmember Barker MOVED THAT RESOLUTION NO. 12-04, A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, APPROVING A FINAL SUBDIVISION PLAT FOR "APACHE JUNCTION TOWNHOMES", IN CASE SD-1-11, BY PATHFINDER TRF THREE LLC AND ADAMS CONSTRUCTION COMPANY, REPRESENTED BY BEUS GILBERT PLLC, BE APPROVED. Councilmember Smithson SECONDED THE MOTION. VOTE: Unanimous . The motion carried. Mr. Paul Gilbert asked for a point of order. Mayor Insalaco granted the point of order. Mr. Paul Gilbert stated the city will be receiving a letter from the State of Arizona Low Income Housing Credit Program. He will leave a copy of this with the city manager. The letter needs to be filled out and returned prior to March 1, 2012 . It is cutting it very close, but they would appreciate it if they would fill it out and make sure it gets turned in. Mayor Insalaco stated they would do so . OLD BUSINESS QUARTERLY UPDATE ON DOWNTOWN REDEVELOPMENT AND IMPLEMENTATION STRATEGY REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 18 OF 50 . Assistant City Manager Bryant Powell gave a brief presentation on the Downtown Redevelopment and Implementation Strategy. He included pictures of before and after redevelopment projects . Parks Superintendent Nick Blake gave a briefing on the new Trail of Flags for the national flag, state flag, and armed forces flags project at the .•. intersection of Apache Trail and Phelps Drive. It will be across from the focal point . Photographs and development plans of the ongoing project were provided. During the discussion the mayor stated that he had turned in a check for $2, 500 from VFW Post 9399 and he has a commitment from the American Legion for $2, 500 and Dave Waldron is working with VFW Post 7968 for another $2, 500 that should also cover most expenses . Mayor Insalaco commented he has also talked to some of the auxiliary organizations of the clubs to keep the city supplied with flags There will be basically no cost to the city. The flags will fly all year long except from June through August because of the monsoons . They will be put up for Flag Day and Fourth of July. Parks Superintendent Nick Blake stated one good monsoon will destroy the flags . Councilmember Serdy asked if he had drawn up the design Parks Superintendent Nick Blake stated he did. Councilmember Serdy commented it is good they did not go out of house . He likes it when they do it all in house. Assistant City Manager Bryant Powell stated they will be back in two weeks for direction to staff. Mayor Insalaco closed the item. This was a discussion item only with no action at this time. He called for a brief break. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 19 OF 50 A Mayor Insalaco reconvened the meeting. MEDIAN ENHANCEMENT PUBLIC ART PROJECT ON OLD WEST HIGHWAY AND OVERVIEW OF ALTERNATIVES FOR PUBLIC ART IN THE DOWNTOWN Business Advocate Janine Solley briefed the council on the item. p Councilmember Serdy commented he would like to see the Focal Point and Tourism Committee do what they did with the Trail of Flags . They raised that $8, 000 very quickly. He thinks that group can get together and get the first piece purchased. He would like to not use the $10, 000 if they do not have to . There are lots of opportunities to go out for solicitation, just like the centennial group did. They do not have to get all three at once. They can just do them one at a time. Vice Mayor Dietz asked if they want to stay with this first one or look at some other options The first one was running about $10, 000 per piece Councilmember Serdy commented it appeared everyone liked the designs . He asked if they could cut costs anywhere . The artist himself came up with the material They could look at material changes . If the money can be raised they can do it with the quality proposed. Mayor Insalaco commented the material he proposed shows a light through it . It is almost like a neon sign. He does not know what other material would act that way. There was general discussion and the consensus was to go for the original option. Councilmember Barker asked if this will be a city project and, if so, what process do they go through to raise money. She asked what they need to do if it is a city project and they did not go out for this procurement correctly. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 20 OF 50 City Attorney Joel Stern stated it is up to them to determine if this is a city project . They have options . They can say it is a city project that is more long term than they wanted They can create an art commission. Others cities have done that That commission would be subject the open meeting law so staff resources would have to be used. They can pick and choose who they want the same way they do the planning and zoning commission members . They will probably have to amend the city code as there is no art commission set forth in the city code. If they do all that and the art commission proposed work to them, they would still have to procure the artwork if they are going to use city money. He does not mean donated money. It would be city coffer money from other sources They would have to comply with Article 3-7 which means it must be competitively bid. If they do that, then they can do the artwork. What happened in this case was we did not do it the exact way we should have under the city code procurement process Donations are gotten by asking for them. They can put it out on the city Internet and someone could say they want to donate $100 for this particular purpose. It would go into a special fund. It could be with the Friends of Apache Junction; they could also take the donations . It could be earmarked specifically for that purpose and could not be used for anything else. Business Advocate Janine Solley stated she researched some of the nearby communities to find out how they go through the procurement process . They utilize a process very similar to what we did, but because we were not sanctioned or appointed by the city council for the commission that we put together there was a glitch. They have ANNik art and/or culture commissions that they work with The process is sanctioned and therefore when they go out to bid, they do a call to the artists . They do not bid it out . That is how they procure their art . There are instances where they do direct purchases or artist selections, specific artist selection for services, a direct selection of the artist, direct purchase of existing artwork and instances like that where they enter into an artist contract . Typically if it is a concept or creation they will do the whole process of a call to the artists . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 21 OF 50 Councilmember Barker commented she thought she should bring up some points that have to be ironed out before any decision can be made Business Advocate Janine Solley stated if we use our current bid process that we go through we will still have to answer the question of when we go out to bid who looks at those projects that are proposed when they come back. Typically in other communities the council does not see the public projects . There was one community where if it was $50, 000 or more the contract would have to go before the council for approval . Typically it stays at the level of the commission for a smaller community. They may choose to do that differently. They may want to see the art. It is up to them how they want to do that. Councilmember Smithson stated he did not say anything when it came up before because a lot of work had gone into it . He had been more towards an iron thing as being more compatible with what we have outside here and at the focal point . He is obviously in a great minority but he thought he would express that . Business Advocate Janine Solley stated that is a great point. They had that on the sheet as one of the options . Originally when they thought about the median it was to use iron. The mixed design he did some time ago. When the Downtown Redevelopment and Implementation Strategy came out and it said to engage the community and involve them in the process, that is when the city reached out to the Superstition Area Cultural Alliance and said they should not narrow the concept to just iron. There might be other great alternatives out there. Mayor Insalaco commented they might be able to get all three pedestals done for the price of one. Business Advocate Janine Solley stated that would be a policy decision. Councilmember Serdy commented if they are all donated like the focal point and the Lost REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 22 OF 50 Dutchman, if they fall into our lap, we do not have to do any of this . Councilmember Smithson stated they would have to accept it. Councilmember Serdy commented they did not have to form that group to get the burro and the Dutchman outside. City Attorney Joel Stern stated that was a generous donation from the Superstition Mall owner through a communication to the city manager' s office. Councilmember Serdy asked if there is some way to look at just having these things donated. City Attorney Joel Stern stated they could. Councilmember Serdy asked if they could to it without having to involve all the staff, having them attend all these meetings and posting things. City Attorney Joel Stern stated there is still a staff effort to get the donations, but the answer is yes. Councilmember Barker asked if he knew where these things are. Councilmember Serdy commented they have not been built yet. Mayor Insalaco asked if she needed anything else . Business Advocate Janine Solley stated she will be back in a couple of weeks for direction. City Manager George Hoffman stated tonight' s objective was to get them thinking about it. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 23 OF 50 They will be back in a couple of weeks for them to tell staff what they want to do. Mayor Insalaco closed the item. This was a discussion item only with no action at this time and he moved on to the next item. NEW BUSINESS None . COUNCIL DIRECTION TO STAFF ACCEPTANCE OF RESIGNATION OF FORMER COUNCIL MEMBER DOUGLAS COLEMAN, DISCUSSION ON LEGAL REQUIREMENTS AND MANNER OF FILLING COUNCIL VACANCY CREATED BY THE RESIGNATION AND DIRECTION TO STAFF ON PROCEDURES FOR FILLING THE COUNCIL VACANCY City Clerk Kathleen Connelly briefed the council on the item. Vice Mayor Dietz asked how much time she would need to put the council vacancy packet together He would like to see a packet put together like they have for when someone runs for a council position. One has to come into the city clerk' s office, sign out for and receive a packet and it will have all the information that someone will need. City Clerk Kathleen Connelly stated if they give direction today, they would be sending that out to run in the local newspapers to appear next week. It would be run the week of February 27 . We would take the applications from February 27 through March 5 . Vice Mayor Dietz asked when they would begin accepting application packets City Clerk Kathleen Connelly stated they would not be available before next Monday Next REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 24 OF 50 Monday would be the earliest date and if they want to give a 10 day window they would go into the next week. Councilmember Barker commented she would rather give them a longer window then that . City Clerk Kathleen Connelly stated that is their choice . Councilmember Barker stated she would like the public to have the opportunity to see the press release, think about it and then come in and pick up a packet if they are interested. If we are going to require the talent bank application as well as the disclosure statement, the notarized affidavit plus written answers to questions, which she thinks should be there, it will take longer than a couple of days . People have other things to do, too. She would much prefer to see a 3 week or even a 30 day window. Vice Mayor Dietz commented he was just asking for a date on how much time Kathy needs to put a packet together. City Clerk Kathleen Connelly stated she was assuming they wanted it as quickly as possible because if they were to give direction tonight it would be very tight for my department to have everything ready by next Monday. Councilmember Barker commented they could go the following Monday. Ask City Clerk Kathleen Connelly commented if they went to the following week that would be good. Vice Mayor Dietz commented that would be March 5 . It would be received back by April 2; that would be a month. He asked if that is enough time. Councilmember Barker stated that works for her. Vice Mayor Dietz asked the city clerk if that was alright . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 25 OF 50 City Clerk Kathleen Connelly stated April 2 would be fine. The earliest they would be doing interviews would be April 16. Vice Mayor Dietz commented they would do it March 5 through April 2. He asked if that was good with the council. That is a full month that they would have the packet. They should be able to get everything notarized and answer the questions. Mayor Insalaco commented the interviews would be on a Monday night . City Clerk Kathleen Connelly stated that would be their choice. It is what they have done in the past. They would have the work session of April 16. Not knowing how many applicants they might have, they might not be able to do all the interviews the one night. Mayor Insalaco commented they might have to do some the following night. City Clerk Kathleen Connelly stated we have no way of knowing how many people might be interested. Vice Mayor Dietz asked if they wanted to do the appointing two weeks later. City Clerk Kathleen Connelly commented April 16 would be the interviews . If they do not want to appoint the next night they would be going until May 1 Vice Mayor Dietz asked if they wanted to do the appointment May 1 Councilmember Barker commented that would work. Councilmember Serdy commented the term would expire one year and one month after that. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 26 OF 50 Vice Mayor Dietz commented she would want to swear in the new person. Mayor Insalaco stated that would be done at the first meeting in May City Clerk Kathleen Connelly stated they would only be appointing the person that night . Vice Mayor Dietz asked if they wanted to swear him in as fast as possible. City Clerk Kathleen Connelly stated if they want it done that way they could Vice Mayor Dietz asked if she was talking about swearing him in privately. City Clerk Kathleen Connelly commented that would be if the sequence of events was different. If they did an appointment on May 1, they could also list on the agenda that the person be sworn in that same meeting. Vice Mayor Dietz commented that is a good idea. City Clerk Kathleen Connelly stated they could put it on like a dual agenda item. Vice Mayor Dietz asked if that sounded okay to everybody. Mayor Insalaco commented this way, whoever it is, has a couple of weeks to go through the orientation for the second meeting in May. They are getting close to budget time. He would like the person to know something of what is going on. He thinks a whole month for the packet is too long. He could see 2 or 3 weeks. This is getting them right down to budget time and they will be trying to bring on a new person. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 27 OF 50 "IN ems Councilmember Serdy commented he thinks they could do all the applications in one night. He does not see why they would have to go two nights. City Clerk Kathleen Connelly stated if it appears that they have 20 applicants it would be up to the city manager to shorten that work session agenda so that all they do is interviews. elS Councilmember Serdy commented they used to stay to midnight on cargo containers. Councilmember Barker asked how they would get them to Kathy if they want different questions or additional questions . City Clerk Kathleen Connelly stated the questions that she gave them, and some of them are very old questions, had already been pre-cleared by the city attorney If they have other questions they want to bring up, she suggested they run those first by the city attorney He will then need to get them to her so that she can include them in the packet. Vice Mayor Dietz commented these are not something you would need tonight. City Clerk Kathleen Connelly stated she does not need them tonight, but she will need them within the next couple of days so that she can start getting the packet together. eN Councilmember Barker asked if they are saying they want all these questions in the packet or can they talk about these questions and decide which ones they want or if they want any of them. Some of them are irrelevant . Vice Mayor Dietz commented he had 3 he would like to add. Councilmember Barker stated she would like to get rid of some. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 28 OF 50 /ml Vice Mayor Dietz stated some of them need to be gone. Councilmember Serdy commented they could limit their answers They do not have to write everything. City Clerk Kathleen Connelly /, stated some of the questions were requested to be answered in writing. The shorter list she gave them were answered verbally. There was general discussion as to which ones were verbal questions . City Clerk Kathleen Connelly stated they can go through each one of them and they can answer yes or no. Councilmember Barker stated some of them were written specifically for specific instances . City Clerk Kathleen Connelly stated they are not as broad as they could have been. Councilmember Barker agreed and added they are not open-ended at all. Vice Mayor Dietz asked about the first questions which asked the applicant to give examples of situations when one believes it is important to maintain confidentiality as a councilmember He asked if they should /°\ keep it or have it go. Mayor Insalaco commented he liked it. Vice Mayor Dietz commented he liked it to, so that is staying. The second one asked from a business point of view, what characteristics make for an efficiently run city government. Councilmember Barker stated she does not even understand that question. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 29 OF 50 emN City Clerk Kathleen Connelly stated she still has the binder from 2008 and she took a look at it today. That question caused a lot of confusion. Councilmember Barker stated she would like to scratch that. This is not a business. It is called a city. Vice Mayor Dietz stated the next one asked how you get cooperation from someone with whom you work. Mayor Insalaco commented they could take this question and the next one and almost put them together. Vice Mayor Dietz read the next question that asked to please share an example of a situation where your negotiation style worked to bring about a win-win situation. Councilmember Smithson stated he would take that one over the previous one There was general discussion with the consensus being to remove the one dealing with how one usually gets cooperation. Vice Mayor Dietz commented they have gotten rid of the second and third one. He stated the next question asked the applicant to show an example of a situation where your negotiation style worked to bring about a r'1 win-win situation. Mayor Insalaco stated he liked that one. Vice Mayor Dietz commented they will keep that one. The next one asked what processes the applicant used to problem solve. Councilmember Smithson stated that one would be very hard to answer. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 30 OF 50 City Clerk Kathleen Connelly stated that one also caused a lot of confusion. They could not figure it out . Councilmember Barker asked if they wanted an essay or what. She could do that in 5 paragraphs or so. OIN Councilmember Smithson stated they could also have answered that question in the previous one if they did a good job of it. Councilmember Barker agreed. Councilmember Smithson stated it they do not, they do not appoint them. Vice Mayor Dietz stated the next question asked if selected to fill the vacancy on the council, how would the applicant expect to impact the residents of our city He believed that one should stand. Councilmember Serdy commented that would give them a chance to elaborate on what they think they have to offer. Councilmember Smithson stated they could just ask them what they have to offer. Vice Mayor Dietz commented the next question asked when is it most difficult for the applicant to be attentive to or give consideration to another individual' s point of view. Councilmember Barker stated when you disagree with them. She asked what they do about it She thinks the question needs to be reworded. They can all name when it is most difficult but it is how they handle it. Councilmember Smithson agreed that is the question. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 31 OF 50 Councilmember Barker commented the question is what do you do. Vice Mayor Dietz asked if they should rewrite it . Councilmember Barker commented Joel is rewriting it. Vice Mayor Dietz stated they get rid of this one as it is . City Attorney Joel Stern confirmed that they wanted it to ask how they would handle that situation. Vice Mayor Dietz commented the next question asked in the applicant' s mind, what distinguishes a superior employee from an employee who gives a typical good performance. There was general discussion and the consensus was to get rid of that question. Councilmember Serdy commented the city manager is over the employees . Vice Mayor Dietz commented the next question asks what skills the applicant possesses that make them uniquely qualified to fill this vacancy. Councilmember Smithson stated eN he liked that one and to keep it. Mayor Insalaco agreed. Vice Mayor Dietz stated the last one asks the applicant to give examples of instances where the applicant believes they may use these skills as a councilmember. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 32 OF 50 Councilmember Barker asked what skills they are talking about, and then realized it meant the skills mentioned in the previous question. Councilmember Serdy commented they can blend that into one question. Councilmember Barker stated /, they could make it A and B. Councilmember Serdy stated it could give them the opportunity to be longwinded and he does not want to see that . Mayor Insalaco commented they could be essays as Councilmember Barker stated earlier. City Attorney Joel Stern stated they could have the questions and then limit the space to 3 or 4 lines in between to limit how much they can write. They can do that. That way they do not have to go on for 20 pages. Councilmember Barker commented what happens if they write very large. City Attorney Joel Stern stated they can have a disclaimer stating no more space will be allowed than what is provided. Vice Mayor Dietz commented they could limit it to 25 words . Councilmember Barker stated they cannot answer those questions in 25 words, even as precise as some of them are. She has a few she wants to pass by the city manager. Vice Mayor Dietz commented he has a few he is going to give to the city attorney. Councilmember Barker stated they are probably the same questions she has. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 33 OF 50 Vice Mayor Dietz commented they are pretty close. City Clerk Kathleen Connelly stated if they go a page or two further there are the additional questions . Vice Mayor Dietz commented they do not want to let those out. e'1 City Clerk Kathleen Connelly stated they are already in a public packet Councilmember Barker commented they are two words or less, basically yes, no or maybe some more. Vice Mayor Dietz commented these are questions they may want to ask or may not want to ask. City Clerk Kathleen Connelly asked if they want them to be responded to in writing. Vice Mayor Dietz and Councilmember Barker both stated no. City Clerk Kathleen Connelly stated that is what she needed Councilmember Barker stated her next question is that they cannot add any other questions to these at this time. If they pass them through Joel, then the e1, rest of the council will not have seen those questions. We just eliminated a bunch of questions . She asked what if they had a question that they gave to Joel and he stated it is legal to ask but no one else on the council heard the question and they did not like it. There was general discussion on what they should do. City Attorney Joel Stern commented they could state them right now REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 34 OF 50 City Clerk Kathleen Connelly stated they have 5 written questions. Vice Mayor Dietz commented what he wants to ask is what is a recent action that the city council made that you agree with and why. Councilmember Barker commented she would make it the current city council. City Attorney Joel Stern stated that is legal. 1 Vice Mayor Dietz commented the other one is what is a recent action the current city council made that you did not agree with and why. Councilmember Barker added and what would the applicant have done differently. City Attorney Joel Stern stated that is legal. Councilmember Barker stated those are the two she had. Vice Mayor Dietz commented he had a third one that asked if chosen, what action would the applicant like to put on an upcoming agenda and why. City Attorney Joel Stern stated they are legally and technically not council members yet but this is open to the public. Vice Mayor Dietz commented it does say if chosen. City Attorney Joel Stern stated it is legal. Vice Mayor Dietz commented he does not know what everyone else thinks. He was just thinking about it . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 35 OF 50 Councilmember Barker stated she believed they almost asked that question with one of the earlier ones with how they would expect to impact the residents of our city. Councilmember Serdy stated it is basically the same thing. Vice Mayor Dietz commented it --- could be a question that a council member might just ask It might not be on the sheet. Councilmember Smithson stated they could solve all of this and not accept his resignation. Vice Mayor Dietz asked if there were any other questions the others would like to add. Councilmember Serdy commented there will not really be a live interview. Vice Mayor Dietz stated there will be. Councilmember Barker asked if they can ask questions during the live interview from their answers to these questions . City Attorney Joel Stern asked if she meant him or them. Councilmember Barker stated r" any of us . City Attorney Joel Stern stated they could. Councilmember Serdy commented that all the questions have to be run through Joel . Councilmember Smithson stated he will tell us if it is not a good question. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 36 OF 50 Vice Mayor Dietz commented he just wants to make sure it is all legal Councilmember Barker commented this is where someone answers one of these questions, we read the answer and wonder what they meant by that. She asked if they can ask them what they meant by that. City Attorney Joel Stern stated absolutely. That is fair game. There was general discussion on their being able to ask questions of the answers. Councilmember Serdy commented he always asks a question about HOAs because half of the city is for them and half are against He could not ask that question of third candidate if he did not ask it of the previous candidates. City Clerk Kathleen Connelly stated if he wants to ask that question of everyone she would suggest they make it a written question and make it part of the packet. Vice Mayor Dietz stated he had no problem with it being on there. City Clerk Kathleen Connelly asked for the question. Councilmember Barker stated she did not see the point of asking that question. Councilmember Serdy commented it helps determine peoples' thought processes for property rights and what you can do with your own property. Councilmember Barker stated that is kind of political . There was general discussion on whether they wanted to add that question. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 37 OF 50 City Clerk Kathleen Connelly asked if he would prefer to have that question asked at the interview and not have it in written form. Councilmember Serdy stated that is correct. City Clerk Kathleen Connelly stated it will have to be asked of all the applicants. Vice Mayor Dietz asked if there were any other questions . Mayor Insalaco commented he thought they had enough City Clerk Kathleen Connelly stated they have eight written questions. Vice Mayor Dietz commented they took five out and added two. Mayor Insalaco stated they added three. City Clerk Kathleen Connelly stated there is one on what recent action of the current city council did you agree with and why, what recent action of the current city council did you not agree with and why and what would you have done differently and the last one states what action would you place on a future agenda and why eN Councilmember Barker commented she believed the last one could be woven into the one that reads if selected to fill the vacancy on the council how do you expect to impact the residents. Mayor Insalaco commented they could ask it in a different way. Councilmember Barker stated it is pretty much the same question. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 38 OF 50 Councilmember Serdy commented they might not have an agenda yet. That means they are looking for someone who has an agenda . Vice Mayor Dietz commented this is just something they would like to put on that is on their minds . Councilmember Barker commented anyone who runs for council generally has something on their minds. Councilmember Serdy commented they might not have anything they want to submit. City Clerk Kathleen Connelly stated they might want to submit something that is not legal . Mayor Insalaco commented some might not know. There was general discussion on whether they wanted that question The consensus was they did not want the question City Clerk Kathleen Connelly stated they have 7 questions . Councilmember Barker stated she thought that was a prime number. 111, Mayor Insalaco closed the discussion with no further comments and called for a motion. Vice Mayor Dietz MOVED THAT WE ACCEPT THE RESIGNATION OF DOUGLAS COLEMAN FROM HIS POSITION AS A CITY COUNCIL MEMBER EFFECTIVE JANUARY 31, 2012 . I FURTHER MOVE THAT THE FOLLOWING DIRECTION BE GIVEN TO STAFF REGARDING THE PROCESS FOR FILLING THE VACANCY: 1) THAT A PRESS RELEASE ASKING FOR QUALIFIED APPLICANTS BE SENT TO THE AJ INDEPENDENT AND THE AJ NEWS FOR PUBLICATION THE WEEK OF FEBRUARY 27, 2012, AND THAT THE PRESS RELEASE ALSO BE POSTED AT THE REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 39 OF 50 CITY' S THREE OFFICIAL POSTING LOCATIONS AND PLACED ON THE CITY WEBSITE AND CABLE CHANNEL; 2) THAT ALL APPLICANTS BE REQUIRED TO COMPLETE A TALENT BANK APPLICATION, A LOCAL ELECTED OFFICIALS FINANCIAL DISCLOSURE STATEMENT, AN AFFIDAVIT OF QUALIFICATION, A WRITTEN RESPONSE TO QUESTIONS AS INCLUDED IN THIS PACKET AND AS DISCUSSED THIS EVENING; 3) THAT APPLICATION PACKETS ONLY BE ACCEPTED BEGINNING MARCH 5, 2012 AND ENDING APRIL 2, 2012 AT 5. 00 P.M. ; 4) THAT PUBLIC INTERVIEWS OF THE QUALIFIED APPLICANTS BE HELD ON APRIL 16, 2012; 5) THAT THE APPOINTMENT BE MADE ON MAY 1, 2012 AT THE REGULAR MEETING; 6) THAT THE SUCCESSFUL COUNCIL APPOINTEE BE PUBLICLY SWORN IN AT THE MAY 1, 2012 COUNCIL MEETING ALSO. Councilmember Barker SECONDED THE MOTION . VOTE: Unanimous . The motion carried. ACCESSORY BUILDING DESIGN REGULATIONS Development Services Director Brad Steinke briefed the council on the item. Councilmember Smithson stated Exhibit D states it affects horse shades, mare motels, hay storage buildings and carports with no walls or partial walls extending no more than 6 feet from the roof line. He is not sure how to interpret it. He sees no comma after buildings or carports. He asked if partial shade only applies to carports or to everything preceding it. Development Services Director Brad Steinke stated it would apply to the horse structures that are parenthetically included and to carports . Councilmember Smithson stated it seems to him there should be a comma after carports . Development Services Director Brad Steinke stated he would agree. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 40 OF 50 0 Councilmember Smithson asked if a person could have a Quonset hut that was strictly used for horses . Development Services Director Brad Steinke stated they could not. Councilmember Smithson stated Amor it states here that horse stuff is excluded. Development Services Director Brad Steinke stated Quonset huts are expressly prohibited regardless of the use . He believes he is saying they should put that in the ordinance to be clear. Councilmember Smithson asked if metal buildings that would be very high, higher than the house, but still used for horses, would be excluded. Development Services Director Brad Steinke stated they would not . The only exemption for horse structures and carports has to do with the design; not with the height or the size. If that was confusing, then they need to clarify that . Councilmember Serdy commented what he sees is the problem with most of these is the color. When Gold Canyon Resort was stark white and you drove along US 60, people would look over there and wonder what it was . Now that it is blended in with earth tones and it is not even seen. He was at Apache Lake Marina a couple of weeks ago. There is one silver building. You have a beautiful lake and you do not even see a lot of the homes and buildings there, but that silver and stark white ruins the views . These things should be blended in. Development Services Director Brad Steinke stated our present ordinance does require the use of earth tones and to have desert colors . Councilmember Serdy commented any silver building like this would be illegal . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 41 OF 50 A. A. Development Services Director Brad Steinke stated staff could make the case that it should not be approved. The city also requires that they put textured paint on it that is usually beige or an earth tone color. One could make the argument with the existing regulations that if it is a silver building it should not be allowed. Mayor Insalaco asked if the Quonset huts were made of galvanized steel. A''` Development Services Director Brad Steinke stated they are. Mayor Insalaco asked if he knows how long paint lasts on galvanized steel . Development Services Director Brad Steinke stated one of the arguments under the current ordinance is that they require them to spray them with textured paint as one remedy and some folks in the opposition group state it would probably void the warranty on the galvanized steel immediately. In a few years it might start chipping and look worse than the galvanized steel would. They took issue with the textured paint being an aesthetic remedy. He asked if the majority of them believe that prohibiting Quonset huts is a reasonable regulation. The consensus was it was . Development Services Director Brad Steinke stated the neighborhood group would like to see all metal-sided buildings in the R-143 prohibited. That would include the Quonset hut and prefabricated, galvanized metal steel buildings . The majority of the commission did not want to go this far. Councilmember Wilson commented the all metal buildings do not necessarily have to be galvanized. He passed around a brochure on equine-related structures from MD Buildings . They are metal, painted and have a warranty on the paint as well . There is currently one inside the city at this time and in this district that he knows of. Unfortunately the individual selling these is at a show in REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 42 OF 50 Scottsdale right now. They are all over the state and are very good buildings. He does not see why the city would not allow them. They could decide they need to have a conditional use permit . They would have a rule that says no metal buildings at all and someone wants to come in and do it, they are creating an undue hardship for anyone that would want to put something up like this. He thinks they are stepping on the property owners' rights and privileges. Councilmember Barker commented they are talking about accessory buildings. From what she understands, the exterior walls of an accessory building located in R-143 need to be covered with building materials that are compatible and consistent with the main dwelling structure. That is where she is wondering how these MD Buildings will fit . These are beautiful buildings; there is no doubt about it. Councilmember Wilson commented they are barns . Councilmember Barker stated they are and there are accessory buildings in here. Vice Mayor Dietz commented if they are used for horses they should be excluded. Councilmember Wilson commented they have to have a solid wall down and they will have to meet the requirements. Vice Mayor Dietz asked if the R-143 was originally set for conventional construction. Development Services Director Brad Steinke stated that is correct. Councilmember Barker stated they could not build one of those ugly metal buildings constructed into a home. She has seen it done. Development Services Director Brad Steinke stated in this environment he has seen very little metal-sided homes . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 43 OF 50 Councilmember Barker commented it would seem a little hot . Development Services Director Brad Steinke stated the strict constructionist view of the ordinance as the commission has recommended it strengthens the aesthetic connection between the main home and the accessory building Unless the main home has metal siding, staff is not going to approve a metal-sided building even if it is a beautiful metal-sided building. Councilmember Barker commented because it would not meet the one she just read. Development Services Director Brad Steinke stated it would not meet the intent and spirit of the ordinance However, there is one slight variation of this. If someone has a wood-sided home or board and batten or clapboard horizontal on the bottom, it is steel. You cannot tell the difference between that and vinyl at a distance of 15 to 20 feet and aesthetic wood. This is where staff is uncomfortable to prohibit a whole sector of material. It might be an unnecessary quantum leap. This is something they have to be mindful of. There is aesthetically pleasing steel. The question comes back that when they have a wood-sided building like this and someone wants to reflect it in a metal building, should staff have the discretion to approve it as long as the design is similar. Councilmember Barker commented if they can answer number 7 which states that it should be covered with building materials that are compatible and consistent and if you as the zoning administrator see it as metal but it was compatible and consistent, then it would seem to meet the requirements . Development Services Director Brad Steinke stated if the council says compatible and consistent to staff when this ordinance comes back and that it does not have to be the exact material on the main building and the accessory building, but it has to be compatible visually, then that gives them the marching orders to do what we want to do. Several years ago the council said put textured spray paint REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 44 OF 50 for metal buildings . They went ahead and approved everybody with textured spray paint . It did not do a bit of good for anybody, but they followed direction. He asked them to keep that in mind. The question is should this ordinance prohibit all metal-sided buildings . Councilmember Barker stated Amokshe would say no They are talking about accessory buildings here, not huge buildings . Councilmember Wilson asked if someone would be able to build one of those barns if they wanted to. It is metal . Mayor Insalaco stated if it is compatible with the house. Councilmember Wilson asked how they can make it compatible with the house. Councilmember Barker stated he showed him that when he showed them the pictures with the siding. Development Services Director Brad Steinke stated if the house is stucco, and most of them are, and someone comes in and wants to build the lower right hand building in the photos, they will say no. Councilmember Wilson asked —161/4 what he would say on another one that he showed him the picture of. It is metal and painted. Development Services Director Brad Steinke stated the one on the left is like a board and batten. If the house is board and batten in wood and they came back with this, then they would probably say that would be compatible. The color scheme would have to have some compatibility. Councilmember Wilson asked if you had stucco outside your home. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 45 OF 50 p Development Services Director Brad Steinke stated they would say it is not compatible If they felt that staff was wrong, they could go through planning and zoning for a conditional use permit and try to convince them of that . They are not the final arbitrator, they are the first step. Councilmember Wilson commented they will not have much of a chance of coming in. Development Services Director Brad Steinke stated if it was stucco and they want to do either of these two, he would probably not approve them. That is what this ordinance is suggesting. It is the compatibility or strengthening of the two. That is really the strength of where this ordinance goes . To make it clear, if they want to see these types of buildings allowed by right, then they should not approve this ordinance. Or if they want to exempt all horse structures of any size from any of these regulations, they could set those aside by themselves . Councilmember Barker stated that is a huge can of worms . Development Services Director Brad Steinke agreed that it is a huge can of worms and he does not recommend it . Councilmember Smithson asked how tack rooms fit in here. They are not one of the exemptions here. Development Services Director Brad Steinke stated the ordinance before you has the partial . If someone has a tack room underneath there as part of their horse shade, that would be fine. Most people do not want to have a tack room in an open area . The next question was in regard to limiting the building height to the main building height He commented he saw some nodding the other way but he does not believe they will get unanimous approval on this thing. The next question was on equestrian structures . The six foot commission recommendation allows this sort of thing. At the last meeting council members raised the issue about three-sided REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 46 OF 50 buildings for equestrian uses. If we do that we would go with the exemption for three-sided buildings. A 5, 000 sq. ft. three- sided metal building will not look a whole lot better than a 5, 000 sq. ft. four-sided metal building. If they want to allow this sort of thing, 75% of the exterior wall surface is covered and 25% is open. It would be virtually closed, but not completely. When people say this is for equestrian use they believe them. Three months later there could be motorcycles in OmN there When you start to make exemptions, that Pandora' s box does start to play a part in all this. The question before them is six foot or beyond that exempt three-sided equestrian structures with 75%. Councilmember Wilson commented if they are storing hay and you are only coming down 6 feet, you will have a lot of destroyed hay at $20 plus a bale. They forecast the price of hay going up just like gasoline. It will be expensive There will be hay wasted because of damage from rain. Even though we do not get much rain, it will rain and the hay will mold. Councilmember Barker stated three-sided does not answer that either. Councilmember Wilson stated it does because you put the open side against the prevailing wind. Or you can put a gate up in front . Councilmember Barker stated she likes the three-sided and she thinks he makes a good argument. ON Development Services Director Brad Steinke stated he will come back with three-sided. Councilmember Smithson commented he assumed they will have the opportunity to hear what the neighbors think. Development Services Director Brad Steinke stated that should be it He has the direction he needs to bring this back He estimated four weeks before he would schedule a public hearing on it . They should let him know REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 47 OF 50 eeN O^ about anything they have issues with between now and then He asked Councilmember Wilson if he wanted him to hold onto the information from MD Buildings and include them in the packet next time. Councilmember Wilson stated he would. Councilmember Smithson suggested the public might want to be here on this issue and be aware of what has been tentatively decided, at least for consideration, and write letters to us so that we know ahead of time rather than wait for the public hearing. And they need to come to the public hearing, too. Mayor Insalaco closed the discussion with no further comments and called for a motion. Councilmember Barker MOVED THAT THE FOLLOWING DIRECTION BE GIVEN TO STAFF REGARDING ACCESSORY BUILDING DESIGN REGULATIONS: THAT THEY TAKE THE CONVERSATION THAT WAS HEARD TONIGHT AND WORK IT INTO A DRAFT ORDINANCE AND BRING IT BACK. Vice Mayor Dietz SECONDED THE MOTION. VOTE: 5-1 (Councilmember Wilson voted in opposition. ) The motion carried. SELECTION OF MEETING DATES, TIMES, LOCATIONS, AND PURPOSES a^ Vice Mayor Dietz MOVED THAT AN EXECUTIVE SESSION AT 5 : 45 P.M. AND A WORK SESSION AT 7 : 00 P.M BE HELD ON MONDAY, MARCH 5, 2012, IN THE CITY COUNCIL CONFERENCE ROOM AND CITY COUNCIL CHAMBERS, RESPECTIVELY; AND THAT AN EXECUTIVE SESSION AT 5 : 45 BE HELD ON TUESDAY, MARCH 6, 2012 IN THE CITY COUNCIL CONFERENCE ROOM. Councilmember Barker SECONDED THE MOTION. REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 48 OF 50 ON VOTE: Unanimous. The motion carried. CALL TO THE PUBLIC: Ms . Myrna Kuki, 1770 N. Valley Drive #48, Apache Junction, addressed the council regarding the septic problems in Acacia ON Villa Mobile Home Park and her hope for relocation. Ms . Donna Marquardt, 1770 N. Valley Drive #59, Apache Junction, addressed the council regarding the septic problems in Acacia Villa Mobile Home Park They would like the park to be closed and for them to be relocated. She provided them with a copy of a letter she sent to the attorney general . Mr. Darryl Cross, 1018 N. Acacia, Apache Junction, addressed the council regarding the proposed ordinance for accessory buildings . He is against the ordinance as written as it does not consider horse owner needs . Mr. Todd House, 5027 E. Hidalgo, Apache Junction, addressed the council to announce he is a candidate for Final County Supervisor District 5. Mr. Elliott Fisher, 547 E. Quail, Apache Junction, addressed the council regarding the proposed Trail of Flags and the ongoing litigation in the court of appeals. Mr. Douglas Coleman filled out a request card but declined to speak ADJOURNMENT Mayor Insalaco adjourned the meeting at 9: 53 p.m. Consent Agenda Items are as follows: 1 . Acceptance of Agenda 2 . Approval of Minutes of Regular Meeting of February 7, 2012 . REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 49 OF 50 ACCEPTED THIS 6TH DAY OF MARCH, 2012, BY THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA SIGNED AND ATTESTED TO THIS 6TH DAY OF MARCH, 2012 . JOHN S . INSALACO Mayor ATTEST: KATHLEEN CONNELLY City Clerk 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 21st day of February, 2012 . I further certify that the meeting was duly called and held and that a quorum was present . Dated this 29th day of February, 2012 . KATHLEEN CONNELLY City Clerk REGULAR MEETING OF THE CITY COUNCIL FEBRUARY 21, 2012 PAGE 50 OF 50 ROLL CALL VOTE NOTES: 6_,,,„44 , v ,n, i1 (r ITEM # \ MEETING OF MOTION BY: ( () ,, SECONDED BY: '' `k y `` YES NO ABSTAINED COUNCILMEMBER SMITHSON I COUNCILMEMBER BARKER V VICE MAYOR DIETZ I COUNCILMEMBER SERDY COUNCILMEMBER WILSON f MAYOR INSALACO v UNANIMOUS IN FAVOR OPPOSED ABSTAINED TOTAL CONSENT AGENDA ITEMS NO. 1-2 I MOVE THAT THE CONSENT AGENDA BE ACCEPTED AS PRESENTED. O� Pq AC Hf G4-0 Q City of Apache Junction Home of the Supei:c itiolt a ioruttelins gRi10t4* Print TO: City Manager's Office FROM: Jerald Monahan, Public Safety Director DATE: March 6, 2012 Agenda Type : Regular Agenda Council Priority Focus Area: TITLE OF AGENDA ITEM: PRESENTATION OF 25-YEAR SERVICE AWARD TO CARLENA LAWSON OF THE APACHE JUNCTION POLICE DEPARTMENT. ACTION REQUESTED: DISCUSSION/ BACKGROUND INFORMATION: FISCAL IMPACT: OPTIONS/ALTERNATIVES: RECOMMENDATION: ATTACHMENTS: Click to download No Attachments Available PpACHf�G ° 4 � y�o C,zty of Apache Junction Horne of the .S upel:ctztlon Mountains 4Qizo' Print TO: City Manager's Office FROM: George Hoffman, City Manager DATE: March 6, 2012 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 PUBLIC HEARING /" 1. For APPLICATION FOR AN INTERIM PERMIT,NEW LICENSE, CORPORATION, SERIES 10 LIQUOR LICENSE FOR CIRCLE K#3444 LOCATED AT 2933 SOUTH TOMAHAWK ROAD 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. Pp ACkf�G "b- c4y Z of 1pache Junctio ii Hoi;ie of the .Si perslztzoii Mountains Print TO: City Manager's Office FROM Kathy Connelly, City Clerk DATE: March 6, 2012 Agenda Type : Regular Agenda Council Priority Focus Area: Required by Federal Law or State Statute TITLE OF AGENDA ITEM: APPLICATION FOR AN INTERIM PERMIT, NEW LICENSE, CORPORATION, SERIES 10 LIQUOR LICENSE FOR CIRCLE K#3444 LOCATED AT 2933 SOUTH TOMAHAWK ROAD. ACTION REQUESTED: Recommendation for Approval DISCUSSION/ BACKGROUND INFORMATION: 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 Arizona Department of Liquor Licenses and Control. FISCAL IMPACT: OPTIONS/ALTERNATIVES: IECOMMENDATION: ATTACHMENTS: Click to download D cover memo D application part 1 D application part 2 D application part 3 D notice D applicant letter D department memo D planning recommendation O police recommendation D fire district recommendation Ask FEBRUARY 23, 2012 MEMORANDUM TO HONORABLE MAYOR AND CITY COUNCIL MEMBERS THROUGH GEORGE R HOFFMAN CITY MANAGER THROUGH KATHLEEN CONNELLY CITY CLERK,! c FROM JAN MASON, DEPUTY CITY CLERK -f SUBJECT AGENDA ITEM FOR MARCH 6, 2012. APPLICATION FOR A LIQUOR LICENSE FOR CIRCLE K#3444 An application for an Interim Permit, New License, Corporation. Senes 10 Liquor License has been submitted by Mr Kim Kwiatkowski for Circle K Store #3444 located at 2933 S Tomahawk Road, Apache Junction. Arizona Correspondence has been received from the police department, planning department 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 /\. /1 Arizona Department of Liquor Licenses and Control 800 West Washington,5th Floor Phoenix,Arizona 85007 www azliquorgov 602-542-5141 APPLICATION FOR LIQUOR LICENSE TYPE OR PRINT WITH BLACK INK Notice Effective Nov 1 1997 All Owners,Attents.Partners.Stockholders.Officers,or Managers actively involved in the star to day operations of OIN the business must attend a Department approved liquor law training course or provide proof of attendance within the last live years See page 5 of the Liquor Licensing requirements SECTION 1 This application is for a SECTION 2 Type of ownership MORE THAN ONE LICENSE INTERIM PERMIT Complete Section 5 O J T W R O S Complete Section 6 NEW LICENSE Complete Sections 2,3, 4, 13, 14, 15, 16 0 INDIVIDUAL Complete Section 6 0 PERSON TRANSFER(Bars&Liquor Stores ONLY) 0 PARTNERSHIP Complete Section 6 Complete Sections 2,3,4, 11, 13, 15, 16 ®CORPORATION Complete Section 7 O LOCATION TRANSFER(Bars and Liquor Stores ONLY) 0 LIMITED LIABILITY CO Complete Section 7 Complete Sections 2,3,4, 12, 13, 15, 16 0 CLUB Complete Section 8 O PROBATE/WILL ASSIGNMENT/DIVORCE DECREE ❑GOVERNMENT Complete Section 10 Complete Sections 2, 3,4,9 13, 16(fee not required) 0 TRUST Complete Section 6 0 GOVERNMENT Complete Sections 2,3,4, 10, 13, 15, 16 0 OTHER l Explain SECTION 3 Type of license and fees LICENSE#(s) 1011312Z. I Type of Licenses Lt.) taGrle' tU ) 1 Oe:artrt;ent Use O'y 2 Total fees attached ; 5 APPLICATION FEE AND INTERIM PERMIT FEES (IF APPLICABLE)ARE NOT REFUNDABLE.. The fees allowed under A.R.S.44-6852 will be charged for all dishonored checks. rr, row SECTION 4 Applicant �V f S D KM/IATKOWSKI KIM KENNETH r" C,wner/Age.rt's Name +0+—__ Insert:ne name ON_t o aopaar o; >.ct r east First M$t st e 2 Corp/Partnership/L L C CIRCLE K STORES INC 1004314 r'r ,cxactiy as i ap�rs on Anicies 'f�„ or Alt les of O,g 3 Business Na — b deName CIRCLE K STORE# �y�y (Exactly as tt appears cn tr`e exterior of premises) 4 D,,nopal Street Location )T) S '(c,m R A w�C !/ Rc �4 t,+? ,Do nct Lae PO Box Number)) City County d Z,p 5 Business Phone U) ' 1 j ') J 5 . Daytime Contact (GL0.\ -0.6- 6 Is the business located within the incorporated limits of the above city or town? YES ONO 7 Mailing Address LICENSING DC 36, PO BOX 52085,PHOENIX,AZ 85072-2085 City State Zia 8 Price paid for license only bar beer and wine, or liquor store Type 3 Type DEPARTMENT USE ONLY Fees /eV l00 c�0a Application 'ntenm Permit Agent Change Club Finger Prints S co TOTAL OF ALL FEES ' Is Arizona Statement of Citizenship &Alien Status For State Benefits complete? 0 YES i NO ' Accepted by A t(� Date �/ l / t it _ # 1 dr 13 22 Z ,n,ty 2010 'Disabled individuals requiring special accommodation,please call(602)542-9027. ON riN i SECTION 5 Interim Permit 1 If you intend to operate business when your application s pending you will need an interim Permit pursuant to A R S I-203 01 2. There MUST be a valid icense of the same type you are applying for currently issued to the location 3 Enter the license number currently at tits location_ 10113117 _ 4 Is the license currently in use?20 YES 0 NO If no,how fang has it been out of use? na ATTACH THE LICENSE CURRENTLY ISSUED AT THE LOCATION TO THIS APPLICATION. A i ,l'ASOs.; I.EVISKe -__ declare that I am the CURRENT OWNER AGENT CLUB MEMr1SER, PAR i NER, _•__(P.nt kill ram t'EMB TO ' .L ERf R LICENSEE(circe'ha title which applies)of,e s'a.ed license and Iouatior f State of A t.Ir ±A County of Plo-r co.Qt'A X( - / The foregoing instrument was acknowledged before me this i i >•s q day of3q✓,.,a4:"( 2O I .2. My Co IS - :i . • I i R.'uO ID Day 1 FAon tt � Year y , Public•Minna Minna �. Maricopa County l �. `�,0.1 My Comm Epirus Sep 1.2015 tScnawre rx MDTAE;!t'PUHLIC) SECTION 6 Individual or Partnership • ,ners EACH PERSCN LISTED h%:ST sushi;r A COMP(:T•• 4.iE-i ION.VAIRE(FORM L40101!AN-APPLIC ' TYPE F!NGERDFJH'CARD,AND 524 PR0'_E55240 FEE FOR EACH CA.RG - , 1 Ir.0 vidusl in r-n, L,I t 11 . Nile :t)rx,ec MA:,. Az/dress C ty State /r .i Pima ip Name (Only the first partner liv..7c wi I nppe an license.) C eaiLeraed Lint Fs151 td,1VIA n9� S.'ain .4w..r:........ :K.. Slate ---,• / - . f.-- 0 0 elliS ❑ n , / _____ . - — — / ATTACH ADDITIONAL SFIEET'F t CESSARY) 2 Is any person,other th die above,going to share in the profits/10 es of the business? ❑YES 0 O If Yes,give name,cupent address and telephone number of the erson(s) Use additional sheets if n'cesser,' L1e1 rxat Middle Mailin Ad Girl,Stale,Zip Teechcoe# I 2 eiN SECTION 7 CorporationfLimited Liability Co EACH PERSON LISTED MUST SUBMITACOMPLETED OUESTIONNAJRE(FORM LIC0101) AN 'APPUCAhT"TYPE FINGERPRINT CARD,AND S24 PROCESSING FEE FOR EACH CARD ® CORPORATION Complete questions 1, 2, 3, 5,6, 7,and 8 ❑ L L C Complete 1,2,4, 5, 6, 7,and 8. 1 Name of Corporation/ L C CIRCLE K STORES INC. (Exactly as 4 ape co Articles of Incorporation or Articles of Organizalior) 2 Date Incorporated/Organized 06/08/1951 State where lncorporatedWOrganrzed TEXAS 3 AZ Corporation Commission File No. F_0006598-0 Date authorized to do business in AZ_ 04!08/1957 4 AZ L.L C File No NA Date authorized to do business in AZ NA 5 Is Corp IL L C Non-profit?0 YES IS/NO 6 List all directors,officers and members in Corporation/L C ��•,{ F rSt Middle Tdie Mailing Address i*y State Zip 1 Hannasch Brian Patrick Pres/Secr 18815 West SE 46,Columbus,IN 47201 % Hughes Cheryl Kay Treas/AS i26a4 W Flint 5t,Chandler,AZ 85224 i7.}ti4 — , Haxel Geoffrey Charles VP/DIR 7849 E Vista Bonita Dr,Scottsdale,AZ 85255 Kwiatkowski Kern Kenneth Asst Secr t7853 S Michele Ln,Tempe,AZ 85284 ;ATTACH ADDITiON.AL SHEET F NECESSAPY' 7 List stockholders who are controlling persons or who own 10%or more 11St Firs' 1,addle i tJ t•.13i1¢.Add oss C r Srato Z,1 11.1 CIRCLE K DELAWARE INC 100% 1130 W Warner RD,Tempe,AZ 85284 I r; (ATTACH ADDi riONAL SHEET IP NECESSARY) .._ 8 ii the corporation/L C is owned by another entity, attach a percentage of ownership chart,and a director/officer/member disclosure for the parent entity Attach additional sheets as needed in order to disclose personal identities of all owners SECTION 8 Club Applicants: EACH PERSON LISTED MUST SUBMIT A COMPLETED QUESTIONNAIRE IFORM UC0101),AN 'APPLICANT-TYPE FINGERPRINT CARD,AND S24 PROCESSING FEE FOR EACH CARD, 1 Name of Club Date Chartered (Exactly as r appears on Cb_b Charter or Bylaws) (Attach a copy of Club Charter a 8/3v s: 2 Is club non-profit? ❑YES ❑ NO 3 List officer and directors' Last First Midiie Title t.Mta in Address Ctv State La 1 • (ATTACH ADDITIONAL SHEET IF NECESSARY) 3 F 1" ifl —1?+ Lit:. 1. t z1 Circle K Stores tnc Texas 618151 Charter No 0010697700 FttJtt T4-1149540 OFFICE Name BUSINESS ADDRESS PHONE ' Prrslitani and Secretary Bnan Nannasch 1130 tat hornet rid Tempi' Al 85204 (602)728-8000 Virg Prasic4mi (wohroy C Hexer 1130 bt"harper iid,Terve. AZ 85:84 (602)728-80;,0 r Vice President Timothy Strewn'Iousel. 495Lftii car Stare 150 Comae CA 92873 (651)270-0126 Vice President Hobert G Cantpau 1 110 W Warner F,:!,Tempe AZ 85264 (602)728-8000 r Vice President Michael t Struhle 12011'olecom Parkway Tampa,FL 33a3i (613)010-6882 i Vice President Lou Valdes 3001 Gateway Or al30 tr ring 1 X 75063 (502)728 8000 i Vice President Jason Broussard 12911 Telecom Parkway Tutnpu FL 33637 1850)454 1073 i Vice President Matt McCune 2450 WhitetlaI3 Park Or 6800 Charbite NC 28273 (704)583 5700 ' Treasurer and Assistant Secretary Cher,:Kay Hughes 1130 W Wwi'e-Rd Tempe AZ 85254 1602)728 8000 n As#rscs.:t Secretary Scull J Stevenson 1130 W Warner Ho Tempe AL 85264 1502)726.8000 r Assistant Secretary Ken Kwieteovesk.r 1130 W Warner Rd Ienr,:e AZ 65284 (602)728 8000 r Assistant Secretary Syla lin Aubry 1600 St Martin SW East 1 uwel 13 Suite 200 4-aval Quebec H7G 457 (450)602-663Z r Assistant Setahey Richard Douglas Hamlin 113U W Warner Rd Ien.r:e AZ A52A4 (602)728-800U r Asacdate Secretary Marc Lee 1-loner, 495 a FAna-an Suae 150.Carona CA 02670 (951)270-5136 Assistant Secretary Mathew Lew Hemtansen 2440 Whitens.)Park Dr 4600 C.hartcttc NC 28273 (704)583.5716 Aserst am Secretary Beam G Morgan 3001 Gatnedy Dr #130,Irving TX(5063 (6021725-8000 Assistant Secretary David 0 Wrikina 12911 Telecom Parkway,Tame a,FL 335s7 (613)WO-SS15 Assailant Secretary Pater Uhlrcti 129t 1 Telecom Parkway,Tampa FL 333637 (613)910.6878 " Direct,r business Address 1130 V. Vlarner Road Bldg B Tempe AZ 85284 (n02)'_8.8001) i t)omrcie Address n.CSC-Lawyers Inrxc, aging Serowe Company tin Brazes Sheri Suite 1050.Austin,TX"8701 i 12 000,000 Snares Authenzed I OW r5sued et 51 CC Par 102%ne-wd by Crclo)(Deaware inc ()-SI 4ti05'0672, a Crete K blares Six as uric. ed r1 Al.• AZ,AR CA.CO, FL,GA,,10 KS LA MS MO NV NM NC OK OR SC.,TN TX,IT WA I Corporate Se rcture Circle K Delaware Incis 100%stand by The Carle K Cotp<xallen(Brian Nannasch PraeidenVD•ixector) The Circle K Corporation is It 4 owned by Couche-lard U.S LP(Brian iannasch PresidenVDtrectorl Carche-1en)1)5 LP phis General partner is 10'4854 Nora Scotia Company Ilia+rested parlrurr is Mac's Convenience Stores Lac.) 3056854 Nova Scotia Company is 100%5 owned by Mac'S Convenience Sterol:tar, (Brian Hannasctt Sr Vice President) t Mac's Convenience Stores Inc is 100%craned by Ca udtc Tarn Inc (Brian Rannasch Sr Vice President) Couche-Tard Inc is 100%owned by Depan Escempte Conchs laud Inc (Arlan Nannasch Sr Vice President) Dopan-Escompte Couche-Taro tnc rs 100%owned by Aliment:Own Ccrr.:he Tard Inc (Brian liannascn Sr Vice President) Arrmentation Couches Tam Inc.Is a publicly traded company(Brian Nannasch Sr Vine President; OFFICERS XLS SECTI Qtj9 Probate,Will Assignment or Divorce Decree of an existing Bar or Liquor Store License. 1 Current Licensee's Name (Exedly as it appears on license) Last First �M die 2 Assignee's Name __�__ Last :first Middle 3 Ucense Type License Number Date of Last Renewal _ T_ 4 ATTACH TO THIS APPLICATION A CERTIFIED COPY OF THE WILL PROBATE DISTRIBUTION INSTRUMENT OR DIVORCE DECREE THAT SPECIFICALLY DISTRIBUTES THE LIQUOR LICENSE TO THE ASSIGNEE TO THIS APPLICATION SECTION 10 Government' (for cities,towns,or counties only) ens 1 Governmental Entity 2 °erson/designee -ast F r''.t Middle Contact Phone NL.n-iper A SEPARATE LICENSE MUST BE OBTAINED FOR EACH PREMISES FROM WHICH SPIRITUOUS LIQUOR IS SERVED. SECTION 11 Person to Person Transfer Questions to be completed by CURRENT LICENSEE(Bars and Liquor Stores ONLY-Series 06,07,and 09) 1 Current Licensees Name Ent:ly (hxactiy 3s it appears on icense) Last :.:st Middle (Intl;v Agent etc Corporation/L L C Name Exactt}a3"aopea'S cr'`:c=enW fri Cf 3 Currant Business Name iExactiy as r appes-_ l 4 Physcai Street Location of Business Street City State Zip 5 License Type L cense Number 6 If more than one license to he transfered License Type License Number 7 Current Mailing Address Street (Other than business) City State,Zip 3, Have ail creditors lien holders interest holders etc been notified of this transfer ❑YES 0 NO 9 Does the applicant intend to operate the business while this application is pending? 0 YES 0 NO If yes,complete Section 5 of this application,attach fee, and current license to this application 10 I ,_ hereby authorize the department to process this application to transfer the (pr'nt ru:i names pnvilege of the license to the applicant,provided that all terms and conditions of sale are met Based on the fulfillment of these conditions I certify that the applicant now owns or will own the property rights of the license by the date of issue declare that I am the CURRENT OWNER AGENT,MEMBER, PARTNER (print full name} STOCKHOLDER,or LICENSEE of the stated ;icense I have read the above Section 11 and confirm that all statements are true, correct, and complete State of County of 45g-,Bare cr CURRENT LICENSEE) The foregoing instrument was acknowledged before me this Day Month Year My commission expires on ,Sronature of NOTARY PUBLIC( 0 SECTION 12 Location to Location Transfer(Bars and Liquor Stores ONLY) APPLICANTS CANNOT OPERATE UNDER A LOCATION TRANSFER UNTIL IT IS APPROVED BY THE STATE 1 Current Business Name (Exactly as it appears on license) Address 2 New Business Name {Pltys+;.al Street Location) Address 3 License Type License Number 4 If more than one license.to be transferred License Type License Number 5 What date do you plan to move? What date do you plan to open'? SECTION 13 Questions for all in-state applicants exclpolr j those applying for government. hotgimptei,dpd restaurant licenses(series 5, 11,and 12). A R 3 §4-207(A)and(3)state that no retailers icense matt be issued for any premises which are at the time the llcenss appbcahon is received by Me director within three hundred(3D0)horzontal feet of a church within three hundred(300)horizontal feet of a public Cl private school building wrlh kindergarten programs or grades one(1)through(12)or within'hree hundred 1300)horizonal feet of a`erred recreational area adjacent to such school buildin; The aoove paragraph DOES NOT apply to a)Restaurant license(§4 205 02) i)Government license(§4-205 03) o'Hotel/motel ricer se(§4 205 01) di Fenced playing area of a golf col re t§4-207(B;(5)) n 1 1 D'stance to nearest school �t Name of school 1)e'Ce.-tr rcl-r3 E--lenv=.,.."-A,rtiy_L} t"' Address 1 S �� (A) -�c?J ta?'i�d r� N��c(�e .3 r , IS..c.2J9 City, State Zip 2 Distance to nearest church 1.{tat-i,t ' ft Name of church �t'SLti Address 610 t_ ()Li) ut'0.1T l:a;(w`Hw '1-4-+ fCi Z� _r City, State Zip 3 i am the (Lessee J Sublessee tU Owner 0 Purchaser(of premises) 4 If the premses Is Ieawd give lessors Name t7l J L L r:tr•eRi', ,> L LC. Address `�',1st G S J L f .1?2, L xJ4 L;344, 'tIty, State Zip 4a Monthly rental/lease rate S IV (AN:' .__What is the remaining length of the lease30yrs 0 mos 4b What is the penalty if the lease is not fulfilled? S - _ or other tC`(,. Lie-to (give detail_-attach additional sheet necessary) 5 What is the total hilliness indebtedress for th s iicense+locatiron excluding the lease?$ cc Please list debtors below if applicable Last First t fdde Arrgcus Orod tPaill ,A&'kkess City State ZLp WELLS FARGO BANK ACCT 412302078o t_) cy 1 333 S GRAND AVE,12TH FL,LOS ANGELES,CA 90071 Case a 4ia(ATTACH SHEET IF NECESSARY) What type of business will this license be used for(be specific)? RETAIL CONVENIENCE STORE 5 SECTION 13 - continued 7 Has a license or a transfer license for the premises on this application been denied by the state within the past one(1)year? 0 YES iR NO If yes attach explanation 8 Does any spirituous liquor manufacturer wholesaler,or employee have any interest in your business? 0 YES E NO g is the premises currently licensed with a liquor license? '( YES 0 NO If yes give license number and licensees name License# t` t 1 ' (exactly as it appears on license) Name 0 lot_ * t C i SECTION 14 Restaurant or hotel/motel license applicants OIS 1 ,s there an existing restaurant or hotel/motel liquor license at the proposed location? f❑' YES ❑ NO f yes give the name of licensee Agent or a company name and license# Last Fast^ +Addle 2 f`he answer.o Question 1 is YES you may quaky for an Interm Perm t to operate white your application is pending consult A R S §4-203 01 and complete SECTION 5 of this application 3 Al,restaurant and tzoteumotel apprcants must complete a Restaurant Operation Plan i,:"orm LiC01 1 1)provided by the Department of Liquor Licenses and Control 4 As stated in A R S §4 205 02 G 2, a restaurant is an esLabashment which derives at least 40 percent of i s gross revenue from the sale of food Gross revenue is the revenue derived from all sales of'ood and spirituous liquor on the licensed premises By applying Tor this 0 hotel/motel O restaurant license I certify that I understand that I must maintain a minimum of 40 percent food sales based en these definitions and have •ncluded the Restaurant t otet/fvlo'el Records n. Required forAud;t iform LIC 1013)with 'his application ri m applicants signature As stated in A P S 3 4-205 02 Bt I understand it is my responsibility to contact the Department of Liquor Licenses and Control+o schedule an inspection when ail'axles and chairs are on site, kitchen equipment and if app-icabie patio barn,&rs are in place on the licensed premises WO the,exception of than patio barriers. these items are not required to be propertz irstal,ed 'or this inspection Failure fo schi:Buie an inspection will de ay issuance of the license if you are not ready for ytbur inspection 90 days arter riling your apple:.teal please request an extension ,n writing,specify why'he extcnsior is necesiar) and the new inspection date you are requesting To schedule your site inspection visit www azliquor gov aid click on the "Information"tee acicants initials SECTION 15 Diagram of Premises.(Blueprints not accepted, diagram must be on this form) Checx ALL boxes that apply to your business Entrancos/Exits ® Ligiicr storage areas Patio ❑ Contiguous ❑ Ser"ice windows ❑ Drive-in windows ❑ Non Contiguous 2 is your licensed premises currently closed due to construction renovation, or redesign? 0 YES NO if yes what is your estimated opening date? month/day/year 3 Restaurants and hotel/motel applicants are required to draw a detailed floor plan of the kitchen and dining areas including the locations of all kitchen equipment and dining furniture Diagram paper is provided on page 7 4 The diagram(a detailed floor plan)you provide is required to disclose only the area(s)where spiritous liquor is to be sold served consumed dispensed possessed or stored on the premises unless it is a restaurant(see# above) 5 Provide the square footage or outside dimensiors of the licensed premises Please do not include non-licensed premises such as narking lots living quarters etc As stated in A R S §4-207 01(8),I understand it is my responsibility to notify the Department of Liquor Licenses and Control when there are changes to boundaries,entrances,exits, added or deleted doors,windows or service windows,or increase or decrease to the square footage after submitting this initial drawing. \f ibc\L applicants initials SECTION 15 Diagram of Premises 4 In this diagram please show only the area where spirituous liquor is to be sold, served, consumed, dispensed, possessed or stored It must show all entrances, exits, interior walls, bars, bar stools, hi-top tables, dining tables, dining chairs, the kitchen, dance floor, stage, and game room. Do not include parking lots, living quarters, etc When completing diagram, North is up t If a legible copy of a rendering or drawing of your diagram of premises is attached to this application, please write the words 'diagram attached" in box provided below r N g o 7 p y n J m giD o � - m w m z �» 1., O tt rA ftl y' p t.ci -n { 3 m F-' 3 3 A :n m x • SECTION 16 Signature Block . 3 I, KIM KENNETH KWIATKOWSKI , hereby declare that I am the OWNER/AGENT filing this fprirt iu.i name of aopliciartj application as stated in Son 4, Question 1 I have read this application and verify all statements to be true, correct and compl e X (signdture of applicant listed r,r Section Question?, State of ARIZONA County of MARICOPA The foregoing instrument}was acknowledged before me this �0� of__.f�.l) .VP}n4 , ZGt2 Gay Mom 'Year My con-mission expires on Q � 1' ! �r Q Day Marti Year sicyreturra NOTARY PUBLIC 7 ON /1 Print Form ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL 800 W Washington 5th Floor Phoenix AZ 85007-2934 (602)542-5141 QUESTIONNAIRE Attention all Local Governing Bodies Social Security and Birthdate Information is Confidential This information may be given to local taw enforcement agencies for the purpose of background checks only but must be blocked to be unreadable prior to posting or any public view el% Read carefully This instrument is a sworn document. Type or print with BLACK iNK An extensive investigation of your background will be conducted False or incomplete answers could result in criminal prosecution and the denial or subsequent revocation of a license or permit '__ rt.., = _ "f'lJL_`;ram P='r=.SON AGENT OR MANAGER _ACri PERSON CCMPLE-NN,'--k`S coR•Mu5—: ,--,._:1:-,‘ :". r:.CA.`.-- E^i>f4. CAR_V."0lCH+.t r BE c BTAINED AT CXLO f,NGERPRiNTIiv G MJS-BE DO, E BY SO...,FOE_Ei= MENT AGE',:'e OP A rlNCERT•RIN—ING SERA:'CE APPROVED BY Of tC THE DEPARTMENT DOES N T PROVIDE TH'S ER`:ILE E.ffecUve 10/01(07 there is a 524.00 processor/f.ge for each fin eonntsart, uhmitted, i�� Liquor License # The fees allowed by A.R S.5 44-6852 wili be charoed for ail dishonored checks, '5) /6ii.32ZZ —� _N Ilrthe location is currently licensed} Check Z,Controlling Person ❑Agent L Manager(Only) appropriate (Complete Questions 1.19) (Complete All Questions excrzi a 14,14a&21) I box --1011. Controlling Person or Agent must complete#21 fora Manager Controlling Person or t m st cam 211 i;ur, HUGHES(ANDERSON) CHERYL KAY e o+31riti :t _rx_.. ta;, F,rs; M cd;e t b.ic Record) AZ rr, • S.r': .' SeC„r tw^t7,r _ ' L ;9? —,_ _-- State rrt record) a public record) �= %dce of 9 Tit PHOENIX AZ USA y„igt1e. 5'7' i.,vell1„l 135 -,a,s BR H.i, BR f .. Sta e Country 'not CJU'ITv} (q02) 1 ao3 Ir.'+ .i,,a S atu _S+ e Maned t_C;.:,.rrc-J w: Oi,err- ,tn!nc' l'cne _ .. --------- HUGHES TIMOTHY RUSSELL n!a . Name o4 Cu.reni or Most Recen Spouse Date cA B..th _ _ List all for last 5 years Use additional sheet if necessary) =s' rI sl hUddln I taiden (NQI a public recorr a w t t t o ARIZONA a r 03r22/1969 - ,(-)u are a bona i'c_e PS-..i 1,of.v sta e If Arizona date of'fS,de,Cy � iv ness N .a�,- (602)728-3164 <. TP:e;>hane r!rite,to c„ylt aut you damn M s ness ho,irs to-any yu'i'ter rr r j ding this Si...,:mer, `a 1'yoj have bee-,an Arizona rer7 lent for:ess'nail th ee(3,months su",mlt a copy of your Anzo,a drivers i!Cerse cd V_.. • s"atich ca-r' •1 1 ` 7 7 10 '1 n e o'License..P,er:sr s Y,..,i c�L i 4e _5 ii_..:,E. ,' i( Premises Prone CI ' f : ) ,.L.1 I()Ca'-•NI o.L•r.vnse.,Pf'irt:ISCS^'i1:3reiS R 1 �" 3. Lv;� i� ` rf#''tl�,r'. ..�-uc.. �,y ,i ON St oct& cress 0ti not use PO Box k? C'v Ccun'y r: ' - t.,.' 'Lus s d',--r ' -( _5'ril;s'ii t d S ''onerrpt-� e'1 I of're Irre,lis,those dares List most recent 1st ,15 {...r t+t,p;Gyrneri ,r ., �, >.- 'Y pa ._._. _.._.._ — FROM j TO DESCRIBE POSITION I EMPLOYER S NAME OR NAME OF BUSINESS ' Mcsill;r'Car fii Montle tear 1 OR BUSINESS 3 ia'rwet atfd,eaS city state&zip) 05 97 ! uRRENT Treasurer I Asst Secretary Circle K Stores Inc 1130 W Warner Rd Tempe AZ 85284 Director of Financial Accting ATTACH ADDITIONAL SHEFT IF NECESSARY FOR EITHER SECTION,'' 1? I`0 r tC Your res4ciencC aci'ress t,li the:last r,,e i5i vear5 4, ----_' i FROM TO Rent or RESIDENCE Street Address ;Icy It,-,ear Morthr"roar Own t1 rentec; as,a-n aLa-IC-nai sleet va ,'• role^ addreis and C^ur m .,n ry bi rt, telc,'+l , C.', State Zit?i ! 1 04104 CuR,E'T Own 1 2644'Al Flint Street Chandler AZ 85224 l 1 _ UC:101 9i2412009 Disabled individuals requiring special accommodations please cat;the Department 1,602)542 9027 If you checked the Manager box on the front of this form skip to#15 ... As a Cor'ro;iing Persona Agert wili you he Dhysi. i'y pn9eent ami operatma+hn- itronsan pramisn9 OYES pNO IIII if you answered YES how r"arty hrsiday?_ ,and Answer#14a below If NO skio to#15 114a ;-lave you attended a Dt_LC approved Liquor Law T,a:ning Course wrih,n the past 5 years' ,Must provide proof) OYES ONO If the answer to#14a is NO" course must be completed before issuance of a new license or approval on an existing license 5 Have you peen detained.cited,arrested.Indicted or summoned into court for violation of ANY law or [Q YES ,E NO ordinance,regardless of the disposition even if dismissed or expunged,within the past ten(10)years (include only traffic vioiaticns that were alcohol and/or drug related)? 16 Are mere ANY administrative law citations compiii3nce actions of consents,criminal arrest,indictments YES 0 NO or summonses PENDING against you or NY enU in which you are now involved? v,-,f 17 -4ave you o ny entity which you haze held ownership,been an officer, member,director or manager �. e OYES '_j NO FVER had a business .ro'essiimal r ;ic c.^r,ionlicat n or Ii^ H e rejected,denied,revoked. G is e s, d, sus ended_d� � ae d 1 e1 cr fined;n^his or arty other states r L 13 riys anyone EVER :fled suit or obtained a Judgment against yg,:_ toe subject of wr'ch tnti olved fraud or OYES NO ,nisreoresentatiort' 1 a Are you NOV),or have you e!,_R held owne sh:.. been a,x;ntror;ng;lemon been Fier member, DYES —'NO lector or manager on 3t1v other fi,;Lor I•cen5si in this or any other state") r't t: r tc C' eat 5 t t 4 -"YES"YOU MUST attacr r, }aas: � c.rs 1., hro is fl G+'re complete detaita incfud ag dates agencies invot.ei and lisp SUBSTANTIVE CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED CHERYLKAY HUGHES 2 hereby declare that i,cri the APPLGANTREPFESE iTr r'.E ;orr"u,t rarne-ri Appicar„ r'lrny;his questionnaire I have rear+ th:s questionnaire and all statements ar..tr.ie correct rd corn rp.c:e 7 1 ff� JJ ARIZONA 8,1.RR+COPA X i ;Litt_ ): �t t' �') - — - Sate of _ Coi:nt> (S+grat..+s ci Aoplca . :•as�a;,Kn',', ::Pine n.g i yr, _day' ortihis" der c,rn7rssicn rrG-es on �.� �,. Year 5igr.a+ E t+f NOTARY PI_'P.l IC f COMPLETE THIS SECTION ONLY IF YOU ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21 The:applicant Hereby authorizes the person named on this questionnaire to act as manager for the named liquor license The manager named must be at least 21 years of age State of .__._. _- _County of T'ie foregoing rstrumen'was ackrvswiecgers Wore me trxs X day cf S orature of Centrotii-ig Person or Agent rc-rcie one, Morin", teas 'S gnaturo of NOTARY PUBLIC) P.rt Nfr^7v, '1v ryrrr ss Cr e z res Or Gay ',. n rear Questionnaire Supplementary for AZ Dept of Liquor License &Control Entity Responses -Circle K Stores Inc re Cheryl Kay Hughes QUESTION 16: Entity response for Circle K Stores Inc See attached list of AZ violations QUESTION 17. Entity response for Circle K Stores Inc PIN Circle K Stores Inc interest in any other alcoholic beverage business Alimentation Couche-Tard inc is a publicly traded company and has several subsidiary's which operate retail convenience markets in the United States and Canada under the following names Circle K(US) Tabatout(Canada) Phillips 66(US) Dipanneur 7)ours(Canada) Mac's(US) Mac's(Canada) Bigloat(US) Wink's(Canada) Handy Andy(US) Mike's Mart(Canada) Dairy Mart(US) Becker's(Canada) Couche-Tard (Canada) Daisy Mart(Canada) r" provi-Soir(Canada) Dunkin'Donuts(Canada) Most of these sites have alcohol r Number of Sites Approximately 5 000 c3 000-US&2 000-Canada) Circle K Stores Inc operates approximately 2,000 stores in 18 states Interest is limited to employee/manager/officer relationship License applications denied-it is the company's policy to secure alcohol licenses prior to constructing/acquiring sites If an agency recommends denial of a license application for Just cause(close to school,church,high crime area,etc), the application is usually withdrawn and the site is not purchased Licenses suspended/fined -The company trains its employees on the techniques of alcohol management Periodically an employee of ours may incur a violation related to alcohol Some jurisdictions will only issue a citation to the employee, therefore it is difficult io obtain knowledge of these violations When the company is also issued a citation the company may be fined a dollar amount or the store is required to suspend sales for a period of time A report of citations can be created by request for those citations where the company was fined Licenses revoked - To the best of our knowledge there has been no alcohol license revoked QUESTION 19. Only as an officer of Circle K Stores Inc __ ^ ___. 2012 AZ LIQUOR VIOLATORS 2012 1 I ` — --1-- . ._ - _- -- T �a d t w.wt ws riw+a 1.t s.a - t"a:4 +e�,. _...I—r a.i-+- 1 _. .1 1E r o1•� 0 0 0 0 0 F---0 - f—.— 1 _ 03aIa 2. w _`- --- - SC: - cat+. : 2 — 1 MTH -LJCENse•NO.TfTOa ; ::»F ' CITY j AAR 1 to 3,3_am Y-OArg A0544CY CUB ASK. tt7 YIOLATN TQM►LOYIS -NO VIOLATIONS FOR 2012 -.._.. 4-._ I 1 1 ___ .!._.__ , 4 • 011 A2LOUOR Mt-ATOMS 2011 - - _.._.. ••-- VW/ I{a t..... V S > O,r.teda11,4q ty1 i 2nd *Aam ' TOW __.-.. _-._ _.._ ft 0. 6V ' 375.0:4- ! aru,7 1 MTH 1 LiC4RISE-NO,1 6T09II 1 ZONE CRY Mir } I..(2n4_4th V OATS AGENCY I CU3 : ASK-A VIOLATOR IMPLQYLf :+5-l11 24072709 IZ'35233f 23116 C*Swl ,__f'7t....C.D0 4.i 3r17.I7,41I Vtan?U He Yec 3 w 04In!Amu Orekl .IkN 23111 t0.020153 12720563I Z3+14 r3RRIN* f751000 I iyt 5341041 420OI •1e i. rio SMR,Afro .rla Paoun 2,II! 'JS-OYJM ',0 L T: 73.2 3.rfa Yoga 175030 f [I 751`201 I AZ DMI.* b 1 Swel to Wet _..1414o CanWD —t__. 2010 AZUOR VIOLATORS 2010 —. I. _.._. 91,ksM1t. O6artdi .d } 1st 2nd 3rd ... 44h I Total... 1 Y1 �_ Mandl.,M" 0 0 0 I 9 i 0 0 _ _ . _ _osa.s1v. f-a iff 3 - --- - MTH 1 LIC..NSC-NO I.,SORE�ZONL _ fTY _ ANT `tst,+sd._161 YL`ATE_ 1 AGENCY i CU9 ABK-D'YiDS,A7ON EtlYLOY!! NO VIM-ATONE'FOR 2019 r __ _. 1 �.�1 V- y r-r- _ _ .._ .. _ 2002 AZ LIQUOR VIOLA `Jvf .r—_- _ ._.- _. _. __ M vluiritFans 01smissod 41 __.__ Ind t• aid f .th total I._... "w` _--_ NumDar al D 2 2 0 0 - ___ —_, ._ _____ 1o.t4w MT)4 LtVNS!NO STORE I SON! CITY --- AM? 1 141,2,r+Q,Ath VOAT! ACANCY f GUR_ ASK-O tV10IATCN EMPLOYEE M.CS Q-31004 2)71E63 IL'73 "2 61-WW1_1..$5 >3 IN j=51 4p„a-,n4 Grey S61 -JO !` IM a ;3$110 at tit.'iteln Mclt✓dWn_ it '�03 03-3030CC 7"�QSa ASS t"7 Yednn. 1551.CO _ I81 S't 6230S Sonora M, - 0 No 4SoIN to from( f Ter F v.+palrt 5 X1 0-1CC1!ll :'S44, -21361 '+-sz,n 34 Yh CO 1 2,0 224:PAN -.r_tor PO r ... ,. edo$ la leer c4ar1J�.- ... 3�'--5-C91 ?1 0.^i44`3.55 •uA IJ;IY'79 :-4 11JY2'?f9 .csa�.L' na na a]1l l3044dT4I*1 � M..Jam. !. _- -1-— .L._ __1,__ 1 — _ �.,� ,-- F.Q.1 n _ _Ask _ - Print Form ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL GG 'N Washington 5th Floor Phoenix AZ 85007-2934 (602)542-5141 QUESTIONNAIRE I Attention all Local Governing Bodies Social Security and Birthdate Information is Confidential This information may be given to i local law enforcement agencies for the purpose of background checks only but must be blocked to be unreadable prior to posting I or any public view Read carefully This instrument is a sworn document. Type or print with BLACK INK "I\ An extensive investigation of your background will be conducted False or incomplete answers could result in criminal prosecution and the denial or subsequent revocation of a license or permit. •FIE.,.:3MP�E TEo BY EA....1.4 COr.TRCILLI'r.,PETS '.1 AGENT OR MANAGER EACr1 PERSON COMPLET NG--Ft;$FORM MUST'3USPAIT .N ,F ','CANT"_y PE FiNGERPRIN'CARD Vir.—CH Mnt BE OBTAINED AT OLLC HPJGERPR INT•Nc.7 MUST BE DOt E B'i A BONA FIDE LAW L^ 1 E iCNT 4.GEN{.Y O^'A FF'NOEi'''Ri''.T'NO �.:4' UL Ar'PRO ED 9V DU-C. THE DEPARTMENT DOES NO- D THIS..';EP.V.CE Effective 10/01/07 there is a$24.00 urocessing fee for each fingerprint card submitted, ,�,1�q Liquor License # Ib _(eeS allowed by AI,R$ §4Jt 6852 will be charted(nJ- ighonor1 ,(J check 9 ,,\ /01'[r' 22 2-- �c) (if the location Is currently licensed) Check I 5i Controlling Person =Agent 1 J Manager(Only) appropriate (Complete Questions 1 19) (Complete All Questions mut#14,14a&21) I box —.b. Controlling Person or Agent must complete#21 fora Manager Controlling Person or n lust o • IS 21 2 ' HAXEL G EOF REY CHARLES Da!e of B:rt' Ldsr 1 orrJ% ti-,cii San.,r+i. Nnrrbe. L'P State AZ lic record) btic record) 4 `),,y-e:,r B,H PONCA Clry OK USA -Ie hL 5'11" We,ght 248 „:_yes BLU Hair " BR_ _ G! : _tilt: Country i'-'ul'._u'tr ;r a S'a..s _, ^o.c Z t,ta•.. _ _1- _aAI- e car tau,-hnne lo02) 728-4302 _ N.;rne rf Cr tier) or Must R'ce' S;wvse. HAXEL LORI GI,YN SMITH bate,Ir ewth ai iL•st all for last 5 years Uso sdd'tional sheet if necessary/ .1st St ki Vdle Me'Oele (NOT a public record] n '. , ,i e a bcvta ride et.t.�. ., ,..":i' 5 te" ARIZONA 'Arko^a date 4r res•dency AUGUST 2001 '3 ;lep'o-,e nwmEe''o r.�n..ac ,..•.i a..'. __. ' ;Tess hours'for any q,,as•ons rega=dtrq,r't!s,ibctrert (602) 728 4302 F^ .. t,'1°L.r.aip been ar A r.ona esid:ill fix.ei.s tr,11r1•'.r,e'31 rnor''rr Si.t.),ne a rop of':(-:r Anzora c.river'S llcerse to v'r'Ner.u'tv r-iu,:,ra— -"- 117' N a•-np of Lir:RrsrN1 Prerr ses C,t i�.1 l i tit L- i tht.. .,1'LI r 1 Prr-r`t,5p Phone 4 C L' --- C)f})s-3.4'• ___ P'..'.i.t ai Location of L,i.erised i'renrses Add,ess :I:t : _4:tr1AV1.[1LL.1C N1„r4.rAt IAY ,.7!•f'''i;,N. _V__)•_N41 c'��\. Sireet Address 'Dry,c4 use PO Box#; ' City Cr:.0 arty i 7ii I ^ '2 us;your employrnert or tit e of business during the oast fiae t5,years If unemployed Bari of the tame,'Ist those dates List most recent 1st ' FROM TO DESCRIBE POSITION EMPLOYER'S NAME OR NAME OF BUSINESS "..1crtnife,a Monin,=ear OR BUSINESS s:roet ar;O* is �'y „ate&zip] 08/01 C,;Fr _i' I Regional Vice President Circle K Stores Inc 1130 W WARNER RD,TEMPE,A?85284 1 1 03/00 07/01 ,, NW Regional Manager Circle K Stores inc 1130 W WARNER RD TEMPE.AZ 85284 JI I ATTACH ADDITIONAL SHEET IC-NECESSARY FOR EITHER SECT+ON4 13 indicate your residence aCdress for the last five(5)+ears w 1FROM 1 TO 1Rentor, RESIDENCE Street Address 'irrr YearI Mor•rvY€ar l Own It rented attach a dd ofnai sheet a'H name:address and phone rirrib-Y•a,laralord City i State I Zic 1 08101 j CURRENT OWN! 7849 E VISTA BONITA DRIVE Scottsdale AZ 85255 r I i , ii I I I _ _ _ . , LIC 0101 113012008 Disabled individuals requiring special accommodations please call the Department.(602)S42 9027 If you checked the Manager box on the front of this form skip to#15 14 As a Controlling Person or Agent,.'i t you oe 5njs,catly present and operating Ile II-ceased premises'? OYES ONO I`you answered YES how many h-s,oay? anti answer#14a below ;f NO,skip to#15 +•ta Have you mended a DUX-approved Liquor law Training Course Within the past 5 years', (Must provide proof) OYES ONO if the answer to#14a fs"NO" course must be completed before issuance of a new license or approval on an existing license. 15 Have you been detained,cited.arrested.Indicted or summoned into court for violation of ANY law or D YES C NO ordinance,regardless of the disposition,even if dismissed or expunged,within the past ten(10)years {include only traffic violations that were alcohol and/or drug related)? 16 Are there ANY administrative law citations, conirslrance actions or consents,criminal arrest,indictments 0 YES C NO or summonses PENDING against you o�NY entity,rt•which you are now involved? 1U_ a entity, Kr t G 1/ Have you of any t4 in which you have held ownership, been an officer, member,director or manager OYES L.NO EVER had a 6ut;fness,professional or liquor application or license rejected,denied,revoked,suspended or fitted in this or any other states ="r''' 13 Has anyone EVER filed su+j nr_obtoinet•a,i,dgment against yoe,the subject of which in/Dived frz;,i r DYES 0 NO misrepresentation/ 19 Are you NOW or have you EVER held ownership been a control`ina person,been an officer,member, DYES C NO !".±rector or manager on any other ficior Ocensre in this or any other state/ If any answer to Questions 15 througn 19 is"YES`YOU MUST attach a signed statement v:y cprlplete ueilnii,G,,inctud,ng dates agencies involved,and dtsposittons SUBSTANTIVE CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED r= 2J I GEOFFREY CHARLES ttAY.XEL hereby declare that I am the APPLICANT/REPRESENTAT,VE or int fur ,,ar=e of Appi;,a fiiing t"tis questionnaire i have read this questionraire and all statements are true correct and complete X ARIZONA P.AAICCP.A n State of Covt<ty of iriat.rro of A,;,,licart{ r,1'o•oyarvj v.,s 'refute•n.-tt'•e *ri _ 0'1 day of f 7,i'I �'^ Vat.' 3 ail ..t car- mta ]sior expires cr Z 'SJ. :;+�4ce... /� �a��. r•`-� Day bti 4fti" Yet. C ,Sigr; re of NOTARY PUBLIC) COMPLETE THiS SECTION ONLY IF YOU ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21 The applicant hereby authorizes the person named on this questionnaire to act as manager for the named liquor license The manager named must be at least 21 years of age State of _e County of The foregoing instrument was acknowledged'Je'o'e me this X day of Signature of Controiitng Person or Agent(circle ore) Month Year •S+nahi;e of NOTARY PUBLIC) Pint 7,4ene My commission expires on Day V,c-rth Year /nik Questionnaire Supplementary for AZ Dept of Liquor License&Control QUESTION 15 1985-Tulsa, OK, arrested for misdemeanor public intoxication&disturbing the peace Paid a fine&released 2004 Peoria AZ arrested in February and convicted in August of an extreme DUI QUESTION 16. Entity response for Circle K Stores Inc See attached list of AZ violations QUESTION 17. Circle K Stores Inc Interest in any other alcoholic beverage business Alimentation Couche-Tard Inc is a publicly traded company and has several subsidiary's which operate retail convenience markets in the United States and Canada under the following names Circle K(US) Tabatout(Canada) Phillips 66(US) Dipanneur 71ours(Canada) Mac's(US) Macs(Canada) Bigfoot(US) Wink s(Canada) Handy Andy(US) Mike's Mart(ranada) Dairy Mart(US) Becker's(Canada) Couche-Tard(Canada) Daisy Mart(Canada) Ti Provi-Soir(Canada) Dunkin'Donuts(Canada) Most cf these sites have alcohol r Number of Sites Approximately 5,000(3,000-US&2 000-Canada) Circle K Stores Inc operates approximately 2 000 stores in 18 states Interest is limited to employee/manager/officer relationship r-- License applications denied It is the company's policy to secure alcohol licenses prior to constuctingtacquinng sites If an agency recommends denial of a license application for lust cause(close to school, church,high crime area,etc),the application is usually withdrawn and the site is not purchased Licenses suspended/fined-The company trains its employees on the techniques of alcohol management Periodically an employee of ours may incur a violation related to alcohol Some jurisdictions will only issue a citation to the employee therefore it is difficult to obtain knowledge of these violations When the company is also issued a citation,the company may be fined a dollar amount or the store is required to suspend sales for a period or time A report of citations can be created by request for those citations where the company was fined Licenses revoked To the best of our knowledge there has been no alcohol license revoked QUESTION 19 Only as an officer of Circle K Stores Inc Signature , Date 21 I t .1 did .l Jtry tur,.. ...1A^11 at pas IL I I, c,-L . r Ci'7,,x CS i .'1'1 I e.:pl ;J ; •.. •..,,, *fat r c1.su Q CLa21 M • S. ::t1.ns� t '•^5 t4 t"1^1 t G 1 rp.2l - it 5- M1't•T .. w0lsum olio—o__.aN- 8 W=• .. tt -II.IS i Kt O."�'S I E L`li 12 CG 10000t �.r,,,� I ..„.4 c.444-41i.rl Na1¢.:g .Wnu+ni S40$ aN ,, i1'1? t$1$ * )J"J=. .a L �.t.�" tst '0 S .I T o-rt � Itasca,:i s"00 iz,63 1 r: _. _._ 1 et 33A6`<dW3� 14O12Y101A 01'7MSY RJ73 AM➢OY Lora A !N►"tweiZrIF, 1010 u' 1 alv--?2' 3MC1 t Q---. all Nl.W 1 ., -. ._--- r - G 0 Z L J is AequlnN t 0101 tap .L p,C_--., 0.4 1.1 p.wvuw.Q .1.40.01117.1, -.. ... _--.---i000. iiiiiV,01A lfO`/en Zv SOCt w. il-` ... _ __ .. q{ _ _.. 1 t I. e:nFeoetNounarOft 4-- 0y liA_of _ -tsCti IaAt a•as'e' an* AnN30Y i SIVO A T UM -1R Mt ARV— AI* 3N2 WHO1 N O •3SM3'Dt1;Kt Pi .-- 0 •erg O�O 9A S : -A� ^t0 r-- ._ -- _. ---__1.—..-__t_.�._ .1 ._. - .__.._-.. ._ ___, __i_� r !`'+°: iHr F4 ^". FL I4e444!10e1SF ;'.wil►F,Ih • .._-.. ' --_LIt7'. __--RW0110:GIA dOA 4 7 OIo2 • O'Ieu+6:J p.et "Ann 51 SNfx1 SN 1 1e,t IOC 2'r 1541:•=ki WI I C0 SL PA=+A 0. ,E LS.tEY Eft0L I St002O-Gi tr" M=4100 O.." ,9Jgs Qt.,."1 44, M IOC A 221, t 1ltXJ1/K t*t_..,4 cc xi.* 3 p 1342 C4S001:; CS:OLQC' t,t-4 =iccd OM'�° "011 WOM'P ' 00A att O i+WtS'i7 t L0211 LOC 7}1 Mt I CC•z$ t Ina£ !°JS€, CKSALZ i 002010-67 1...- 32A014giB NpiYlgI '01.1IS , 1h3 AONsers ' 31C0'A !NY"1:Arei.l1 2WY I A113 (?NCZ itlO15 I OM31N]Z1t MAPI _ _ t sM'u , __ *__1_ _ ;_ 1 Mtn 1_. I 0 6 0 0 0 70 Ast'N0'>t'1 1 WW1 -nr vJ¢ wa 1=t o�t+aao =btltplA t t,JZ SY441Y141I.4 iiL41MDn ZY 410¢ j i 1, ten 404gkaiY1OAok -..��-• g3A0101$1 Karnak.mutt gm* , Apote., i1:Ye'A i 4tr'RtTisi I an, I A1.7 j3NG2 'gaols' ok•33N33tt;N11t , t. :_ j. G Matsoc - a I o i o o a a t?wannN , 1 , Mb: ! IIIr j D1[ t P.C. Xt W=ESt0s!C �'l6eISIA. �...�__._- _._...L.�..... 1 _._.___-__ Print Form ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL 800 W Washington 5th For Phoenix AZ 85007-2934 (602)542-5141 QUESTIONNAIRE Attention all Local Governing Bodies Social Security and Birthdate Information is Confidential. This information may be given to local law enforcement agencies for the purpose of background checks only but must be blocked to be unreadable prior to posting} or any public view. I Read carefully. This instrument is a sworn document Type or print with BLACK INK An extensive investigation of your background will be conducted. False or incomplete answers could result in criminal prosecution and the denial or subsequent revocation of a license or permit. TO EF COMPLETED S e EACH CONTROLLiNG PERSON.AGENT OR MANAGER EACH PERSON COMPLETING THIS FORM MUST SUBMIT AN ASP•-.CANT-TYPE FiNGERPRINT CARD WHICH MA) BE OBTAINED AT DLLC FINGERPRINTING MUST BE DOf.E RV A 9O"d.A 'IOF LAW NFOPI EAENT AGENCY OR A Fit.GERPRINTNG SFR',ICE APPROVED BY OLLC THE DEPARTMENT DOES NOT.PROVIDE THIS SER,"I'.E Effective 10(01t07 there is a S24.00 Dro essing fee for each fingerprint card submitted, / Liquor License nse # The fees allowed by A R.S. 44-6852 will be chanted for all dishonored checks. 1S 0/62z2 § a! t tr. (If the location Is currently licensed) Check 7 Controlling Person nAgent 0 Manager(Only) appropnate (Complete Questions 1 19) (Complete All Questions except#14,14a&21) box —.pp- Controlling Person or Agent must complete#21 for a Manager Controlling Person or 1 c 81 KWIATKOWSKI KiM KENNETH •,- Na'rre Date of Butte Lan, rsI ( is rd) r n. ',.i.-.. -ii Recitnt,,Numtei ----D nrers Li r•nsei A State AZ �i rocord) ( OT a pu iic record) <,c;H of ,,th MESA AZ USA ,g,,1 5'i i" Weight 200 Eyes BR tiJtr' BR . City State. Country -tot ot,nN 602 j�j ii'1Jn.i S.aWs Sir ,e Ma^"i r` D,crced L0 fMidc'veJ is tme CortactPhone —— e i...3n---.of Ci.rrnnt tb Most Recent Sticiusr7 KWIATKOWSKI JANIE HELEN NOGA Date o'Bir'n _ +if.t all°or Last 5 years Use additional sheet if necessary) Lai' - First toddle Ma,ier — (NOT a public rocord) , S.a'C a{tor a fide t'�rie:'lt Of.,,i at stdIP ARIZONA — if&ninon :We of'esidency 07,0l'1952 r,lep'-)Grw n'r^.bar to CGr'tAct ic- t,i,,,-,'..sic .,r F S nose,5 For any q-iesti'r s.eyardi g th5 doturra. t 602 509 5465 :I d0,1 -lave.been an nrzona:es cer't for,e!:.;5 thai three.3)months submit a copy of your Are ona drivers license or vo.er r,•gistrat on card irne.31 Licensed Premises C.. 'c , • tI J-i-,,,..,t_ $.r_ y li L.I Premises Phone t_t `� r t L -'br -} 1 Ps cai Location of Licensed Premises Address ''I i ).. _ 1 ''1,\o,,�_`e._ �/`,.` •f .t-y,i.•1` r tie_ni �'i +'Li .>)ir' Streit Artiness iDr i r.at irte PO 8 %a) / — City 1 Z p ON2 L:,:aou, employment o't e o'o' u>,ness vteinq,-4 past'I've(51 re.rs If unemployed Dart of the time Its:those dates List most recent 1st FROM TO DESCRIBE POSITION EMPLOYER S NAME OR NAME OF BUSINESS I MorilntY•ar Morehi'ea. OR BUSINESS rstre.t address city, stale&zip) i i 1 0.1/94 _ CURRENT Licensing AgentiAsst Secr J Circle K Stores Inc. 1130 W Warner Rd Tempe,AZ 85284 i ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION/' 13 indicate your residence address for the last five(5)years ' FROM ( TO i Rent or RESIDENCE Street Address I ',eel xYear.MortruYearl Own if�ontod attic',u 'tiit,c>na i'?ecl wth rare,a' less and phone number iarultord .y C State, Zip i i 07/10 'CURRENT Own - 7853 S Michele Ln Tempe AZ !85284 07/09 t 07/10 Own 3935 W Roundabout Ctr `Chandler AZ 85226 j 09190 ; 07/09 Own 336 W Larona in Tempe AZ 85284 r f I i UC 0101 9/24/2009 Disabled individi.als requiring special accommodations please call the Department (602)542 9027 If you checked the Manager box on the front of this form skip to#15 4 4..s_ 'ontraillrq-=ersc.i or Agent,w.II you De pn•,stcatty preser.t and operating the licensed premises', DYES ENO if you arswered YES 'mow manly urs..:;ay" _,and answer#14a below If NO,skip to#15 14a Have you atended a DLLs, approved Liquor Law Training Course within the past 5 years'' (Must provide proof) DYES D NO If the answer to#14a is-NO',course must be completed before issuance of a new license or approval on an existing license 15 Have you been convicted fined.ordered to deposit bail,imprisoned.olaced on probation Of p,1rral:'.. D YES X NO had to tort bond or ttad sentencQ,,usoentg for any violation of ANY law or ordinance within the past r=un (10)years(include only traffic violations that were alcohol andior drug related)? 16 Are there ANY administrative law citations cvmpllance actions or consents,criminal arrest indictments YES L NO elliN or summonses PENDING against you or i1Y erti•4n which you are now involved', 7 Have you el-any e��_n,,,t jyin wh oh you have held ownership been an officer,member director or manager gy`S ID NO EVER had a�bt7'Gtrress pr;ifess•onal or 'Zttg-opi,ca',i4nsr to: ,n ze_lee,^ctect_s_find d,E.i=E=ed *..tgae is ,r fined in this or an,/other state? &Ncl c-'fu 4'( g Has anyone AVER filed sL,it or obta.rted a i.idamen:t a;ain,st you the subtect of which invo'ved fraud or -t'ES 12 NO r^sre;areseniati]fin? 1 j Are you NOW or have you EL ER held ownergun been a contrQjtno>Yers; n been an pfrkt lileipbef X;YES l.Ti NO ireGtor or manager on any other houQr license in this or any other state If any answer to Questions 15 through 19 is `Y,E>"�'Q!)MUST attac.n a z!gp.gcl,taterrenj Gibe comolete details includ'ng dates, agenc,es rv.olved, and dispositions -ri rn SUBSTANTIVE CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED t1'" _:i KIM KENNETH KWIATKOWSKI — — :e y .1.ciorr_e ha I am t'i:•APPLtCANT'REPRESEN'ATIVE i- 3 tprm=i.=t ram cf A. n} r"rigg it 5 luestiornaire I have re d thi„ l.os`io n+1aire and all stater'e+tr5 a'e true cor'ect and complete __, �-- -- Q f— X \4\ ^ �"J — —-- 3t.,,„if ARIZONA Cui.r'iv of_MARICOPA (sky,I.e.,cr-+upiiran) $ 1 Th'toregoznr3 nst*I•;man was,ck::ow udge,Jdi?re ire 1-s r.v commfs5:on expires on 04.5---:SAC' `2ar j . H• o ff_-`' J a i nth YriOf .,gi'„�+ u!Wr1`rArcY f'+J'3L!i i ^ COMPLETE THIS SECTION ONLY IF YOU ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21 The applicant hereby authorizes the person named on this questionnaire to act as manager for the named liquor license He manager named must be at least 21 years of age State of County of _ T'ir'forf3goi.49 tl4trtafnefft'r.as aCknowiecged-Afore rne:P'S X day of 5.ui"r`'ure of Controlling Person or Ageeni(c.:c:e c.ne I A4Ontn�..-.—.._— Year —.— _ —._� _— Sian, l,re_f NOTARY PUBLIC) Prr'P»^-w •,•ty commission exp,es or • — ---_._ ay t.V,r^ \'r-a Alelk Questionnaire Supplementary for AZ Dept of Liquor License& Control Entity Responses-Circle K Stores Inc re Kim Kenneth Kwiatkowski QUESTION 16: Entity response for Circle K Stores Inc. See attached list of AZ violations QUESTION 17 Entity response for Circle K Stores Inc. Circle K Stores Inc Interest in any other alcoholic beverage business Alimentation Couche-Tard Inc is a publicly traded company and has several subsidiary's which operate retail convenience markets in the United States and Canada under the following names Circle K(US) Tabatout(Canada) Phillips 66(US) Dipanneur 7 purs(Canada) Mac's(US) Mac's(Canada) Bigfoot(US) Wink's(Canada) Handy Andy(US) Mike's Mart(Canada) - Dairy Mart(US) Becker's(Canada) re Couche-Tard (Canada) Daisy Mart(Canada) r;; rovi-Scar tCanada) Dunkin'Donuts(Canada) Most of these sites have alcohol Number of Sites Approximately 5,C00(3,000 US &2 000-Canada) Circle K Stores Inc operates approximately 2 000 stores in 18 states Interest is limited to employee/manager/officer relationship License applications denied-It the company's policy to secure alcohol iicenses pnor to constructing/acquiring sites If an agency recommends denial of a license application for just cause(close to school, church, high crime area,etc), the application is usually withdrawn and the site is not purchased Licenses suspended/fined-The company trains its employees on the techniques of alcohol management Periodically an employee of ours may incur a violation related to alcohol Some jurisdictions will only issue a citation to the employee, therefore it is difficult to obtain knowledge of these violations When the company is also issued a citation,the company may be fined a dollar amount or the store is required to suspend sates for a period of time A report of citations can be created by request for those citations where the company was fined Licenses revoked-To the best of our knowledge there has been no alcohol license revoked QUESTION 19' Only as an officer of Crcle K Stores Inc elliti "T- . 3013 02 LIQUOR VEXATTOtt0 2013 1 I ----L- -1 -r---- VIO-lottorti Dismissal lst . 3010 Hid ''..- 4ttt 1 EMS I I- , 0 , 0 , -0 , 0 , 0 1 4 I tOoDOV -.- I 00•LIN4 7.-- SO CA 4- cant." -3.1 1-- Ira',11442111E.140...STORE i =A 2, CM MIT i 1st 2n4-41h V-DATE AtIENCY 1 CDS I A33C-0 10134.117014 f EMPLOYEE I 40 viiitAno048 FOR ow: i i t---- , I -- . 1 1 r ...L. 1 — ,.-_____; . .., . r . . ; .. -WI AZ L.CtUalt%nat./1.737mA .:ow — 1 ; 1 ! e -7 — 7 illik ' - Oltailtais: Oismarod '. ad 1 atti It d I- MI, t-Total 1.- L- Stondar ol: 0 1 3 e 0 0 3 01.4ulna ...-,,, uCENSE-.10 istaftg I rpNE erra 4307DATE 1 40.514CY --CVO A2X•43 tvlousraki . -iiMPI,Fiti :0,11 I 04-070703 4:2LX1i1.031'..1:3106 tiOsal $700 00 01 VI?zol ii...040.,100 $0 "rIms i3ci0 10 Slaw OssoallPorks 00 11 10-070103 2700563j t'aiii- okn4.4. Pso 00 it &I,1201 i I Az Mt '404 . 31,3-1-4. --law- IDattas Swarm ..,. 33. 1 08.420010 2700100i:3'V Sari*ism I st 1.22201'I 42 Da. , 'fos _ No ISal Is Saar •tIs i Caraila • ! 1 r r . I 2010 - AZ LICUOR litZi-AT rani 2010 I I .L —. Violation*.!--Oltattio0•41 . I ti - I ,toil 1- NS Ms 1 Toad I-. ------ 0 ' 0 to..evw i , i ....Lisos , So 07 i came. _ .0 _. 1 MTN i ucet030440[STORE 1 ZO1*E -- ' cooy ,. 001T---riTas ri-70ArE r iaiirt ,i I Edill Au iitic-7anot• 1 ESSPLOY1.1 - 4 . • ---WO-ViDLAT33443 FOP 2010 —r- . r- _ - , 1 . . .. .. . .._. _ _. ^ne, SZ LADOR Y1OLATOS411 3000 -1-1 ' . —..1- , 1 ..... Via soca, C.o.d.s's! - tot Did N.11 401 to I I - WI t- 11,-titat at ol 0 2 2 0 0 ' 4 s itilISOT _ I I •:-DI, . 00 1- ...-. *I/---1..1214-7400TiTt0O1 izai4/1---crt 7 414 2 i st2nd.4t01y4L),je 44,1:E04S1:. F dB t ,0..St4:0341/10.4,STION ,FAIrsoar. .4,.9, c...,:.,010060 fi700,603 I T .6,Java Lc • , t .4704-1,0 t .T.., -1 t T Emo:mat 1..01.41t10 4 to.: 1 3 163013. 3 Eamla PC3 CUP i 110 ri.Sod Oa ntra.,1 23133 $7$2. .,t4 2 122X14 7411$t3 E07 Ilo Sad saIMM I rort-g novos i--;• ra"-Viiiis I:r.713 ,?..7:',00 r- -'1,;,,A 04365733 ' .,..0 t I 1 3 0.100110 27220411 22150 I Tt.r.swi ..T.0 1 224 Y•339' lissta,TD $3 2O3 DC :fa I 313,RO39 741 I 'rasa\PO I NI ' •ta 4....STO 1.0rtot i ft. .Si,10 to 0/1.-natautal ,alaro...,:s. ran:Joss 1'..4 311 1 • - ''-•.- t-I• •-' illiN elk ON Print Form ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL 8i00 WW Washington 5th Floor Phoenix AZ 85007 2934 (602)542 5141 QUESTIONNAIRE Attention all Local Governing Bodies Social Security and Birthdate information is Confidential This Information may oe given to , local law enforcement agencies for the purpose of background checks only but must be blocked to be unreadable prior to posting 1 or any public view ^ Read carefully This instrument is a sworn document Type or print with SLACK INK An extensive investigation of your background will be conducted False or incomplete answers could result in criminal prosecution and the denial or subsequent revocation of a license or permit '-0 bf .�C. ETsu tat EACH "-v'TRC'ult,<,G PERSC:'v ,AGENT Uiii MANAGER riACH PERS)N:I.).iPLETNG THIS FCRM MUST SU3MT AN -AP PLtC.-".1-'YPE r'NGERRI'JT CARD'li`+ICri MAY BE_STAINED AT =!NGERPRINTI.NC MUST BE DONE BY A BONA FIDE L�•h _':F CF,CEMENT A.GL NAY C,P A FINGER RIN'ING SER`i,^CE APPr:c3' ED BY C_L T-IE DEPARTMENT DOES NOT PPOt1DE THS SEPVICE Effgctive 10/01/07 there is a S24,00 orno_mssinq fee tQLgach fingerprint card submitted., `,�j Liquor License # The fees allowed by A.R.S.4 44-6852 will be charged for all dishonored checks. i701 l /f?}2Z Z �� (tf the location is currently licensed) i Check 1 El Controlling Person- EjAgent ® Manager(Only) appropriate I (Complete Questions 1-19) (Complete All Questions£i4.ceGt#14,14a&21I I box --bp, Controlling Person or Agent must complete#21 for a Manager Controlling Person o t lee#21 'Ix MEZA JANET KAY , ,Ir Flirt.,. � T ,;,o -- ..tt , dl .a _.-.. _ ,:a:Security Nur t or. — _Drfvt, L.'c!�n:e# _ Sta,e AZ i _. a pu Ilc record) bile record) -ri p',c,., Bet, GLENELLEN ALASKA USA e,yht 513 ,ye'ght 185 Eyes BR_ Ha-rBR i"i City SFa'e Country i'O'. CUn'y l _ ,'4 .- S atUS -1` '-,g;P X. bt_3- la,o.:_:.E''i.:wed Daytime Cantac,?',ore 1602) 728 7750 43-1e it C.urrer't or h lost"Recent Soo..se MEZA HERNANDO (none) Jate of BirthBalh101101111111111111WT�-- List all for last 5 years-Use add tional sheet it necessary) t:si Fr'si kiddie Maicen (NOT a public recordx T 'r,u die a bona`rte'os,dent o;.vha'..ta'e? ARIZONA if Ari7o-a c e of rnsit,e^ 10/1072 _ d Tc - r"., .•^e our-be.to crf:i-t it. 3u•na ,,.r s t: ^i„ S' . y4 ,. , ...^,ti,�r s e,a-t't'g ih,s l ci~'ent 542) 728 7150 __ .1 .f you rid e been al A7,01.1a resirt,'nt'iy ess IN-in'Untie 13)months s.;"_'rnii'3 copy of}our C.nzona dove"s I,Gonrie or voter rPg's rabon ca'il i i C f j^3e of uicersed Frem,ses i, . -i c. %qa0 _ Prem.ses Phone. 1 F t L)- ,f.- 5L i3 C r'" k( i i i `�' 1 P,.rs^a,LoCatron of L.cense'i p t,T+•."e Air :; ,- ) ) l A i fl(}h.,.l '"'t` P"C t,t,c ,3...c"�c.v i..__:r 3L ).2(C OIN SI.tr I Ae e5s ,U use FO L._Ix it; City n Gou ly Z o 1." L,ct yU it err`t:1ov--nert Cyr l-,pe of busirress d.crnc toe past rive 5i years uncrrakO od oart of Inc Iine •.:s, rose da._:s List most recent 1st FROM TO DESCR'SE POSITION EMPLOYER S NAME OR NAME OF BUSINESS Mcrth'rear MontnPiear OR BUSINESS isw . (st t.,r,nre„ cxiy,State.- ._,v) 08/98 CURRENT 1 Convenience Store Circle K Stores Inc 1130 W WARNER RD TEMPE AZ 85284 I I ATTACH t.TE. TIONAL SHEET IF NECESS4RY FOR EITHER SECTION$ 3 t^dicate}oar residence adhress for ne L •` i ;_-ors FROM I TO i Rent Of RESIDENCE Street Address 1 = ',t?^:n";ear Month,Yeai I Own i t,,-,,.•7 .a:`:a s sti 2.t.t With name,s, adsurss and ehure”...in- er c,t ard,cta { O'r'1 State I Zo ('' 10/91 CURRENT{OWN 10411 E RUSHLIGHT DRIVE TUCSON AZ f 85748 1 I Li LIC 001 ti30r2009 Disabled individuals requiring special accommodations,please call the Dc,partment (602)542 902T If you checked the Manager box on the front of this form skip to#15 14 As a Controlling Person or Agent will fou be pnysicalty present and optaratng the licensed premises? i_AYES ONO If you answered YES how many brsiilay?_ are iinswer#14a below if NO,skip to#15 14a Ha,e you a"ended a EiLLC app,ored Liquor Law Traning Course with,-::Pa oast 5 years') Must pro cc proof) EYES'ENO If the answer to#14a is'NO course must be completed before issuance of a new license or approval on an existing license 15 Pave you been convicted,fined,ordered to deposit bail. imprisoned,placed on probation or parole, i=s YES 5'NO rad to post bond or had sentence suspended for any violation of ANY law or ordinance within the past r=n(10)years(include only traffic violations that were alcohol anchor drug related)'? 1,3 Are there ANY administrative law citations,cc_mplierIce actions or consents, criminal arrest, indictments AYES Li NO or su nrnonses PENDING against you oc'ANY entiniyi which you are now involved? _ ,r; '7 Have you or,a ny enti i' n which you have held ownership been an biker member director or manage- jXyL:S U NO EVER had a business profr.sson<tl or I!ilynr ap};a:ir. ;jpn Gr!Ic n e_r,t'rstied at?ri .IQYS.i"L1 S10,2g'.rJ.`=d r fined in this or any other state? 8 Has anyone EVER filed suit or obtained a :udgment against You the subject of which involved f-aud o, L YES A NO i'isrepresentation'? 19 tare y'ou NOW or have you EVER held ownership been a•or frplltngp,'ersort, been an effjcej, rn nt)er, `%T,YEES _;,•NO director or manager on any other liquor license in this or any other state? Mc,is 4. ,;-iv,,„ c „_k k ;.t,.,`„ ry '1 any answer to( ,:es?inns 15 througn tra is tLES r OW Mt ai1Cch a signed statement Tt Gn:,complete details including dates agent les involved and dispositions fi SUBSTANTIVE CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED 20 JANET KIAY hMEZA hereby declare that I am the APPLICANT/REPPESEN-ATIVE pr nt tut name,'.-,ppi ants `.1.,_I th.s gL.estionn.itre I have fead i ` questionnaire and all staten-me,.ts are true correct and complete FAAPCICOPA n X (...ellWrg: State:,i/ ARIZONA CO,„ y of 'R The fr,Kagetng.nS?ri.ntrli v.85._ad,!ta,vl,3"y 1',c`;.wv ne errs 77 i t',cC,mmiGs.on ex.el-ps ,n e _'l am—_e'),C,2 'f_ lit , � /� Day X4wrr isQrs.r. ',Dr,R'r-.E,L r COMPLETE THIS SECTION ONLY IF YOU ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21 The applicant hereby authcnzes the person named on this questionnaire to act as manager for the named liquor license The manager named must ce at least State of __ears of age ARIZONA County of MARICOPA 1 The forepn'n9.nstrumont K8s ar.%mwledgeo t)Pfor s me;his X .._.._... `.�'� Url day ni- 1, C'e-t'),:. d:t'i,3 ,(2 S.gnatu"e of Controlling Person gent,4r.;rc e o^r, r- Y<sr Kim Kenneth Kwiatkowski a —_ �__. (Si:t�itu:e of NOTARY PUBLIC) ` t ty';oriirrissic"explason ?►ice,'.r `J'cO/ _ 0,0 Month Ythir -r=.` =i•. .i' /al - a 800 W ashen ton Al Floor - 400 T Congers=150 Phoenix AZ 85007-2934 Tucson AZ 85701-1352 (603)542-5141 . 01 (520) 628-6595 CERTIFICATION OF COMPLETED ALCOHOL TRAINING PROGRAM(S) • OBTAIN ORSQMALS Or TICS FORM FROM 0241G-0O NOT PHOTO'.OPV;OCCUMENT 6 COMfP'tl'OW!SCANsiED. TYPE OR PRINT WTTN BSACK aaS. ALCOHOL TRAINING PROGRAM INDIVIDUAL INFORMATION /�Ik tndwrd ama Pnnt) • itterviciva:Signatur TYPE OF TRAINING COMPLETED i TRAINER MUST CHECK YES OR NO FOR EACH TYPE Date Train^.,;Completed 1111 YES❑NO BASIC ❑ YES I' NO ON SALE LANGUAGE OF INSTRUCTION I YES ❑No MANAGEMENT 1 YES ND OFF SALE ■ ENGLISH Li SPANISH 111 YES ❑ NO BOTH YES NO OTHER IF TRAINEE IS EMPLOYED BY A LICENSEE' r KIm Kwiatkowski Circle K Stores Inc. NAME OF-THE uceNS� — aUSiNESs NAME LIQUOR LICENSE NUMBER ALCOHOL TRAINING PROGRAM PROVIDER INFORMATION • Circle K Stores Inc. (company or individual Name ,- i 1 30 W Warner Rd, Bldg B F ooresa Tempe AZ 85284 602-728-8000 C1y State Zip Phase I Certify the above named Inonnduai has successfully completed the specifteci,program(s) Korn Glover ffil ,(�/r Trainer Name(Font) i rnner Siglltiiature (sate Trainer give original of completed form to trainee, photocopy and maintain completed document for your moon:_ Mandatory Liquor Law Training for all new appiiretions submrtted after Nov 1,'n47 &P:E Section 4-112(3) ). Compietion of the liquor License Trainrg Courses is required et ttr_isjuari a of a tioerrse, The personts)required to attend both the Basic Liquor Law aril Management;raining.(either or-sale or oft-sale),will include aft of the ic?;ovnng ormerfs),licenseelagent or manage(s)WHO ARE ACTIVELY INVOLVED IN THE DAY TO DAY OPERATION OF THE BUSINESS proof of attendance vv{dhin the Iasi five years for the required courses must De submitted to the Department better the licence apph anon is wnvoered complete Before acre rani of a Manaoe!s Cuesiianraire and/or Agent hange for an endating liens,prof of attendan a for the Basic Liouor Law area Management Training(efttm,on-sale or of-saie)wgt be required - :r_1=1 Di-,abied turn auats requiring special ar;.Lorninaasiiors ciease OW)542 9027 ------ -- Questionnaire Supplementary for AZ Dept of Liquor License & Control Entity Responses •Circle K Stores Inc QUESTION 16- Entity response for Circle K Stores Inc. See attached list of AZ violations QUESTION 17 Entity response for Circle K Stores Inc. Circle K Stores Inc Interest in any other alcoholic beverage business. Alimentation Couche-Tard Inc is a publicly traded company and has several subsidiary's which operate retail convenience markets in the United States and Canada under the following names Circle K(US) Tabatout(Canada) Phillips 66(US) Dipanneur 7)ours (Canada) Mac's(US) Mac s (Canada) Bigfoot(US) Wink's (Canada) Handy Andy(US) Mike's Mart(Canada) Dairy Mart(US) Becker's(Canada) Couche-Tard(Canada) Daisy Mart(Canada) Provi-Soir(Canada) Dunkin'Donuts (Canada) Most of these sites have alcohol Number of Sites Approximately 5 000(3,000-US & 2,000-Canada) C rcle K Stores Inc operates approximately 2 000 stores in 18 states Interest is limited to erriployeelmanager/oif-cer relationship License applications denied - It is the company's policy to secure alcohol l.censes prior to constructing/acquiring sites If an agency recommends denial of a I.cense application for just cause(close to school church, high crime area, etc), the application is usually withdrawn and the site is not purchased Licenses suspended/fined - The company trains its employees on the techniques of alcohol management Periodically an employee of ours may incur a violation related to alcohol Some jurisdictions will only issue a citation to the employee, therefore it is difficult to obtain knowledge of these violations When the company is also issued a citation,the company may be fined a dollar amount or the store is required to suspend sales for a period of time A report of citations can be created by request for those citations where the company was tined Licenses revoked - To the best of our knowledge there has been no alcohol license revoked 1 1 : 1 1 : 1 , ! i I, 11 I 1 1 !, ,., 1 , 1 1 , . i .... . . .. . , . , ......__..... i i 1 I _I . I. , -7;Te*P.M,1 M.NOS orV ---,.-rr.'' c4s1 statz,t ;,,,,, 1,;sir.: tfrazAZ 14 past C. OTC{gP,...),...4., CI Fto'S 171-r-.11- IV Oti 099-0%1 a=14C7.71- 00, Co V,'S••1 004",,,,i 11S tEZ reg0..2 0 t‘09 t-0 ,^ ri Igartnil u41i- !WM:ca WS i c,1 I 0(10 0014DR'0-0-Ea7r40t.0 1444 CK43.c.0 7 94-4409a A,..e:c;. .r.vsooLT 06-so 1-1'arin T430 At,*4644*.f`V etYte'1424:4T 194 7.9•:45....$ 4, 44.90 4,-; J.77,11: E939.0LE Sat1.74.0•90 ..teasta , kai..014:19.1.i._ N OWVIC14114 CI YIS-711 Ell:, i .cv4arcrs: viidlA illiv.p,,,s1,1.j :t:L„,:r. 4 A-1•13 I 3,4,0Z 2014 ..,..'1"4 204"4. r.i 6474 ,._ .7.4 4,..1 ._ 4 4 • 1 1 i M.11.11. cf.-4 1 I 9 0 1 c 1 t 7 z ` r.., 1 io 4 I • t 1.1 or, trial t _ fop i p.tc 1 1,47 L is.,„1 roswmo - .01rt.!.,10. 1 1.a. __...4.. 14 1 L , sotg 0N<XT•9190,400fIbri re Oat r— r -- - . . . i , . -- mar ___ Whl SO4Ct L9-100040 ; - _ 7 , ., azioViiii molly-tato% go4s-rt gri3 A...,1440cV ...,,,,0 IVO A 1441r-99Z11,91 • ii11---7-1-7--ki----i.39 ..,,, 11-314cr.7. 3 401S 4 0N-210340X1 1 Kt A 4 00 01 ' 1 M.014-m6a _ I t .1NO.P1 —- I 9 0 0 0 4 0 44494114•9910 ....__, , • . ' fot9,1 1 Wt. 9444-0 9 0Z 1*1 ;p0v.944urstat 1 VUOIttillyt - ' --t--- - Ol'OL Stial.VICIA 410;101 ro• a LOZ _.., r -I- - - _- 1 i I ____ 09.9•••1110:57419.4.; 40091 9t.PP.; 9f41 564•4 11.r'.4....1••24e :var..=; 101 Clj cist s •zA zu-sets a is2 1st ccazz 610,37;0'EO i_t vs ,...... - 4.4.94.0a skitt990.1 40W41 q FPS Cli 01.,k 100 Z.V I tat'St? IICO Nit 4500.-V4:. I t 1E2 £95GOZZ ESN30 I I-4.14 ---- ,t,litl 0.0,400t ,9i1iry 0191984 99,1+. 94441 Cd‘911q4e 1 .e.1,E•! 12 I 00 ZELt whirr! so;a =sot z ealaL0-% t 4'4901 13,1.0141134 NOLLVICIA CO451.1 ono 4.3.aost 1 Riva-i-I14v-ptst III, Ipet 1110 1 3/932 1V0.1.9 04444.01stoort HsIN • 4 0 .4 44./, f CO'nUt Mittf1.40 I I 1 -... L 0 a 1 0 L 0 ..ptO A 000114 1 %Id '., .... . ---..., t i I P L. t,AZ , le PaltsP0S10 :51,0 I --I r0*MLIt.i . I . 1 , - it.n2 stIc0101;190 ke.:..-4G14 .7.: lir: — 1 i 14 .,.. 1 4 1 -I _,. ZI.04 noa vsicou-v- A trg-- --.. i_ , ....., aStaletyp NO1,1,1rica4 01•14180 4 5012 .04. l40.:4.:4 ii.....,:: , 1.000..Z .1.11V 1 .•.1.4. I 0ric411-1111'3190.1.6 orentwei Hifi : :14: f. AV01-100a ..... mis.0 I. --- -ii -1.'— a 0 -'. - 9 — 0 /44 a -Bo leg4,unN 1.40.1 i tot 90010,14.0.4 - 1 .1— i . . _ — 21402 0tr011y1CIA tiC141-tli:V Z tee Ask, 0^ 1 Print Form I ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL 800 W Washington 5th Floor Phoenix AZ 85007-2934 (602)542 5141 QUESTIONNAIRE Attention ail Local Governing Bodies Social Security and Birthdate Information is Confidential. This information may be given to I i local law enforcement agencies for the purpose of background checks only but must be blocked to be unreadable prior to posting� or any public view Read carefully This instrument is a sworn document, Type or print with BLACK iNK, ,m1N An extensive investigation of your background will be conducted False or incomplete answers could result in criminal prosecution and the denial or subsequent revocation of a license or permit 'OBE COMPLETED BY EACH CONTROLLING PERSON ACENT OR MANAGER. EACH PERSON COMPLETING T H!S FORM`,JUST SUBMIT AN MP;LdvANr TYPE clNGERPRl.'fl'CCARD,:H''..M m. B nB r„It�EC AT UL_ G E.?PRINTttrv':ILS R' A SO NA F!CE ',yI F'eFORCEMENT AGENCY OR A P'I'sGERPRINT t2 -_R` 1APO BY C it `r+E t_; .'.+RT ME JT DCES'v0T PRC. H 5 S_PPsnCE Effective 10101t07 there is a S24.00,proce +wing fee for aci'finnerorint card su mitted. Liquor License T. fees allowed by A.R.S.6 44 8852 will be charged for ail dishonored checks. (��/ qa� d 1 '��L )` l Of the Iecation is currently itceriaed) Check Z Controlitrg Person °Agent i 11 Manager(Only) appropriate (Complete Questions 1-19) ; (Complete All Questions except a 14 14a&211 box --lir Controlling Person or Agent must complete 021 for a Manager j Controlling Person or must complete g 21 f•a..,e- HANNASCH BRIAN PATRICK Dri*e`A-3'ttn. a First ? ..die tit .r;.irl`y NI rnfee, Divers i_i ren�e ii ,,...--_._ State. �.... IN IN, a • .tic record) C record) 'Iw _ ri D acw of Binh CAROLL IA USA Heicht 5'10" Ale,oht. 180 y.es BLU ;air BR -l� ... City State Country of ro rr:t .,_ _- 5 f.laq.a•S ,_tatus ,Singe ig M?rri ld 17 Cw rcer'_E",n ..rxi w eaylirr Contact 7:et-rone (812 35fro'35 %are of Current or Most Recant Spouse HANNASCH PA FRICIA ANN HUEGERICH mate o{B.rtn E 'L.st ail for last 5 years Use addluonal sheet if necessary) ;asr ,,;: rAnzte .Mayer (NOT a public record)': NA ' 7 v a-e a bona fine res.dem of what state"? INDIANA ___. ,f Ari?or:a date cf residency �— 3 te,ea^one num;;er to cor a ,.•yoi,Cu^ng business hn-J.s to' ani cucsttons rega•ding this dal rnent ,i8121 3511573E r You have been an Arizona resident for less tHan three(i)months,ssb"tit a copy of your Arizona diver's ltcer^„e or voter re-grs.raticn care Name Of L.cersed Premises - i_._`t `-_.o Ce t:�._ _ -1, Premises Prone 'i L' =i G:J -'-�, ',r s �; 1; +tsical Locator of Licensod?rermseSAddress ' et} a I, r:+;,i.fNItR I< }7i `ct_',tit --,v'!c ,'..,.. ' ,1'01 Street Adtt"ess iOOo not Ise O Boa C ty Cuory' Lc: eiS 2 Li it a'our employment or tyoc of business dune :le O ast five 1.5 i gea'S If unemployed part of the Urns ;1St those ca,es List most recent 1st I FROM TO 1 DESCRIBE POSITION I EMPLOYER S NAME OR NAME OF BUSINESS 3n'ir,•'YearMonth/Yea- ' OR BUSINESS 1t-reet address cry state&zip) 12/03 ;.URPE_NT PresidenVSecretary Circle K Stores inc 1130 W WARNER RD TEMPE,AZ 95284 02/00 CURRENT • VICE PRESIDENT Alimentation Couche-Tard 1600 bout, St Martin Est,Tour B j 1 bureau 200 Laval,Quebec,CANADA H7G 4S7 ATTACH ADbiTIONrL Si-)BET tP NECESSARY FOR EITHER SECTiON i 3 ndicateyour residence address for the last i e(5r years Y rFROM I TO Rent orl RESIDENCE Street Aodres$ I!!I tfar lvrtar Moat"year Own {.•cried attacr arf it.o a — .F itt r3^'ie.SVdre5rt and;.,none r t^;ben"!.a;edii "d I ;City State ZZo i 04/07 CURRENT_ _ 1 OWN 615 WEST SR 46 I COLUMBUS IN 47201 Y 02/00 04107 i OWN, 4422 MALLARD POINT 1 COLUMBUS IN 147201 1 - - t I I I ' 1 , LIC alai 1130t2009 Disabled individuals requiring tpe,cial accornmotiations p!eatet call the Department i&02)542-9027 e\ /1 If you checked the Manager box on the front of this form skip to#15 14 As a Controlling Person or Agent,will you be ptaysically present and operating the ti «rased premises?_ ' OYES ONO r you answered YES how many hrsrday? __ and rnswer#14a beltaa if NO,skip to#15. 148 Have you attended a MC-approved Liquor Law Training Course within the past 5 yeas? (Must provide proof) - OYES ONO If the answer to#14a is'NO".course must be completed before issuance of a new license or approval on en existing license 15 Have you been rnnv'eted.fined,orr:4rec tn Leoosit hail.Imprisoned.pieced on probation or parole. 0 YES gj NO had to cost bond or had sentence saspenced for any violation of ANY law or ordinance within the past ten(1Q)years(include only traffic violations that were alcohol andfor drug related)? 16 Are there ANY administrative law citations,compli Ace actions or consents,criminal arrest, Indictments N. 0 NO or summonses PENDING against you or Y entity n which you are now involved? += ='i D la l 11 Have you or ay ent f in which you have held cwnership,bean an office', member,director cr manager OYES 0 NO EVER had a business,professional cr';ruler ataoticatlffl or.ir sl r eiai ter, enteal re:okair attt penned Galas f NLLal or fined In this or any otter state? 18 Has anyone EVER filed suj pr nbt .ri a}adamant against vtoi.i,the subject of which invcl ved fraud or DYES 2 NO 7tjarepreseri on? 19 Are you NOW or nave you EVEP held QainQrahip,been a controiling person,been an pffcer,mamhef, ZYES ONO diresol or manager on env other Itcuor license in this or any other state? If any answer 3o Questions 1 i avatars 19 is 'YES-a OU MUST attach a sicred statement rl 1 Give co"Vete deteiia including date's,agencies;nvo1ved,and d'socs;lions ,,.i SUBSTANTIVE CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED <,) i, BRIAN PATRICK HANNASCH _._.._, hereby declare that I am the APPLICANTiREPRESEN1 a1 IVE ior'ni fun name of Applicant) ry r ng this questionnaire I have read this questigrtnaae and all statements are true,correct errs)complete X at) f �// r,, % s ARIZONA C MARICOPA ..- .lv .0 as aaa G --• - stated. ou�ty rf tSignoiu4e of Applicant) rt'u roregoing instrument'.as acknowledged:reface roe h 3 !::----: __C r day of f toil'-„iv1�r;L ._._ ,Lie±sv. / � � Milt, Y ;;'y+.ornrYrission expires on �- --C:- C:ay rnlorh 'Yea (Signature JOTARYAtat.:C) COMPLETE THIS SECTION ONLY IF YOU ARE A CONTROLLING PERSON OR AGENT --- APPROVING A MANAGER'S APPLICATION „` 21 The appfi ar.ebtauthorizes the person named on this questionnaire to act as many r'-` r tne named iquer license The manager named Must he at least 21 years of age "'„--..- Slate of County of �� ,` i ire foregoing instrument was acknowledged before me this X day of Signatu-e of Controlling Person or Agent(circle one) .-r'- Month Year - . �. Prni Nan f ti nor; a of NOTARY PUBLIC) My cOmr',tesion cx jilt _ `�� ,/' Day Mortal Year � ,�� 104, ^, fr Questionnaire Supplementary for AZ Dept of Liquor License&Control Entity Responses-Circle K Stores Inc re. Brian Patrick Hannasch QUESTION 16. Entity response for Circle K Stores Inc. See attached list of AZ violations QUESTION 17. Entity response for Circle K Stores Inc Circle K Stores Inc Interest in any other alcoholic beverage business' Alimentation Couche-Tard Inc is a publicly traded company and has several subsidiary's which operate retail convenience markets in the United States and Canada under the following names Circle K(US) Tabatout(Canada) Phillips 66(US) Dipanneur 7 jours(Canada) Mac's(US) Mac's(Canada) Bigfoot(US) Wink's(Canada) Handy Andy(US) Mike's Mart(Canada) Dairy Mart(US) Becker's(Canada) r'y' ri Couche-Tard(Canada) Daisy Mart(Canada) Provi-Soir(Canada) Dunkin'Donuts(Canada) Most of these sites have alcohol. ;Number cf Sites Approximately 5,000(3.000-US&2,000 Canada) Circle K Stores inc operates approximately 2 000 stores in 18 states Interest is limited to employee/manager/officer relationship License applications denied-It is the company s policy to secure alcohol ;tenses prior to constructng'acquinng sites If an agency recommends denial of a !;tense application forust cause(close to school,church,high crime area,etc),the application is usually withdrawn and the site is not purchased Licenses suspended/fined-The compary trains its employees on the techniques of alcohol management Peiiodicaily an employee of ours may incur a violation related to alcohol Some jurisdictions will only issue a citation to the employee, therefore it is difficuit to obtain knowledge of these violations When the company is also issued a citation, the company may be fined a dollar amount or the store is required to suspend sales for a period of time A report of citations can be created by request for those citations where the company was fined Licenses revoked-To the best of our knowledge there has been no alcohol license revoked QUESTION 19• Only as an officer of Alimentation Couche-Tard Inc and it subsidiary's,including Circle K Stores inc,operating convenience markets under the names listed above in question 17 3 ) ' T . ' i' si i 1 , 1 i ,i5-,1 1 i I ; , , , .‘, 1 4 • I ' I ____.1 . .0,•J T, I ' ' i , 1. ...:•:: 421 1 ! , t), -21, 1 ' • i —61--1 . , _ ,.........c.7.1, gl Fsi I 1 t--"-L--.1-- i,.. 1 1 , I 11 , -I I .*•,'• il j'Alta I 1 i lit 1 P''' 1 •,:,E.gi gi.' , .,, 0 i ' -42 1 I 14.14,4 -I--.U1 I l'i .... , I =',., ,-........ 1,-a.": r.lit4 177/tsi 1 E I m ift r --0.•.n,“. .1..* . i a 2.1:!; -- ---- I I i -1----i--- • • I , f •,--,- 1 , i,-- i ) 'dr..:•,, i 1 7 I 1 . 7 1 1 , ir - i ' , . I ,. il- 1 1 , -i ''' I ..:..31-4 0 I . 1 1 It , .. tz.. ,..,, i I I; 5 1111 ! l'g 4 i--........_ w.,. -.7 r . - 1?„31-1i,rigi i 47 I '' 1 g C '11 t. 1:21',1:1M t 41 ri' 1, 1 __ _,,..„_____,T— .:_i, I 4. 777'. t.i x 4'SI 61 -t Ii .4 , 7. . ___. I I ,,..5, • 1 -1- -•--1---t----1# i E. I Z I-El ,.1,-c ..2. i i • fis r tv ft I I ,,,_, i 1 / V 1 la Z SZ i 1 I 1 ?4 1 ; ' ,-'•'''14-' . ' i i ' • , . rt, .'...• I I : , , ! ; t I licisr t 7171 7 ,g "---1 77 i I , 1 -T , . i , .:•:,,c,,,.:irr:; i- 7 ! , I ------------, I I ',' ' I ' • i I I .., 1,1 2, ' 7 7 t I ' ' 1 7 t• i I I If I 'I I7 7 1, , 7 , I I ' / 1 7 , . ' II 1 -----'``.4.-----,1 .. ,, . , 6 ' ! , 1 1 q.;,:,,,t, t , , • ; 1 0, I t, ' 1 1 1 • I .1., I i 1 , t , ' ! ,_... ,:11,04.ki ..I1 I • T U, ,t-2 C, PEACH tf4At 49,19e C#arafte/ 11,114711/011` Home o.f'the Superstition Mountains 14. z o' NOTICE The attached application for an Interim permit. New License. Corporation, Beer and Nine Liquor License submitted for Circle K #3444 located at 2933 S Tomahawk Road, Apache Junction, Arizona, was posted on the 15th day of February, 2012. 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 (1/2) mile radius from the proposed premises to be licensed may file written arguments in favor thereof, or objections thereto with the City Clerk at City Hall 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, March 6, 2012, at the City Council Chambers, 300 E Superstition Blvd , Apache Junction, AZ at 7 00 p m , at which time any objections filed will be heard Kathleen Connelly City Clerk DO NOT REMOVE THIS NOTICE AND/OR ATTACHMENTS. REMOVAL OF THIS APPLICATION MAY JEOPARDIZE CITY COUNCIL RECOMMENDATION. • voice(480)982-8002 •1 A\(180)982-7018• TDD(480)981-009i • ,tjcatr net 100E Superstitaon E#otaletiard Apache Junttiun, A7 1 5219 ACH�� 04 WI,* eVtaeite,-14,,ftetiotu c5 > Home of the Superstition Mountains 4Rtz ol4P' February 15, 2012 Mr Kim K Kwiatkowski Circle K Stores, Inc Licensing DC-36 P 0 Box 52085 Phoenix, AZ 85072-2085 RE Circle K Store#3444 Dear Mr Kwiatkowski Please be advised that the application for an Interim Permit, New License, Corporation, Series 10 Liquor License submitted for Circle K Store #3444 located at 2933 S Tomahawk Road, Apache Junction, Arizona, was posted on February 15 2012, in accordance with State law The Apache Junction City Council will hold a public hearing on March 6. 2012, 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 "IN the processing of your application There is a S50 non-refundable application fee that is due and must be received prior to Wednesday, February 22, 2012, in order for 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 or(480) 474-5050 Sincerely, e Kathleen Connelly _, ; _ t e i - City Clerk /(, - e • Voice(480i 982-8002 •FAX(480)982-7018 •IDE)(480)98:j-009i • %m W aJcth net 300 1 Superstition Boulevard Apache Junction,Al 85219 oiniN FEBRUARY 14, 2012 MEMORANDUM TO DEPARTMENT OF PUBLIC SAFETY PLANNING DIVISION APACHE JUNCTION FIRE DISTRICT THROUGH KATHLEEN CONNELLY, CITY CLERK FROM JAN MASON, DEPUTY CITY CLERK ; ' SUBJECT APPLICATION FOR LIQUOR LICENSE FOR CIRCLE K #3444 Mr Kim Kenneth Kwiatkowski has submitted an application for an Interim Permit, New License Corporation and Series 10 Liquor License for Circle K #3444 located at 2033 S. Tomahawk Road, Apache Junction, Arizona Please conduct the necessary inspections and submit your recommendation by email no later than Wednesday. February 22, 2012, in order for this item to be on the agenda for the City Council meeting of March 6, 2012 Janet Mason From: Rudy Esquivias Sent. Wednesday, February 22, 2012 12 50 PM To: Janet Mason Subject RE Circle K 03444 liquor license application(Tomahawk/US 603 Jan The property at 2933 S Tomahawk Road,currently the Carl's Jr/Bill s Ghost development site,is zoned CB 2 (General Business Zone) These business uses were approved and developed under County jurisdiction, and later annexed by the City CB-2 zoning as appropriate for a convenience store with liquor sales Planning staff has no objections to this request cRit4 3gaivia9 Senior Planner/Zoning Administrator City of Apache Junction 300 E Superstition Blvd Apache Junction, AZ 85119 480-474-2645 SERVICE OVER A2:1) ABOVE THE REST (Deve l op— i i^� :'.c3SViC� o -'�L�_f?o>.S:L .�i.:1!'t� 1'O d.:3 t*'u,3T`C.��t7 "f''>~s:'1Ct1 �:�'t`.7li�fl%;t�7 �`I;q� 'Oar. to OCpm, ^.czsed E' ;y- -s, 3 h' 1_:3. ys } From. Janet Mason Sent Thursday, February 16, 2012 4 03 PM To: Jeff Robinson, Rudy Esquivias Subject Circle K #3444 liquor license application (Tomahawk/US 60) have received a liquor license application from Circle K#3444 at Tomahawk and US 60 Please have your /, recommendation to me no later than Wednesday, February 22 so that this can be on the March 6 agenda Thanks Jaret Mason Deput/City Clerk City Ot Apache Junction 300 E Superstition Blvd Apache Junction,AL 8o119 4e0 474 50€68 jr^asoni 4city_net Si.rvice Over and Above the Rest This message and the information within is intended for the recipient If you received this email in error, please notify the sender and then delete the email Emails generated by council members or City staff pertaining to City business are public records and are preserved according to the Citys records retention schedule To ensure compliance with the Open Meeting Law, members of the City Council should not forward email correspondence to other 1 Apache Junction Police Department -:$ interdepartmental Memo 4' DATE 02/18/2012 e TO Lt Robinson THROUGH FROM Sgt Durkin SUBJECT Circle K #3444 At your request. I went to Circle K Store #2444, 2933 S Tomahawk Rd. Apache Junction, regarding a liquor license request This is within the city limits of Apache Junction and AJPD's jurisdiction This Circle K (prior Bill s Ghost) is attached to the Carl's Junior Restaurant is a free standing, and a well established business Posted on the window of the restaurant, is the city license request, and liquor license request dated Feb 15 2012 I contacted Heidi Young the store's Asst Manager The Exterior is un-changed except the signage from Bill' Ghost to Circle K The interior's only change is stock and shelving The staff has changed from Bilr Ghost employee's to Circle K employees The diagram for the cooler and storage has not changed and per Heidi, she didn't believe the intenor would undergo changes The exterior window is properly posted with the `NOTICE' and the existing liquor of 10113117 was present and posted at the cashiers counter Parking is ample, and the building. and business, is well established I did not see any challenges in granting this, nor do I see any objections to the application forms or on-site inspection Am. .... trict �stse D�sArizonacrod�t . 10 �o,,,iicsfuo na , „= Apache Junction Fire District G oisiSni trial vNouotr FN1Ng AZ 85219 !;6 ,,,�.E ! 565 North Idaho Road, Apache Junction, /'�Eniss��` Phone (480) 982-4440, Fax(480) 982-0183 "�4ccREOVC$' n•crnatioc MEMORANDUM TO Jan Mason, Deputy City Clerk City of Apache Junction 300 E. Superstition Blvd Apache Jct,AZ 85219 FROM: John Suniga,Deputy Fire Marshal DATE: February 21,2012 SUBJECT Application for Liquor License for 2033 S.Tomahawk,Apache Jct.,AZ The Apache Junction Fire District has reviewed the application as noted above regarding the facilities at 2033 S Tomahawk, (Circle K #3444). We have recently completed an annual fire and life safety inspection with no major violations found 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 my office at 982-4440 Thank You JOS ATTN Application ROLL CALL VOTE NOTES: 4Y1 5)11)1 't)/ ITEM # MEETING OF \yi OA" r , MOTION BY: SECONDED BY: YES NO ABSTAINED COUNCILMEMBER SMITHSON COUNCILMEMBER SERDY COUNCILMEMBER BARKER COUNCILMEMBER WILSON I VICE MAYOR DIETZ MAYOR INSALACO j J UNANIMOUS IN FAVOR OPPOSED ABSTAINED TOTAL Amok ITEM NO. 5 I MOVE THAT THE APPLICATION FOR AN INTERIM PERMIT,NEW LICENSE, CORPORATION, SERIES 10 LIQUOR LICENSE FOR CIRCLE K#3444, SUBMITTED BY KIM KWIATKOWSKI, BE RECOMMENDED FOR(APPROVAL) OR(DENIAL)TO THE ARIZONA DEPARTMENT OF LIQUOR LICENSES AND CONTROL 1110. AM. PUBLIC HEARING 1. For APPLICATION FOR A NEW LICENSE,LIMITED LIABILITY CO., SERIES 7 LIQUOR LICENSE FOR ELVIRA'S MEXICAN RESTAURANT LOCATED AT 1520 WEST APACHE TRAIL 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 discussion9 7. Call for a motion. 8. Call for a second. 9. Roll call vote. Pp AC He JG 20a City of Apache l unctwon U z Home of'the Stipei:ttttion .11ountain+• gRIZON* Print TO: City Manager's Office FROM: Kathy Connelly, City Clerk DATE: March 6, 2012 Agenda Type : Regular Agenda Council Priority Focus Area. Required by Federal Law or State Statute TITLE OF AGENDA ITEM: APPLICATION FOR A NEW LICENSE, LIMITED LIABILITY CO , SERIES 7 LIQUOR LICENSE FOR ELVIRA'S MEXICAN RESTAURANT LOCATED AT 1520 WEST APACHE TRAIL. ACTION REQUESTED: Recommendation for Approval DISCUSSION/ BACKGROUND INFORMATION: 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 Arizona Department of Liquor Licenses and Control. FISCAL IMPACT: OPTIONS/ALTERNATIVES: RECOMMENDATION: ATTACHMENTS: Click to download D cover memo D application part 1 L] application part 2 LZ application part 3 D notice D applicant letter D department memo LI planning recommendation D police recommendation D fire district recommendation Asa FEBRUARY 23, 2012 MEMORANDUM TO' HONORABLE MAYOR AND CITY COUNCIL MEMBERS THROUGH GEORGE R HOFFMAN. CITY MANAGER THROUGH KATHLEEN CONNELLY, CITY CLERK!{'„. FROM JAN MASON, DEPUTY CITY CLERK SUBJECT AGENDA ITEM FOR MARCH 6. 2012 APPLICATION FOR A LIQUOR LICENSE FOR ELVIRAS MEXICAN RESTAURANT An application for a New License, Limited Liability Co , Series 7 Liquor License has been submitted by Mr Eddie Valdez for Elvira's Mexican Restaurant located at 1520 W Apache Trail in Apache Junction Correspondence has been received from the planning department, police department and 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 - Auk oisei, Arizona Department of Liquor Licenses and Control 800 West Washington,5th Floor Phoenix,Arizona 85007 www aziiquor.gov 602-542-5141 APPLICATION FOR LIQUOR LICENSE TYPE OR PRINT WITH BLACK INK Notice. Effective Nov.1,1991,I,11 Qwnsrs,Agents,Partners,Stockholders,Officers,or Managers actively involved in the day to day operations of Am\ she business must attend a Department approved liquor law training course or provide proof of attendance within the last five years. See page 5 of the Liquor Licensing requirements. SECTION 1 Thts application is for a: SECTION 2 Type of ownership Di MORE THAN ONE LICENSE INTERIM PERMIT Complete Section 5 ❑J T W R 0 S Complete Section 6 .4NEW LICENSE Complete Sections 2,3,4, 13, 14, 15, 16 INDIVIDUAL Complete Section 6 PERSON TRANSFER(Bars&Liquor Stores ONLY) ❑ PARTNERSHIP Complete Section 6 Complete Sections 2,3,4, 11, 13, 15, 16 ❑CORPORATION Complete Section 7 0 LOCATION TRANSFER(Bars and Liquor Stores ONLY) LIMITED LIABILITY CO Complete Section 7 Complete Sections 2,3,4, 12,13, 15, 16 LUB Complete Section 8 ❑ PROBATE/WILL ASSIGNMENT/DIVORCE DECREE E.I. GOVERNMENT Complete Section 10 Complete Sections 2, 3,4,9, 13, 16(fee not required) 0 TRUST Complete Section 6 ❑GOVERNMENT Complete Sections 2,3,4, 10, 13, 15, 16 0 OTHER(Explain) SECTION 3 Type of license and fees LICENSE#(s). t ') I i OO 1 Type of License(s) 13 r- .c._- .t L�': ,,.L_. Cl,cl_-s -I Departml.lis5Only t 2 Total fees attached $ f APPLICATION FEE AND INTERIM PERMIT FEES (IF APPLICABLE) ARE NOT REF NDABLE. The fees allowed under A.R.S.44-6852 will be charged for all dishonored checks. SECTION 4 Applicant btr 1 !. / l 1 Owner/Agent's Name lttr t� r �,. ��^(( } � '` L _- !nset one name ONLY to appear on license) Last First Miodie 2 Corp./Partne+shipfL.LC 61 t- I y L'15 011� 4.-0 t,t li r-) 1-(_1r 11 # 1.1-L.- ExaGly as'I appears or Articles of Inc or Articles of Org j IL(( �} 3 Business Name Ct1!tii1. �'`It`,li``t 'I1 T-1"'t?iI.it Ill S/ V 31 (Exactly as it appears on the extern of premises; `") I , rr� 4 Pnnctpal Street Location 1)LO \' i"h`.lt W., I Yt%-4 ft,l'•-lh. .\i,jri(Ti!)r'l t iC.(.0 fit), 0 .i_# ,( (Do not use PO Sox Number; City ,,// County Zip 5 Business Phone `T"S t . _,5I `i;it' -''15.1 'r`l i aytime Contact r� cit6, 4-6z ' 7V- '574 6 Is the business located within the incorporated limits of the above city or town? AYES ONO 7 Mailing Address 7- ti.I-I i'1'i!''`''l i :I r 1 ,,..• ' '.i j;-1 t '‘l _) ; ----- Ciy State Zip 8 Price paid for license only bar, beer and wine, or liquor store Type (? 1 $ Type $ f- DEPARTMENT USE ONLY loa 100.00 1D 00 Fees t n n Application Interim Permit Agent Change Club Finger Prints$ �-1 0 I) TOTAL OF ALL FEES Is Arizona Statement of Citizenship&Alien Status For State Benefits complete? 0 YES 0 NO Accepted by_ Date it - 3-0 - 1, Lic # 07 t 0 0 3 z Jury 2010 'Disabled individuals requiring special accommodation,please call(602)542-9027. SECTION 5 Interim Permit. 1 it you intend to operate business when your application is pending you will need an Interim Permit pursuant to A R.S 4-203 01, 2 There MUST be a valid license of the same type you are applying for currently issued to the location 3 Enter the license number currently t the location 011 1 120 .? 1+ 4 Is the license currently in use? YES❑NO if no how long has it been out of use? _ ATTACH THE LICENSE CURRENTLY ISSUED AT THE LOCATION TO THIS APPLICATION. I j�r!1i I y a £ Mall Ill ldeclare that I am the CURRENT OWNER,AGENT,CLUB MEMBER, PARTNER. rn (Print full name) MEMBER,STOC OLDER, OR LICENSEE(circle the title which applies)of the stated license and location t/j� State of Art I•C'�,41 County oft , t tcL is s r The foregoing instrument was acknowledged before me this CsKih My commission expires on ,1x3 `fli PU�r BLIC 7 t day of r C: ),0 II r i• .,,A1201,14D Monti Year `.. 1 ii ANNE S TES &111t-. sf J o&23/1 (Signature di NOTARY PUBLIC) SECTION 6 Individual or Partnership Owners EACH PERSON LISTED MUST SUBMIT A COMPLETED QUESTIONNAIRE(FORM LIMO),AN"APPLICANT"TYPE FINGERPRINT CARD,AND 524 PROCESSING FEE FOR EACH CARD. 'ndtvtdual Last r.i Middle %Owned Mailing Address City Slate Zip Partnership Name (Only the first partner listed will appear on license) General Limited Last Feet Middle %Owned lMtaitingAddress Cdv State �� ❑ ❑ ❑ ❑ CI 0 ❑ 0 (ATTACH ADDITIONAL SHEET IF NECESSARY) 2 Is any person,other than the above,going to share in the profits/losses of the business? 0 YES A.NO If Yes,give name current address and telephone number of the person(s) Use additional sheets if necessary Last Fist Middle Malting Address Cty,State,Zip Telephone, 1 SECTION 7 Corporation/Limited Liability Co EACH PERSON LISTED MUST SUBMIT a COMPLETED QUESTIONNAIRE(FORM LICD1 OI L AN"APPLICANT"TYPE FINGERPRINT CARD,AND S24 PROCESSING FEE FOR EACH CARD. 0 CORPORATION Complete questions 1,2,3,5, 6, 7,and 8 L C Complete 1,2,4, 5, 6, 7,and 8 1 Name of Corporation&L L C Ill; i"'-'t - I C42 '1 J �, I,LL1 41 Exactly as t appears on Articles of Incexporation or Articles Of Organization) 2 Date Incorporated/Organized r X/Iv'1 t i c i /State where Incorporated/Organized �1 ki in-= 3 AZ Corporation Commission He No % '" 3 Date authorized to do business in At Z #4J ij 4 AZ L L C File No G 1 {n ,�'-(.� Date authorized to do business in AZ. I r "-ergs I 5 Is Corp./L L C Non-profit?0 YESfO 6 List all directors officers and members in Corporation&L C ast zits! r:•Jdi'r "flee bta ling A,odresS City Stale Tip trt 1 „if1 JiW c , s �/.i/. ? • .. Z.k� 4 I o)6 5 /.5-,,Qi�A. .. - i Tot H ADDITONAL SHFFT IF NFCESS.,RY List stockholders who are controlling persons or who own 10%or more Last First F.L" %Owner/ ^a ling Auc;ess State Zip (i+JL`. :,f lll` �'('/_ L f�T', ul A /L:/S )( i 4.+1 iL r 42..55/2 • A I aCI I ADDITIONAL St IEET IF.NECESSARY) 8 If the corporatior_%L L C is owned by another entity attach a percentage of ownership chart and a director)`ficerlmember disclosure for the parent entity Attach additional sheets as needed in order to disclose personal identities of all owners OIN SECTION 8 Club Applicants. EACH PERSON LISTED MUST SUBMITA COMPLETED QUESTIONNAIRE;FORM L1CDID1) AN 'APPLICANT"TYPE FINGERPRINT CARD AND S24 PROCESSING FEE FOR EACH CARD, 1 Name of Club Date Chartered lExat2iy as't appears rh Ch:b Chafer nr Bylaws) ;Attach a copy of Out Chart;r.or Bylaws, 2 Is club non-profit? 0 YES ❑NO 3 List officer and directors Last 1-r'st f'u d--e Tile Accres, +?'i State Li. _ ---_ 93 5 i i E r rArr.aellADOirt,)MAL S'{LL"IF NEIIESS; ' . ,., ,,, ,,,,, .‘, `,'''':, , ;- . • ,... . .. ' . ' ' .,''..)."'-.,' , .. ' . , '.;,"'''.%P.' ' ' .. - '-- , '. , „.:, , , , .•:,' .1.'"0-•-•,---ii..' .' A'""--:---74,-ilf'''''?-''-hf" -,ilt?._ 14!_..1..,-,,,„ ,:•,,--..4-... - - , ' - ,. .... . STATE OF ARIZONA „ . ' ,.. ,, ‘,• . . .. , OF: DEPARTMENT . LIQUOR -ILIC L,NSS ....... .. ,. . .. . _ . „.„..,. AN D CONTROL ..„,...... ) AtC0 - 01 . C B t V - . RAGE . LICENSE . ,......•. • . .....,, License 0 ,.._ ki I 003 2 ' 7 1 1 Issue Date- 1/1/1986 Expiration Date: 8/31/2012 -itAiyir le' IS-Stled 1 o Beer & Wine Bar LI.VIKA G MANR1QULZ,(...nxner Mahn Address Location Et VIKA G MA N kl()LIEL LLV1RA'S RLS1 AURAN r 1520 V/APACIV FRI Fl V1RA'S REST AIJRAN1 . . ... . ,.),j0.,. APACIfl JUNCTR)N,AZ 85220 2155 1-. SCENIC APACIir JUNCTION AZ 85119 1 • :::....''''''',''''.,')'''''''.'"::1'.,..,'-n.'.11'''. 4.1t.",•!• , At 1 . ..., , . • .R•i - '• -.''',,,,‘, «"44 ,,• , ,,,.." '''''''' .„t.- ‘4, '4,4 •,. f . ,..... , . . . - „., . ..., „ ,•,.: ..v.,,, 4„,,,,,-, ,, I., ,-(4 ,A .,-i• .,...---.* •,''4:'.41‘VA''''Y -,YVP:'''''T 1 t.,,,,..1..1414-- 1:,,Licrils,:si it4,4,t.,„01\sPit VOUS P01(-1 '•-.-7';';%' r,' A.,,,,,•-,'-' - - 1-* -. .4:--, .,V,. ,"" ",-' ',.1,41p-,:,-i.;:,,54,,,,,,ajr,01:* Vr °fr `''°"-'-"-• 4,.., ,,,,,,,,,,Jz-f.„z ,,-,-...„" . "' --.. ''''' '' ....''''''' '' '' 1 ' -..' ,"'' Wi'-'' '1.1'%efe,,,Z.."''....4,. ,',""":** ...,. ....4.,0,,,r•,.../ -r,,,,,, .-y, . -...t 1,..„' '' ' '1'-r- t''' '''' ' - 11''-''."'' - ' ' .';''''-''''r '' ' ' -'.b.1' ' ,A,,--'-",- 4, ' ,,,,r;;,..-.1,,,),k,t4P ',,t. " •,V.,0 ,,.." ii .40.',..-;,," ,„4,, , .„ ,„,:,,,,,t).4.- . ',..;,--, . - , - ' -,,-,,,4,...„:„, .-., ,,,,,. -, .,..--"t ,„...- ,„. ,...„..4L7.4-,o,,,,--P41--/1„ . -4 4t'-.•"444.- ' .'''' . ' '' ' ,,,-4,,,,,,,,o.,7?,,;',4.-,.?,- ,.,t,--0, ... . , . . , , 3 3 . .... Bill of Sale r'k1 CONSIDEFATION OF THE SUM OF ***One Hundred Thirty.Seven Thousand Five Hundred Dolien And No Cents***lawful currcoy of the United States of Attaenca.end other valuable consideration,receipt of which is hereby acknowledged,the SELLER. Etvlre Manrique,as unmarried woman hereby grants bat gall u o.sells and traitors unto the BUYER, Eddie Valdez,as uamarrlad oast and his,her or their heirs,personal representatives,or assigns,to have and to bail forever,the following disc bed personal property goods or ehaneh That reran bw-tt)ms known ss,P.krira's Mexican Restaurant, presently located+4 1.520 W.Apatite Trail. Apache Jiraaioa,AZ 05120,and all nght,tide sod tattiest us and to all assets described in the Purchase Agreement,including ben not united to.tin business trade name,tsadatyle.gwdwiti,covenant not compete,inventory.Stara of Arizona Liquor License 007110032, vntd that cumin equipment per the a:ureited Exhibit'A",while exhibit is incorporated herein by refinence. ors Btk of Sale:s conditional on rod sulr}cct to the Leas,terms sad conditions imposed by that certain promissory note and chattel security agreement by and between the Buyer and Sella or assignee minced than ,cur Same ciao.% FURTHERMORE Seller warrants that he,the cr they are the lawful owner of said goods and hereby certifies,under oath,thai he,she or they have good right to sell the same as aforesaid,and that the above described property is free and clear of all claims.liens and other encumbrances visanoever EXCEPT,as spocified herein.Seller further agrees to werrant and defend sane against the lawful claims and demands of ail persow whomsoever DATED January 13,2012 Lf.3.ddl?'.asJ4k Elvira Maarigttrt,Her Ophelltt C.Mitchell as her attorney ea Jac[ State of N_A- iss County of l l On January 13,2012,before roe,the undersigned,a Notary Public in and for said County and State, personally appeased Elvtra ttiannquez.By:Ophelia O.Muchell as her attorney us fact personally known to me(or proved to me oa the hares of satisfactory evidence)to be the person(s)whose trame(s)[slue subscribed to the within instrument and acknowledged to tax that hrlsho/they executed the same in haerhhar authorized cxpacity(ies),and that by his/ha/their stgnature(s)on the iststrurttent the person(s),or the entity upon behalf of which the person(s)anted,executed the ms0tnsent. WITNESS my hand raadd�off6eial seal Notary Public I wN Escro o.. 001 7 it3� EXUE `,A, Elvira's Equipment Schedule Booths P1 Tables & chairs, high chairs, booster seats Cash register Ice Machine Beer Cooler / x Freezer • Phones et" Adding Machine Salt, Pepper, Sugar Containers, Napkin holders Silverware 5 stainless steel tables 2 stoves 1 deep fat fryer 1 Steam table/w steam table trays 1 large refrigerator 1 Walk in refrigerator 1 sandwich refrigerator 1 meat slicer machine 1 grinder /si. A\ 1 imuisifier (grinder) 1 large sink 2 small sinks 7 foodsafe steel shelves Various Kitchen large spoons, ladles, forks, tongs > N op 1 food processor, 1 blender • 0 Various pots, pans, lids, stainless steel trays Various size dishes Miscellaneous cleaning equipment, mops, brooms, mop bucket 2 freezers in back building 1 L�� DIM ART.F PONNTR OF -1TTURN-iv I, ELVIRA G. MANRIQUEZ, a resident of Pula! County, Arizona, hereby make, constitute and appoint my daughter, OPHELIA G. lvIiTCHELL, (hereinafter "agent"), a resident of the State of Anzona, as my true and lawful attorney-in-fact. I also appoint my daughter,MARY HELEN THRUNBECK, a resident of the State of Arizona, to serve as alternate agent but without authority to exercise any of the powers set forth below except that if my agent shall be unable or unwilling to serve or to continue to serve as such agent, then my alternate agent shall be fully authorized to serve hereunder and shall have all of the powers granted originally to my agent. My alternate agent may execute and attach hereto an affidavit to the effect that my agent is unwilling or unable to serve or to continue to serve Such affidavit shall be conclusive evidence insofar as third parties are concerned of the facts set forth, and any person acting in reliance upon such affidavit shall incur no liability because of such reliance. ARTICLE I—ASSET CONTROL My agent shall have full power and authonty to do any and all acts for my benefit which I might do if present, including by way of illustration but not by way of limitation,the following 1 To demand, sue for and receive all money and all property now due or v.hich may become due and owing to me,and give receipts and discharges for such payments, 2 To sell. assign and transfer stocks, bonds, and other secunnes standing in my name or belonging to me, including specifically the authonty to buy and sell stocks, bonds (including U S Treasury Bonds referred to as "flower bonds") and other securities in my name and for my account and at such prices as he or she in his or her discretion shall determine, 3 To borrow money and to pledge assets for such loans if in the judgment of my attorney such action should be necessary; 4. To consent in my name to reorganizations, mergers and the exchange of stocks, bonds and other securities for new securities; 5 To manage, sell, convey, and mortgage realty. to foreclose mortgages and to take title to property. and to execute, acknowledge and deliver deeds of real property, mortgages, releases, satisfactions and other instruments relating to realty; 6. To place and effect insurance, 7 To do business with banks, to endorse all checks and drafts made payable to me and collect the proceeds, to sign in my name checks on all accounts in my name, to withdraw funds from said accounts, including IRA or 401(k)accounts in my name, to open accounts in my name or in the name of my agent, 1 3. To review my medical records, reports and charts and to consult with and secure information from treating physicians and employ other persons on my behalf as my agent may deem necessary to assist him in malang medical treatment decisions Any physician, hospital or other health-care provider is hereby fully released from any liability for damages or injuries resulting from honoring the direction of the agent. My agent is authorized and directed to commence legal action for actual and punitive damages against any person who fails to honor this Durable Power of Attorney ARTICLE III—ADMINISTRATIVE PROVISIONS It is my intention by executing this Durable Power of Attorney to provide for the administration of my affairs and the provision of personal and medical assistance without the necessity of Court action. Accordingly. I request in the strongest possible terms that any Court which may receive or act upon a petition for the appointment of a guardian and/or conservator for me should deny such pennon so long as my agent is acting under this Power of Attorney. If any Court should deem it necessary to appoint a fiduciary in spite of this request. then I nominate and appoint my agent to sera e,and request that my agent be given priority for appointment. This instrument shall be governed by the laws of the state of Arizona in all respects, including its validity, constriction. interpretation and termination, and to the extent permitted by law shall be applicable to all property of mine,real, personal, intangible or mixed, wherever and in whatever state of the United States or foreign country the situs of such property is at any time located arid whether such property is now owned by me or hereafter acquired by me or for me by my agent. If any part of any provision of this instrument shall be invalid or unenforceable under applicable law, such part shall be ineffective to the extent of such invalidity only, without in any away affecting the remaining parts of such provisions or the remaining provisions of this instrument This instrument may be amended or revoked by me. and my agent and any alternate agent may be removed by me at any time by the execution by me of a written instrument of revocation. amendment, or removal delivered to my agent and to all alternate agents If this instrument has 06% been recorded in the public records,then the instrument of rev ocation,amendment or removal shall be filed or recorded in the same public,records My agent and any alternate agent may resign by the execution of a written resignation delivered to me or, if I am mentally incapacitated, by delivery to any person with whom I am residing or who has the care and custody of me or in the case of an alternate agent,by delivery to my agent. My agent shall have full power and authority to do and perform all and every act and thing whatsoever requisite and necessary to be done in order to accomplish the aforementioned acts as fully and to all intents and purposes as I might or could do if personally present, and I hereby ratify and confirm all that my agent shall do or cause to be done by virtue of this instrument. Every bank or other financial institution, insurance company, transfer agent, issuer, obligor, safe deposit box company, tale insurance company or other person, film or corporation to which this power of attorney or a photocopy hereof is presented is authorized to honor and give effect to all instruments signed pursuant to the foregoing authority without inquiring as to the circumstances 3 The Principal by minaling below, wishes that the Agent additionally benefit from the Principal's assets,specifically outlined as follows N/A By initialing below,in the presence of the witnesses, the Principal wishes the inclusion of this paragraph Principal's Initials_NIA_ Witnesses Initials NIA WARNING TO PFRSQNS 'TING THIS D1 rRART.R POWFR OF ATTORNFV This is an important legal document It creates a Durable Power of Attorney Before executing this document,you should know these important facts 1 This document may provide the person you designate as your Agent with powers to dispose,sell,covey,and encumber your real personal property 2. These powers will exist for an indefinite period of time unless you limit their auration in this document These powers will continue to exist notwithstanding your subsequent disability or incapacity You have the right to revoke or terminate this durable power of attorney at any time by (a) recording a revocation in the public office designed for that purpose on this Power of Attorney and(b)directly notifong your Agent with respect to your property or other matters DATED thisfoZday of April,2001 ELVIRA G. MANRIQUEZ l' Principal WITNESSES: �►�`t 7"7am , ��-..vj.(..J ►J' f //J�, �"�w III 5 STATE OF ARIZONA ) )ss. County of Maricopa ) I, ELVIRA C. MANRIQUEZ, the Principal herein, have signed my name to this Durable Power of Attorney on the date set forth above, and being first duly sworn, do declare to the undersigned authority that I signed and executed this instrument as my Durable Power of Attorney and that I signed it willingly, and that I executed it as my free and voluntary act for the purposes expressed in the Durable Power of Attorney and that I am eighteen (18) years of age or older, of sound mind and under no constraint or undue influence SUBSCRIBED,SWORN TO, and acknowledged before me thisiday of April, 2001, by the Principal named herein. My Commission Expires. ' /2411, Notary Pub ERMA JO ZORZ "ts MaAR'GCutb,c PA CQt1 State of'NTvAnrazo'`N My Exrres Awls y, y*Ark*********************it***it***k STATE OF ARIZONA ) )ss, County of Maricopa ) We, the undersigned witnesses, have signed our names to this Durable Power of Attorney on the date set forth herein, and being first duly sworn, do declare to the undersigned authority that the Principal signed and executed this instrument as her Durable Power of Attorney anc that she signed it willingly, that she executed it as her free and voluntary act for the purposes expressed in the Durable Power of Attorney and that she was eighteen (18)years of age or older, of sound mind and under no constraint or undue influence. SUBSCRIBED, SWORN TO, and acknowledged before me this:/Any of April, 2001, the aforesaid by res d witnesses My Commission Expires -I Notary Pubho� J OM:1AL SEAL ERMA JO ZORZ Yota;v 7-l0;tc State of raacna YARtC'OPA COUNTY t 4y.,^•-in Ex0.res Apt 5 2033 SECTION 9 Probate,Will Assignment or Divorce Decree of an existing Bar or Liquor Store License: 1 Current Licensee's Name (Exactly as rt appears on license) Last Middle 2. Assignee's Name Last F ir:i Middle 3 License Type License Number Date of Last Renewal 4 ATTACH TO THIS APPLICATION A CERTIFIED COPY OF THE WILL,PROBATE DISTRIBUTION INSTRUMENT,OR DIVORCE DECREE THAT SPECIFICALLY DISTRIBUTES THE LIQUOR LICENSE TO THE ASSIGNEE TO THIS APPLICATION SECTION 10 Government: (for cities,towns,or counties only) 1 Governmental Entity ,- 2 Person/designee Las! Wad le Ccrtac'I-monr Number A SEPARATE LICENSE MUST BE OBTAINED FOR EACH PREMISES FROM WHICH SPIRITUOUS LIQUOR IS SERVED SECTION 11 Person to Person Transfer- Questions to be completed by CURRENT LICENSEE(Bars! and Liquor Stores ONLY-Series 06,07,and 09) 1 Current Licensee's Name ►1-i=)Y1 r�1 , Z- I U ' r Entity X „V'"c� . (Exactly as It appears on license) Last First Middle (ind' .Agent etc.) 2 Corporation/L L C Name (Exactly as it appears on license) 3. Current Business Name 1 v r {Cti- ,,e)(4(-r).i 126. tZ,1 L_I C1{i r {Exactly as it appears on license) 4 Physical Street Location of Business Street � f 1 (1 - :e .--'�,-- / , 'q L�� City. State,Zip /Zi.t -1!c: jr / L...-- 2.s1O 5 License Type Jrit i-:: •r- t1. /-& License Number Cl // [r C 3 6 If more than one license to be transfered License Type License Number 7 Current Mailing Address Street�7_)• ft.Y E, iv/f r /';6 . e1i/(-- (Other than business) e r [ City, State,Ztpi-4,7L44 .. . > A/'9.,:k<.,},,.u.ba.,42 I i �``8 Have all creditors. lien holders interest holders, etc been notified of this transfer? YES 0 NO OIN 9 Does the applicant intend to operate the business while this application is pending? iiYES 0 NO If yes,complete Section 5 of this application,,/attach fee,and current license to this application. 10 I, �� cL 4f i E f i i+/LlG L hereby authonze the department to process this application to transfer the (print tun name) Li privilege of the license to the applicant, provided that all terms and conditions of sale are met Based on the fulfillment of these condi pns, I certifythat the applicant now owns or will own the property rights of the license by the date of issue i, G'1 i' i t'"t;. (/7 r1 Y_i ii YrrA,II e'L . declare that I am the CURRENT OWNER,AGENT,MEMBER,PARTNER (print full name) 1/ STOCKHOLDER, or LICENSEE of the stated license I have read the above Section 11 and confirm that all statements are ,,,,;rue,corre ,a mplete P(..:)4 `Ni 11�4'h: `J 'r - ,I,t/ State of Pill O County of ! f{1t�� \ '6 ' ( nature of CURRENT LICENSEE) The foregoing instrument was acknowledged before me this ` 0 J1— i , t> 22 !`�,, M Year My commission expires an C l,-7 '11 \ r•UBLIC/ f j i r ' ARIZOtiiq- , t-C 1 trs,_.._ &- 4 .r a>'rHl County '":s "' �Ct Q� l_ SITES rte of NOTARY PUBLIC) '. • ;.0 212'3I13 Auk Pik SECTION 12 Location to Location Transfer(Bars and Liquor Stores ONLY) APPLICANTS CANNOT OPERATE UNDER A LOCATION TRANSFER UNTIL IT IS APPROVED BY THE STATE 1 Current Business Name Exactly as it appears on license) Address 2 New Business. Name (Physical Street Location) Address 3 License Type License Number eiS 4 If more than one license to be transferred License Type License Number 5 What date do you plan to move? What date do you plan to open, SECTION 13 Questions for all in-state applicants midi:Rag those ap01yjfl t for government,hotelirnpt n¢ re aurant licenses(series 5, 11,and 12). A.RS.§4 207 IA)and tB;i state that no retailers license shall be issued for any premises which are at the time the license application is received by the director within three hundred(300)horzontal feet of a Jis,r t.within three hundred(300)horizontal feet of a public or pnvate school building with kindergarten programs or grades one(1}through(12)or within three hundred 300)hor:zoriat feet of a fend recreational area adjacent to such school building The above paragraph DOES NOT apply to a)Restaurant license i§4-205 02) c)Government license i;§4-205 03) ❑t Ho`ef:~notel license,§4-205 01) d)Fenced playing area of a golf course II§4-207 iB)(5)) t r 1 Distance to nearest school ?.r/ ft Name of school f fc',�-, ill Al Address ' r„:y State Zip "-'11'L?t ; j / 2 Distance t0 nearest church I ,1 ft Name of church �#tom•, Jr i.i J t y f'7�?l Lf`t ftA Address /c,e? fit-a !7oi� ri r it :'- .r/-t !}ill xx / Stateif fh is 11,:,hz lam'he ❑Lessee 0 Sublessee Owner ❑ Purchaser(of premises) 4 If the premises is leased give lessors Name /•l,. f A Address 1 City State Zip MI 4a Monthly rentallease rate$ i"d IA- What is the remaininglength of the lease—yrs mos 4b What is the penalty if the lease is not fulfilled? $r ii rrrr or other (give details-attach additiexnal sheet if^essaryi 5 What is the total business indebtedness for this licensetlocation excluding the lease?$ I) Please list lenders you owe money to Last r'st Mr'die Amount Owed malting Address City State Zip • i I ADDJTiOSLAL SHEET iF NECESSARYi What type of business will this license be used for be specific)? IKe-t :t:•i:1,_.- SECTION 13 -continued 7 Has a license or a transfer license for the premises on this application been denied by the state within the past one('y)year? 0 YES X NO If yes,attach explanation 8 Does any spirituous liquor manufacturer,wholesaler,or ern loyee have any interest in your business? 0 YES _MO 9 Is the premises currently licensed with a liquor license? YES 0 NO If yes,give license ruArnber and licensee's name License# 01 1 1 CC 3- / c.� L.:._r . (exactly as it appears on license) Name '�/l�!1'�.�-�j�. SECTION 14 Restaurant or hotel/motel license applicants' 1 Is there an existing restaurant or hotel/motel liquor license at the pro d location? 14 YES 0 NO If yes,give the name of licensee,Agent or a company name. TTT"''" l�f �lYl " 1-. (r a 1 1 i%"z- 1 f� 01"t.�,First middle and license#. 1 �/L G 2 if the answer to Question 1 is YES,you may qualify p an Intenm Permit to operate while your application is pending,consult A R.S §4-203 01,and complete SECTION 5 of this application t 3 All restaurant and hotel/motel applicants must omplete a Restaurant Operation Plan(Form LIC0114)provided by the Department of Liquor Licenses and Control 4 As stated in A R S §4-205 02 G 2, a;'estaurant is an establishment which derives at least 40 percent of its gross revenue from the sale of food Gross revenue is the revenue derived from all sales of food and spirituous liquor on the licensed premises By applying for this/0 hotel/motel X.restaurant license. I certify that I understand that I must maintain a minimum of 40 percent foo¢-sales based on these definitions and have included the Restaurant Hotel/Motel Records Required for Audit(form,LIC 1013)with this application .r, err- f, applicant's signature As stated in A.R S'§4-205 02 (B) I understand it is my responsibility to contact the Department of Liquor Licenses and Control to schedule an inspection when all tables and chairs are on site kitchen equipment, and if applicable patio barriers are in place on the licensed premises With the exception of the patio Owners. these items are not required to be properly installed for this inspection Failure to schedule an inspection will delay issuance of the Iicense If you are not ready for your inspectio790 days after filing your application please request an extension in writing, specify why the extension is necessary and the inew inspection date you are requesting To schedule your site inspechorp visit www azliquor gov and click on the "information°tab e r' applicants initials SECTION 15 Diagram of Premises. (Blueprints not accepted, diagram must be on this form) Check ALL bo s that apply to your business Entrances/Exits 5Netoquor storage areas Patio 0 Contiguous eliN 0 Service windows O Drive-in windows 0 Non Contiguous 2 Is your licensed premises currently closed due to construction, renovation,or redesign? 0 YES NO If yes, what is your estimated opening date? / month/day/year 3 Restaurants and hotel/motel applicants are required to draw a detailed floor plan of the kitchen and dining areas including the locations of all kitchen equipment and dining furniture Diagram paper is provided on page 7 4 The diagram(a detailed floor plan)you provide is required to disclose only the area(s)where spintous liquor is to be sold, served, consumed, dispensed, possessed,or stored on the premises unless it is a restaurant(see#3 above) 5 Provide the square footage or outside dimensions of the licensed premises Please do not include non-licensed premises, such as parking lots, living quarters, etc As stated in A.R.S.§4-207 01(B),i understand it is my responsibility to notify the Department of Liquor Licenses and Control when there are changes to boundaries,entrances,exits,added or deleted doors,windows or service windows,or increase or decrease to the square footage after submitting this initial drawing. f''1r applicants initials SECTION 15 Diagram of(*remises 4. In this diagram please show only the area where spirituous liquor is to be sold, served, consumed, dispensed, possessed or stored. It must show all entrances, exits, interior walls, bars, bar stools, hi-top tables, dining tables, dining chairs,the kitchen, dance floor, stage, and game room. Do not include parking lots, living quarters, etc. When completing diagram, North is up i. If a legible copy of a rendering or drawing of your diagram of premises is attached to this application, please write the words "diagram attached" in box provided below SECTION 16 Signature Block I. Cik4t. \iAA\(k? , hereby declare that I am the OWNER/AGENT filing this (pant full name of applicant) application as stated in Section 4, Question 1 I have read this application and verify all statements to be true, correct and.complete, X 21C-47. (signature of applicant listed in Section 4 Question 1) State of f {•t rl 2!.'i`1l .. County of 1 Pa. f_he foregoing instrument was acknowledged before me/t is Month - Year My commission expires on R A I 6idte d c, • Day Month Year i , signature of NOTARY PUBLIC r + '_=Buc I O ni onia • tkunty 'TES raw•R+ra-rsW^i'1., +Y�+�iv�af ' eIN rilli‘ C.) (I- pv, , . „et , t---. -,.. t ft 4..0 t 4 WILMS q GCOLER I .44 1......2. filliN ( ar ..1 .44 ---...1\ N 11 ,s. 11 1 75 A call' tro. .2 n t L_i f G .it Tri.",, \T 12 I , 4 1 I AP e'tr 'i t ' ' f-,1 044. ',...)-• ' 4t L. 4 1- 4t„124; -JP 1 47 Lli v. PARKING 5-700,--c=i12.74".t 1 7 ..,., , I ....^ ' 14----r....--I'• ° t • 6- 0 0 ---- 0 = I I --------...,,..ttoda,..,......_----—... .,.... t,...r ' --t -4.."11‘11'' 0C.411'CL4403------'-')C."' 4 4 11/4 eo C 1 1 i If erg, .ct.t.4 , ' ' HA .. t - ,s--•rsci. ... i 164/411-1 -1 1 1 1.........., ........„4._,,.....i... ti,.....,.1.,_-.-.1...........-,—..-.14.6-I-44,-+ ,,,',4----L-=---,. t , / r r - _ 4.1,..... ..........-.. , FLOOR PLAN 1,4.117 Adak _ _ — Amok Page I of 2 AI Corp. 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A REEERVE0 TO THE MEIMEM =""" 1 viaraimarremlammumwrompoitatinmow,.c.ac I B 0 VESTED 14 ONE OR MORE MANAGERS t met A*Mr r.w.40•1011 F-411rt.wrafenninmpwr...16Ttr.nr on nis IL..al MAR"in liNtiliANANNIWOMMINIL , ••••••••••ee 411,11.• ..A1.111 Yitdi.z. .......•b,, mosi••••••IWO. 6maislartre Venom 3 mows Nit rw*loans adbao 0 sarexr C 3 Owner or*re'imouri silm4 *Moo*via p.p.* Mint=424,1,4 S. Ph.i fin -Ar" hadrwia4 t="1,..• ClY.tipalitiSViitli.ILL ZW.D.W Oft Gnitn. zilm ,.., INI/abrom Sz• ..t1 pmlittlo o w*and Maws None ilkkleidea Neitzif 1 Nome fa retort-1.a tobernw DI MINPACtr poi if ir lb 41114ai am} 0 iilint•er 0 kinragir 70,41.rr is wieuri sile•61 gamma IA as, •••••/.. A52114416-0_,L:Arelkeljg:± 1 hilwr., la!worm sr or =try= Cti,Clit a a. air"/6 as-a52t4 clo. samit, zo- ......,........ ......nom. 7 nurimn Ole 1/14M•011/4110.111•111M:P.11.111101 Wilt AMOS TIMIIIIIMML Mar IC TO denuus•••••••*•••••‘ el sal nmoW gm,illaldi VINI4Ir et pew i ow* .10.14 OM w+ 7, ' 1.-JIATIJSZ mow gametr rAorr AL% . , - Siglild Cin Viii daiat 14 I/4 1 I (irtmtt 4.-yrii. t triun,lin lormmkpint N. Uknetrzeqfrs. /... '---- !ROM.MIN MR I*anns•p•••• ....6..tim I'awing on boa al A nonnoty.pigeon prits ea=nanny wt.nom llon•ttscnor WO^Mr 15t-8324 -.-"cx Rims:-14,4#-.114-017 U-2004 wTher.CN,ftsilles.74.-1.6.'...0.- fime4111A1114 Papa 4 et :agaecnnitlear.. http tut i 2,:::: a ZcC i:e's .q.rirns.(.:_.t .7 A icprirt.2 prCONIM.A_ND-4&:;,FSSIONID=CiorTV6p1 ' I 8'2012 . ._ cErvira 's , ex can restaurant 1520 W.Apacfe*ad ,:Apache Junction, 4Z 85120 (480) 982-9916 Fax: (480) 982-0817 OPERATING AGREEMENT Eddie Valdez is 81% stockholder of Elvira's ?Mexican Restaurant, LLC. I-Ic iti111 oversee the training of staff and management, daily operations, will implement procedures in accordance with Arizona Law as to the distribution of alcoholic beverages as well as overseeing the training of the food handling as is ell as the guidelines as set forth by the Final County Health Department. Chandera Newby is 19% stockholder Her duties will include maintaining the accounting records, distribute tax payments to C.t' , State and Federal Agencies Maintain and file all receipts properly for the purpose of having records for auditing requests She will also be tm olved with the public co n.L-nuncts relations and adt ertising for the operation. jz G ,1P^")pr 1', feints I9 _ - ^, - - I Print Form ARIZONA DEPARTMENT OF UQLIOR LICENSES&CONTROL 800 W Washington 5th Floor Phoenix AZ 85007-2934 01710 0 (602)542-5141 QUESTIONNAIRE P104 24 )- Attention all Local Governing Bodies: Social Security and Birthdate Information is Confidential. This information may be given to local law enforcement agencies for the purpose of background checks only but must be blocked to be unreadable prior to posting or any public view Road carefully This instrument is a sworn document. Type or print with BLACK INK �� An extensive investigation of your background will be conducted. False or incomplete answers could result in criminal prosecution and the denial or subsequent revocation of a license or permit. TO BE COMPLETED BY EACH CONTROLLING PERSON,AGENT OR MANAGER EACH PERSON COMPLETING THIS FORM MUST SUBMIT AN APPLICANT TYPE FINGERPRINT CARD WHICH MAY BE OBTAINED AT DLLC FINGERPRINTING MUST BE DONE BY A BONA FIDE LAW ENFORCEMENT AGENCY OR A FINGERPRINTING SERVICE APPROVED BY DLLC THE DEPARTMENT DOES NOT PROVIDE THIS SERVICE Effective 10/01/07 there is a$24.04 nrocessino feeler each fingerprint card submitted. Liquor License # The fees allowed by A.R.S.§44-6852 will he charged for all dishonored checks. Q J I I QO } ^) (it the location is certainty licensed) 1 Check IControlling Person gent I Manager(Only) appropriate (Complete Questions 1-19) (Complete All Questions except#14,14a&21) box —p Controlling Person or Agent must (complete#21 for a Manager VA- � Controlling Person or Agent must complete#21 2 Name V( UGle 1. E fir !I () VA-t Date Birt1141111111111111111110._ Last First Middle 3 Social Security Numb • Drivers License State AZ- (NOT a public record) (NOT a public record) 4 Place of Birth 1�'�t'!I 1 1•a�1 i A y LI 1 Height 5'i1 Weight 2D Eyes }i , Harr (,Jt :t,i:%tl City State Country ';not county) Manta!Status [ ! `� r} �f Single L;Married Divorced i�-Z�(YJsdon�d ( Gaytame Contact Prone ` ( r 6 Name of Current or Most Recent Spouse it t''c.kt' �{i v(U I\ v- eAl Date of (List all for last 5 years-Use additional.sheet if necessary) Last First Middle Maiden (NOT !public/record)- 7 You are a bona c resident of what state' If Arizona date of residenc "'t !I�/I{l) t a Telephone number to contact you during business hours for any questions regarding this document r L'O-is EI-'s' ;)2L 9 If lesssr you have been an Arizona resident for than th,^ee.(3)months submit a of your Arizona drivers license or voter :, istrebar.card GY c may 4}0.1 r�� ` - 10 Name of Licensed Premzes W I i I k s ex !e cttl (-4\11 (I(_�t i'CiAtremises Phone 10 i d - - i' 11 Physical Location of Licensed Premises Address 1510 Y AT tit.he 1 icy l I i Pat...._ 'I ii(1 i){ , Street Address (Do not use PO` it ti City County Zip 12 List your employment or tine of business during the past five(5)years If unemployed part of the time,list those dates List most recent 1st FROM TO DESCRIBE POSITION EMPLOYER'S NAME OR NAME OF BUSINESS MorrthtYear Montnr"Year OR BUSINESS (street address city state&zap) CURRENT tLrl)tl J 1 JV,2.rtV2 AJ-2ti-,,s /1•Lr r..e— s..- lf t.' f C� h-12 .f%i l %J 1 _. lea(t et.4- "S.;.r� C.-C C.*1-$47 t f‘i.--. ��(. i d Lit i t)6 jt11 1,111 L Gt:'eir . 3s1;eI s /ice l't AV, 4-74 4- f3S/2 ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION4i 13 Indicate your residence address for the last five(5)years. �i FROM TO 1 Rent or RESIDENCE Street Address tinntivYear Month1Year Own if rented,attath additional sheet win name.address and phone number of landlord City ? State f Zip CURRENT Of 1 �if % !- .?e*1cr:, Sz` I /)ic.Srl i rf7 P iel C I `i` !PIA 0 5 i ii 7 1 y -' 14-7 A.y .9...5719 - LIC 0101 9124/2009 Disabled individuals requiring special accommodations.please call the Department,(602)642-9027 /I% p if you checked the Manager box on the front of this form skip to#15 14 As a Controlling Person or Agent,wilt you be physically present and operating the licensed premises? 'OYES ONO if you answered YES how many hrstday? fi�11 t • ,and answer#14a below( If NO skip to#15 r,�.f,r 14a Have you attended a OLLC-approved Liquor Law Training Course within the past 5 years? (Must provide proof) AXES ONO If the answer to#14a is"HO",course must be completed before issuance of a new license or approval on fj an existing license. 15 Have you been detained,cited.arrested,indicted or summoned into court for violation of ANY law or CI YES VINO ordinance,regardless of the disposition, even if dismissed or expunged within the past ten(10)years (include only traffic violations that were alcohol and/or drug related)? 16 Are there ANY administrative law citations,compliance actions or consents,criminal arrest,indictments (3 YES VNO or summonses PENDING against you or ANY entity in which you are now Involved? 17 Have you or any entity in which you have held ownership been an officer, member,director or manager OYES 4NO EVER had a business professional or liquor application or license rejected denied,revoked.suspended erjeig in this or any other state? 18 Has anyone EVERfiled suit or obtaineita ju•gment :gainstyou,the subject of which involved fraud or DYES 00 misrepresentation? / 19 Are you NOW or have you EVER held ownership, been a controlling person, been an officer,mem , XYE director or manager on any other liquor license in this or any other state? If any answer to Questions 15 through 19 is`YES'YOU MUST attach a signed statement Give complete details including dates,agencies involved,and dispositions SUBSTANTIVE CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED �a` i 20 I �',t aut ` = `rtt. C. . hereby declare that I am the APPLICANT/REPRESENTATIVE (print full name of Applicant) filing this quuestionnaire I have read this questionnaire and all statements are true,correct and complete X t`1° II ,,,..t"'' State of (L-Pt 1 -G'rla County of //262 fSignature of Applicant) The fi.regong instrurnerrt was acknowledge"before me this Yi day of k % )71 // Year Aft My comm ssiom expires on 03/ )i! 3 3 <G - 617 Day Month Year c Signature of N.421,8 ) ir%' =IZCtwA I{ice ' CoLnty SITE.S COMPLETE THIS SECTION ONLY iF YOU ARE A CONTROLLING PERSOOR AGENT c�r3'13 APPROVING A MANAGER'S APPLICATION - 21 The applicant hereby authorizes the person named on this questionnaire to act as manager for the named liquor license The manager named must be at least 21 years of age State of County of The foregoing instwinent ves admowtedgec before me this X. day of Signature of Controlling Person or Agent(circle one) Month Year (Signature of NOTARY PUBLIC) Pnnt Name My commission expires on Day Month Year 1 . t t .3 0 C ��' ' .l 0S ()a, f 1 to c, ‘Sc) t '--1%<- /44) • Print Form ARIZONA STATEMENT OF CITIZENSHIP AND ALIEN STATUS FOR STATE PUBLIC BENEFITS Professional License and Commercial License Department of Liquor Licenses and Control Liquor License# 01 1 t 00 3 �• _ Ownership Name; ��1 G�{`, I C(i f1 r r t Ci w W{tilt U � (as listed on the current liquor license application or renewal application) Title i\i of the federal Personal Responsibility. and Work Opportunity Reconciliation Act of 1996 (the "Act"), S G S C 3 1621, provides that, with certain exceptions, only United States citizens, United States non-citizen nationals, non-exempt "qualified aliens" (and sometimes only particular categones of qualified aliens), nonimmigrants,and certain aliens paroled into the United States are eligible to receive state or local public benefits With certain exceptions, a professional license and commercial license issued by a State agency is a State public benefit. Arizona Revised Statutes § 1-501 requires, in general, that a person applying for a license must submit documentation to the licensing agency that satisfactorily demonstrates that the applicant is lawfully present in the Lnited States Directions. All applicants must complete Sections I, II, and IV. Applicants who are not U.S citizens or nationals must also complete Section III Submit this completed form and copy of one or more documents that evidence your citizenship or alien status with your application for license or renewal. SECTION 1 iPLICANT INFORMATION APPLICANTS NAME(Print or typc) I-Ci,i<C \,aloe,1 DATE `��Jl cfg/Lc'i I TYPE OF APPLICATION(check one) ')( INITIAL APPLICATION —RENEWAL TYPE OF I ICENSE �1/ i4 tO//l - 0' SECTION II—CITIZENSHIP OR NATIONAL STATUS DECLARATION Directions. Attach a legible copy of the front.and the back(deny).of a document from the attached List A or ther document that demonstrates U S citizenship or nationality Name of document provided, r rt-ti (er t/W(4t'- A Are you a citizen or national of the Lined States?(check one) „, Yes No I3 If the answer is"Yes."where were you born? List city,state(or equip alent),and country City M i(Mt t State(or equivalent) It Country or'Temtary t1/4 () If you are a citizen or national of the United States,go to Section IV If you are not a cinzen or national of the United States,please complete Sections III and IV DLLC 2120/09 AG 11i08/07-81662 Page I of? /'\ SECTION III—ALIEN STATUS DECLARATION Directions. To be completed by applicants who are not citizens or nationals of the United States Please indicate alien status by checking the appropnatc box. Attach a legible copy of the front,and the back(if any),of a document from the attached List B or other document that evidences your status A RS § 1-501 Name of document provided "Qualified Alien"Status f 8 U S C. 1621(a)(1),-1641(b)and(c)) ❑ 1 An alien lawfully admitted for permanent residence under the immigration and Nationality Act(INA) ❑ 2 An alien who is granted asylum under Section 208 of the INA. ❑ 3 A refugee admitted to the United States under Section'207 of the INA ❑ 4. An alien paroled into the United States for at least one year under Section 212(d)(5)of the INA ❑ 5 An alien whose deportation is being withheld under Section 243(h)of the INA ❑ 6. An alien granted conditional entry under Section 203(a)(7)of the INA as in effect prior to April 1, 1980 0 7 An alien who is a Cuban and Haitian entrant (as defined in section 501(e) of the Refugee Education Assistance Act of 1980) 08 An alien who is, or whose child or child's parent is a "battered alien" or an alien subjected to extreme cruelty in the United States Nonimnugrant Status(8 U S C§ 1621(a)(21) 09 A nonimmigrant under the Immigration and Nationality Act(8 U S C § 1101 et seq J Nonmimigrants are persons who have temporal) status for a specific purpose See 8 U S.0 § 1101tii.l(15) Alien Paroled into the United States For Less Than One Year(8 U S C§ 1621(a)(3)) ❑10 An alien paroled into the United States for less than oneyg;,a1 under Section 212(d)(5)of the INA Other Persons(8 Ui S C,; 1621(0(2)A)and(C)) 0 II A nonimmigrant whose visa for entry is related to employment in the United States,or ❑ 12 A citizen of a freely associated state,if section 141 of the applicable compact of free association approved in Public Law 99-239 or 99-658(Or a successor provision)is in effect[Freely Associated States include the Republic of the klarshall Islands,Republic of Palau and the Federate States of Micronesia,48 U S C § 1901 et seq J; ❑ 13 A foreign national not physically present in the United States Otherw ise Lawfully Present(A R S § 1-501) C7 14 A person not described in categories 1-13 who is otherwise lawfully present in the United States. PLEASE NOTE The federal Personal Responsibility and Work Opportunity Reconciliation Act may make persons who fall into this category ineligible for['censure. See 8 U S C.§ 1621(a), Page 2 of 7 eIN SECTION IV—DECLARATION All applicants must complete this section. 1 declare under penalty of perjury under the laws of the state of Anzona that the answers I have given are true and correct to the best of my knowledge APPLICANT'S SIGNATURE TO AY'S DATE Page 3 of -. :ti .-4 :4`vaNY,..r�,: ;...sd'- a 4P '+�6 'ai•�it`: "wsM .0 74r:3' 'i..'r. ..ry 3_'.° J-;g02L`vd+i v:4'' +f: .N � ilf , +y's'+. *e .A �T t CERTIFICATION OF VITAL RECORD �. .I,— .,� __. ,,,n ..• " STATE OF ARIZONA • zs. Yr 1• ' STATE OF ARIZONA BIRTH NO 71• i..1 ORIGINAL DEPARTMENT OF HEALTH SERVICES—OFFICE OF VITAL RECORDS mmoi �1n STATE COPY CERTIFICATE OF LIVE Elf .as: , !,._., 1"CMLD'S NAME A.FIRST B MIDDLE C.EAST :' EDDIE VAL VALDEZ ?$.1'.. 2.SEX" 3A.PLURALITY(SPECIFY) 3B.IF MULTIPLE BIRTH(SPECIFY} 4A.DATE OF BIRTH[MONTH DAY,.YEAR) z ' MALE _SINGLE ' • ' J Ft HOUR OF BIRTH 5.PLACE OF BIRTH A.COUNTY B.TOWN OR CITY '°` s _. SS GILA b LFE _D FACILITY NAME(iF NOT INSTITUTION GIVE STREET ANDNI.$LSER) ,.;;'` d:PtACF OF E„Nrri ❑ HOSPITAL to FREESTANDING BIRTHING CENTER 0 RESIDENCE ' ❑ CLINICTiOCTOR'S OFFICE ❑ OTHER(SPECIFY) Tea. ` 5 i=ATHER•S NAME(FIRST MIDDLE LAST SUFFIX fOVtinnal;) 13' ERNEST,OLVERA,VALDEZ l_ .L.i`• 7.DATL R OF`i;RTH(MONTH DAY YEAR) 8- ACE OF BIRTH(STATE OR COUNTRY) ''eta} ' -MOTHERS MAIDEN NAME(FIRST,MTOOLE LAST) 0' SALLY., MADRID i ItD.DATE OF BIRTH(MONTH DAY YEAR) 1` PLACEOF SIRTh)STATE OR COUNTRY) s ;, „ 12:MD I)ER'S USUALRESIDENCE A STATE B ', .:,t";h I Y C.TOWN OR CITY U.ZIP J 12E.STREET ADDRESS OR Ri.J iSF IN CITY LIMITS ` - U YES ❑NO:0 UI*(NOWN i, 4.-ii. -i3.MOTHERS MAILING ADDRESS(IF DIFFERENT FROM ITEM IS) Wfi,,r Ts'' ' 46. DATE REGISTERED. SEPTEMBER 23,1957 DATE ISSUED DECEMBER 20,2011 .1 F 4J tCZ t u/-Ll 1-,GSA` This Is a trun cett# ti e sca ,ud the facts on file nrsh the OFFICE OF VITAL RECDRDL PATRICIA ADAMS ! t•P•I2ONADEA1TSTUElI1CF HEALTH SEIEICES.IUI•NixARTONA ASSISTANT STATE REGISTRAR I Arizona( Revised O V.IAT G I Department of This-fti m.a Sdu^iessp,epatedye a te.'r.desdayiee the S'cte!in:sire rrj o,se4. Ostia...Id teal of the nstinti il;rn }rl€altM Strafe''- � "' 6 T ANY AtTERATKIN OR ERASURE VOIDS THIS,DT)CUAFtel.. "or1..... ' = '""ift ,..., , nl ..-"'_- r F'd' 'sY� rt XF'1 e'' N•'`Ya , n ,.vV' y }{. O tiP 4frf 1� u T . :,(wlov._-.._ i _ oink /Mk Arizona Department of Liquor Licenses and Control 800 West Washing ton;5th floor Phoenix,Arizona 85007 www.azilquorgav 602-542-5141 • CERTIFICATE OF TITLE 4 TRAINING COMPLETION Do Not Duplkaie.this Form Certificates must be completed by a state-approved training course provider,in black inlc,on an original form Eddie V Valdez Full Name(please rint) Signature . 12/20/2011 16.55 CST Training Completion Date Type of Training Completed(check Yes or No) ❑Yes•. ❑ No BASIC IY ❑ No ON SALE 12/20/2016 16-55 CST ❑x'Yes 0 No MANAGEMENT ❑ Yes ❑ No OFF SALE Certificate Expiration Date 0 Yes ❑ No BOTH ❑ Yes 0 No OTHER ;MANAGEMENT-5 years from completion date) (BASIC-3 years from completion date) If Trainee is lv`Employedn By A Licensee Eddie V Valdez E J11+� N can 07 t / D 03 - Narne of Licensee Business Name Liquor L ken se► Alcohol Training Program Provider Information 360training corn, Inc Company or Individual Name(please print) 13801 Burnt Rd. , Suite 100 Address Austin TX 78727 ( 888 ) 360 8764 City State Zip Daytime Contact Phone# I certify the above named individual has sucressfully completed the training specified above in accordance with Arizona Revised Statue,Arizona Administrative Code,and the training course curriculum approved by the Department of Liquor Licenses and Control ^ jjj April Thomas ry Name of Trainer(please print) 0 ( 12/20/2011 16-55 CST 1 Trainer Sig nature Date Pursuant to A.R.S.§4-112(G)(2),mandatory Title liquor law traineig is required prior to the Issuance of all new liquor license applications submitted after November i,1997. Ttie persons(s)required to attend both the BASIC and MANAGEMENT Title 4 liquor law training,on-or off-sale,will include al of the following Owner(sl Licensee/agent or managers)actively involved In daily business operation A valid(not expired)Certificate of Title 4 Training Completion must be submitted to the Department of Liquor Licenses and Control before a liquor license application Is considered complete Before acceptance of a manager's questionnaire and/or agent change for an existing liquor license,proof of attendance for the.BASIC and MANAGEMENT Title 4 liquor law training(on-or off-sale)is required. t e,200 Disabled individuals requiring special accommodations,please call(002)542-9027 1 Pnnt Form 1 ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL 800 W Washington 5th Floor 'i I) Phoenix AZ 85007-2934 �� I"� {602)542-5 QUEST(O611A►RE 1'I06614 I Attention all Local Governing Bodies Social Security and,Birthdate Information is Confidential. This information may be given to local law enforcement agencies for the purpose of backgro(Und checks only but must be blocked to be unreadable prior to posting or any public view. , ' Read carefully This instrument is a`sworn document..Type or print with BLACK INK. An extensive investigation of your background will be conducted False or incomplete answers could result in criminal prosecution and the denial or subsequent revocation of a license or permit. 'IN TO BE COMPLETED BY EACH CONTROLLING PERSON,AGE_N : VAN A.t1ER .(I-H_PERSON COMPLETING THIS FORM MUST SUBMIT AN "APPLICANT TYPE FINGERPRINT CARD%/MiCH MAY BE Of3 i'.FH)A r,'i I.:' "iGERPRINT,ING MUST Be DONE BY A BONA FIDE LAW ENFORCEMENT AGENCY OR A FINGERPRINTING SERVICE Ai'PRO _ BY D;I THE DEPARTMENT DOES NOT PPOVIDE THIS SERVICE Effective 10/01/07 there 11, 24,Q0 Processing tee for each finoerpriet. arri submitted Liquor License # The fees allowed by A.R.S.§44-5852 will be charoed for all dishonored checks. (If the location is currently licensed) 1 Check Controlling Person ❑Agent _I Manager(Only) appropriate (Complete Questions 1-19) (Complete All Questions gacsegt#14,14a&21) box ---) Controlling Person or Agent must complete#21 for a Manager Controlling Person or Agent must complete#21 2 Name hff_vUbt _ (2410t)r4ei`"G4- L, Date of Birth 11111111101111MI Lase First Middle (NOT a Public Record) L 3 So'i l Secur'ty Num � Drivers Licens State _/i`'� - - - — (NOT a public record) _ } (NOT a public record) 4 Place of Birth i.k1h l FerI✓?r ,�?� US, 4 Height, / 'i .Veighr 11 t� Eyes irK.° Hair jk'G? City tq V Country (not county) �^ '/aritsl Status- +e 0 Marc•,. [2( iwrced 0 W `"1�dowed Daytime Contact Phone 0--C, 5 - 9I (--/ I 6 Name of Current or Most Recent Spouse Date of Birth if List all for last 5 years•Use additional sheet if necessary) Last First Middle Maiden Maiden (NOT a public record) 7 You are a oona fide resident of.hat state' A2 If Arizona date of residency 0 7- a 1-19 61 S Tr lephone rurrber to contact you during business hours for any questions regarding this documert LI ei)C 3„_" 611 t-} I 3 If you have been an Arizona resident for less than three(3)months submit a copy of your Arizona dnver's license or voter registration card 13 Name of Licensed Premises 1 Vi r i f A((Cot r\t'c t-? l,(r a i t+ Premises Phone I -61 S'.. -9 f 1(r 11 Physical Location of Licensed Premises Address I F.---. 0 t) 1't' ct is 161 i I i1 )-f �{ '' ' pll�. t" r. . c, fa r rY.t� u��1� Street Address (Do no use PO Box#) Chy Coirity LP 12 List your employment or type of business during the past ve iF)years If unemployed part of the time,!list those dates List most recent 1st. FROM TO lI DESCRIBE POSITION EMPLOYER'S NAME OR NAME OF BUSINESS Mont /Year MorritnhYear y� OR BUSINESS (street address city slate&zip) t t•f J CURRENT i 1 (.1.0 f l �T _ a• r,]-et Lf f Ma t yp 5 Dr'- ! f �E':!r Ah 1-,t e i raft S it,u(blef.. f1`ido�i,r 4r- r- .�F2 95r7. ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION 13 Indicate your residence address for the last five(5)years FROM TO Rent or RESIDENCE Street Address i tortivY=_ar Manth•'Year Own If rented.attach additiorui sheet witn name,address and phone number of landlord City State Zip t71(� CURRENT t T Zl ^� 7 yf _ .c-r Kt cyfirs n pp /1 t!ttr 3 o e c. ue.itit li F� ^"'5) ,_rSG 4•32"t../2„2y mesa_ i-7. 85;e7 1 t o 10C1 °`V) c\ >"<, ((03r7 a 1-6 f)t'((A -. Ale CA '4 4 " '=,2'1 1�r,rnt T nits A-piei'h(E r' I(41'• C2.I"1 .ktP4- 73,3 :„„, f I .>F �i;.. 1.:.; / .1�.Vt A? .: e, 1 LIC 0101 9/2412009 Disabled individuals requiring special accommodations,please call the Department,(602)542 9027 /'N ON If you checked the Manager box on the front of this form skip to#15 14 As a Controlling Person or Agent will you be physicality present and operating the licensed premises? OYES[ NO If you answered YES,how many hrs/day? .and#nsweJ#14a below If NO,skip to#15 14a. Have you attended a DLLC-approved Liquor Law Training Course within the past 5 years? (Must provide proof) OYES ONO If the answer to#14a is"NO",course must be completed before issuance of a new license or approval on an existing license. 15 Have you been detained, cited,arrested_indicted or summoned into court for violation of ANY law or ❑YES 'NO ordinance regardless of the disposition,even if dismissed or expunged, within the past ten(10)years (include only traffic violations that were alcohol and/or drug related)? ells 16 Are there ANY administrative law citations,compliance actions or consents criminal arrest, indictments DYES LIMO or summonses PENDING against you or ANY entity in which you are now involved? 17 Have you or any entity in which you have held ownership, been an officer, member, director or manager OYES O EVER had a business professional or haunt application or license rejected.denied. revoked. suspended fQC! eci in this or any other state'? 18 Has anyone hi+ it qr Wained a iu ament against you,the subject of which involved fraud or DYES 'NO rnisrepresegtation? '9 Ar�Q�.NOWQJ EVER held ownership, been a controlling person, been an officer,member OYES VfvO dire&&for or Managey other iicuor license in this or any other state? q any answer to Oues sts` *thro‘+ '''' ES`YOU MUST attat'e gnedait tes Give complete details in_`udingg dates, agencies involved an dispositions / SUBSTANTIVE CHANGES TO THiS APPLICATION WILL NOT BE ACCEPTED 20 I t 4°1t1.r?r11±V 1 - 1 t r,,U 1.7 i j hereby declare that lam the APPLICANT REPRESENTAT IVE ;print fjR name of Appiicansi filing this questionnaire I have read this questionnaire and all statements are true, correct and complete t'l x t/1/1444_,.&-!„,e,-77,- / �14f� State rf ,' Co::nty of lGt 14c( ),P r5ature of Appiica 1) The pegoing instrurne •as acknowledged before're this (rdh Year My /d. els commission expires on . Day Month ,Signature of NOTARY IC) COMPLETE THIS SECTION ONLY IF YOU ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21 The applicant hereby authorizes the person named on this questionnaire to act as manager for the named liquor license The manager named must be at least 21 years of age State of County of The foregoing instrument was acknov edged before me this X_ ._„ day of Signature ofControiimg Person or Agent(circle one, Month Year �ISatnature of NOTARY P BLIii`c Print Name My commission expires on Day Month Year i Print Form ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL 800 W Washington 5th Floor Phoenix AZ 85007-2934 0/-17 r(11 02)542-5.! l' ..1-10 VNAIRE VIICe1)9** Attention all Local Governing Bodies. Social 5ecuri ..a(Id Birthrlat Infermatign Is Confidential This information may be given to local law enforcement agencies for the purpose of, round checks only.b`ut must be blocked to be unreadable; prior to posting c3 lr.i -rod any public view s Read carefully This instrut jent is`a stvorn documerit:/type or print with BLACK INK. �w An extensive investigation of your?to ckgtdrid witLtie'cor4,du rcted False or incomplete answers could result in criminal prosecutiorearld that.denial or ubsegiient revocation of a license or permit. TO BE COMPLETED BY EACH CONTROLLING PERSON AGE t Cl. rt itil PEtiaFON COMPLETING THIS FORM MUST SUBMIT AN APPLICANT'TYPE FINGERPRINT CARD WHICH MAY BE O _ L' :1 GE{PRMN ING MUST BE DONE BY A BONA FiDE LAW ENFORCEMENT AGENCY OR A FINGERPRINTING SERVICE,i,P i! t�THk DrI RTMENT DOES NOT PROVIDE THIS SERVICE Effeetrvg 1t1101t07 there rs a S24.Ot)oror.P,,, Ina feP for mach fingerprint card submitted. Liquor License # The fees allowed by A R S §44 6852 will be cll r fp£A(js} ono cd chnclie 017/Jia),.'d Of the location is currentty licensed) 1 Check ❑Controlling Person ent I Z Manager(Only) appropnate (Complete Questions 1-19) (Complete All Questions gxc eat#14,14a&21) j box --). Controlling Person or Agent must complete#21 for a Manager Controlling Person or Agent must complete#211 2 Name 11!Ara . Wort -Del ELta"+viiC.,,. ---- - Date of Birth _ L First Middle (NOT a Public Record) -41 Social Security Number Drivers License11.1111111111111 -- ,I� State i I (NOT a public record) (NOT a public record) 4 Plan?of Birth 1,1,nq 11 F a? Heignt 4 `!0 r� Weight 2Cf_3 Eyes A,e Ha5r. ./r) Citii State Country (not county') 7 / 5 Marital Status D Single CQ Manned; Divorced El Widowed Daytime Contact Phone _ 6 6 u i c, 6 Name of Current or Most Recent Spouse Date of Birth _I_, (Llst ail for last 5 years-Use additional sheet if necessary) Last First Middle Maiden (NOT a public record) l _ 7 You are a bona fide resident of what state' "-I?,.— If Arizona date of residency f fi.,)a Telephone number to contact you during business hours for any questions regarding this document Li d'0 -IS 2._e 71!/(e) 9 If you have been an Arizona resident for less than three(3)months.submit a copy of your Arizona driver's license or voter regrstratrgn card 10 Name of Licensed Premises `l i 6.i i` C,'5 1'0.P X I Cal) t qaL tircZv.. P amines Phone L f1 ? �' ?-'" i " ' t `I{' 11 Physical Location of Licensed Premises Address / �as.-L" t.�"'. ,f-f I4'c;t l/.1c11 f /-� ti'Arj �+f� � Street Address (Do not use PO Box i:) City /1r, 11-1 t ounly Zip 12 List your employment or tyae of business dunng the past five j5)years if unemployed part of the time list those dates List most recent 1st FROM TO DESCRIBE POSITION EMPLOYER'S NAME OR NAME OF BUSINESS Month/Year Month/Year OR BUSINESS / _4, L tLt ee i i f ,r?h� `_eie$z+p `.r�'L.. a1..i,c1 c..c, r/1+' //ize , _ CURRENT M.5 / ,—I . - '��" J lL., 5 Sf 2 �t( f"�C���cct .y^ _ rv',, ,1i3 !� `Xi Le.14.. i StcGztra..(.L / 7t //f ii ?e.r�-e-1'- `` ;1',t ; s f' to rc.:c ,. 's �..ttv2.t .. ,7 / .2.0 W "9'gdc- 7r"4//�i e�� ..Jxw 'c,4 ,23 r. . .2,,1 S C.) ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION 13 Indicate your residence address for the last five(5)years FROM TO Rent or RESIDENCE Street Address ,MonihtYear Month/Year Own if rented,attach additional sheet with name,address and phone number of landlord City State 4i ilti. CURRENT f�;,i,'� root i)N�c''t/oe, AA' s'i ii-p4( r'•. 42 f5,-/) - . LIC 0101 9/24(2009 Disabled individuals requiring special accommodations,please call the Department(602)642-9027 If you checked the Manager box on the front of this form skip to#15 14 As a Controlling Person or,Agent,will you be physically present and operating the licensed premises? OYES®NO If you answered YE&how many hrsfday? ,and answer#14a below If NO,skip to#15 14a Have you attended a DLLC-approved Liquor Law Training Course within the past 5 years? (Must provide proof) OYES ONO If the answer to#14a is"NO".course must be completed before issuance of a new license or approval on an existing license 15 Have you been detained.cited.arrested.indicted„ r iumfi4ned into court for violation of&F Y law or ❑YES ®NO ordinance,regardless of the disposition, even if dismissed or expunged within the past ten(10)years f`� (include only traffic violations that were alcohol and/or drug related)? 16 Are there ANY administrative law citations,compliance actions or consents criminal arrest,indictments OYES NO or summonses PENDING against you or ANY entity in which you are now involved? 17 Have you or any entity in which you have held ownership, been an officer, member,director or manager OYES ;Yj NO EVER had a business professional or liquor application or license rejected.dented.revoked.sul.gen "�• or fined in this or any other state? 18 Has anyone EVER flit („ t r o*tamed a iudomf; ;igajastygu,the subject of which involved fraud or OYES ONO misrepresentation? 19 Are you NOW or have you EVER,held ownership, been a controlling person, been an Officer member OYES NO director or manager on any other liquor license in this or any other state? if any enswer to Questions(I5 through 19 i5`YES"YOI)MUST attach a signed statement Give complete details including dates agencies involved and dispositions SUBSTANTIVE CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED 20 I Vii.; i ,,,_ _ `._�0 ,.;-.', rxi.att-,5 , hereby declare that t am the APPLICANT/REPRESENTATIVE {grim full name of.Appb filing this questionnaire I have read this questionnaire and all statements are true correct and complete Xilia,zi"i.C f) _,.1 K{ )1 "_ 'k' _—_______ State of C.!y y County of (Signatifre of A nu The foregoing instrument was acknowledged before me this [a day of •--)0-s-,i,4-c- s - 5Zco 11. I Month Year ^ My commission expires on 03/i'ilr) ,_. - -- , .i s_ �r.L.:/ Dap Month 'fear IL(}t:A (5 jr,ature of NOTARY PUBLIC; t ,c"unry (;) cziTES 0' COMPLETE THIS SECTION ONLY IF-YOU ARE A CONTR G PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21 The applicant hereby authorizes the person named on this questionnaire to act as manager for the narred liquor teens.. The manager named must be at least 21 years of age �' I, State of L V ' 'D" County of /1//Wt. ' %y—• The foregoing instrument was acknoiledced before me this X �' ����" 2 day of `•""'hit r2 r",y7 ::, /)-+ Signature of ontro0trifl Pers>1Agent(circle one) _(211.4. •(,-. I�foi>f+' Year ... _. .. ,,,,4Signat'Urs of NOTARY PUBLIC) Pont Name i -- BL iC My commission expires on 03 /•23 ; ,;. 1;ouc y Day nah r.Year _.,;lNF SITES I; 7r,1/13 AIN - r Arizona Department of Liquor Licenses and Control 800 West Washington,St ti Floor Phoenix,Arizona.85007 www.azliquor.gov 602-542-5141 CERTIFICATE QF TITLE 4 TRAINING COMP ION Do Not Duplicate This Form. Certificates must be completed ,a state=approved training course provider,in black ink,on an original form. Carmen Burgess /lul Name(please pr t) signatute 01/18/2012 18.25 CST Training Completion gate Type of Training Completed(check Yes ar No) Eyes ❑ No BASIC ❑ 1e' ❑ No ON SALE 01/18/2017 18.25 CST 0 Yes ❑ No MANAGEMENT 0144 0 No OFF SALE Certificate Expiration Date ❑ Yes ❑ No BOTH ❑ Yes ❑ No OTHER (MANAGEMENT-S years from completion date) (BASIC 3 years from completion date) If Trainee Is Employed By A Li l Carmen Burgess \fj ' ,. at2/l 003a, L r Name of Licensee Business`Name Liquor License e Alcohol Training Program Provider Information 360training corn. Inc Company or Individual Name(please print) 13801 Burnet Rd. Suite 100 Address Austin TX 78727 ( ass ) 360 8764 City State Zip Daytime Contact Phone a I certify the above named Individual has successfully completed the training specified above in accordance with Anzona Revised Statue,Anzona Adrninistr ative Code,and the training course curriculum approved by the Department of Liquor Licenses and Control. April Thomas d n Name of Trainer(please print) )?f7vdY 01/18/2012 18.25 CST Trainer Signature Date Pursuant to ARS.4 4-112(GX2),mandatory Tale 4 liquor law training is required prior to the issuance of all new liquor license applications submitted after November 1,1997 The persons(s)required to attend both the BASIC and MANAGEMENT Title 4 liquor law training,on-or off-sale.will indude all of the following: Owner(s) Licenseeiagent or manager(s)actively involved In daily business operation A valid(not expired)Certificate of Title 4 Training Completion must be submitted to the Department of Liquor Licenses and Control before a liquor license application is considered complete. Before acceptance of a managers questionnaire and/or agent change for an existing liquor license.proof of attendance forthe BASIC and MANAGEMENT Title 4 liquor taw training(on-or off-sale)is required 612009 Disabled individuals requiring special accommodations,please call(602)S42-9027 Pp pcH rely oicileete j( ttleettew/ Home of the Superstition Alountarns 4 ZONP NOTICE The attached application for a New License, Limited Liability Co , Beer and Wine Bar Liquor License submitted for Elvira s Mexican Restaurant located at 1520 W Apache Trail, Apache Junction, Arizona. was posted on the 8th day of February, 2012, 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 (1/2) mile radius from the proposed premises to be licensed may file written arguments in favor thereof, or objections thereto with the City Clerk at City Hall 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, March 6. 2012, at the City Council Chambers. 300 E Superstition Blvd , Apache Junction, AZ at 7 00 p m , at which time any objections filed will be heard. ANN Kathleen Connelly City Clerk DO NOT REMOVE THIS NOTICE AND/OR ATTACHMENTS. REMOVAL OF THIS APPLICATION MAY JEOPARDIZE CITY COUNCIL RECOMMENDATION. •‘ 'ILL (1801982-8002 • IA X(-180)982-'018• TUt)(4801983 009s • K N diot> net 100 C Superstition Rouiesard Apache Junction AL 85219 �QACH _try- ore..cilictriw U " Home of the Superstition Mountains qR ZOt February 8. 2012 Eddie Val Valdez Elvira's Mexican Restaurant 264 S Phelps Drive Apache Junction. AZ 85120 Dear Mr Valdez Please be advised that the application for a New License, Limited Liability Co . Series 7 Liquor License submitted for Elvira's Mexican Restaurant, located at '1520 W Apache Trail. Apache Junction Arizona, was posted on February 8, 2012. in accorda-ice with state law The Apache Junction City Council will hold a public hearing on March 6, 2012. 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 processing of your application. "1\ There is a $50 non-refundable application fee that is due and must be received prior to Wednesday, February 22. 2012, in order for this application to be placed on the City Council agenda if you have any questions concerning this matter, please contact my office at 474-5068 Sincerely, • Kathleen Connelly City Clerk • vol;-..1-18t1)482-6002 • i.\\ I-Ohtt' -70I8• i L)L)080)98;-00'1; •; v 4Jctt�not 100 E. Superuition fBinile%ard. Apache Junction AZ 8•2I9 ON FEBRUARY 6, 2012 MEMORANDUM TO. DEPARTMENT OF PUBLIC SAFETY PLANNING DIVISION APACHE JUNCTION FIRE DISTRICT THROUGH KATHLEEN CONNELLY, CITY CLERK./A FROM JAN MASON, DEPUTY CITY CLERK3�--' SUBJECT APPLICATION FOR LIQUOR LICENSE FOR ELVIRA'S MEXICAN RESTAURANT Mr Eddie Valdez has submitted an application for a New License Limited Liability Co Series 7 Liquor License for Elvira's Mexican Restaurant located at 1520 W Apache Trail, Apache Junction Please conduct the necessary inspections and submit your recommendation by email no later than Wednesday, February 22, 2012, in order for this item to be on the agenda for the City Council meeting of March 6, 2012 Janet Mason From: Rudy Esquivias Sent. Wednesday, February 22, 2012 10 36 AM To: Janet Mason Subject. RE Liquor license application for Elvira's Mexican Restaurant - Series 7 Jan The Elv,ra s Restaurant property is a long established use in the City and the property is zoned CB-2(General Business Zone) Restaurants with beer, wine and liquor sales are allowed outright in this zoning district Planning Staff has no objections to this request cRiccicycfluivicts 9en_or Planner/Zoning Administrator City of Apache Junction 300 E Superst,tion Blvd Apache Junction, AZ 85119 480-474-2645 SERVICE OVER AND ABOVE THE REST ,Je c•pment. Ser.v es cepart_m +nt office hours 'Monday through TYur:.daj :roil, Onam t: 6 00pc and Holidays ) From: Janet Mason Sent.Tuesday, February 07, 2012 2 54 PM To: Jeff Robinson, Rudy Esquivias Subject: Liquor license application for Elvira's Mexican Restaurant- Series 7 I have received two liquor license applications for Elvira's Mexican Restaurant One is for a series 7 and the other for a series 12 Please have your department recommendations to me,one for each,by Wednesday, February 22 Thanks es The series 12 will be in a separate email Janet Mason Deputy(Ay Clerk City Of Apache Junction 300 E superstit:on Blvd Apache;unction,AL 851i9 480 474 5068 1rn son@a1city,net Service Over and Above the Re;t This message and the information within is intended for the recipient If you received this email in error, please notify the sender and then delete the email Emails generated by council members or City staff pertaining to City business are public records and are preserved according to the City's records retention schedule To ensure compliance with the Open oak Apache Junction Police Department y -, • x Interdepartmental Memo 4. 1 tA;e4 DATE 02/16/2012 TO Lt Robinson THROUGH FROM Sgt Durkin SUBJECT Elvira's Restaurant At your request I went to the Elvira s Restaurant 1520 W Apache Trail, Apache Junction regarding a liquor license request This is within the city limits of Apache Junction and AJPD s jurisdiction This restaurant is a free standing and a well established business Posted on the window of the restaurant. is the city license request and liquor license request dated Feb 8 2012 I contacted Carmen Burgess John was present also She is a US citizen and known to us as the manger of this business The bar/restaurant area matched the diagram provided The intenor will be changing and is +^ currently still 'under construction'. The provided diagram, did match the new area for their dining room Parking is ample, and the building, and business. is well established i did not see any challenges in granting this, nor do I see any objections to this application This up grade to their building/ business appears to be a welcome addition to our city CFAI ��__ Apache Junction Fire District yr P„�„o,, 565 North Idaho Road, Apache Junction, AZ 85119 ,lit ,a,. = ��! Phone (480) 982-4440, Fax(480) 982-0183 ~ iiDisl' ` www ajfire.org \\� MEMORANDUM '"... TO: Jan Mason,Deputy City Clerk City of Apache Junction FROM: John Sumga, Deputy Fire Marshal DATE: February 10,2012 SUBJECT: Series 7 Liquor License Application for Elvira's Restaurant The Apache Junction Fire District recommends approval of the above noted application As always we will conduct the needed safety inspections as this new construction project progresses Thank you for your notification on this matter J � Jos �.. ATTN: Application ROLL CALL VOTE NOTES •), .c/\ ITEM # )\ 4/1 MEETING OF 1/1 MOTION BY SECONDED BY YES NO ABSTAINED COUNCILMEMBER SERDY VICE MAYOR DIETZ COUNCILMEMBER SMITHSON COUNCILMEMBER WILSON V COUNCILMEMBER BARKER MAYOR INSALACO UNANIMO S IN FAVOR OPPOSED ABSTAINED TOTAL \ ITEM NO. 6 I MOVE THAT THE APPLICATION FOR A NEW LICENSE, LIMITED LIABIITY CO., SERIE 7 LIQUOR LICENSE FOR ELVIRA'S MEXICAN RESTAURANT, SUBMITTED BY EDDIE VALDEZ, BE RECOMMENDED FOR(APPROVAL) OR(DENIAL) TO THE ARIZONA DEPARTMENT OF LIQUOR LICENSES AND CONTROL PUBLIC HEARING ORN 1. For APPLICATION FOR A NEW LICENSE,LIMITED LIABILITY CO., SERIES 12 LIQUOR LICENSE FOR ELVIRA'S MEXICAN RESTAURANT LOCATED AT 1520 WEST APACHE TRAIL 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. /'\ 444,..:e; p110N�` ACHt ity of p��c lie J unction t�o,wt' of the .S upt'l:sliiion .11oiiillcllll.cgR Print TO: City Manager's Office FROM: Kathy Connelly, City Clerk DATE: March 6, 2012 Agenda Type : Regular Agenda Council Priority Focus Area: Required by Federal Law or State Statute TITLE OF AGENDA ITEM: APPLICATION FOR A NEW LICENSE, LIMITED LIABILITY CO., SERIES 12 LIQUOR LICENSE FOR ELVIRA'S MEXICAN RESTAURANT LOCATED AT 1520 WEST APACHE TRAIL ACTION REQUESTED: Recommendation for Approval DISCUSSION / BACKGROUND INFORMATION: 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 the Arizona Department of Liquor Licenses and Control. FISCAL IMPACT: OPTIONS/ALTERNATIVES: RECOMMENDATION: ATTACHMENTS: Click to download ❑ cover memo D application part 1 D application part 2 D application part 3 ❑ notice D applicant letter D department memo D police recommendation O fire district recommendation FEBRUARY 23. 2012 MEMORANDUM TO HONORABLE MAYOR AND CITY COUNCIL MEMBERS THROUGH GEORGE R HOFFMAN, CITY MANAGER THROUGH- KATHLEEN CONNELLY, CITY CLERK I, FROM. JAN MASON, DEPUTY CITY CLERK — SUBJECT AGENDA ITEM FOR MARCH 6, 2012. APPLICATION FOR A LIQUOR LICENSE FOR ELVIRA'S MEXICAN RESTAURANT An application for a New License. Limited Liability Co Series 12 Liquor License has been submitted by Mr Eddie Valdez for Elvira's Mexican Restaurant located at 1520 W Apache Trail in Apache Junction Correspondence has been received from the planning department, police department and 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 egS Arizona Department of Liquor Licenses and Control 800 West Washington,5th Floor Phoenix,Arizona 85007 wwwazliquorgov 602-542-5141 APPLICATION FOR LIQUOR LICENSE TYPE OR PRINT WITH BLACK INK Notice, Effective Nov 1,1997,All Owners,Agents,Partners,Stockholders,Officers,or Managers actively involved In the day to day operations of A\ the business must attend a Department approved liquor law training course or provide proof of attendance within the last five years. See page 5 of the Liquor Licensing requirements. SECTION 1 This application is for a. SECTION 2 Type of ownership. O MORE THAN ONE LICENSE � NTERIM PERMIT Complete Section 5 O J T W R O S Complete Section 6 NEW LICENSE Complete Sections 2,3,4, 13, 14, 15, 16 O INDIVIDUAL Complete Section 6 ❑PERSON TRANSFER(Bars&Liquor Stores ONLY) 0 PARTNERSHIP Complete Section 6 Complete Sections 2, 3,4, 11, 13, 15, 16 0 CORPORATION Complete Section 7 0 LOCATION TRANSFER(Bars and Liquor Stores ONLY) LIMITED LIABILITY CO Complete Section 7 Complete Sections 2,3,4, 12, 13, 15, 16 ❑CLUB Complete Section 8 0 PROBATEIWILL ASSIGNMENT/DIVORCE DECREE 0 GOVERNMENT Complete Section 10 Complete Sections 2, 3,4, 9, 13, 16 (fee not required) 0 TRUST Complete Section 6 0 GOVERNMENT Complete Sections 2. 3,4, 10, 13, 15, 16 0 OTHER(Explain) SECTION 3 Type of license and fees LICENSE#(s)• / / ,-CJ t + - 1 Type of License(s) r, '_% _,.1 ; > 0 r(e., /2 t {.'t' I -� � ant t 1iv Ot�''r _ 2 Total fees attached S {,I . 1 APPLICATION FEE AND INTERIM PERMIT FEES(IF APPLICABLE)AR ' NOT REFUNDABLE. The fees allowed under A R.S.44-6852 will be charged for all dishonored checks. SECTION 4 Applicant . h,,, rJ 1 Owner/Agent's Name Mr ,A U i' Z- &,`'b'(' ) €-- \i`cA Insert one name ONLY to appear on sense) Last ,� First Middle 2 Corp./Partnership/L C I /V"rd. S /t)e';r--r c.r.�.-s--1 ,mac..-f r3 i if ?/11 1 L�G-c... (Exactly as it appears on Articles of inc or Articles of Org) 3 Business Name (1l. ') cl / ie X- / c.a/1 k;,?5.,6411 r/L:/7 t (Exactly as it appears on theexterior of premises) `� f•r f /� ! t� 4 Principal Street Location • -- L`' Ir.`-r 4.70?!'.f u? / t il.1 / /4 ��'`t �/f);,2 L �l /)., (Do notn use PO Box Number),,),,� City r^� ; !i j County Zip 5 Business Phone L[G7al.' . !i `{t'1 Daytime Contact c ! 47'5 c. 2.2)7 r• .i-2 Li 6 Is the business located within the ircorpo ted iitnits,,00f__the above city or town? YES ONO 7 Mailing Address al-l/'li a l"''h,i/0 S Or- i +1 t?- i( t to z . f: / �.C) City 111/ Static* Zip 8 Price paid for license only bar, beer and wine,or liquor store Type $ Type $ I DEPARTMENT USE ONLY �'( CC3J3 6-' Fees / Application Interim Permit Agent Change Club Finger Prints $_ I TOTAL OF ALL FEES Is Arizona Statement of Citizenship&Alien Status For State Benefits complete?YES 0 NO Accepted by i i 'f Date ' Lic #_;_,z� --I 1 " Jetty 2010 'Disabled individuals requiring special accommodation, please call(602)542-9027 1 SECTION 5 Interim Permit: 1 If you intend to operate business when your application is pending you will need an Interim Permit pursuant to A R S 4-203 01. 2. There MUST be a valid license of the same type you are applying for currently issued to the location 3 Enter the license number currently at the location 4 Is the license currently in use'?0 YES 0 NO If no, how long has it been out of use? ATTACH THE UCENSE CURRENTLY ISSUED AT THE LOCATION TO THIS APPLICATION. , declare that I am the CURRENT OWNER,AGENT, CLUB MEMBER, PARTNER, (Print full name) MEMBER,STOCKHOLDER, OR LICENSEE(circle the tale which applies)of the stated license and location State of County off X The foregoing instrument was acknowledged before me this (Signature) of My commission expires on. Day day Month Year (Signature of NOTARY PUBLIC) SECTION 6 Individual or Partnership Owners. EACH PERSON LISTED MUST SUBMIT A COMPLETED QUESTIONNAIRE(FORM LICQ101),AN"APPLICANT'TYPE FINGERPRINT CARD,AND S24 PROCESSING FEE FOR EACH CARD 1 Individual Last First .Middle %Owned Mailing Address City Stale Zip Partnership Name (Only the first partner listed will appear on license) G.enerai Limited Last First Midtlte %Owned mailing Address City Sta�ts�Z) ❑ ❑ ---- t _ o (ATTACH ADDITIONAL SHEET IF NECESSARY) 2 Is any person,other than the above,going to share in the profits/losses of the business? 0 YES 0 NO If Yes,give name, current address and telephone number of the person(s) Use additional sheets if necessary Last First Middle Marling Address City.State,7p Telephone* 2 /I N /'k SECTION 7 Corporation/Limited Liability Co EACH PERSON LISTED MUST SUBMIT A COMPLETED QUESTIONNAIRE(FORM LIC0101),AN"APPLICANT"TYPE FINGERPRINT CARD,AND$24 PROCESSING FEE FOR EACH CARD El CORPORATION Complete questions 1,2, 3, 5, 6, 7,and 8 j5CL L C Complete 1,2,4,5, 6, 7,and 8 1 Name of Corporation&L C t A); ''" ' 1 S Le,-4.`a.i, RC,-5 '- ;12 f2'L� / /- --L" --- .-_ (Exactly as il appears on Articles of Incorporation or Articies of Organization) 2 Date Incorporated/Organized t oLitt'/r ► State where Incorporated/Organized a ei 2-0 ele- '.,f J Y CJ' t in AZ f h' 3--AZ Corporation Commission File No - �_- ._ _ � date authorized to do business � 4 AZ L.L C File No L 1`l, ,5' 'C)> Date authorized to do business in AZ i } 1 A.t 1^ 5 Is Corp./L L C Non-profit's 0 YES*NO 6 List all directors,officers and members in Corporation&L C Last Firs! Middle Title Maihig Address City Stale Zi. al )da 1 (1, (11J e Vi2 t M. �b9 het/ �j S rhd j . y f ,¢TI/4 e..6`i)-e) A I elidbil . C110/116?).. 4., /lot ha/ A,ki _5'ih,c,-( ,,6 i" /17 3--,/1- .951)o ,A r7A.CH ADDITIONAL SHEET IF NECESSARY) 7 List stockholders who are controlling persons or who own 10%orttmore Last First ,Middle %Ownea� 1, Mailing Address, City Slate Zi), i:V I (17..11/ t:.,,,, t I 'kV ii1141 .2› i/1144-(' 4 Ki'v'e, 4--ri /1-- e.--.4.4-.., N t '.;1,) C. Ct ki{((. t i'7.& )(tic! . Pnel(i Dr ripilG€1t.fl,_i1, tr- ;ATTACH ADDITIONAL SHEET IF NECESSARY; 8 If the corporation/t..L C is owned by another entity,attach a percentage of ownership chart,and a dtrector'officer/mernber disclosure for the parent entity Attach additional sheets as needed in order to disclose personal identities of all owners SECTION 8 Club Applicants 1 EACH PERSON LISTED MUST SUBMIT A COMPLETED QUESTIONNAIRE[FORM LIC1liltI),AN"APPLICANT TYPE FINGERPRINT CARD,AND$24 PROCESSING FEE FOR EACH CARD 1 Name of Club Date Chartered !Exactly as it appears on Club Charter or Bylaws) (Attach a copy of Club Chaster cr Bylaws) 2 Is club non-profit? 0 YES 0 NO 3 List officer and directors Last — First Middle Title mailing Address a '•?ate Zi i I " I (ATTACH ADDITIONAL SHEET II-NECESSARY) -j SECTION 9 Probate,Will Assignment or Divorce Decree of an existing Bar or Liquor Store License: 1 Current Licensee's Name (Exactly as rt appears on license) Last First Midge 2 Assignee's Name Last list Middle 3 License Type- License Number Date of Last Renewal. 4 ATTACH TO THIS APPLICATION A CERT1FiED COPY OF THE WILL,PROBATE DISTRIBUTION INSTRUMENT OR DIVORCE DECREE THAT SPECIFICALLY DISTRIBUTES THE LIQUOR LICENSE TO THE ASSIGNEE TO THIS APPLICATION SECTION 10 Government:(for cities,towns,or counties only) Governmental Entity /y 2 Person/designee Last First Middle Contact Phone Number A SEPARATE LICENSE MUST BE OBTAINED FOR EACH PREMISES FROM WHICH SPIRITUOUS LIQUOR IS SERVED. SECTION 11 Person to Person Transfer: Questions to be completed by CURRENT LICENSEE(Bars and Liquor Stores ONLY-Series 06,07,and 09). I Current Licensee's Name Entity (EsactIy as rt appears on license) Last First Middia ilridrir 'gent etc) 2 Corporation/LI C Name (Exactly as it appears on(*wise) 3 Current Business Name (Exactl).as it appears on license} 4 Physical Street Location of Business. Street City State Zip 5 License Type License Number 6 If more than one license to be transfercd License Type License Number 7 Current Mailing Address Street (Other than business) City,State, Zip 8 Have all creditors,lien holders,interest holders.etc been notified of this transfer? 0 YES 0 NO 9 Does the applicant intend to operate the business while this application is pending? 0 YES 0 NO If yes complete Section 5 of this application, attach fee,and current license to this application 10 I, , hereby authorize the department to process this application to transfer the (pnni full name) privilege of the license to the applicant,provided that all terms and conditions of sale are met Based on the fulfillment of these conditions, I certify that the applicant now awns or will own the property rights of the license by the date of issue I, , declare that I am the CURRENT OWNER, AGENT MEMBER,PARTNER (print toil name) STOCKHOLDER,or LICENSEE of the stated license I have read the above Section 11 and confirm that all statements are true. correct, and complete State of County of (Signature of CURRENT LICENSEE) The foregoing instrument was acknowledged before me this Jay Month Year My commission expires on (Signature of NOTARY PUBLIC) SECTION 12 Location to Location Transfer(Bars and Liquor Stores ONLY) APPLICANTS CANNOT OPERATE UNDER A LOCATION TRANSFER UNTIL IT IS APPROVED BY THE STATE 1 Current Business Name (Exactly as it appears on license) Address 2 New Business Name (Physical Street Location) Address 3 License Type. License Number ON 4 If more than one license to be transferred License Type License Number 5 What date do you plan to move? What date do you plan to open? SECTION 13 Questions for all in-state applicants excluding t e pfy_,ilr g for govern tmegt,hotetl gl t Li ng restaurant licenses(series 5, 11,and 12). AR S §4-207(A)and(B)state that no retailer's license shall be issued for any prernses which are at the time the license application is received by the director within three hundred(300)horizontal feet of a church within three hundred(300)horizontal feet of a public or private school bulling with kindergarten programs or grades one(1)through(12)or within three hundred(300)honzonai feet of a fenced recreational area adjacent to such school building The above paragraph DOES NOT apply to 3)Restaurant license(§4-205.02) c)Government license(§4-205 33) b Hotel/motel license(§4-205 01) d)Fenced playing area of a golf course(§4-207(B)(5)) Distance to nearest school : 1 )`� ft Name of school i, ft/ 'r<-+�j C (r,i - piifi t/t t .! `'(%(. t aiy2 Address .. . Ci - 'Y r /'11.,0 L' .:(7)... ))11`" f 17 A- _.- City, State Zip j •'`« ` ,,�<E-'>-�/J 2-0') ! 2 Distance to nearest church f./f t ft Name of church r '�+c'.. ± . ik r... d acitta,t / MI b'e ,- • J Address /'�?-/t7 t t) COS -'€ i if ,iv .:i ,4 3 /2i.) City, State.Zip <. ''`',:;i 3 I am the u Lessee ❑ Sublessee Owner 0 Purchaser(of premises) 4 if the premises is leased give lessors Names r 4� r — Address = A City, State,Zip 4a Monthly rental/lease rate S i\i { ri' What is the remaining length of the lease_yrs mos 4b, What is the penalty if the lease is not fulfilled? $ p i A. or other (give details-attach additional sheet if necessary) 5 What is the total business indebtedness for this iicensellocabon excluding the tease?5 L. Please list lenders you owe money to Last First tvtdcle Amount Owed ring Address City Stale Zia i 1 (A rTACH ADEXTiONAL SHEET IF NECESSARY) 6 What type of business will this license be used for(be specific)? /4 -- ,2 r''/r?r SECTION 13 -continued 7 Has a license or a transfer license for the premises on this application been denied by the state within the past one(1)year? L7 YES C3 NO If yes, attach explanation 9, Does any spirituous liquor manufacturer, wholesaler or employee have any interest in your business? 0 YES ❑ NO 9 is the premises currently licensed with a liquor license? ❑YES 0 NO If yes, give license number and licensees name _icense# r ' t+ et° (exactly as it appears on license) Name t f Vr F L fl I r'r r «r C G� r SECTION 14 Restaurant or hotellmotel license applicants: 1 is there an existing restaurant or hoteVmotei liquor license at the proposed location? YES 0 NO If yes, give the name of licensee,Agent or a company name f t1 G- V f i ! 3 !f l -t and license � '� l ! �: r_ i_as First Mit.ldfoa 2 if the answer to Question I is YES you may qualify for an Intenm Permit to operate while.your application is pending consult A R S §4-203 01 and complete SECTION 5 of this application 3 All restaurant and hoteli hotel applicants must complete a Restaurant Operation Plan(Form LIC0114)pro\ed:d by the Department of Liquor Licenses and Control 4 As stated in A.R S §4-205 02 G 2, a restaurant is an establishment which d v 1' i 'r c-tit . venue from the sale of food Gross revenue ,s ine revenue derived from all safes � i _i"sed premises By applying for this Q hotel/motel 0 restaurant license, I certify that I understand t;at -i °a minimum of 40 percent food sales based on these definitions and have included the Restaurant Hotel/Motel Records Required for Aud t(form LIC 1013) with this application appiicant's signature As stateo in A R S§4-205 02 (B) I understand t is my responsibii ty to contact the Department of Liquor Licenses and Control to schedule an inspection when all tables and chairs are on site, kitchen equipment, and if applicable, patio barrens are in place on the licensed premises With the exception of the patio barriers, these items are not required to be properly installed for this inspection Failure to schedule an inspection will delay issuance of the license If you are not ready for,you' inspection 90 days after filing your application, obese request an extension in writing, specify why the extension is necessa'y and the new inspection date you are requesting To schedule your site inspection vtstt www aziiquor goy and olio'‹on the 'Information"tab applicants initials SECTION 15 Diagram of Premises. (Blueprints not accepted,diagram must be on this form) Check ALL boxes that apply to your business U Entrances/Exits 0 Liquor storage areas Patio (LI Contiguous 17 Service windows C3r ive-in windows D Non Contiguous 2 is your licensed;remises currently closed due to construction, renovation or redesign'? 0 fES 1]NO if yes, what is your estimated opening date? monthldaylyea r 3 Restaurants and hotel/motel applicants are required to draw a detailed floor plan of the kitchen and dining areas including the locations of ail kitchen equipment and dining furniture Diagram paper is provided on page 7 4 The diagram (a detailed floor plan) you provide is required to disclose only the area(s)where spiritous liquor is to be sold, served, consumed dispensed, possessed, or stored on the premises unless it is a restaurant(see#3 above) Provide the square footage or outside dimensions of the licensed premises Please do not include non licensed premises, such as parking lots, living quarters,etc As stated in A R S §4-207 01(3),I understand it is my responsibility to notify the Department of Liquor Licenses and Control when there are changes to boundaries,entrances, exits, added or deleted doors,windows or service windows,or increase or decrease to the square footage after submitting this initial drawing, applicants initials ON SECTION 13 - continued 7 Has a license or a transfer license for the premises on this application been denied by the state within the past one(1)year? 0 YES X NO If yes,attach explanation. 3 Does any spirituous liquor manufacturer,wholesaler,or employee have any interest in your business? 0 YES NO 9 Is the premises currently licensed with a liquor license? ES 0 NO If yes, give liven eipumber and licensee's name* License#01 ! I DO 3 (exactly as it appears on license) N . i, f criawit Ed<!iC Vt ! VAltlf z- SECTION 14 Restaurant or hoteitmotel license applicants: ./uN 1 Is there an existing restaurant or hotel/motel liquor license at the proposed location?,ES ❑ NO If yes,give the name of licensee,Agent or a company name Villd6 ',i(� 1'.t �1 i ( and license# (,. I//40C2 3.) ast list middle 2 If the answer to Question 1 is YES,you may qualify for an Interim Permit to operate whileyour application is pending, consult A R S §4-203 01 and complete SECTION 5 of this application 3 All restaurant and hotel/motel applicants must complete a Restaurant Operation Plan(Form LIC0114)provided by the Department of Liquor Licenses and Control 4 As stated in A R S §4-205 02 G 2, a restaurant is an establishment which derives at least 40 percent of its gross revenue from the sale of food Gross revenue is the re enue derived from all sales of food and spirituous liquor on the licensed premises By applying for this 0 hotel/motel 'restaurant license, I certify that I understand that I must maintain a minimum of 40 percent food sales based on these definitions and have included the Restaurant Hotel/Motel Records Required for Audit(form LIC 1013)with this application _ µ;ice*2_,_, _ applicant's signature As stated in A R S§4-205 02 (B), I understand it is my responsibility to contact the Department of Liquor Licenses and Control to schedule an inspection when all tables and chairs are on site, kitchen equipment, and, if applicable, patio barriers are in place on the licensed premises With the exception of the patio bamers, these items are not required to be properly installed for this inspection Failure to schedule an inspection will delay issuance of the license If you are not ready for your inspection 90 days after filing your application, please request an extension in writing, specify why the extension is necessary and the new inspection date you are requesting To schedule your site inspection Vt " www azliquor goy and click on the 'Information'tab 1.:',/ ! applicants initials SECTION 15 Diagram of Premises (Blueprints not accepted,diagram must be on this form) 1 Check ALL boxe that apply to your business eN ntrances/Exits O, Liquor storage areas Patio 0 Contiguous • ❑ Service windows 0 Dnve-in windows 0 Non Contiguous 2 Is your licensed premises currently closed due to construction, renovation, or redesign? 0 YES NO / if yes, what is your estimated opening date7 month/day/year 3 Restaurants and hotelmotel applicants are required to draw a detailed floor plan of the kitchen and dining areas including the locations of all kitchen equipment and dining furniture Diagram paper is provided on page 7 4 The diagram (a detailed floor plan)you provide is required to disclose only the area(s)where spiritous liquor is to be sold, served, consumed, dispensed, possessed, or stored on the premises unless it is a restaurant(see#3 above) 5 Provide the square footage or outside dimensions of the licensed premises Please do not include non-licensed premises such as parking lots, living quarters, etc As stated in A.R.S §4-207 01(B),I understand it is my responsibility to notify the Department of Liquor Licenses and Control when there are changes to boundaries,entrances,exits, added or deleted doors,windows or service windows,or increase or decrease to the square footage after submitting this initial drawing , applicants initials p SECTION 15 Diagram of Premises 4. in this diagram please show only the area where spirituous liquor is to be sold, served, consumed, dispensed, possessed or stored. It must show all entrances, exits, interior walls, bars, bar stools, hi-top tables, dining tables, dining chairs, the kitchen, dance floor, stage, and game room. Do not include parking lots, living quarters, etc. When completing diagram, North is up I. If a legible copy of a rendering or drawing of your diagram of premises is attached to this application, please write the words `diagram attached" in box provided below i^ 0.9 .1.ki 41(1(71‘ SECTION 16 Signature Block I, (�a t'� �Ci �;l� i�'L- , hereby declare that I am the OWNER/AGENT filing this (print firti name of applicant) application as stated in Section 4. Question 1 I have read this application and verify all statements to be true, correct and complete signature of applicant listed in Section 4,Question 1) State of 2--0)1!?.._ County of �� J The foregoing instrument was acknowledged before methis of �/Q-4-1L[..,a_ L-1 ay Month I . .) �✓/ Year My commission expires on 0-12} /-3 s= Day Month Year ' _- ,:st nature oil NOTARY PUBLIC • - Ll,,t -• county 7' NWF SITES , .• . ... AN ON --) 1..., ( L. AP Li - I. ' k-,. •".- ff,, . ,...__...., ___•.1.......u. ? ° .. . i vi AciOri 1 e.oi f/1 L.....: 4.„-. OuN , 1 .e ii rs! /, ..—',...I 4 i s . i 1.0.... - i , , KITCHEN / r ail i M r‘li I. I d I il.• 7—]„.', 1 :Lpavi tee t 31 . 1241 \ ev. Lty:r.. 1 U. e ,P - -3 • .,. h i - , i , „ — ..._,,,,,,, , Ft 0 Q 1 ..,, ,, 7-PARKING li .... i 0 .------i Fi. Hi . i I I , , 4 \.. ItC.L3 •..:( t ' I ' -,,,1 , 4 g 1 i 1 • .)‹ _ sx--- •—..x... : . ..6, • .,,,s4 ,•',.r. t n:. 1 1 - _ !'Lje.>":_:.-•P6°.' ---, .1. ___..t.._,1 i 1 reur._ _ .i,s__ _ 1_ __ L. ... ______ L_ OFIN 1 . , J 1 qi.- 01.14. I PLAN 11 4'n I 0" -------1/P7-A--Li'71----FLoo FLOOR /'1\ /On\ Pont Form ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL 800 W Washington 5th Floor Phoenix.AZ 85007-2934 www azliquor gov (602)542-5141 RESTAURANT OPERATION PLAN • LICENSE# l kt �t t List by Make,Model and Capacity of you Grill 5' hcIcL— " Oven getior. :EL.r' i -j, .;.' x ,1.1 ,' if Ca C' /-,z Freezer w..hlr//I(C/ tt,vc. /g/k G-t".- kt Refrigerator `.lot _t�+- }s ;•1.y,,. it- Ae<>--f/-1- a� „De,/.,.- 54.7t294., L / Lc'dc v1 Lei, )4 3'• p )4'it, Sink A)c // /.) 14 eiry,r% a--ec7_ it"/";I Y /l"/i "L X /' " Dish Washing Facilities } e'- <,t, .rc ,- �•., Food Preparation t3 - , z 't3 x '' f-/ Counter(Dimensions) �' a ;, ,�,„a z • ti{ Other _Dee re ye,- i2090-( w� r ?,e) t 1 2 Print the name ofyour restaurant: E14tt �� �J1c ,tk't.st1 -�1��iU O 3 Attach a copy of your menu(Breakfast,Lunch and Dinner including prices) 4 List the seating capacity for a. Restaurant area of your premises ( I 1eiN b. Bar area of your premises ( + 0 1 c Total area of your premises ( I h' 5 What typ3 of dinnerware and utensils are utilized within your restaurant? Reusable 0 Disposable b. Does your restaurant have a bar area that is distinct and separate from the restaurant seating? (If yes,what percentage of the public floor space does this area cover) 0 Yes Rio fig No 7 What percentage of your public premises is used primarily for restaurant dining? (Does not include kitchen,bar,cocktail tables or game area.) cc.) % '"Disabled individuals requiring special accommodations,please call(602)542-902/ tot; 1405fi./09 -- /'1 e\ 8 Does your restaurant contain any games or television? 0 Yes X No If yes.specify a hat types and how many of each type(Televisions,Pool tables. Video Games,Darts.etc). 9. Do you have live entertainment or dancing? 0 Yes l(No ON (If yes,what type and how o tie n'') 10 Use space below or attach a list of employee positions and their duties to fully staff your business. /L'L • (*ill clz: -- C. u-1'Srz S C CCir,S. •I' f I", •.'_s'lls'i+ �:4- ct-Li 'P Lxt. ['Ceg. . r;r4ct_St 8 IN,(t;''i' t.CCf (•%:,0f•- ~ C;1 s L sf LC Lts,-:ic_`l' ec ct c L• cier/4 i 055 3 s Lo(:_ CCt:-'t- 1l_� .nt - 7r1^ C `" .' r-t;:. /')i.iIth..t bttr. r'1tc /-,' c 6%<i"I •.S / i<_,tiS f.•.,1- -l'i-1ja.-1 y_€.9-11.o-• - L//,teC '' Cor2n rf" .1. 1.-` , —-. t . - 4 ILO hi'f�''JI1 /,"il :f ' l;i,? )i..??..� i S-"k•t,:, 2' ‘.'u- 1.;r/-Mr`i- Cam'! d, i 'L-� /114,1l ,=i.+ l't fJ (If-CY:"' J LT/ ',"e t- tali 4 :,'!"t_"fC$.S, �a s' `..J't.rft/ f ,,1/i? ,, �'t t 1 :„y (1 f!t _ h J...t4i E.z.,t-'.`/,e.i- -- Iti(Z-j'(Fr r'di V/" r. r t/2 i t f .:.1( • J 1/./i I P\(tit c{.'1it t,. hereby declare that I am the APPLICANT filing this apphcation I have eiS (Print full name) read this application and the contents and all statements true correct and complete jj ) 4,re,/, ....e.---P- aState of f_ti F l i-L'i tz'____ County of P t r i'-LE __ __ The foregoing instrument+vas acknowledged before me this Signature of• ICANT) /t,- 1 w ' day of "1-Criht+ if D of 4o,imh Mon '� Yea: t„4 h,3 i „, / 'vly commtssran expires on --�~ + 'e ,1/1 Li.^ � — t 'V T"�MI•lY DISCyr� 4,,1 STAt �;i .ArRIZONA I.i, 'l r in&County \ JO AN NE SITES (Signature ofOrARY P1r13LIC) ,^ vi a a atexican good gteatau.r.ant A La Carte Closed Cheese Crisp $ 4.75 with Green Chile strips S 5.25 Open Face Cheese Crisp $ 5.75 with Green Chile Strips S 6.00 Green or Red Chile con Came Burro OR Combination(meat and beans) $ 6.00 Deep Fried Burro S 6.25 Enchilada Style Burro $ 6.75 Deep Fried Burro Enchilada Style S 7.00 Chorizo and Egg Burro S 4.00 Bean Burro (with Cheese add 500) S 4.00 Deep Fried Burro $ 4.25 Enchilada Style Burro S 4.75 Deep Fried Burro Enchilada Style $ 5.00 Chimichanga S 6.50 Enchilada Style $ 7.25 Chili Relleno $ 5.00 Flauta topped with guacamole $ 2.75 Tostada S 2.50 Meat Tostada (ground beef) ..$ 3.00 Chorizo Tostada .S 3.50 Tamale (red chile con came) .S 3.25 Enchilada, cheese and onions (add 60c for each egg) $ 3.00 Beef Enchilada (red chile con carve) $ 3.75 Taco, ground beef (add 150 for soft shell) S 2.50 Chicken Taco .S 2.75 Bowl Green Chile or Red Chile con Came S 5.50 Bowl of Beans ..$ 4 00 Dessert Flan, Ilomeade (Caramel Custard) 4.00 Beverages Beer Iced Tea .. 1 50 Domestic 3.00 Hot Tea 1.00 Bud,Bud light, Bud lime,MGD, Coors light,Michelob Ultra, O'Douls Coffee 1.00 Imported 3.75 Children's Drinks 1.50 Corona,Pacifico,NegraModels,;�X Fountain drink.. Amber,XY Lager -Punch, Cr nRashinery Fountain Drinks 2.00 Specialty Drinks 3.75 Pepsi,Diet,Root Beer,Sierra Mist, Pink Lime Mike-a-rote,Raspberry Mike-a-rua, Lemonade, Dr. Pepper Sangria Combination Plates #1 *Elvira's Special: Taco,Tostada, Cheese Enchilada,Chile con Carrie and Beans.. 11.75 #2 *Enchilada,Tamale,Tostada and Rice 9.75 #3 *Enchilada,Tostada, Taco and Beans . 8.50 #4 *Enchilada,Tostada, Taco and Tamale .. 10.50 #5 Taco,Rice and Beans 6.00 #6 *Enchilada, Rice and Beans 6.50 #7 Chimichanga, Rice and Beans, with guacamole 10.00 Or Enchilada Style 10.75 #8 Red or Green Chile con Came Burro with Rice and Beans 9.00 Enchilada Style 9.75 Deep Fried Enchilada Style 9.75 #9 Green or Red Chile con Carrie, Rice, Beans and flour tortilla 9.00 #10 Flautas(3), Rice and Beans 11.00 #11 Chile Rellenos (2), Rice and Beans . 11.75 #12 Spanish Steak (ground beet), Rice, Beans and flour tortilla 11.75 * Beef Enchilada 75¢ extra - Soft beef taco 25¢ extra -chicken taco 25¢ extra NO other Substitutions Please e•-.. .� .-. .-..-�-.-- 1 ..-a-_. Order of Tacos (3) (add 750 for soft shell) .... 7.00 Order of Chicken Tacos (3) 7.75 Order of Enchiladas (3) cheese and onions 8.25 Order of Beef Enchiladas (3) Red Chile con Carne 10.50 Rtee and Beans added to and above dinner please add$3.50 .+"w--I"I...-.I.�./^l l•ll���.+f'�f.i+..in..-�'S/^�y�-'^',.r'�.J-./�.i"./�.,.w'�sr.IY�e....r1.�+^�..'.,, Side Orders or Extras Rice or Beans 2.00 Tortilla $1.00 Buttered Tortilla .. 1.25 Green or Red Chile eon Came .. 3.00 Onions, Cheese,Tomatos, Lettuce, Guacamole 2.75 Jalapenos,Olives 50¢ Children's Menu Ground Beef, Rice and Beans 4.00 Ground Beef Taco with cheese only ...... 2.00 Cheese Crisp 4.00 Ground Beef Taco-Soft, cheese only ... 2.25 Bean Burro ... 3.00 Chicken Taco, crispy or soft, cheese only 2.25 with cheese 3.50 Tostada Beans and cheese only . 2.25 • The consumption of raw or undercooked meat,poultry, eggs, seafood or shellfish may increase the risk offood-borne illness. ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL 800+IV Washington 5th Floor Phoenix,AZ 85007-2934 www azliguor gov (602)542-5141 RECORDS REQUIRED FOR AUDIT SERIES 11 (HOTEUMOTELW/RESTAURANT AND SERIES 12 (RESTAURANT) MAKE A COPY OF THIS DOCUMENT AND KEEP IT WITH YOUR DLLC RECORDS In the event of an audit. you will be asked to provide to the Department any documents necessary to determine compliance with A R S §4-205.02(G) Such documents requested may include however, are not limited to 1 All invoices and receipts for the purchase of food and spirituous liquor for the licensed premises 2 A list of all food and liquor vendors 3 The restaurant menu used during the audit period 4 A price list for alcoholic beverages during the audit period 5 Mark-up figures on food and alcoholic products during the audit period 6 A recent, accurate inventory of food and liquor(taken within two weeks of tha Audit Interview Appointment) 7 Monthly inventory Figures- beginning and ending figures for food and liquor 8 Chart of accounts (copy) 9 Financial Statements-Income Statements-Balance Sheets 10 General Ledger A Sales Journals/Monthly Sales Schedules 1) Daily sales Reports (to include the name of each waitress/waiter, bartender, etc with sales for that da}) 2) Daily Cash Register Tapes - Journal Tapes and Z-tapes 3) Dated Guest Checks 4) Coupons/Specials/Discounts 5) Any other evidence to support income from food and liquor sales B Cash Receipts/Disbursement Journals 1) Daily Bank Deposit Slips 2) Bank Statements and canceled checks 11 Tax Records A Transaction Privilege Sales, Use and Severance Tax Return (copies) B Income Tax Return -city, state and federal (copies) C Any supporting books, records, schedules or documents used in preparation of tax returns 12 Payroll Records A Copies of all reports required by the State and Federal Government Lic1013 05/2009 B Employee Log (A R S §4-119) C. Employee time cards (actual document used to sign in and out each work day) D Payroll records for all employees showing hours worked each week and hourly wages 13 Off-site Catering Records (must be complete and separate from restaurant records) A All documents which support the income derived from the sale of food off the license premises /4 B All documents which support purchases made for food to be sold off the licensed premises C All coupons/specialsid scounts The sophistication of record keeping vanes from establishment to establishment Regardless of each licensee's accounting methods, the amount of gross revenue derived from the sale of food and liquor must be substantially documented REVOCATION OF YOUR LIQUOR LICENSE MAY OCCUR IF YOU FAIL TO COMPLY WITH A R.S. §4-210(A)7 AND A R S §4-205.02(G). A.R.S §4-210(A)7 The licensee fails to keep for two years and make available to the department upon reasonable request all invoices, records, bills or other papers and documents relating to the purchase, sale and delivery of spirituous liquors and, in the case of a restaurant or hotel-motel licensee, all invoices. records. bills or other papers and documents relating to the purchase. sale and delivery of food A.R S §4-205 02(G) For the purpose of this section 1 "Restaurant` means an establishment which derives at least forty percent (40%) of its gross revenue from the sale of food 2 `Gross revenue" means the revenue derived from all sales of food and spirituous liquor on the licensed premises. regardless of whether the sales of spirituous liquor are made under a restaurant license issued pursuant to this section or under any other license that has been issued for the premises pursuant to this article (print licensee name) kNj Last First Middle have read and fully understand all aspects of this statement State of Oil) le/ti County of 7/ /1 Li f �t The foregoing instrument was acknowledged before me this 411,1t.Xday of 1 k'f'r'rf1l�iJ% 71L) (Signature of Licensee) Cay Month Ye3r ,A (ivecc '267 My commission Expires on 'pay tori..h Year 'Signatu�Qcf ROTARY PUBLIC) MAKE A COPY OF THIS-DOCUMENT AND KEEP IT WITH YOUR DLLC RECORDS E r}�.T `, t) A.Ri7-i�SA I + '' NNE SITES Pagzlof2 ucaopsrzNcetu.sam !While Li!iU F T odes,csz DEC F S Ott Do'Cr'rou Aa'tv==ac axa.r ARTICLES OF ORGANIZATION �„ � iisstanr.:"ta form rrywlaudFtx: '.ra tireeaealtd AFC:MI KA LAMM t L6w..[LflY CO ANY„_...pat)* a-r.eW,r tee: ❑ Aibi KA Pt:CPURONALLAMM LIAC LITY ccW+r.CY t ."t-ti1.4s} 7071~1118area-Mt7.i 0614 rro ea r 1 The mow of IMF+ry 1/111614D(ii MOM Nalleswarvg 1rte Y.11we-• - Oat ow ,.~rat Limpistx LLGrsrn Rwarran rM MtnorU ono Per me.atkMte.:-(*at owl:EA lrs*we} t Thoth:nor.m rsee-asay irvert"o well.is-.11 'bird Wog :Y7w7 r ln rwwvof.rh. fM = Kn041101 t a!`Jta1t1CCi In located C's tinc4 so,.aatr.a.q 1.tfra.3 yra sate." 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Prresstral Proftwalarse Sera-bees- i PreitteggEat Lim -use servos t meaty Ceswerf 411:mei&to tazueng etoiesuots-el tere:Eats: 4 Oer*UM Gs^ wwiadow.1161* twe lb= - swim lid Ile sCiVEit seism VISAS .01111.4k4 NOWA..an*, kailoraww 5. LI*Petkid of to limead Lty Czeispaver thee*we wpoteelese Uriaroonftw. tat*.011114. Ur*!IC vol tattooist**, eswas seas MX*,411.1 fin.S ti-e ag,l;glir) 1110611. itkr-se Leattal.1tORty betapir,fra period a ams ger llogrAna www d'amillosi*** e Ilisra4pasu4re 2snmesne:oget eAwk Ira off:AAA gseum amen;Owen, Vr▪epollid roar A A RE2ERVED TO ME WEWBERS be V 11011PIMICRO TIEVINANIMIAMT OleCt AO*ivtleet==EL movivballb I n. 0 vEsTED ri ONE OR MORE VANN3ERS ClOotel A*** www,, rvertstritcursaelmetuesarves 114.1t mar mult utawimacsumezes_ %Sams Itif itere wodiswii%two =r,Z wow .4artfore atiter-wor crirrir mitedatefto G.)* rye Umemeer Pe* 1...f.s4t="0 Adv.= AUL'. rristticS Dr- luettese._ itt=7:ott. Cte 4eagJkLii'St4g,.t.s.Lnietti-JaP Iliabri sat ▪ imoolvat • Ma= ?Kong 60.11.0 dle4 M.10111 MEM od*wont - 1 sewbvi SY MUMS NU thrrWlf pel%K ***WM alpevel lawthor kilervtiOr V•EVAMV*Vv., area&ory 'Nam" rha. ti 4'51 Ara..., ev.s.sta ==. (av•Algt..4__ /4"71 rAf vsks•_ bow anotpowbala emu al 0111.0 •701111111rIDer fkin.Me LIMO 1•0•1~: AT 14115111MIMIL la tor mil.At ea,Aalioltjews, at ar•.1.0040. o r*me orwair Uowic fvebbt cet114 r ero,Allt RE nt MC,* Avripl Ihk 53°61 11.6)"12; 14:1' tlar-‘414)Tyyl. 0.14.00.11 ow*wog 104'W•t-Mi--& ..4worme If* =OW PAWL%ort bor.(onlwaLarty pins et*=rm."voi iesor. ateerN- MY 71-3 ..,z• L'ect Maus-LISS' r (1-501 wsits*rAtifteint,7,101.0. f PAM te4 2.$011allta Weak cE vira s Wie.xicare, Restaurant 1520'`'F Apache'Rau' Apache Junction,AZ 85120 (480) 982-9916 Fax: (480) 982-0817 OPERATING AGREEMENT Eddie Valdez is 81% stockholder of Ehira's Mexican Restaurant, l..l.C. He .N-ilI oversee the training of staff and management, daily operations, will implement procedures in ai.cordance with Arizona Law as to the distribution of alcoholic beverages as ,yell as overseeing the training of the food handling as well as the guidelines as set north b, the final Count) Health Department Chandera Newby :s 19% stockholder Her duties will include maintaining the acc°ounting ecords, distribute tax payments to City, State and Federal Agencies Maintain and file all receipts properly for the purpose or having zccords tor auditing requests She will also be u-A olved with the public community relations ns and ad'.ertising for the operation i c'c3�e y rt °t ndern Newby %Ifn,nbir Member 19% ?PIN - - - Ask Auk Punt Form ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL 6). BOO W Washington 5th Floor \9( Phoenix AZ 85007-2934 ,{602)542-5141 (-)Pic•ACa'QUESTIONNAIRE �J Attention all Local Governing Bodies: Social Security and-Birthdate Information is Confidential. This information given to local law enforcement agencies for the purpose of background checks only but must be blocked to be unreadable riOr y o posting . :'or-any public view . Read carefully. This instrument is a sworn document.Type or print with BLACK iNK. An extensive investigation of your background wilt be conducted. False or incomplete answers could resutt in criminal prosecution and the denial orsubseeguent revocation of a license or permit i O BE COMPLETED BY EACH CONTROLLING PERSON AGENT,OR Kt!N.Afigtr.k0-,pEftspt,4 COMPLETING THIS FORM MUST SUBMIT AN APPLICANT"TYPE FINGERPRINT CARD WHICH MAY BE CBfAlNED AT D LET-F)fI ''6ER INTING MUST BE DONE BY A BONA F'DE LAW ENFORCEMENT AGENCY OR A FINGERPRINTING SERVICE APPROVED,!irrpliv,THE'DEPARTMENT DOES NOT PROM S ER Effective t4tQit07 there is a$24.oaprocessing fee for each fingerprint card submitted. Li r Licet1Se The fees allowed by A,R.S.§44-6852 will be charged for all dishonored checks. _ J _ �� (If the location is currently licensed) 1 Check Controlling Person Agent i_; Manager(Only) appropriate (Complete Questions 1 19) (Complete All Questions except#14,14a&21) box --10.. Controlling Person or Agent must complete#21 for a Manager Controlling Perso #21 2 Name' V at de (":r"1L1 e V{? I Date of Last First Middle (NOT a Public Record) 3 Socal Security Num Drivers Lice State A ``�� (NOT a public record) ( a public record) �7 4 Piece of Birth V\`(.l VI l t3� U)A Height 5.t ' Weight. 2 Eyes f)1 , Hair thedo%f1 City Stale Country ;not county} ,, 7 5 Marta!Status ❑Single t_.1 Married s Divorced LI Widowed Daytime Contact Pt:orti:"t�,��-.r5 — J Z 1 6 Name of Current or Most Recent Spouse V()Adel \I IV(Ll I\ ilt.lYi Date of (List all for last 5 years Use additional sheet If necessary) Last First Middle Maiden • ) You are a bona fide-esident of....hat state? if Arizona date of resrlenc. d Telephone number to contact you during business hours for any questions regarding this document i-1 SCi -1 .G 11` ?.724-1 9 If you have been an Arizona resident� for less than threer1/ (3)months sub�mitt a copy of your Arizona{- driver's license or voter registration card 10' Name of Licensed Premises t�I i 1 {i. ) i' eiC I Call L}.-�( \, (.I U if o f iF'remises Phone L0110—�t d ` q C1 fl ^ i 1 Physical Location of Licensed Premises Address. 15 1 i A v1 tc 'I ¶'LU i{1`ot ilf 3/Li Plow D✓/2,G) Street Address (Do not use PO Box.it) City County 2ip 12 List your employment or tyoe of business during the oast five ,5)years if unemployed part of the time list those dates List most recent let IFROM TO DESCRIBE POSrTiON EMPLOYER'S NAME OR NAME OF BUSINESS Month/Year Mortal/Year OR BUSINESS (street address city state&zip) / �V� l)J� • ;Z i/c'�•r �i 1La�/lL>!er.S c 4� /�0 CURRENT �j{,yf i{,t�/ {���)�� dill 1/'� C J �� �erf -S i ,,/,G L'afdte/.. t- S'.,+ e:1i 1'' 7•C - "{(� ; /0 t tt.11�4%9?!1�'s:'r-t. t:',:,-i i" 3•i;4 -5- /A.,s /1 1-.. 4-14 .4 1 Yy/2-c' ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION 13 Indicate your residence address for the last five(5)years FROM TO Rent or RESIDENCE Street Address 1 Moir vYea Month/Yea Own tf rented.attach additional sheet wkh name.address and phone number of landlord City State Zip 1 Ojai CURRENT 0 11,37 L emsoc.,.. s , fl'f t .44 e )0, / r l qq t 1 n/o'3 Q <I ti? i pl, ,A.✓G 4.3- /44 %' 01 LIC 0101 9/24/2009 Disabled individuals requiring special accommodations,please call the Department(502)542-9027 0006., If you checked the Manager box on the front of this form skip to#15 14 As a Controlling Person or Agent will you be Qhysicatly present and operating the licensed premises? S'ES UNO I If you answered YES,how many hrslday" (POP') ,and gnawer#14a below If NO skip to#15 14a Have you attended a DLLC•approved Liquor Law Training Course within the past 5 years? (Must provide proof) S ONO If the answer to#14a Is"NO",course must be completed before issuance of a new license or approval on an existing license. 15 Have you been detained, cited,arrested,indicted or summoned into court for violation of ANY law or O YES"NO ordinance. regardless of the disposition, even if dismissed or expunged within the past ten(10)years (include only traffic violations that were alcohol andlor drug related)? 16 Are there ANY administrative law citations compliance actions or consents criminal arrest indictments OYES �NO or summonses PENDING against you or ANY entity in which you are now involved? 17 Have you or any entity in which you have held ownership, been an officer member director or manager OYES ENO EVER had a business, professional or liquor application or license rejected.denied, revoked, suspendec '_ or fined in this or any other state? 15 Has anyone EVER filed suit or obtained a judgment against you the subject of which involved fraud or OYES NO misrepresentation? .t; 19 Are you NOW or have you EVER held ownership, been a controlling person, been an officer,member, (_ XY director or manager on any other liquor license in this or any other state? If any answer to Questions 15 through 19 is"YE,S"YOU MUST attach a signed statement. Give complete details including dates agencies involved and dispositions SUBSTANTIVE CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED 2C I rI r'1`?/ ,x(L' 616, L , hereby declare that I am the APPLICANT/REPRESENTATIVE ;print full name or Applicant) filing this questionnaire I have read this questionnaire and all statements are true,correct and complete 111 X -- —// 'j _ -- State of ( f,t`/)G{� County of J t Prj t nature of Applicant) The foregoing instrument was acknowledged dgei before n e itus b day of c -L T 1/11I i'2/ ,L% ipito'HIth Year 31 3 t My commission expires on 4 2� ,r Day Month Year (Signature of NOTARY PUBLIC) COMPLETE THIS SECTION ONLY IF YOU ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21 The applicant hereby authorizes the person named on this questionnaire to act as manager for the namec liquor license The manager named must be at least 21 years of age State of County of The foregoing in52risner*was wed before me this X day of Signature of Controlling Person or Agent circle one) Month Year Print Mama (Signature of NOTARY PUBLIC) My commission expires on Day Mor Year eiN OcL t (L L.. 0 tv .:. ck. s f v r" Gam'= 14-- //L1) } _ Print Form ARIZONA STATEMENT OF CITIZENSHIP AND ALIEN STATUS FOR STATE PUBLIC BENEFITS Professional License and Commercial License Department of Liquor Licenses and Control einN / / gz Liquor License# � ���.� 4 � } Oµnership Name ` rY � J t' /z f `�._ f'="c/l.1e:ey 2/fG (as listed on the current liquor license application or renewal application) Bile IV of the federal Personal Responsibility and Work Opportunity Reconciliation act of i996 Ithe "Act"), 8 S C b 1621, pro).ides that, with certain exceptions, only United States citizens, United States nen-citizen nationals, non-exempt "qualified aliens" (and sometimes only particular categoncs of qualified aliens), nonimmigrants.and certain aliens paroled into the United States arc eligible to receive state or local public benefits With certain exceptions, a professional license and commercial license issued by a State agency is a State public benefit •lnzona Res'sett Statuses 1 50; requires, in general. that a person applying for a license muss submit documentation to the licensing agency that satisfactorily demonstrates that the applicant is lawfully present in the United States. Directions All applicants must complete Sections f, Ii, and IV. Applicants who arc not I.S. citizens or nationals must also complete Section III. Submit this completed form and ropy of one or more documents that evidence your citizenship or alien status with your application fur license or renew a1 SECTION I—APPLIc?IT INFORMATION APPLICANT S NAME(Pnnt or t)pe) l t'�pr/ 1; 2t�Ly[� DA It ei TYPE OF APPLICATION(check one) x INITiAL APPLIC A fION RENEWAL TYPE OF LICENSE /._'_StaL C(t&t rr1 '-s / SECTION Il--CITIZENSHIP OR NATIONAL STATUS DECLARATION J Directions.Attach a legible copy of the front.and the back(if amy) of a document from the.,anachcd 1_ t 't'r other document that demonstrates L S citizenship or nationality Name of document provided /^/ /i 7 LJ�' A Are you a citizen or national of the United States?(check onel ✓ Yes No B If the answer is"t S 1!s,"where were you born/ List city state(or equivalent),and country r �} City 1)', f ? fl t, State(or equivalent) 2- Country or Tcrntory a-- �r if you are a citizen or national of the United States,go to Section iV. If you are n_ot a citizen or national of the United States,please complete Sections iiI and iV DLLC 2!20/09 AO 1 1/08 07-81662 Page I of 7 ON eiN SECTION III-ALIEN STATUS DECLARATION Directions To be completed by applicants who are not citizens or nationals of the United States Please indicate alien status by checking the appropriate box Attach a legible copy of the front,and the back(if any},of a document from the attached List B or other document that evidences your status .A R S § 1-501 Name of document provided "Qualified Alien"Status(8 U S C§§ 1621(aX1).-1641(b)and(c)) ❑ 1 An alien lawfully admitted for permanent residence under the immigration and Nationality Act(RNA) ❑ 2 An alien who is granted asylum under Section 208 of the(NA ❑ 3 A refugee admitted to the United States under Section 207 of the INA ❑ 4 An alien paroled into the United States for at least one year under Section 212(d)(5)of the L".A ❑ 5 An alien whose deportation is being withheld under Section 243(h)of the NA ❑ 6 An alien^ranted conditional entry under Section 203(a)(7)of the INA as in effect prior to April 1 1980 ❑ 7. An alien who is a Cuban and Haitian entrant (as defined in section 501(e) of the Refugee Fducatron Assistance Act of 1980), ❑8 An alien who is or whose child or child's parent is a battered alien' or an alien subjected to extreme cruelty in the United States Nonimmigrant Status(8 U S C 3 1621(ai(2)) 09 A nonimmigrant under the Lnm,gration and Nationality Act[8 U S C § 1101 et seq.] Nunimmigrants arc persons who hale temporary status for a specific purpose See 8 U S C 1101(a)4IS) Alien Paroled into the United States For Less Than One Year t8USC§ 1621(al(3)) ❑10 An alien paroled into the United States for less than one year under Section 212(d)(5)of the IN 4 Other Persons(8 U S C§ 1621(c)(2 N A i and IC)) ❑ 11 A nonimmigrant whose s isa for entry is related to employment in the United States,or 1 ❑ 12 A citizen of a freely associated state.if section 141 of the applicable compact of free association approved in Public Law 99-239 or 99-658(or a successor provision)is in effect[Freely Associated States include the Republic of the Marshall Islamic,Republic of Palau and the Federate States of Micronesia,48 U S.0 § 1901 et.seq]. ❑ 1 3 A foreign national not physically present in the United States Otherwise Lawt'ully Present(A R.S.§ 1-501) ❑ 14 A person not described in categories 1-13 who is otherw Ise la%s fully present in the United States PLEASE NOTE- 1`he federal Personal Responsibility and Work Opportunity Reconciliation Act may make persons who fall into this category ineligible for licensure. See 8 U S C § 1621(a) Paite 2 of 7 1 AMN SECTION IV—DECLARATION All applicants must complete this section. I declare under penalty of perjury under the laws of the state of Arizona that the answers I have given arc true and correct to the best of my knowledge 4/1((•e#1."---- (.21//z7b., 2_ APPLICANT'S SIGNATURE TODAY'S DATE r � Page 3 of 7 ... ..... .,,, ,,.-- ,.,...%,....-:,,,,-.,,,,A40,-•-r-ryz: ,k...e ..9k,,J , 2-.A.-,-,t.'-- '--- , -r....,...,,, -.,:...... , -,...:,,,,,,...,,,:,:,A„:„ift -,.,,, ,..,,•,-:—.s.,14,...-,:v.,--„::„.4:,. .-.;:l'f", • --'''-.::::1.1''':(..'7;4'—:--- ''' CERTIFICATION Of VITAL RECORD I'''.. ..•*••--,---LL4ii,"1.e.-771*------:.!::::*,;'-`,.''.450...:--..'...,=--1144,-, '...4...=-..--- .... —. ......... ..,. . ....... .......• , ....... ....... . _ . STATE OF ARIZONA .. it t 1.1 . . . . 1/ ..0 . !.... STATE OF ARIZONA . ORIGINAL DEPARTMENT OF HEALTH SERVICES-OFFICE OF VITAL RECORDS B 102-1957-02061 Ns STATE COPY 6 ' `-, .., CERTIFICATE OF LIVE BIRTH ilLD'S NAME A FIRST 3.&TOOLE C.LAST ,'").•t• EDDIE VAL VALDEZ •.a' 2 1-, •,, 2...SEX 3A.PLURALITY 4 SPECIFY) 38,IF MULTIPLE BIRTA ISPEC/F-Y) 4A_DATE OF BIRTH(MONTH DAY,YEAR) .4: MALE SINGLE - -, - I F._PLACE OF BIRTH A. T .TOWNORcTY 14. ‘e' GILA L TAI..IL-",k.4.):4L•f.F N-21,iNi7-1..:TION GIVF.S TREET AND r.t,..0.441-,T1 -.s C.RACE DI DIFITI-4 0 liCtSP"AL. 0 FR.::..,-A.NOING firAITIr,ND CENTER 0 RESIDENCE L.: . .1"... ti ' -• .,- !" 4 0 curnooccroRs OFFICE 0 0 TRER;SPECIFY] -(-•-.:—.... .... _ - ._,L,......— FATHERS NAME'FIRST NODDLE.LAST SUFFIX TOpteralI ..:,4'...,- ERNEST,OLVERA,VALDEZ ii. z,'. ir•, 7 DATE OF'BIRTH iMONSH DAY YEAR, S.PLACE DF BIRTii E TATE Oft COUNTR'll •;, - • I-. II.- I 9 14(2.THERIS MAIDEN kkkl4E ITRITT kr r...‘,.7e.,7. EAST :f ..- SALLY, MADRID A-4 ,.. 13 D.ATE Or MTN'100Ii DAY YEAR) II PLAC.LT.OF BARTH;ST T--,Ir'COUNTRY) ' 'i• 2 MDTHEPS USUAL RESIDENCE. A.STATE B.COUNTY C TOWN OR C;TY D ZIP f. ... ... ............... ....;,=-7,. 12E STREET ADDRESS OR R.ir D I?.F IN OTT LIMITS I..,.'.'. .. i-,s ti uo 0 ifiq....i. s"1 , 13.MOTHER'S MAILING ACLat,t5.3;IF DrIi,r-LRENT FROM 71.14 1 T,I , ,t.....-...„,:. - ... . ti ....,:..,. ,... • .. -4: ,,..., ... . A. DATE REGISTERED SEPTEMBER 23 1957 DATE ISSUED DECEMBER 20,2011 .•...-.-. ' .:11"..., - ..,.... ---:-•- ' _,,, i....,.:--.-z)e-ze--#----- ,_-1.."-2:-.•-ir.2...- ' iir •, I i ,,,,.... •+. ••,.,`t_mol.:.r1..,,,'ht.1st:a';;I fur..,..,'+••,s.. ', . -... :.. „.....,.... , AP%,1,1A rt. -KLST OF ritA,TH:',EIr'.;-:,..-,;,,,,-.r.,• ,F.....:'.,F. PAI RIC,A ADAMS i i Anz' ona *- ,. Eeeal,s , ci, 1 ASSISTANT STATE REGISTRAR ' 1)epar1rnent of -......t_......,p•#I.'. _.,c.. ..- .4,..31,,r.: 3—,1-1,1,1P,Iyithl VIC SLIET''". — —r-J lot.i.1.1.,r,....,,,)39C it, ''', It 11 Service ... --- , .. k•'-'1:. .--, . ,-/-4,.' --- -,- ''.' ,;-,,_.---.? ..]I_Arr,, ..; .)r'')1.r-r s k Or;)V4..1 ,t,,Iii,J1'.11.41S DOLL'I-I I'•' NI -.......-.%)%,--)e-A.-INNTITT-- --St:IT_.;-Ni. S. - ...,--- . ,..,;.:.Ak-iii,4c: .-,-.1--:.--4,. ..... ... : ...-1,,,..-„7., -..„ 0,,,,,,.,....,,*4.„.„.•,,, -.7.7?Fer4,: . -_ '4%.,:4?:,:4`;', .4.:--,--'•,,:i.:Mtri!' '''..-, -"X",;:7;,..-_ _- ',. Arizona Department of Liquor Licenses and Control 800 West Washington,.5th floor Phoenix,Arizona 85007 www.azliquor.gov 602-542-5141 CERTIFICATE OF TiTLE 4 TRAINING COMPLETION Do Not Duplicate This Form Certificates must be completed by a state-approved training course provider,in black ink,on an original form.. Eddie V Valdez Full Name(please Litt) . ` . Signature 12/20/2011 16.55 CST Training Completion Date Type of TrainingCompleted(check Yes or No) [ Yes, 0 No BASIC (xi Yea L]No Del SALE 12/20/2016 16.55 CST n Yes ❑ No MANAGEMENT C❑Y+s D No OFF SALE Certificate Expiration Date 0 Yes 0 No BOTH ©Yes CI No OTHER (MANAGEMENT-5 years from completion date) (BASIC-3 years from completion date) if Trainee Is Employed By A Licensee Eddie V Valdez ( i tit l 0 71 / D O>2 Name of Leer see Business Name Liquor License M Alcohol Training Program Provider Information 360training corn inc Company or Individual Name(please print 13801 Burnet Rd , Suite 100 Address Austin TX 78727 ( 888 ) 360 8764 City State Zip Daytime Contact Phone* i certify the above named individual nas successfully completed the training specified above in accordance with Arizona Revised Statue,Arizona Administrative Code,and the training course curriculum appivved by the Department of liquor Licenses and Control April Thomas r, Name of Trainer(please print) lr( ';/ 12/20/2011 16.55 CST Trainer Signature Date Pursuant to ARS.4 4-I12(GX2),mandatory Tide 4 liquor law training is required prior to the issuance of all new liquor ficrose applications submitted after November 1,1997 The persons(s)required to attend both the BASIC and MANAGEMENT Title 4 liquor taw training,on.or off-sate will include al of the following Ownerts) Licenseefagent or manager(s)actively involved in daily business operation A valid(not expired)Certificate of Titie 4 Training Completion must be submitted to the Department of Liquor Licenses and Control before a liquor license appl cation is considered complete Before acceptance of a manager's questionnaire and/or agent change for an existing liquor license,proof of attendance forthe BASiC and MANAGEMENT Title 4 liquor law training(on or off-sale)is required ?.r200 9 Disabled individuals requiring special a ccornrnodatiorts.please call 002)542-9027 Ask ,IIN Print Form ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL j��,� " 800 W Washington 5th Floor "/E Phoenix AZ 85007-2934 1 ;�tJ/ i+502}542-5141 � � ,/ QUESTIONNAIRE / Attention all Local Governing Bodies: Social Security and Birthdate,Information is Confidential This informat' rn \given to local law enforcement agencies for the purpose of background checks only but must be blocked to be unroadalit nor o posting or`any public view. - \ Read carefully, This instrument is a sworn document. Type or print with BLACK INK. ``� An extensive investigation of your background will be conducted False or incomplete answers could result in criminal prosecution and the denial or subsetkient revocation of a license or permit 70 BE COMPLETED BY EACH CONTROLLING' RSCA AGENT,C4-MANAGER E.4CI-(PERSON COMPLETING THIS FORM MUST SUBMIT AN AF''PL'C.Nr TYPE FINGERPRINT CARD WHICH MAY BE OBTAINED ATDLLG. PINGOrPRIkeTING MUST BE DONE BY A BONA f'DE LAW ENFORCEMENT AGENCY OR A F,NGERPRINTING SERVICEAPPROVED BY DLLC. Tr4EDt(ARTMENT DOES NOT PROVIDE THIS SERVICE. Effective 10/01/07 there is a S24.00 processing foe for each fngeror nt card submitted, Liquor License # The fees allowed by A.R.S.S 44.6852 will be charged for ail disflpnOLPSLaltth . / --/.; 'f S / (H the location is currently licensed) ' Check 0 Controlling Person (_,'.Agent 0 Manager(Only) appropriate (Complete Questions 1 19) (Complete All Questions en gin#14,14a&21) • box — N. 1 Controlling Person or Agent must complete#21 for a Manager Controlling Person or Agent must c�21! 2 fame NiCkiibil NW,lice l y1 L Date of Last First Middle T a Public Record) Rcc.a° C u t'y Nu Drivers Loer State A Z-- (NOT a public record) (NOT a public record) Iu e 1 �In� c e 'BIrh . ftit.!.'_L.i.t'./. y-- - - t4j4- Heicht 1I0" Weight I(r,ij Eyes ; Pak:. C ty t . Country snot county'. _ 5 Manta Status :i 1:..Marri Ej or ed 0 Widowed Daytime Contact Phone LfS •,2 D=3; _ i I"1 t f.ane:if Curre^•t or Most Recent Spouse _ Date of Both _ List aft for last 5 years Use additional sheet it necessary) _act Fist Mind a Maiden T 'cu:ire a bona'de resident of Mat stale) A 2— f Aru.o -sra da:e of,e denz. Ta!ephona. ^urttier+n,cntarrt you during bus ness t'n:.rs for any 0,estlans regarding;`is document _-4 EV-.2 /) L?1 Lit Zi if you have been an Ar zc^•a resvdent for less ehan th cc(31"1?^t:'1_ s idm I a Cosy of you AiIZGna driver s(ice se or voter registratro^caic :0 Name of Licensed Premises V V. V p 's /i t x,l,ff 1, )SI i .hi F i r a.1-__I Prernises Phone f r )- "l:1,C - (! ';1 y, I` Prysica!Lacat'ort o'Loe^seed Premises Address I `). .t i) 4f,?r h e i f a i 4 icf:e _.)IAi‘lf-irit- Al- t lrc'1 3.:1 t' OIN Street Address ,Do not use PO tBox%) City Count, Zp 12 L's,your ernpeoyrnent or type of business during the past`.ve,5)years If ancomployed part of the time, 1st those dates List most recent 1st. i FROM TO DESCRIBE POSITION EMPLOYER'S NAME OR NAME OF BUSINESS I Mo?1ttdYear f t.rttl.Year i OR BUSINESS (street address oty state&zip) ty 5 fxAt I r'; Pe ' 1! ( Cl1RRFPIT qQ IyI L ) c ( L rya, i I-r,�/L r 1kitZli4 r=1-(1 r,T11ui t�LtJ /tll 1 E ..'c-i AZ. GlLArl.. J I ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTIONS 13 indicate our residence address for the last fire(5)jeers FROM TO i Rent or RESIDENCE Street Address l.tc itrYYear 11 M nt.''ear I Own If rented attach addaional i h_et r nh nacre.address and phone number of landlord City State Zia Nig cURRFNTk Pt,ir ?�1-1() +: tl'c De; k;?)l ht.t1 . �1 :c 1... `-.7,K a ill/k-s : AZk22 1-I67 CLI/1t ILi,tn ,7t_yli is I..rr;t:rt'i ,i 1 illej4a. A? g5a 71 e.r l t+ , + rj .-•Qtt 0 ' t '.' _ 7 �Ii1 & re 1/ . f f ,ry. 1r5l J? ;,:�.! LIC 0101 1t24t2009 Disabled individuals requiring special accornmodatee i; pieaaa call the Department(602)542 9027 If you checked the Manager box on the front of this form skip to#15 14.As a Controlling Pelson or Agent, will you be physically present and operating the licensed premises? DYES EiNO if you answered YES how many hissday? ,and answer#14a belong If NO,skip to#15 14a Have you attended a DLLC-approved Liquor Law Training Course within the past 5 years? (Must provide proof) DYES ONO If the answer to#14a is"NO",course must be completed before issuance of a new license or approval on an existing license 15 Have you been detained.cited, arrested. indicted or summoned into court for violation of ANY law or D YES fD 0 ordinance, regardless of the disposition, even if dismissed or expunged,within the past ten(10)years (nclude only traffic violations that were alcohol andlor drug related)? 16 Are there Ably administrative law citations,compliance actions or consents, criminal arrest, indictments DYES {S.,' O or summonses PENDING against you or ANY entity in which you are now involved? 17 Have you or any entity in which you have held ownership been an officer, member, director or manager DYES icYgl0 EVER had a business, professional or Ijoj pr application or license reiectesi dented, revoked,suspended or fined in this or any other state? 13 Has anyone EVER filed silitQr otstairiesLajudgment against yQsi, the subject of which involved fraud or OYES NO f?Lt`epre$entation? �/ ,4 • jjjVER held ownership been a contr person, been an pffjcer,Damper, OYES L?NO ecicr • or manag r her liquor license in this or any other state? it any a,swe' !U Q 5}toriS 1 T�t�l t� you 111'i��ta`SL - Rx -l_k.,: • Give co nplete details including dates agencies involved, and dispositions SUBSTANTIVE CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED 2C' I tA14 f:rQ L • Nt..,Q ii hereby declare that lam the APPLICANTIREPRESENTATIVE print rill name of f ppiicartt filing t ocaatre ave read this questionnaire and all statements are true correct and complete i X (_„li A/..7fT4,[-t: `!`t State of 6- County of p(Gt 0(-,(146 nature of.4ppi..ant) foregoing mstru s acknowiedoesi t r e e nn�th;s aV day Month Year i My cumin ssion expires on Day Month Year i,Sigiiature c TARY VLEiiC) COMPLETE THIS SECTION ONLY IF YOU ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21 The applicant hereby authorizes'he person named on this questionnaire to act as manager for the named liquor license The manager named must be at least 21 years of age State of County cf The foregoing instrument was acknowledged efore me this X _ day of Signature of Contro=ing Person or Agent(circle one) month Year ... _ _... (S•3nalure cf NO T^.kY=UBLIC) 7'rird`.ant e M .cr mission expires on Day Month Year -- - - . Oink - ' Print Form ARIZONA DEPARTMENT OF LIQUOR UCENSES& CONTROL S00 W Washington 5th Floor Phoenix AZ 85007-2934 f.)369'.* r rt$02)542-5 1; Cit ,i, � - RE :y—am `` L? Attention all Local Governing Bodies' Social Security_.altif BttZtid3ti titJ tlQQis Confidential This info atton a 'be give to local law enforcement agencies for the purpose ofbackgratinrt.checksoOiy6ttt must be blocked to be unre tt 1€ rior to posting <'"., Tor#tp-pubilC-9lek+. li .'j Om\ Read carefully This Instru erit isaswp•�rdopiineit:Aype or print with BLACK lN4 An extensive investigation of you l?acktirobt wtl&b4`co cted. False or incomplete anew could result in criminal prosecutio 4t}d the:denia 't ji c T.-OR revocation of a license or permit TO BE COMPLETED BY EACH CONTROLLING PERSON AGE ,-O A. ER ON COMPLETING THIS FORM MUST SUBMIT AN APPLICANT-TYPE FINGERPRINT CARD WHICH MAY BE 0 A yM' WING MUST BE DONE BY A BONA FIDE LAW ENFORCEMENT AGENCY OR A FINGERPRINTING SERVIC- Egt�t\,� ti I rrYXPTMENT DOES NOT PROVIDE THIS SERVICE Effective 10/01107 there is a $24.00 processing fee for each find 'art Liquor License # The fees allowed by A.R.S. §44-6B52 will be charged for all dishonored checks. I --/ s_ 6 _ ( \11 (If -f0zatt.n is currently licensed) ' Check 0Controlling Person - .geatL" I , Manager(Only) i appropriate (Complete Questions 1-19) I (Complete ons except#14,14a&21) box --♦. Controlling Person or Agent must complete#21 for a Manager Controlling Person or A.--. r. om.iete 0 21 Name ?L.lS4L..55 °6f1C4.r lr%i. e t (.Cat-NAtiv\. ----- Date of B Last First Middle :Grin a -u• re-ono Social Secunty Nu, Drivers Gcersi Stye fit ~- " a public record) (NOT a public record) 4 P-ace of Bsrth 04 ti Z- l i_511 Height a Weight 2,() Eyes E:'rn Hair l;. Clti/ Stale Country (not county) Marital Status L..)Single 0 Married gbrvorced u Wrdowed Daytime Contact Phone ' / ) -75'2. /? ' 6 Name of Current cr Most Recent Spouse Date of Birth _+_' (List all for last 5 years-Use additional sheet if necessary) Last First Middle Maiden (NOT a public record) r} _ YOU are a bona fide resident or what state 'I/,•" if Arizona date of residency i(J-S `- B Telephone number to contact you dunng business hours for any questions regarding this document I U-' ` , 1 o II you have been an Arizona resident For less than three(3)months s1�I Zubrmt a copy of your Anzona drivers license or voter registration card 0 Name of Licensed Premises `( it,(i L i5 j't: f?,* t GL(IA (4 .t i'L% Premises Phone Li 5 e) - /Y f -``7/V / / d.tf1lip.' ^ 11 Physical Location of Licensed Premises Address /.`. U l(� G��- 7,:e I/ /-�•t,�;i.^" ( ( 8,5 j 1•Ci Street Address (Do not use PO Box t) City County Zi.: 12 List your employment or type of business dunng the past(rye S5)years If unemployed part of the time list those dates List most recent tst i FROM TO DESCRIBE POSITION EMPLOYER'S NAME OR NAME OF BUSINESS i Month/Year Month/Year OR BUSINESS {street address,city,state a zip) } ! - l t-.r GURRENT ` S- trr- r.t•4-i f c. t•'• 12. 11 sue:- '.- t.1 c?.1 a ii� Z,I it,rot 5 it k-1 C d4k. / 5 tir2L.+ 47 J try ,.4 4 d'4/ / rt:.tr 1„;kt1ix it /� 71Ct /JP . ,,e t l it l r��s �1,, 5 �urzx t., sin 4.51 i I `— ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION 13 Indicate your residence address for the last five(5)years FROM TO Rent or RESIDENCE Street Address Mon h/Year Month/Year Own I1 rented.attach additional sheet with name,address and shone number of landlord City State Le _s fOJ CURRENT t>i 11 22100 1JGS['I,'7( t l' 1� QC1 T 2L I , 5,flf I i i LiC 0101 9/2412009 Disabled individuals requiring special accommodations,please cell the Department-16021 642•90i7 If you checked the Manager box on the front of this form skip to#15 14 As a Controlling Person or Agent.',Ali you be physically present and operating the Licensed premises'? DYES ONO If you answered YES,how many hrsfday? and answer#14a below If NO skip to#15 143 Have you attended a DLLC-approved Lepuor Law Training Course within the past 5 years? (Must provide proof) OYES ONO If the answer to#14a is"NO",course must be completed before issuance of a new license or approval on an existing license. I 15 Have you been detained,cited.arrested,indicted or summoned into court for violation of ANY law or 0 YES p NO ordinance,regardless of the disposition, even if dismissed or expunged,within the past ten(10)years , (include only traffic violations that were alcohol and/or drug related)? elIN 16 Are there Ma administrative law citations compliance actions or consents,criminal arrest, indictments DYES NO or summonses PENDING against you or ANY entity in which you are now involved? 17 Have you or any entity in which you have held ownership been an officer,member director or manager OYES NO EVER had a business, professional or itauor application or license rejected.denied.r'v s' c suspended przineg,in this or any other state? 18 Has anyone EVER filed suit or obtained a judomer,.t against you, the subject of which involved fraud or OYES '1.N_O misrepresentation? ,t 19 Are you NOW or have you E E held ownership, been a controlling person. been an officer member DYES q NO director or manager on an at Iitll�or_iicenfie in this or any other,state? If any answer to Questions 15 through 19 is'YES'YOU MUST attach a signed statemert Give complete details including dates, agencies involved, and dispositions. SUBSTANTIVE CHANGES TO THIS APPLICATION WILL NOT BE ACCEPTED 2C. I ,'vl r.x i-,. of i ,v,-*,,,; (,t� �.,.3 , hereby declare that I am the APPLICANT/REPRESENTATIVE print LA name of kpplica •? filing this questionnaire I have read this questionnaire and all statements are true,correct and complete x 44 s A �T ✓� P.r)Li.": ,'1, —�_ State of t...0 " L-c=rt.4 County of r/ I'lett (Signatune ai Apphcant)i The foregoing instrument was acknowledged before me this in day of ✓C�-r.0 co.r;.,r C. /). /3 ._ %/rdenln "ea' nn 3 eN t�tv commission expires on L'A /f _ __>. — -�• .�u'- ...,�. !F Div ' Mon af•sr ( natioe of NOTARY PUELtC) t l ;-: -1 Inty ',` .;" jC' :_r `FES COMPLETE THIS SECTION ONLY.IF4 U ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21 The applicant hereby authorizes the person named on this questionnaire to act as manager for the named liquor license The manager named must he at least 21 years of age State of r Iv'2� County of rf�IK2-f //j/, // ��j The foregoing instrument was acrnc+vledged before me this / X / L��� � lU day of L'A-1-'t 14-(2 1 )6r! ), Signature of ontrotlir4g Person 4l Agent(circle one) yt `tt Year t---- 901"/".'t•-• Cdd 6 tt, .e'L.. ... aturs.oLNOTAEtY PLCLiC) Piro!Name - 'PLC My commission expires on U 3/z4 / I County Day h�ithZ`'•. =#:Year ,t_ ;ENE SITES Arizona Departrnent of Liquor Licenses and Control 800 West Washington,5th Floor Phoenix,Arizona 85007 ,.vw w.az li q uol.gov 60275424,5141 . CERTIFICATE OF TITLE 4 TRAINING COMPLETION Do Not Dud!ic ate This Form PS Certificates must be completed by a state-approved training course provider,in black ink,on an original form Carmen Burgess t`rittillll. ",.,lNlance(please p' t} .....,„;-„,- Signature, - J 01/18/2012 18,25 CST Training Completion Date Type of Training Completed(check Yes or No) El Yes 0 No BASIC 0 Yes El No ON SALE 01/18/2017 18:25 CST 0 Yes ❑ No MANAGEMENT [ Yss 0 No OFF SALE Certificate Expiration Date ❑;Yes ❑ No BOTH 0 Yes ❑ No OTHER tMANAGEMENT-5 years from completion date) (BASIC-3 years from completion date) if_j'raincse jsingpselgyAlicensee e), Carmen Burgess ; it-G^ : 1i'47 c?M_f . 14444, C18 003 Name of Licensee Business Name Liquor License 0 Alconol Training Program Provider Information 360training corn,Inc Company or individual Name(please print) 13301 Burnet Rd Suite 100 Address Austin TX 78727 ( 888 ) 360 8764 City State Zip Daytime Contact Phone 4 !certify the above named individual has successfully completed the training specified above in accordance with Arizona Revised Statue,Arizona Administrative Code,and the training course curriculum approved by the Department of Liquor licenses and Control- April Thomas PS /I Name of Trainer(please print) t/flL/ 01/18/2012 18 25 CST I Trainer Signature Date Pursuant to A.R.S.4 4-112(G)(2),mandatory Title 4 liquor law naming Is required prior to the issuance of all new liquor license applications submitted after November 1,1997 The persons(s)required to attend both the BASIC and MANAGEMENT Title 4 liquor law training,on-or off-sale,will;nclude ail of the following: Owner(s) Ucenseelagent or manage=Ks)actively involved in dady business operation A valid(not expired)Certificate of Tile 4 Training Completion must be submitted to the Department of Liquor Licenses and Control before a liquor license application Is considered complete. Before acceptance of a manager's questionnaire and/or agent change for an existing liquor license,proof of attendance forthe BASIC and MANAGEMENT Title 4 liquor law training(on-or off-sale)is required. I,2009 Disabled individuals requiring special accommodations,please call(6021542-9027 PP NCH re., fit r//fll'tle lun2('/L()n, U ' Home of the .Supe+•.stttum Mountains RRtzo% NOTICE The attached application for a New License, Limited Liability Co , Restaurant Liquor License submitted for Elvira's Mexican Restaurant located at 1520 W Apache Trail, Apache Junction. Arizona, was posted on the 8th day of February, 2012, 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 (1/2) mile radius from the proposed premises to be licensed may file written arguments in favor thereof, or objections thereto with the City Clerk at City Hall 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, March 6. 2012, at the City Council Chambers, 300 E Superstition Blvd . Apache Junction, AZ at 7 00 p m , at which time any objections filed will be heard Kathleen Connelly City Clerk DO NOT REMOVE THIS NOTICE AND/OR ATTACHMENTS. REMOVAL OF THIS APPLICATION MAY JEOPARDIZE CITY COUNCIL RECOMMENDATION. •Votce t4$Ot 042.8002 * 1'-A t t180j982-7018•TDD(480)983 ot)9;) •n«ka ajtity net 'tilt E Sup_r ttt!k n tRouto,:nd Apache.iuntuon A/10219 Aiikk Pp AC Hz. re 61 Or e_.CIA riche, :it Mille of the Superstition .ikounturns • Rq zON. February 8, 2012 Eddie Val Valdez Elvira's Mexican Restaurant 264 S Phelps Drive Apache Junction. AZ 85120 Dear Mr Valdez Please be advised that the application for a New License, Limited Liability Co . Series 12 Liquor License submitted for Elvira's Mexican Restaurant, located at '1520 W. Apache Trail Apache Junction, Arizona was posted on February 8. 2012. in accordance with state law The Apache Junction City Council will hold a public hearing on March 6, 2012 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 processing of your application. There is a 850 non-refundable application fee that is due and must be received prior to Wednesday. February 22 2012, in order for this application to be placed on the City Council agenda If you have any questions concerning this matter, please contact my office at 474-5068 Sincerely, Kathleen Connelly City Clerk • \+aLe; Isut os2 SU+12 • i \\ ,ast;i •r3= '0n,s • I fir)c-JSQ1 oR;_rnrQ� • •.ti.+•. l;�il� nct 300 E 5u(1r. :r ,r tiouic ,cra r\p..i he Junolon FEBRUARY 6, 2012 MEMORANDUM TO DEPARTMENT OF PUBLIC SAFETY PLANNING DIVISION APACHE JUNCTION FIRE DISTRICT THROUGH KATHLEEN CONNELLY, CITY CLERK FROM JAN MASON, DEPUTY CITY CLERK SUBJECT APPLICATION FOR LIQUOR LICENSE FOR ELVIRA S MEXICAN RESTAURANT Mr Eddie Valdez has submitted an application for a New License, Limited Liability Co Series 12 Liquor License for Elvira's Mexican Restaurant located at 1520 W Apache Trail. Apache Junction Please conduct the necessary inspections and submit your recommendation by email no later than Wednesday, February 22. 2012, in order for this item to be on the agenda for the City Council meeting of March 6, 2012 oft. ON mac:cry,-x 0 0 Apache Junction Police Department y : w°, V. Interdepartmental Memo '� �`.^ 0. ^ DATE 02/16/2012 TO Lt Robinson THROUGH FROM Sgt Durkin SUBJECT Elvira's Restaurant At your request I went to the Elvira's Restaurant 1520 W Apache Trail, Apache Junction regarding a liquor license request This is within the city limits of Apache Junction and AJPD's jurisdiction This restaurant is a free standing and a well established business andliquor license Posted on the window of the restaurant, is the cityrequest, q y request dated Feb 8 2012 I contacted Carmen Burgess. John was present also She is a US citizen and known to us 9 as the manger of this business The bar/restaurant area matched the diagram provided The interior will be changing and is currently still 'under construction' The provided diagram, did match the new area for their /, dining room Parking is ample. and the building, and business. is well established I did not see any challenges in granting this, nor do I see any objections to this application This up grade to their building/business appears to be a welcome addition to our city CFAI ��i'UN� Apache Junction Fire District a deli 565 North Idaho Road, Apache Junction, AZ 85119 :�, H � Phone (480) 982-4440, Fax(480) 982-0183 t ~ qf� www ajfire org MEMORANDUM TO Jan Mason,Deputy City Clerk City of Apache Junction FROM John Suniga,Deputy Fire Marshal - DATE: February 10, 2012 SUBJECT: Series 12 Liquor License Application for Elvira's Restaurant The Apache Junction Fire District recommends approval of the above noted application. As always we will conduct the needed safety inspections as this new construction project progresses. Thank you for your notification on this matter. J�_ dos ATTN. Application ROLL CALL VOTE NOTES k, 41‘, ''2)k f7 ITEM # MEETING OF MOTION BY: SECONDED BY 16A)/V-11 YES NO ABSTAINED COUNCILMEMBER BARKER COUNCILMEMBER WILSON �` COUNCILMEMBER SMITHSON VICE MAYOR DIETZ COUNCILMEMBER SERDY K MAYOR INSALACO , UNANIMOUS' IN FAVOR OPPOSED ABSTAINED TOTAL ;i ITEM NO. 7 I MOVE THAT THE APPLICATION FOR A NEW LICENSE, LIMITED LIABIITY CO., SERIE 12 LIQUOR LICENSE FOR ELVIRA'S MEXICAN RESTAURANT, SUBMITTED BY EDDIE VALDEZ, BE RECOMMENDED FOR(APPROVAL) OR(DENIAL) TO THE ARIZONA DEPARTMENT OF LIQUOR LICENSES AND CONTROL. PUBLIC HEARING 1. For RESOLUTION NO. 12-06, RECOMMENDING THE EXPANSION OF THE APACHE JUNCTION FIRE DISTRICT BOUNDARIES TO ALLOW THE APACHE JUNCTION FIRE DISTRICT TO PROVIDE FIRE PROTECTION SERVICES TO EL DORADO MOBILE HOME ESTATES LOCATED AT 202 NORTH MERIDIAN ROAD 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. PpACHf 4'Po l City of Apache junction U 2 Home of the .S.lipetsiitlo/z Mountains Print TO: City Manager's Office FROM: Kathy Connelly, City Clerk DATE: March 6, 2012 Agenda Type : Regular Agenda Council Priority Focus Area. Required by Federal Law or State Statute TITLE OF AGENDA ITEM: RESOLUTION NO. 12-06, RECOMMENDING THE EXPANSION OF THE APACHE JUNCTION FIRE DISTRICT BOUNDARIES TO ALLOW THE APACHE JUNCTION FIRE DISTRICT TO PROVIDE FIRE PROTECTION SERVICES TO EL DORADO MOBILE HOME ESTATES LOCATED AT 202 N. MERIDIAN ROAD, MARICOPA COUNTY, APACHE JUNCTION, ARIZONA. ACTION REQUESTED: Recommendation for Approval DISCUSSION/ BACKGROUND INFORMATION: This resolution would allow expansion of Apache Junction Fire District boundaries to include 202 N Meridian (El Dorado Mobile Home Estates) This action is authorized by A R S Title 8-462 Deputy Fire Chief Dave Montgomery will be present to discuss this request FISCAL IMPACT: - OPTIONS/ALTERNATIVES: RECOMMENDATION: ATTACHMENTS: Click to download ❑ cover memo ❑ resolution no. 12-06 ❑ fire district attachments ❑ arizona revised statutes attachment 'oak eiN FEBRUARY 15, 2012 MEMORANDUM TO HONORABLE MAYOR AND CITY COUNCIL MEMBERS THROUGH GEORGE R HOFFMAN, CITY MANAGER FROM' KATHLEEN CONNELLY. CITY CLERK SUBJECT RESOLUTION NO 12-06 EXPANSION OF FIRE DISTRICT BOUNDARIES We have received a request from Deputy Fire Chief David Montgomery to perform the legal steps required to allow the expansion of fire district boundaries This expansion would include El Dorado Mobile Estates located at 202 N Meridian This park is already within the city limits Attached is the (a) letter from Deputy Fire Chief Montgomery. (b) a letter from the owner of El Dorado Mobile Estates requesting to be included in the Apache Junction Fire District (c) the legal description and assessed value for the three parcels to be included in the expansion, (d) the 2011 fire board resolution authorizing the change to two district boundaries for parcels 1 and 2 and (e) the 2011 fire district board resolutions authorizing the changes to the fire district boundaries for parcels 3 and 4, /'N The appropriate action by the city council is to approve a resolution allowing the expansion of the fire district boundaries for the four parcels which make up El Dorado Mobile Estates Attached is a copy of A R S § 8-262 which outlines this process This item will be placed on your March 5 work session agenda for discussion and your March 6 regular agenda as a public hearing Please contact me if you have any questions Auk Aft. RESOLUTION NO 12-06 A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, RECOMMENDING THE EXPANSION OF THE APACHE JUNCTION FIRE DISTRICT BOUNDARIES TO ALLOW THE APACHE JUNCTION FIRE DISTRICT TO PROVIDE FIRE PROTECTION SERVICES TO EL DORADO MOBILE ESTATES LOCATED AT 202 N. MERIDIAN ROAD, MARICOPA COUNTY, APACHE JUNCTION, ARIZONA. WHEREAS, pursuant to A R S § 48-252 (I) on or about December 21 , 2011, C A (Tommy) Thompson filed a written request with the Apache Junction Fire District ("AJFD") Clerk requesting their property located at 202 N Meridian Road, Maricopa County, Apache Junction, Arizona, commonly known as the "El Dorado Mobile Estates" (the "Park") , receive fire protection services from Nat'l) rather than from Rural Metro which currently provides fire protection (See Exhibit A, Legal Description and as depicted in Exhibit B) , and WHEREAS, on January 24, 2012 , the City received this request from AJFD; and WHEREAS, on March 6, 2012, the Apache Junction Mayor and City Council reviewed the request from AJFD for expansion of the district boundaries at their regular scheduled Council meeting, and WHEREAS, the City has not previously endorsed fire coverage of the Park for any particular fire protection provider, nor does the City have a fire department; and WHEREAS, pursuant to A R S 5 48-262 (I) , such a request for Aft boundary expansion is only permitted if the governing city council recommends approval of the request NOW, THEREFORE, BE IT RESOLVED by the Mayor and City Council of the City of Apache Junction, Arizona, as follows SECTION I The Mayor and City Council have fully considered the request from AJFD for expansion of district boundaries as referenced above RESOLUTION NO 12-06 PAGE 1 OF 2 -- ^ - ^ - - SECTION II The Mayor and City Council believe that extending the boundaries of the AJFD to provide fire protection services to the property set forth in Exhibit A would promote the public health, comfort, convenience, necessity or welfare. SECTION III /'►, The Mayor and City Council therefore fully endorse the boundary change request SECTION IV The Mayor and City Council directs the City Clerk to send this resolution to the AJFD Board Clerk for filing after it has been signed by the Mayor and attested to by the City Clerk PASSED AND ADOPTED BY THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, THIS DAY OF , 2012 SIGNED AND ATTESTED TO THIS DAY OF , 2012 JOHN S . INSALACO Mayor ATTEST. KATHLEEN CONNELLY City Clerk APPROVED AS TO FORM: RICHARD J STERN City Attorney RESOLUTION NO 12-06 PAGE 2 OF 2 EXHIBIT A LEGAL DESCRIPTION PARCEL NO. 1 . Maricopa County Parcel #220-65-003H) The South half of the East half of the Northeast quarter of the Northeast quarter of Section Twenty-Four (24) , Township One (1) North, Range Seven (7) East of the Gila and Salt River Baseline and Meridian, Maricopa County, Arizona PARCEL NO. 2 (Maricopa County Parcel #220-65-003H) The North half of the East half of the Southeast quarter of the Northeast quarter of Section Twenty-Four (24) , Township One (1) North, Range Seven (7) East of the Gila and Salt River Baseline and Meridian, Maricopa County, Arizona, EXCEPT the South 150 feet thereof PARCEL NO 3 (Maricopa County Parcel #220-64-004G 9) The West half of the following described property . The South 305 feet of the Northeast quarter of the Northeast quarter of the Northeast quarter of section Twenty-Four (24) , Township One (1) North, Range Seven (7) East of the Gila and Salt River Baseline and Meridian, Maricopa County Arizona. /mk EXCEPT the East 65 feet thereof PARCEL NO. 4. (Maricopa County Parcel #220-65-003J Z) The South half of the East half of the Southeast quarter of the Northeast quarter of Section Twenty-Four (24) , Township One (1) North, Range Seven (7) East of the Gila and Salt River Baseline and Meridian, Maricopa County, Arizona, and the South 150 feet of the North half of the East half of the Southeast quarter of the Northeast quarter of Section Twenty-Four (24) , Township One (1) North, Range Seven (7) East of the Gila and Salt River Baseline and Meridian, Maricopa County, Arizona; EXCEPT the South 500 feet of said Southeast quarter of the Northeast quarter; and EXCEPT the North 300 feet of the South 800 feet of the East 300 feet of said Southeast quarter of the Northeast quarter /"v f EXHIBIT B El Dorado Mobile Estates 202 N. Meridian Dr. ..fw icopa Count Parcels 2 20-65-0031I. 220-65-003J and 220-54-004G '.,. it or. 220 64- 1t I. .: ./\ .""' " 1 - !VI I1 4,-..-.-.., I' r-a---'-' .• J uW.. .+ fir._ < •ar+t 410 we AP ' 11. ' V.41- - WI. . 2U'6.3 BO7(iso :war iii, l ! 41‘ Asamr , 414 ., t ,, tit e.--�ig TRIJW • fill/ LP Ila ..., , . , ,,,...,.., ,,,„ . row . — .., ,- -- lit . r.- . ojor , :‘,.. . ue ... 41,, 4 ;'. ,' .�►-220.64-003H ' • sic at :4,.i,.., _ .„. . .-_,-.„7......,,, au _._ --,.:., , :,,,._ -it - - fp t it 141411111111 ges "' 1. , $ .,' ?. -}•4 - - -irtritr 0 ari. 22;-65-0033 ,.':"1=; It . l''-.-. g‘ -"-.::.; '‘• - 4-i L 401.,:vg.--.,„,,,..-,...._., ,,"-f,--,,,i-,---- ',,. . a[[aa 0y v2�0 50i � v8 - " i 220 .5.003P k. /u . `220 5-0011 c _ G -, - . Kathy Connelly From. Dave Montgomery [dave montgomery@ajfire orgj Sent: Tuesday, January 24, 2012 5:27 PM To: Kathy Connelly Cc• Dan Campbell, Bryant Powell Subject: Resolution Attachments: El Dorado Mobile Estates_202 N Meridian Dr_Parcels pdf, Final Resolution 2011-11_Signed pdf, Annex Request Letter 12-5-2011.pdf: Final Exhibit Al pdf, Final Exhibit A2 pdf Final ANN Resolution 2011-10_Signed pdf. Royal Apts 2002 pdf Kathleen, We are in the process of finalizing a request for annexation into the fire district for the properties that make up 202 N Meridian —The El Dorado Mobile Home Park Since this address lies within the jurisdictional boundaries of the City of Apache Junction, and pursuant to the State Statutes that govern our special taxing district, we will need a resolution from the City allowing our expansion of fire district boundaries, to file with Maricopa County I have attached a resolution the City did for us by back in 2002 when the owner of the parcel for the Royal Apartments at 108 N. Meridian asked to be annexed into the district We would be looking to have this same thing done for the parcels at 202 N Meridian Also attached are the associated annexation documents you would need to refer to in your resolution The only statutory change in the annexation process from 2002 until now is that a contiguous property does not have to file an impact statement if both the owner and the fire district find the potential annexation to be mutually beneficial This language is in our resolutions for annexation. I would be more than happy to sit down and go over these items with you to answer any questions or concerns Please let me know. We are looking to expedite this process to the greatest extent possible Thank you in advance for your time in this matter. David Montgomery, CFI Apache_ct Fire District - Deputy Fire Chief (480) 982-4440 - Office (480) 215-9224 - Cell (480) 982-0183 - Fax dave.montgomeryPajfire.org CFAI 1 EL DORADO MOBILE ESTATES 202 N. Meridian Drive Apache Junction,AZ 85220 David Montgomery Deputy Fire Chief Apache Junction Fire Department Apache Junction,AZ 85220 RE El Dorado Mobile Estates being included in the Apache Junction Fire District Dear Mr Montgomery Please consider this letter as my format request to have El Dorado Mobile Estates included in the Apache Junction Fire District El Dorado is a mobile home park consisting of 164 mobile spaces and 14 RV spaces, located on the west side of Meridian, in Apache Junction Attached please find the three parcel numbers, legal descriptions, and the 2011 assessed values, taken from the 2011 tax bills. Please submit this request at the December 21, 2011 Fire District board meeting. I look forward to the response of the board. Sincerely, C A (Tommy)Thompson Owner, El Dorado Mobile Estates (480) 585-8653 direct line p Legal Descnption of El Dorado MHP Parcel Number 220-65-003H 5 Assessed 2011 Value: $278,430 NE4 5E4 NE4 EX S 150F EX N 30F& E 55F RDS&ALSO SE4 NE4 NE4 EX S 30F &E55F RD Parcel Number 220-65-003J 1 Assessed 2011 Value: $21,850 "isftik 52 E2 SE4 NE4 SEC 24&S 150F OF N2 E2 5E4 NE4 SE Parcel Number. 220-64-004G 9 Assessed 2011 Value. $17,650 W2 S 305F NE4 NE4 NE4 SEC 24 EX COM INTER APACHE /IN FIRE BOARD RESOLUTION RESOLUTION 2011-10 A RESOLUTION AUTHORIZING THE AMENDMENT OF THE APACHE JUNCTION FIRE DISTRICT'S BOUNDARIES TO INCLUDE LAND WITHIN THE MARICOPA COUNTY AND ADJACENT TO THE BOUNDARIES OF THE APACHE JUNCTION FIRE DISTRICT AFTER WRITTEN REQUEST BY PROPERTY OWNER IN ACCORDANCE WITH A R S 48-262(I). WHEREAS On December 21, 2011, Mr Tommy Thompson requested, in writing,that the Apache Junction Fire District Board amend the Apache Junction Fire District boundaries to include their property, more particularly described as set forth on the attached Exhibit AI WHEREAS The subject property is located within Martcopa County and is adjacent to the boundaries of the Apache Junction Fire District as shown on map attached as Exhibit Al WHEREAS• The Apacht. Junction lire District has determined that the inclusion of the subject property within the boundaries of the Apache Junction Fire District will benefit the Apache Junction Fire District AND the Property Owner \OW THEREFORE, BE IT RESOLVED that the Fire Board of the Apache Junction Fire District hereby order the following The boundaries of the Apache Junction Fire District are hereby amended to include the property described as tier forth on attached Exhibit Al ADOPTED at a meeting of the Fire Board of the Apache Junction Fire District at a duly noticed meeting held on December 21,2011 by a malonty of the Fire Board Members. on Apache Junction Fire District Atte to / Clerk Apache Junction Fire District Exhibit Al for Apache Junction Fire District Resolution 2011-10 Legal Description PARCEL NO. 1: (Maric opa County Parcel#220-65-003H) The South half of the Fast half of the Northeast quarter of the Northeast quarter of Section Twenty-Four (24) Township One (I) North. Range Seven (7) East of the Gila and Salt River Baseline and Meridian, Mar►copa County,Arizona PARCEL NO 2• alartcopa County Parcel»220-65-003H) The North half of the East half of the Southeast quarter of the Northeast quarter of Section Twenty-four (24), Township One (I) North, Range Seen (7) East of the Gila and Salt River Baseline and Meridian. Maricopa (ounty, Arizona; F\(:l.PT the South 150 feet thereof. FIRE BOARD RESOLUTION RESOLUTION 2011-11 A RESOLUTION AUTHORIZING THE AMENDMENT OF THE APACHE JUNCTION FIRE DISTRICT'S BOUNDARIES TO INCLUDE LAND WITHIN THE MARICOPA COUNTY AND ADJACENT TO THE BOUNDARIES OF THE APACHE JUNCTION FIRE DISTRICT AFTER WRITTEN REQUEST BY PROPERTY OWNER IN ACCORDANCE WITH A.R.S §48-262(I). WHEREAS On December 21, 2011, Mr Tommy Thompson requested, in writing, that the Apache Junction Fire District Board amend the Apache Junction Fire District boundaries to include their property, more particularly described as set forth on the attached Exhibit A2 WVHEREAS• the subject property is located within Maricopa County and is adjacent to the boundaries of the Apache Junction Fire District as shown on map attached as Exhibit A2. 'WHEREAS I'he Apache Junction Fire District has determined that the inclusion of the subject property within the boundaries of the Apache )unction Fire District will benefit the Apache Junction Tire District AND the Property Owner. '4OW FIIEREFORE BF IT RESOLVED that the Fire Board of the Apache Junction Fire District hereby order the following The boundaries of the Apache Junction Fire District are hereby amended to include the property described as set forth on attached Exhibit A2 ADOPTED at a meeting of the Fire Board of the Apache Junction Fire Distnct at a duly noticed meeting held on December 21, 2011 by a majority of the Fire Board Members f /.sue ipiapvcr Apache Junction Fire District A/ sled o , T 0 f 4,0 Clerk Apache Junction Fire District Exhibit A2 for Apache Junction Fire District Resolution 2011-1 I 1 Legal Description PARCEL NO.3: ('1artcopa Comm Parcel 4220-64-004G '1) The West half of the following described property' Fite South 305 feet of the Northeast quarter of the Northeast quarter of the Northeast quarter of Section Twenty- tour (24), Township One (I) North, Range Seven (7) East of the Gila and Salt River Baseline and Meridian. Maricopa County, Arizona: 1 XCEPT the East 65 feet thereof PARCEL NO.4. (tlurnc.opa County Parcel 't 2.20-65-003.11 The South halt of the Fast halt of the Southeast quarter of the Northeast quarter of Section 1 wenty-four (2-1) Township One (I) North, Range Seven (7) Cast of the Gila and Salt River Baseline and Meridian, Maricopa County, Arizona, and the South I50 feet of the North half of the East half ot the Southeast quarter of the Northeast quarter of Section Twenty-four(24) Township One (I) North. Range Seven (7) Fast ot the Gila :nd Salt Riser Baseline and Meridian, Maricopa County, Arizona CXCFPT the South 500 feet of said Southeast quarter of the Northeast quarter,and EXCEPT the North 300 feet of the South 800 feet of the East 300 feet of said Southeast quarter of the Northeast quarter. olgok Format Document Page 1 of 4 I } cif 5 Ti-LL PAGE NEXT DOCUMENT PRC'.10US DOCUMENT i 48-262. District boundary changes; procedures; notice, hearinoi determinations, petitions A Except as prescribed by subsection I of this section, a fire district, community park maintenance district or sanitary district shall change its boundaries by the following procedures: 1 Any adult person desiring to propose any change to the boundaries of a district shall prepare and submit a boundary change impact statement to the governing body of the district. The boundary change impact statement shall contain at least the ..;ollowing information: ,a) A legal description of the boundaries of the area to be included within the proposed change and a detailed, accurate map of the area. The boundaries of the proposed change shall not overlap with the boundaries of any other proposed new district of the same type or any annexation by a district of the same type for which petitions are being circulated on the date that the boundary change impact statement is filed with the governing body. (b) An estimate of the assessed valuation within the boundaries of the proposed change. (c) An estimate of the change in the tax rate of the district if the proposed change is made (d) An estimate of the change in the property tax liability, as a result of the proposed change, of a typical resident of a portion of the district, not in the area of the proposed change, before and after the proposed change and of a typical resident of the area of the proposed change. (e) A list and explanation of benefits that will result from the proposed change to the residents of the area and of the remainder of the district. (f) A list and explanation of the injuries that will result from the proposed change to residents of the area and of the remainder of the district 2. On receipt of the boundary change impact statement, the governing body shall set a day, not fewer than twenty nor more than thirty days from that date, for a hearing on the boundary change impact statement. The board of supervisors may at any time prior to making a determination pursuant to paragraph 5 of this subsection require that the impact statement be amended to include any information that the board of supervisors deems to be relevant and necessary. 3 On receipt of the boundary change impact statement, the clerk of the governing body shall mail, by first class mail, written notice of the statement, its purpose and notice of the day, hour and place of the hearing on the proposed change to each owner of taxable property within the boundaries of the proposed change The clerk of the governing body shall post the notice in at least three conspicuous public places in e area of the proposed change and also publish twice in a daily newspaper of eneral circulation in the area of the proposed change, at least ten days before the ;searing, or if no daily newspaper of general circulation exists in the area of the proposed change, at least twice at any time before the date of the hearing, a notice setting forth the purpose of the impact statement, the description of the boundaries of the proposed change and the day, hour and place of the hearing. 4 On receipt of the boundary change impact statement the clerk shall also mail notice, as provided in paragraph 3 of this subsection, to the chairman of the board of supervisors of the county in which the district is located. The chairman of the board of supervisors shall order a review of the proposed change and may submit written comments to the governing body of the district within ten days of receipt of the notice. 5. At the hearing called pursuant to paragraph 2 of this subsection, the governing body shall consider the comments of the board of supervisors, hear those who appear for and against the proposed change and determine whether the proposed change will promote the public health, comfort, convenience, necessity or welfare. If the governing body determines that the public health, comfort, convenience, necessity or welfare will be promoted, it shall approve the impact statement and authorize the persons proposing the change to circulate petitions as provided in this subsection The order of the governing body shall be final, but if the request to circulate petitions is denied, a subsequent request for a similar change may be refiled with the governing nttp /fwww azleg gov/FormatDocument asp9format=print&inDoc=/ars/48/00262 htm&Tit 1/25/2012 Format Document Page 2 of 4 body after six months from the date of such denial. 6. The governing body shall not approve a proposed annexation if the property to be annexed is not contiguous with the district's existing boundary. For purposes of determining whether or not the proposed addition is contiguous, the addition is deemed contiguous if land that is owned by or under the jurisdiction of the United States government, this state or any political subdivision of this state, other than an incorporated city or town, intervenes between the proposed addition and the current district boundary. 7. The governing body shall not approve a proposed annexation if the area proposed to be annexed surrounds any unincorporated territory and that unincorporated territory is not also included in the district. �►, 8. After receiving the approval of the governing body as provided in paragraph 5 of this subsection and provided no appeal filed pursuant to paragraph 14 of this subsection remains unresolved, any adult person may circulate and present petitions to the governing body of the district 9. Within fifteen days after receiving the approval of the governing body as prescribed by paragraph 5 of this subsection, the clerk of the board shall determine the minimum number of signatures required to comply with paragraph 10, subdivision (b) of this subsection. After making that determination, that number of signatures shall remain fixed, notwithstanding any subsequent changes in ownership of the property within the boundaries of the proposed change. 10 The petitions presented pursuant to paragraph 8 of this subsection shall comply with the provisions regarding petition form in section 48-266 and shall: (a) At all times, contain a legal description of the boundaries of the area to be included within the proposed change and a detailed, accurate map of the area included within the proposed change No alteration of the described area shall be made after receiving the approval of the governing body as provided in paragraph 5 of this subsection (b) Be signed by more than one-half of the property owners within the boundaries of the proposed change and be signed by persons owning collectively more than one-half of the assessed valuation of the property within the boundaries of the proposed change. 11 On receipt of the petitions, the governing body shall set a day, not fewer than en nor more than thirty days from that date, for a hearing on the request 12. Prior to the hearing called pursuant to paragraph 11 of this subsection, the board of supervisors shall determine the validity of the petitions presented pursuant to subsection B of this section 13 At the hearing called pursuant to paragraph 11 of this subsection, the governing body, if the petitions are valid, shall order the change to the boundaries. The governing body shall enter its order setting forth its determination in the minutes of the meeting, not later than ten days from the day of the hearing, and a copy of the order shall be sent to the officer in charge of elections and a copy shall be recorded in the county recorder's office. The order of the governing body shall be final, and the proposed change shall be made to the district boundaries thirty days after the governing body votes 14. On filing a verified complaint with the superior court, the attorney general, the county attorney or any other interested party may question the validity of the annexation for failure to comply with this section. The complaint shall include a description of the alleged noncompliance and shall be filed within thirty days after the governing body of the district adopts a resolution that annexes the territory of the district. The burden of proof is on the plaintiff to prove the material allegations of the verified complaint. An action shall not be brought to question the validity of an annexation resolution unless it is filed within the time and for the reasons prescribed in this subsection All hearings that are held pursuant to this paragraph and all appeals of any orders shall be preferred and shall be heard and determined in preference to all other civil matters, except election actions. If more than one complaint questioning the validity of an annexation resolution is filed, all such complaints shall be consolidated for the hearing B For the purpose of determining the validity of the petitions presented pursuant to subsection A, paragraph 8 of this section: 1. Property held in multiple ownership shall be treated as if it had only one property http //Www azfeg gov/FormatDocument asp?format=print&inDoc=/ars/48/00262 htni&Tit 1/25/2012 Format Document Page 3 of 4 owner, so that the signature of only one of the owners of property held in multiple ownership is required on the boundary change petition. 2 The value of property shall be determined as follows: (a) In the case of property assessed by the county assessor, values shall be the same as those shown on the last assessment roll of the county containing such property (b) In the case of property valued by the department of revenue, the values shall be those determined by the department in the manner provided by law, for municipal assessment purposes. The county assessor and the department of revenue, respectively, shall furnish to the governing body, within twenty days after such a request, a statement in writing showing the owner, the address of each owner and the appraisal or assessment value of properties contained within the area of a roposed change as described in subsection A of this section. 3. All petitions circulated shall be returned to the governing body of the district w►thin one year from the date of the approval given by the governing body pursuant to subsection A, paragraph 5 of this section Any petition returned more than one year from that date is void If an appeal is filed pursuant to subsection A, paragraph 14 of this section, this time period for gathering signatures is tolled beginning on the date an action is filed in superior court and continuing until the expiration of the time period for any further appeal. C For the purposes of determining whether or not the proposed addition is contiguous, the addition is deemed contiguous if land that is owned by or under the jurisdiction of the United States government, this state or any political subdivision of this state, other than an incorporated city or town, intervenes between the proposed addition and the current district boundary. Property shall not be approved for annexation if the area proposed to be annexed surrounds any unincorporated territory and that unincorporated territory is not also included in the district D If the change in the boundaries proposed pursuant to subsection A of this section would result in a withdrawal of territory from an existing district the petitions shall be approved by the governing body only if the proposed withdrawal would not result in a noncontiguous portion of the district that is less than one square mile in size. E If the impact statement described in subsection A of this section relates to the withdrawal of property from a district, in addition to the other requirements of subsection A of this section, the governing body shall also determine. 1. If the district has any existing outstanding bonds or other evidences of indebtedness 2. If those bonds were authorized by an election and issued during the time the property to be withdrawn was lawfully included within the district. F If the conditions of subsection E of this section are met: 1 The property withdrawn from the district shall remain subject to taxes, special assessments or fees levied or collected to meet the contracts and covenants of the fonds. The board of supervisors shall provide for the levy and collection of such ixes, special assessments or fees. 2 The governing body shall. (a) Annually determine the amount of special property taxes, special assessments or fees that must be levied and collected from property withdrawn from the district and the mechanism by which such amount is to be collected. (b) Notify the board of supervisors on or before the third Monday in July of the amount determined in subdivision (a) of this paragraph 3 Property withdrawn from an existing district shall not be subject to any further taxes, special assessments or fees arising from the indebtedness of such district except as provided in this subsection G. If the statement described in subsection A, paragraph 1 of this section requests the annexation of property located within an incorporated city or town, in addition to the other requirements of subsection A of this section, the governing body shall approve the district boundary change impact statement and authorize the circulation of petitions only if the governing body of the city or town has by ordinance or resolution endorsed such annexation and such annexation is authorized pursuant to this title H Except as provided in subsection D of this section and section 48-2002, no change in the boundaries of a district pursuant to this section shall result in a district which contains area that is not contiguous. I. Notwithstanding subsection A of this section, any property owner, including a http://vww:v azleg gov/FormatDocument asp?format=print&inDoc=/ars148/00262 htm&Tit 1/25/2012 Format Document Page 4 of 4 county, this state or the United States government, whose land is within a county that contains a sanitary district or fire district and whose land is contiguous to the boundaries of the sanitary district or fire district may request in writing that the governing body of the district amend the district boundaries to include that property owner's land If the property is located in an incorporated city or town, in addition to the other requirements prescribed in this subsection, the governing_bady of the..iire district or sanita distnct m_ a� pprny the bounder h.-. y.averning rodp-ofiT efi affE' ct' j_ tttor town by or inance or resolution hasapari�yed the jncTusion � hP property-in_ e district rA q st made pursuant to this subsection sPfall b ade before the count' boar�'of supervisors orders the creation of a proposed new district of the same type or the district governing body orders the ek annexation by a district of the same type in which the property owner's land is proposed for inclusion and for which petitions are being circulated. If the governing. bod determines that the inclusion of tfi _iar_oper_tywili benefit the district and the ' prop av�mer; ie^boundary change may be made by order o�1he g4��rnfirg bey_ --an is roar on the recording of the governing body's order that includes a legal description of the property that is added to the district If the governing body does not order the boundary change, the land shall be included in the boundaries of the proposed new district of the same type or annexation by a district of the same type in which the property owner's land is proposed for inclusion and for which petitions are being circulated. A petition and impact statement are not required for an amendment to a sanitary district's or fire district's boundaries made pursuant to this subsection. J. A fire district shall not annex or otherwise add territory that is already included in another existing fire district, unless deannexed pursuant to subsections D, E and F of this section. K. A fire district, community park maintenance district or sanitary district may appropriate and spend monies as necessary or reasonably required to assist one or more individuals or entities to change the district's boundaries pursuant to this section. L. Notwithstanding subsection A of this section, if an incorporated city or town has previously adopted a resolution designating a fire district as the fire service agency for the city or town, the jurisdictional boundaries of the fire district without further notice or election shall be changed to include any property annexed into the city or town. If the annexation occurs pursuant to a joint petition for annexation, any joint petition for annexation shall dearly indicate in its title and in the notice required in the petition that the property to be annexed will be subject to the jurisdiction of both the city or town and the fire district A joint petition for annexation shall comply with both section 9-471 and this section. Any fire district boundary change that occurs through city or town annexation pursuant to this subsection is effective on the effective date of the annexation by the incorporated city or town. If an incorporated city or town that has designated a fire district as the fire service agency for that city or town annexes property that is already part of another fire district, the annexed property shall remain part of the fire district in which it was located before the city or town s annexation. Iv1 For the purposes of this section assessed valuation does not include the assessed valuation of property that is owned by a county, this state or the United States government http llmvw.azleg gov/FormatDocument.asp?format=print&inDoc=/ars/48/00262 htm&Tit 1/2512012 ROLL CALL VOTE NOTES: la' ITEM # MEETING OF MOTION BY q✓V SECONDED BY YES NO ABSTAINED VICE MAYOR DIETZ COUNCILMEMBER WILSON COUNCILMEMBER BARKER /'/ COUNCILMEMBER SERDY COUNCILMEMBER SMITHSON MAYOR INSALACO UNANIMOUS IN FAVOR OPPOSED ABSTAINED TOTAL ITEM NO. 8 I MOVE THAT RESOLUTION NO 12-06, A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, RECOMMENDING THE EXPANSION OF THE APACHE JUNCTION FIRE DISTRICT BOUNDARIES TO ALLOW THE APACHE JUNCTION FIRE DISTRICT TO PROVIDE FIRE PROTECTION SERVICES TO EL DORADO MOBILE ESTATES LOCATED AT 202 NORTH MERIDIAN ROAD, MARICOPA COUNTY, APACHE JUNCTION, ARIZONA, (BE APPROVED) OR(BE DENIED). oak eiN PUBLIC HEARING 1. For RESOLUTION NO. 12-07, AUTHORIZING THE CITY TO ACCEPT MEMBERSHIP IN THE METROPOLITAN PHOENIX MUNICIPAL EMPLOYEE BENEFIT TRUST 2. Will ASSISTANT CITY MANAGER BRYANT POWELL 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. PpACHE d< 0 City of pache Junction U Z Home of the Sllpel:tlition .11olllltcrlll.►- 4P120NF Print TO: City Manager's Office FROM: Bryant Powell, Assistant City Manager DATE: March 6, 2012 Agenda Type : Regular Agenda Council Priority Focus Area: TITLE OF AGENDA ITEM: PROPOSED RESOLUTION NO 12-07, AUTHORIZING THE CITY TO ENTER INTO THE PHOENIX METRO HEALTH BENEFIT POOL. ACTION REQUESTED: DISCUSSION / BACKGROUND INFORMATION: The City of Apache Junction has been actively pursuing alternatives to combat the escalating costs associated with health care benefits to the City and its employees After months of research on several options, staff feels the best option is to join the newly formed Phoenix Metro Health Benefits Pool. The cities of Avondale, El Mirage and Youngtown are also committed. This item was discussed by city council at the Work Session on March 5, 2012 FISCAL IMPACT: OPTIONS/ALTERNATIVES: RECOMMENDATION: ATTACHMENTS: Click to download U Cover Memo U Presentation U Final Bylaws U Conflict of Interest U HIPPA Confidentiality Agmnt U Final Trust Document AO\ ,_ a v ' ° City of Apache Junction IrR Home of the Superstition Mountains 401zot DATE. MARCH 5, 2012 TO. HONORABLE MAYOR AND CITY COUNCIL MEMBERS THROUGH GEORGE HOFFMAN, CITY MANAGER FROM BRYANT POWELL,ASSISTANT CITY MANAGER RE• METRO PHOENIX MUNICIPAL EMPLOYEE BENEFIT TRUST As you know each year the city is faced with a double digit increase in health insurance premiums. This coming Fiscal Year 2012-2013 is no different. Over the past several months city staff has explored options available to the city to reduce these costs without decreasing the level of benefits employees receive. The City of Apache Junction has the opportunity to join a newly formed health benefit pool titled the Metro Phoenix Municipal Employee Benefit Trust along with the cities of Avondale, El Mirage and Youngtown, approximately 800 employees By joining this pool,the city may see significant savings and more importantly may stabilize costs in the coming years as the spread of claims is over a greater number of members Therefore, in reducing the double digit premium fluctuations we have been incurring year to year we will be saving money in good years and better able to weather the bad years when more serious claims are paid out Another advantage in joining this pool is that we as a group have greater flexibility in determining the benefits The health benefits available in this pool are comparable to what employees receive now The pool determines the contracted vendors, assumes claim data and has control over the design of the benefits Jim Loeb, our health consultant, Liz Riley, HR Director, and I have attended all of the exploratory and implementation meetings related to this pool. City Attorney Joel Stern has reviewed all of the legal documents and worked with the pool's attorneys to finalize those We have met with several employee groups including the Leadership Team, F-Troop, and patrol staff that all provided us with positive feedback in joining the pool. I respectfully recommend that city council approve Resolution No. 12-07, authorizing the city to join the Metro Phoenix Municipal Employee Benefit Trust RESOLUTION NO. 12-07 A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, AUTHORIZING THE CITY OF APACHE JUNCTION TO ACCEPT MEMBERSHIP IN THE METROPOLITAN PHOENIX MUNICIPAL EMPLOYEE BENEFIT TRUST. WHEREAS, the City of Apache Junction Council is empowered pursuant to A. R. S . § 11-981 (A) to procure health, accident, life, and/or disability benefits for employees, council members, and appointed officers of the City of Apache Junction through either insurance or self-insurance; and WHEREAS, A. R. S . §§ 11-952 and 11-952 . 01 provide that two or more public agencies may join together to provide for health, accident, life, and/or disability benefits for employees, council members, and appointed officers of the City through either insurance or self-insurance; and WHEREAS, the City of Apache Junction desires to enter into an agreement with the Metropolitan Phoenix Municipal Employee Benefit Trust ("MPMEBT" or `Trust") to provide employee benefits of the type generally described under the provisions of A. R. S . §§ 11-952 and 11-952 . 01; and WHEREAS, MPMEBT has extended an invitation to the City of Apache Junction to join its Trust; and WHEREAS, MPMEBT requires acceptance by the City of Apache Junction City Council through the adoption of a resolution. Amok NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION ARIZONA, AS FOLLOWS: 1 . The City of Apache Junction City Council hereby approves MPMEBT membership commencing July 01, 2012 and terminating June 30, 2015; and 2 . The City of Apache Junction City Council hereby approves and agrees to be bound by the provisions of the Trust Agreement provided by MPMEBT effective July 01, 2012 and as may be amended from time to time . RESOLUTION NO. 12-07 PAGE 1 OF 3 3 . The City of Apache Junction City Council hereby authorizes the City Manager to execute the Trust agreement referenced in Paragraph 1 above. 4 . The City of Apache Junction City Council hereby accepts the Trust Bylaws provided by MPMEBT effective July 01, 2012 and as may be amended from time to time. 5. The City of Apache Junction City Council hereby — N. accepts the proposed schedule of contributions to be effective on July 01, 2012 and as may be amended from time to time. 6. The City of Apache Junction City Council hereby appoints the following Trustee to serve on the Board of Trustees of the MPMEBT Trust from July 01, 2012 until the appointment of a duly-qualified successor: Trustee • City Manager 7 . The City of Apache Junction City Council hereby appoints the following Alternate Trustee to serve on the Board of Trustees of the MPMEBT from July 01, 2012 until the appointment of a duly-qualified successor: Alternate Trustee: Assistant City Manager 8 . This approval is based on the MPMEBT Trust Agreement and Bylaws reflecting compliance with A. R. S . § 42-17106, a copy of which is attached hereto as Attachments A and B, respectively. PASSED AND ADOPTED BY THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, THIS DAY OF , 2012 . SIGNED AND ATTESTED TO THIS DAY OF , 2012 . JOHN S . INSALACO Mayor RESOLUTION NO. 12-07 PAGE 2 OF 3 ATTEST : KATHLEEN CONNELLY City Clerk APPROVED AS TO FORM: RICHARD J. STERN City Attorney RESOLUTION NO. 12-07 PAGE 3 OF 3 :iueiiix 0 REGIONAL EMPLOYEE HEALTH CARE BENEFIT POOLING MARCH 6 , 2012 1 i Advantages and Disadvantages 0 ADVANTAGES: Spread the claims risk over a greater number of members Ability to reduce operating expenses & admin costs Greater flexibility in determining benefits Reducing premium fluctuations due to saving money in good years and weathering the bad years Advantages and Disadvantages 0 DISADVANTAGES: Potential for Assessments Need for consensus with multiple entities A requirement to remain in the trust for a minimum of three years Why Self-Funded? 0 Reduced administrative expenses More dollars available to pay claims Traditional admin charges are i8% to 24% Combined Pool admin charges are approximately 8.4% Greater spread of risk Can chose carriers to do business with Increases employer control Benefit design Contracted vendors Claims data Benefit Team for City of Apache Junction 0 Liz Riley, Human Resources � Liz Langenbach, Parks and Recreation Matt Busby, City Manager's Office Nichole Fernandez, City Attorneys Office Anna McCray, City Manager's Office Meetings Held 0 Leadership Team/Department Directors Consensus was positive to move forward with proposed pool F-Troop Consensus was positive to move forward with proposed pool Patrol Staff Meeting Consensus was positive to move forward with proposed pool Current Medical Membership 0 Current Medical Opt Up Current Medical Base Proposed Pool Membership Employees-Approximately 800 employees What Do We Know at This Point? 0 El Mirage, Apache Junction, Avondale and Youngtown are moving forward. Other entities may join fy 13/14 July ol, 2012 effective date How Does Pooling Work? 0 Legal Governance Formation per A.R.S. § Trustee governance 11-952 and A.R.S. § 11- (Typically) 1 Trustee and 952.01 1 Alternate from each Filed with Department of entity Insurance (DOI) Meetings run like any y Subject to DOI public entity Examination every 5 years 1 Funding Structure Insurance is purchased to stop the liability to pool participants over $ 125,000 per claim. What Happens if Claims Exceed Projections? 0 If cash runs short, each member entity remains liable for their pro-rata share of any deficits So, if your entity is io% of the budget, it is liable for io% of the deficit Pool is funded to the level that shortages are actuarially unlikely Qu estions and Answers O p Metropolitan Phoenix Municipal Employee Benefit Trust (MPMEBT) Bylaws Effective: July 01,2012 TABLE OF CONTENTS Section Title Page(s) 1 Definitions 1 - 2 2 Investments 2 3 Expense Reimbursement 2 - 3 4 Meetings 3 5 Officers 3 - 4 6 Audits 4 7. Entity Contnbutions 4 - 5 8. Membership 6 9. Operations 6 - 8 10. Amendments to Bylaws 8 - 9 Section 1. Definitions The following are definitions of terms as used in these By-Laws as well as the Trust Agreement To the extent a term is not specifically defined in these By-Laws, but is defined in the Trust Agreement, the term shall have the meaning given to it in the Trust Agreement 1.01 "A.R.S." shall mean the Arizona Revised Statues, as amended. 1.02 "Beneficiary" shall mean Employees, their dependents and such other persons designated by the Participating Entities as eligible for coverage as set forth in the Summary Plan Description and approved by the Board. 1.03 "Benefits Administrator" shall mean the person(s) or firm employed by the Board who is responsible for processing of claims and payment of benefits, and related services. 1.04 "Board of Trustees" or "Board" shall mean the Trustees of the Metropolitan Phoenix Municipal Employee Benefit Trust acting in their joint capacity as the governing board of the Trust. 1.05 "Employee" shall mean any person employed by a Participating Entity on a regular basis working not less than the number of hours per week required by the Participating Entities for eligibility, and who are not eligible for benefits under any other employee benefits to which the Participating Entity makes contributions 1.06 "Employee Benefit Program" shall mean the program of benefits to be established by the Board pursuant to this Trust Agreement and A R S § 11-952 01(c) 1.07 "Employee Contributions" shall mean any contributions made by Employees whether comprising part of the Entity Premium or whether made directly to the Fund in order to obtain coverage by the Employee Benefit Program. 1.08 "Entity Contributions" shall mean the contributions made by Participating Entities comprising all or part of the Entity Premium 1.09 "Entity Premium" shall mean the total monies paid by each Participating Entity to the Fund for the Employee Benefit Program, and shall be equal to the sum of Entity Contributions and Employee Contributions 1.10 "Fund" shall mean the Trust Fund created by this instrument, and shall mean generally, the monies, property, contracts or things of value, tangible or intangible, received and held by the Board for the uses and purposes of the Trust, set forth therein, and those things of value which comprise the corpus and additions to the fund. 1.11 "Governing Board" shall mean the policy making board of a Participating Entity duly 1 elected or appointed to their respective positions in accordance with the laws and constitution of the State of Anzona. 1.12 "Participating Entities" shall mean those entities listed in Exhibit A which is attached hereto and incorporated by reference herein, and such additional Participating Entities as may be approved for membership by the Board of Trustees pursuant to Article XIII of this Trust Agreement 1.13 "Summary Plan Description" shall mean the document(s) which generally describe the employee benefits to be provided by the Trust to the Beneficianes. 1.14 "Trust" shall mean the entity established by the Trust Agreement pursuant to A.R.S. § 11- 952.01 et seq., which shall be referred to as the Metropolitan Phoenix Municipal Employee Benefit Trust 1.15 "Trust Agreement" shall mean this Agreement and Declaration of Trust dated July 01, 2012 and any modifications or amendments thereto. 1.16 "Trust Administrator" shall mean the employee benefit consultant retained by the Trust to carry out the obligations of this Agreement in compliance with Arizona Revised Statute § 11- 952 01(H)(5) 1.17 "Trustee or Trustees" shall mean the individual Trustees and their successors as provided for in this Trust Agreement. Section 2. Investments Investments of Trust cash assets not required for immediate operating expenses may be invested by the Trust, but the investments are to be limited to the following investments. Ink A Government Securities; B. State of Anzona Local Government Investment Pool (LGIP); and C Other investments allowable under A R S § 35-323 Notwithstanding the provisions of this section, each type of investment actually utilized shall be subject to pnor approval of the Board of Trustees Section 3. Expense Reimbursement Trustees shall be entitled to receive reimbursement for actual reasonable expenses incurred in carrying out their duties as a Trustee and which are consistent with the Trust Agreement including, but not limited to. A Meals, Lodging, Air Travel. Reimbursement for the actual amount of meals, lodging and 2 air travel expenses as evidenced by receipts. B Automobile Mileage. Reimbursement for automobile travel expenses at the rate established by the Internal Revenue Service for purpose of travel expense deductions C. Other Expenses. Expenses reimbursed under this provision shall be limited to those which would be reimbursable under the policies of the Participating Entity that the Trustee has been appointed to represent. Section 4. Meetings A. Open Meeting Laws. All meetings of the Trust shall comply with the requirements of the Arizona Open Meetings Law B. Annual Meeting. The Trust shall designate one of its regular quarterly meetings as the Trust's Annual Organization Meeting for the purpose of selecting officers and to conduct such other business as may be necessary. To the extent possible, the Board of Trustees shall utilize the same quarterly meeting each year as the annual meeting C Special Meeting. The Chairperson may call a special meeting upon seven (7) days notice to Trustees A special meeting may be also be called by a number of Trustees equal to one less than a majority of the Board. In the event of an emergency, a special meeting may be held with such lesser notice as may be appropriate and otherwise permissible by law. Upon calling a special meeting, the Chairperson or Trust Administrator shall promptly notify all Participating Entities and shall prepare and distribute a wntten agenda in compliance with the requirements of the Open Meeting Law Section 5. Officers A. Election of Officers. At the Annual Organization Meeting, there shall be selected from the Board of Trustees of the Trust, a Chairperson and a Vice Chairperson In addition, the Chairperson shall designate a Recording Secretary. These officers shall have the authority to act in those circumstances and on those matters as specified in the Trust Agreement, in these Bylaws or as otherwise directed by a majority of the Board of Trustees acting in a public meeting B. Term of Office. Each officer selected shall serve for a period of one year, and be eligible for re-election for successive terms, or until his/her successor is duly elected and takes office. C Duties of Officers. The officers of the Trust shall have the following duties 1 Chairperson The Chairperson shall preside at all meetings of the Board of Trustees and perform the usual and customary duties of the Chairperson and such other duties as may be prescribed by the Board of Trustees from time to time The Chairperson, alone or 3 together with such officer or officers as the Board of Trustees may designate by resolution or bylaw, may sign any contracts or other instruments which the Board of Trustees have authorized to be executed. 2 Vice-Chairperson. The Vice Chairperson will, in the absence of the Chairperson or in the event of the inability or refusal of the Chairperson to act, perform the duties of the Chairperson. 3. Recording Secretary. The Chairperson shall appoint a Recording Secretary who shall keep minutes of all meetings, proceedings and acts of the Board of Trustees, which records shall be available at the Pnncipal Office for inspection by all the Trustees and interested persons during usual business hours. Such records and minutes need not be verbatim. The Recording Secretary need not be a Trustee. Section 6. Audits A Mandatory Financial Audit. The Board of Trustees shall retain the appropriate independent professional to perform an annual financial audit as provided by applicable law and the Trust Agreement. In addition to complying with the requirements imposed by statute and the Trust Agreement, the financial auditor shall perform such additional duties as may be directed by the Board of Trustees. B Recommended Audits. In addition to the mandatory audit, the Board of Trustees may conduct the following audits at such intervals as they may determine is in the best interest of the Trust. 1 Claims Audit. The performance of the Benefits Administrator may be audited to determine whether claims have been paid in accordance with applicable provisions of the Plan Document or to otherwise evaluate the general or specific performance of the Benefits Administrator as deemed appropriate or desirable by the Board of Trustees 2 Operational Audit. The Board of Trustees may direct that an independent party conduct an operational audit of the Trust, its individual service providers or any aspect or operation of the Trust. Section 7. Entity Contribution A Entity Contribution Payments. Participating Entity Contribution payments shall be due and payable as of the last business day of each month B Entity Contribution Rates. Contribution rates shall be established annually or at other intervals if determined by the Board of Trustees to be in the best interest of the Trust and its beneficiaries Rates shall be based upon sound actuarial principles consistent with fiscal stability of the Trust and the interest of the Beneficiaries 4 IOW C Past Due Entity Contribution Payments. Entity Contributions not paid as of the date specified in Paragraph A of this Section shall be subject to the following late payment process which shall be in addition to any penalties set forth in the Trust Agreement • 1st Late Payment—Letter of Warning; • 2nd Late Payment — Shall accrue a late payment penalty equal to 0.5% of the Entity's current monthly billing amount; • 3rd Late Payment — Shall accrue a late payment penalty equal to 1 0% of the Entity's current monthly billing amount, • 4th Late Payment — Shall accrue a late payment penalty equal to 1 5% of the Entity's current monthly billing amount, • 5th Late Payment and thereafter — Shall accrue a late payment penalty equal to 2 0% of the Entity's current monthly billing amount 1 Late Payment Penalty Timing. The late payment penalty shall be added by the Benefits Administrator, or Trust Administrator, to the Entity's monthly contribution statement and shall be due and payable as part of the Entity's next monthly contribution 2 Penalties Cumulative. The late payment penalties set forth above are cumulative, such that any late payments during the term of the Trust Agreement, including payments that remain unpaid over more than one payment period, shall be counted for purposes of determining the total number of late payments The following are two examples of the manner in which penalties may be cumulated. Example 1• A Participating Entity's first late payment receives a letter of warning If the first late payment is not paid by the next payment due date, a late payment penalty of 0 5% shall be applied to any outstanding late balances If the first late payment remains unpaid by the next succeeding payment due date, a late payment penalty of 1 0% shall be applied to any outstanding late balances, including any penalty amounts. Example 2• A Participating Entity makes the first three payments timely, but is late with the fourth, which results in a letter of warning. The Participating Entity then timely makes the next three payments, but is late with the eighth payment; a 0 5% penalty shall be assessed. 3 Discretionary Penalty Waiver. The Board of Trustees retains the authority to waive, at its sole discretion, the late payment penalty in the case of extenuating circumstances if requested by the Participating Entity The decision whether to waive the late penalty shall be made at the Board's next-available regularly-scheduled meeting following the Participating Entity's request and such decision shall be final and binding 5 ... Section 8. Membership A Eligibility. Effective July 02, 2012, cities, towns, counties, fire districts, municipal corporations and any other political subdivisions of these types of entities as may be eligible for membership pursuant to A R S § 11-952 et seq located within the State of shall be eligible to be considered for membership as a Participating Entity "R B Application for Membership. 1 Form of Application Application for membership shall be made on forms provided by the Trust. 2. Deadline for Application. Completed applications, as defined by the Board of Trustees, shall be received by the Trust no less than sixty (60) calendar days prior to the proposed date that membership would be effective 3 Evaluation Criteria Application for membership in the Trust shall be based upon criteria approved by the Board of Trustees. 4 Board of Trustees Action. The Board of Trustees shall act on applications no less than ten (10) business days after notification to the applicant that its application is complete. This limit may be extended in order to obtain additional information required by the Trust or other parties involved in the underwriting/selection process C Acceptance of Membership Invitation. Upon notification to an applicant of an offer for membership in the Trust, the applicant shall provide to the Trust a resolution of its Governing Body, no more than thirty (30) calendar days following such notification accepting the offer to become a member of the Trust. The resolution shall include- ... 1. Approval of the Trust Agreement and designation of a representative to execute the agreement; 2 Acceptance of the proposed schedule of premiums as determined by the Board of Trustees; 3 Acceptance of the Trust Bylaws as approved and adopted, and 4 Determination by legal counsel for the entity that the resolution and agreements are in proper form and are within the powers of the entity to approve. Section 9. Operations A. Applicable Laws. The Trust and its officers, employees and contractors will conform to all applicable state and federal laws, rules and regulations. 6 B Principal Office. The Principal Office of the Trust shall be the office of the Trust's legal counsel as follows. Jones, Skelton&Hochuli, P.L.0 ATTN• Michael Hensley, Esq 2901 North Central Avenue, Suite 800 Phoenix, Arizona 85012 C. Risk Management Plan The Board of Trustees shall prepare, or cause to be prepared, a Plan of Risk Management for the Trust The Plan shall include one or combinations of the following: 1. The employee benefits to be offered through the Trust; 2. Limits of coverage, whether through self-insurance, conventional insurance purchased from a commercial camer or reinsurance, 3. The amount of risk to be retained by the Trust, 4. Major loss control techniques to be implemented; 5. The proposed method of assessing Entity Contributions to be paid by each Participating Entity of the Trust, 6. A summary of the preceding year's operations and major activities planned for the coming year; 7 Coverage to be purchased from a commercial carrier, if any, and 8 Such additional information as may be identified by the Board of Trustees. D. Financial Statements and Operating Reports. The Trust shall provide its members with periodic reports concerning the financial condition and operation of the Trust These shall be provided at least quarterly and may be made more frequently if specified by the Board of Trustees E Requests for Information. Requests for records or documents of the Trust shall be made through the Trust Administrator or the Trust's legal counsel 7 F Allocation and Distribution of Surpluses and Deficits 1. Date Credited. Surpluses and deficits shall be credited to the fiscal year in which they accrue 2 Surplus/Deficit Allocation Surpluses and deficits shall be allocated amongst Participating Entities in accordance with the Surplus/Deficit Allocation Policy and according to such Surplus/Deficit Allocation Formula/Methodology as the Board of Trustees may from time to time approve Adoption of the Surplus/Deficit Allocation Policy and the Surplus/Deficit Allocation Formula/Methodology to be followed in allocating surpluses or deficits shall be by two thirds (2/3) vote of the Board of Trustees. 3 Supplemental Assessments for Statutory Compliance The Board of Trustees shall order supplemental assessments as needed to comply with applicable provisions of A R S § 11-952 01 Supplemental assessments ordered by the Board of Trustees under this section shall be calculated in accordance with the Surplus/Deficit Allocation Formula/Methodology approved by the Board of Trustees at the time the supplemental assessment is ordered. 4. Supplemental Assessments for Deficits The Board of Trustees may order supplemental assessments to cure deficits that anse in any fiscal year but which are not sufficiently severe to jeopardize the overall solvency of the Trust Supplemental assessments ordered by the Board of Trustees under this section shall be calculated in accordance with the Surplus/Deficit Allocation Formula/Methodology approved by the Trustees at the time the supplemental assessment is ordered. 5. Release of Surplus The Board of Trustees may allow for the release of surplus to Participating Entities through credits applied to monthly contributions in accordance with the Surplus/Deficit Allocation Policy and Surplus/Deficit Allocation Formula/Methodology approved by the Trustees at the time the release of surplus is _ authonzed. 6 Votes for Assessments Decisions by the Board of Trustees to order supplemental assessments or allow for releases of surpluses as provided for under this section shall be by two thirds (2/3) vote of the Board of Trustees. 7 Compliance with Applicable Law The Board of Trustees shall comply with all applicable Federal, State and Local laws in allocating and/or distributing any surpluses or deficits Section 10. Amendments to Bylaws A. Submission. Proposed amendments to the Bylaws should be filed in wnting with the Board of Trustees no less than thirty (30) calendar days prior to the scheduled date of consideration except in cases of a bona fide emergency. A statement explaining the purpose and effect of 8 the amendment shall be included Proposed amendments to the Bylaws shall be reviewed and approved in writing as to form by counsel for the Trust prior to approval by the Board of Trustees. B. Notice to Trustees. All proposed amendments and accompanying statements shall be transmitted in writing to each Trustee at least fifteen (15) business days prior to the scheduled date of consideration. C. Consideration. Except in a bona fide emergency, amendments shall be considered at a regular meeting of the Board of Trustees. Amendment of the Bylaws shall require a majority vote of the Board of Trustees 9 METROPOLITAN PHOENIX MUNICIPAL EMPLOYEE BENEFIT TRUST (MPMEBT) AGREEMENT AND DECLARATION OF TRUST Effective: July 01, 2012 TABLE OF CONTENTS Article Title Page(s) I. Definitions 1 - 3 II Purpose of Trust and Application of the Fund 3 III. Board of Trustees 3 -4 IV Powers and Duties of the Board of Trustees 4 - 8 V. Payments to the Fund 9 - 10 VI Payment of Benefits 10 - 11 VII. Controversies and Disputes 11 VIII Responsibilities and Liabilities 12 IX. Amendment of the Trust Agreement 12 - 13 X Non-Vesting of Rights 13 XI Provisions Relating to Insurance Companies 13 XII Program Administration 13 - 14 XIII. Additional Members 14 - 15 XIV Duration of Agreement 15 XV. Voluntary Termination of Membership 16 - 17 XVI. Suspension and Expulsion 17 XVII. Termination of Trust 18 XVIII Distributions of Surpluses and Deficits Upon 18 - 20 Termination of the Trust, Voluntary Termination of Membership or Expulsion XIX. Miscellaneous 20 - 22 XX. Stop-Loss Provisions 22 XXI Loss Control Program 22 XXII Use and Disclosure of Protected Health Information 22 - 25 by Participating Entities Exhibit A—Participating Entities 26 ,.R This Agreement and Declaration of Trust, with an effective date of July 1, 2012, is made and entered into by and between the Participating Entities who have been invited to Join this Trust and who have provided a Resolution adopted by the Governing Board of the Participating Entity accepting membership in this Trust, for the purposes set forth in A.R.S. § 11-952.01. RECITALS WHEREAS, The Participating Entities desire to enter into an agreement pursuant to A.R.S § 11-952 01 et seq to pool and maintain a program of employee benefits for the Employees of the Participating Entities and to certain other persons deemed eligible for coverage hereunder; and WHEREAS, To effect the aforesaid purpose, it is mutually beneficial to the parties hereto to declare and create a Trust which establishes a Trust Fund for and in the manner more particularly set forth herein, and WHEREAS, The Participating Entities which accept this Agreement and Declaration of Trust and agree to be bound by the provisions hereof shall, upon acceptance by the Board of Trustees, be deemed parties to this Agreement and Declaration of Trust AGREEMENT NOW, THEREFORE, in consideration of the foregoing recitals, which are incorporated herein by reference, the following mutual covenants and conditions, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Participating Entities hereby agree as follows. ARTICLE I. DEFINITIONS The following are definitions of terms as used in the By-Laws as well as this Trust Agreement. To the extent a term is not specifically defined in the By-Laws, but is defined in this Trust Agreement, the term shall have the meaning given to it in this Trust Agreement. 1.01 "A.R.S." shall mean the Arizona Revised Statues, as amended 1.02 "Beneficiary" shall mean Employees, their dependents and such other persons designated by the Participating Entities as eligible for coverage as set forth in the Summary Plan Description and approved by the Board 1.03 "Benefits Administrator" shall mean the person(s) or firm employed by the Board who is responsible for processing of claims and payment of benefits, and related services 1.04 "Board of Trustees" or "Board" shall mean the Trustees of the Metropolitan Phoenix Municipal Employee Benefit Trust acting in their Joint capacity as the governing board of the Trust 1 1.05 "Employee" shall mean any person employed by a Participating Entity on a regular basis working not less than the number of hours per week required by the Participating Entities for eligibility, and who are not eligible for benefits under any other employee benefits to which the Participating Entity makes contributions. 1.06 "Employee Benefit Program" shall mean the program of benefits to be established by the Board pursuant to this Trust Agreement and A.R.S. § 11-952 01(c) 1.07 "Employee Contributions" shall mean any contributions made by Employees whether comprising part of the Entity Premium or whether made directly to the Fund in order to obtain coverage by the Employee Benefit Program. 1.08 "Entity Contributions" shall mean the contributions made by Participating Entities comprising all or part of the Entity Premium 1.09 "Entity Premium" shall mean the total monies paid by each Participating Entity to the Fund for the Employee Benefit Program, and shall be equal to the sum of Entity Contributions and Employee Contributions. 1.10 "Fund" shall mean the Trust Fund created by this instrument, and shall mean generally, the monies, property, contracts or things of value, tangible or intangible, received and held by the Board for the uses and purposes of the Trust set forth herein, and those things of value which comprise the corpus and additions to the Fund. 1.11 "Governing Board" shall mean the policy making board of a Participating Entity duly elected or appointed to their respective positions in accordance with the laws and constitution of the State of Arizona. 1.12 "Participating Entities" shall mean those entities listed in Exhibit A which is attached '., hereto and incorporated by reference herein, and such additional Participating Entities as may be approved for membership by the Board of Trustees pursuant to Article XIII of this Trust Agreement 1.13 "Summary Plan Description" shall mean the document(s) that generally describe the employee benefits to be provided by the Trust to the Beneficiaries 1.14 "Trust" shall mean the entity established by the Trust Agreement pursuant to A R S § 11- 952.01 et seq., which shall be referred to as the Metropolitan Phoenix Municipal Employee Benefit Trust. 1.15 "Trust Agreement" shall mean this Agreement and Declaration of Trust and any modifications or amendments thereto. 2 ed.. 1.16 `Trust Administrator" shall mean the employee benefit consultant retained by the Board to carry out the obligations of this Agreement in compliance with A.R.S. § 11-952.01(H)(5). 1.17 "Trustee or Trustees" shall mean the individual Trustees and their successors as provided for in this Trust Agreement. ARTICLE II. PURPOSE OF TRUST AND APPLICATION OF THE FUND 2.01 Creation of Trust. There is hereby declared and created the Metropolitan Phoenix Municipal Employee Benefit Trust to provide employee benefits for the Beneficiaries of the Trust Such benefits may include, but are not limited to those described under Article 4.05 of this Trust Agreement, whether provided through one or a combination of self-funded or insured programs or both 2.02 Principal Office. The Principal Office of the Trust shall be located at the location specified in the Bylaws (hereinafter designated and referred to as the"Principal Office") ARTICLE III. BOARD OF TRUSTEES 3.01 Trustees. The Employee Benefit Program shall be operated and administered by a Board of Trustees for the benefit of the Beneficiaries Individual Trustees shall be selected by the Participating Entities as provided herein and may resign or be removed at any time by the applicable Participating Entity's Governing Board Trustees must be employees of the Participating Entity 3.02 Membership and Appointment. The Board of Trustees shall be comprised of one Trustee and one "Alternate Trustee" appointed by each participating entity The Trustee shall be the City Manager (or that participating entity's equivalent) and the Alternate Trustee shall be a management level staff member employed by the Participating Entity The appointing Participating Entity may remove a Trustee at any time without cause. In the event of the removal .. or resignation of a Trustee, the appointing Participating Entity shall designate a successor to such Trustee to serve the remainder of the vacated term The successor shall succeed to the legal interest of his/her predecessor and have the same powers and duties 3.03 Votes. Each Participating Entity shall be entitled to cast one vote in matters requiring a vote of the Board of Trustees which vote may be cast by a duly-appointed Trustee or Alternate Trustee In the event the Trustee and the Alternate Trustee are present at the same meeting, in person or by phone, only the Trustee shall cast the Participating Entity's vote 3.04 Terms of Office. Following appointment, Trustees and Alternate Trustees shall serve until such time as they resign, are removed by the appointing Participating Entity's Governing Board or cease to be employees of the Participating Entity that they were designated to represent In the event that a Trustee or Alternate Trustee resigns, is removed or ceases to be an employee of the designating Participating Entity, the position shall be deemed vacant and a new Trustee or 3 Alternate Trustee shall be designated by that Participating Entity. ARTICLE IV. POWERS AND DUTIES OF THE BOARD OF TRUSTEES 4.01 Appointment of Trustees. The Trust shall be administered by the Board of Trustees who shall be selected and shall serve as provided in Article III 4.02 Duties of the Board of Trustees. The Board of Trustees shall. (a) Hold, manage, care for and keep the Fund for the benefit of the Beneficiaries and collect the income and increments thereof, and shall keep and maintain adequate and proper records to render an annual audit, accounting and reports as hereinafter mentioned. (b) Employ or hire such agents, attorneys, accountants, actuaries, employees or other persons and shall purchase, lease or rent real or personal property as may be necessary or desirable in administering the Fund and carrying out its purposes. Agreements for such expenditures shall be in writing and formally approved by the Board. Fees, salaries, wages, emoluments or compensation of any and all such persons and other such expenses shall be paid from the Fund When acting upon and consistent with advice of counsel for the Trust, the Board shall be relieved of all responsibility for acts performed or not performed (c) Pay any and all taxes of whatever nature the Fund is, or may be, obligated to pay and incur any expenses for supplies, rental of space, or other items, or anything else determined to be necessary or desirable in administering the Fund and carrying out the objects and purposes of this Trust and Trust Agreement (d) Establish terms and conditions of coverage within the plan document including the exclusions of coverage. (e) Ensure that all claims are paid promptly (f) Take all necessary precautions to safeguard the assets of the Trust 4.03 Authority of the Board of Trustees. In carrying out the purposes of the Trust Agreement, the Board shall have all right, power and authority to (a) Enter into contracts, procure insurance policies, or provide such benefits through self-funding, and to place into effect and maintain the desired schedule of benefits (b) Provide the intended benefits under this Trust by means of self-funding by the Trust and/or by the procurement of group insurance contracts (as permitted by the laws of the State of Arizona) including group insurance contracts issued to and in the name of 4 the Trust, together with such other forms of contracts issued by qualified insurance companies authorized to do business in the State of Arizona as may be selected by the Board for the purpose of providing for all or part of the benefits provided for under this Trust. The Board is hereby expressly authorized to pay to any insurance company as may be selected by the Board the required insurance premiums in connection with such group insurance contracts issued to the Trust. Whether or not benefits are provided by means of self-funding or by the procurement of group insurance, such decision shall be at the sole and exclusive discretion of the Board. (c) Should the Board select or provide for any policy or program of self-funding, no claims for benefits or claims for liabilities shall be brought against the Board or any individual Trustee The sole and exclusive liability of said Board in the management and operation of any program of self-funding shall be limited to due care in the selection of administrators, claims representatives, actuaries or other officials charged with the administration of such a program of self-funding, subject to the limitations upon such liability based on actions taken with advice of counsel as provided in Section 4 03 of this Agreement In the event that submitted claims of employees exceed the funds available, the claims shall be paid in the order received (d) Do all those things that the Board determines to be necessary or desirable for the administration and operation of and accomplishment of the objectives and purposes of the Fund and this Trust and Trust Agreement. 4.04 Selection of Benefits. The Board may, subject to their discretion and the continuing right to change, obtain for the Beneficiaries of the Trust forms of employee benefits which may include, but are not limited to, the following (a) Medical and Prescription Drug, (b) Long and Short-Term Disability, (c) Accidental Death and Dismemberment; (d) Dental Benefits; (e) Vision Benefits; (f) Life Insurance; (g) Health Savings Accounts, Health Reimbursement Accounts and Flexible Spending Accounts; and (h) Employee Wellness Programs, Employee Assistance Programs, utilization review programs, claims management programs and other programs intended to (i) improve Employee health, (ii) reduce costs to the Trust and to Employees and (iii) otherwise 5 control losses. 4.05 Deposits and Investments. All corpus or portion of the Fund not expended pursuant to Article IV may be deposited by the Board in the name of the Trust in such depository or depositories as the Board shall from time to time select in accordance with this Section, and any such deposit or deposits should bear interest The Board is empowered to receive for the benefit of the Fund such interest as might accrue on the above deposits. (a) If not so deposited, any accumulated funds not currently required for the purposes of this Trust shall be invested by the Board in reasonably secure, reasonably liquid investments in a manner consistent with the adopted investment policy of the Trust and in compliance with the provisions of A R.S. § 35-323 et seq. (b) The Board may accumulate dividends, experience rating refunds or other monies, if any, accruing from any insurance policy or policies, deposits or investments. Such dividends, refunds or other monies, or all of them, shall be held in the Fund, applied to the payment of self-funded claims, the payment of insurance premiums or held, used or applied as herein set forth (c) The Board may enter into financial services agreements with banks and may authorize the Trust to issue checks in its own name as required to further the purposes and objectives of the Trust 4.06 Trustees' Expense Reimbursement. The Trustees shall receive reimbursement for actual reasonable and necessary expenses incurred by the Trustees in carrying out their duties pursuant to the Trust Agreement. Expenses reimbursed under this provision shall be limited to those which would be reimbursable under the policies of the Participating Entity that the Trustee has been appointed to represent. 4.07 Trustees' Compensation. The Trustees shall not receive compensation for services rendered pursuant to the Trust Agreement 4.08 Presumption of Validity. No person transacting business with the Board shall be obligated to (i) ensure proper application of any monies or property of the Fund, (ii) ensure that the terms of this Trust Agreement have been complied with or (ui) inquire as to the necessity of expediency of any act by the Board Every instrument executed by the Board shall be conclusive in favor of every person who in good faith relies upon it that: (a) At the time of the delivery of the instrument, this Trust Agreement was in full force and effect, (b) The instrument was executed in accordance with the terms and conditions of the Trust Agreement, and (c) The Board was duly authorized to execute the instrument or direct its execution 6 4.09 Withdrawals. All checks, drafts, vouchers or other withdrawals from the fund or depositories and the transfer or liquidating of insurance policies of investments shall be signed by appropriate signatories as determined by the Board of Trustees 4.10 Administrative Disputes. In the event of any dispute between the Board and the Benefits Administrator or any other parties providing services to the Trust over exercise of powers granted herein, the Board's interpretation shall prevail and the service organization shall have no liability to any person with respect to the disputed act or omission in the event that it gives written notice of its dissent from such act or omission to each Trustee and to the Participating Entities no later than thirty(30) calendar days from the date of such event or disputed act 4.11 Selection of Chairperson. The Trustees shall elect from among themselves at their first meeting a Chairperson who shall preside at all meetings of the Board and who shall be empowered to perform ministerial duties of the Board as the Board may from time to time delegate to him/her 4.12 Selection of Vice-Chairperson. The Trustees shall elect from among themselves at their first meeting a Vice-Chairperson who shall, in the absence or incapacity of the Chairperson, preside at all meetings of the Board and who shall, when acting as Chairperson, be empowered to perform ministerial duties of the Board as the Board may from time to time delegate to him/her 4.13 Selection of Recording Secretary. The Chairperson shall appoint a Recording Secretary who shall keep minutes of all meetings, proceedings and acts of the Board, which record shall be available at the Principal Office for inspection by all the Trustees and interested persons during usual business hours. Such record and minutes need not be verbatim The Recording Secretary need not be a Trustee 4.14 Board of Trustees' Meetings. The Board shall hold an initial meeting as soon as practical after being appointed. The Board shall determine the time and place of the regular meetings which shall be held at least quarterly Special meetings may be called by the Chairperson or by a number of Trustees equal to one less than a majority of the Board. Minutes of all meetings shall be taken. Meetings shall be conducted in accordance with applicable laws, rules, bylaws or regulations At least seven (7) days written notice designating the time and place of an annual, regular or special meeting shall be given to the Trustees In the event of an emergency, a special meeting may be held with such lesser notice as may be appropriate and otherwise permissible by law Any meeting at which all Trustees are present, in person or concerning which all Trustees have waived notice in writing, shall be a valid meeting without requirement that notice be given to the Trustees 4.15 Quorum Requirement and Voting. To constitute a quorum at any regular or special meeting of the Board, there must be present in person or telephonically at least one Trustee or Alternate Trustee from a majority of the Participating Entities Unless otherwise specifically stated in this Agreement, or as required by applicable law, action of the Board of Trustees will be 7 ... AMA by a majority vote of the quorum present when such action is taken. 4.16 Location of Meetings. All meetings of the Board shall be held at such location or locations as designated from time to time by the Board, and Trustees may appear by telephonic or other electronic means if necessary. When meetings are conducted electronically, reasonable efforts will be made to accommodate public participation at a publicly accessible location in the Principal Offices or at a facility owned or controlled by a Participating Entity and in a manner consistent with applicable federal and Anzona laws and regulations. 4.17 Fiscal Year and Audit. The accounting year of the Fund shall be on a fiscal year basis. The initial fiscal year shall commence on July 1, 2012 and end on June, 30 2013 Subsequent fiscal years shall commence on July 1 and end on June 30 of the following year. Any report required by law, city, county, State or Federal or the respective subdivisions thereof, shall be made by the Board. The Board shall have an annual audit and accounting of the Trust Fund by an independent Certified Public Accountant in accordance with generally accepted accounting practices, at the end of each fiscal year. The Accountant shall certify to the accuracy of the audit and accounting. A statement of the results of each audit shall be available for inspection by authorized persons at the Pnncipal Office of the Trust. Copies of the audit and generalized statements of the accounting and reports shall be filed with the Arizona Department of Insurance and also delivered to the Clerk of the Governing Board of each Participating Entity and to each Trustee after each audit or as otherwise required Copies of the audit shall be retained by the Board of Trustees for a penod of at least five years. 4.18 Bylaws, Rules and Regulations. The Board shall have the power to adopt bylaws, rules, procedures and regulations pertaining to the purpose, powers and administration of the Trust, which shall be consistent with covenants, terms, conditions and duties as set forth in the Trust Agreement. Such bylaws, rules, procedures and regulations shall be binding on all persons transacting business with the Trust and upon any and all persons claiming any benefits thereunder. Adoption or amendment of bylaws, rules, procedures or regulations shall require a majority vote of the Board of Trustees 4.19 Bonding Requirements. The Board shall procure or provide for the procurement of fidelity bonds for the Trust and persons and organizations authorized to receive handle, deal with or draw upon the monies in the fund for any purpose whatsoever, said bonds to be in such amount to aid in the reimbursing of bondable loss of money, and in the event shall meet the requirements as may be required, from time to time as applicable under United States or State law. Such bonds are to be obtained from reputable fidelity or surety companies as the Board shall determine If convenient, and in conformity with the law, such bonds may be position bonds. The cost of the premiums on such bonds may be paid out of the corpus or income of the fund or paid for by the persons or organizations required to purchase such bonds. If any fidelity or surety company refuses to bond or write a bond for any Trustee, or other person described in this section, said Trustee or person shall not serve and shall resign 8 ARTICLE V. PAYMENTS TO THE FUND 5.01 Entity Contributions. In order to effectuate the purposes of the Trust, each Participating Entity shall contribute to the Fund an amount determined by the Board to be necessary to pay for the benefits provided hereunder to the Employees and other persons covered by the Employee Benefit Program. The Entity Contributions shall be due and payable as of the date specified in the Bylaws. The Entity Contributions shall not include amounts payable directly by persons receiving extended coverage under the Employee Benefit Program as required by law or otherwise. 5.02 Interest on Premiums in Arrears. Entity Premiums not paid as of the due date as provided in Section 5 01 shall be subject to the late payment process as outlined in the Bylaws. 5.03 Employer Contributions Not Wages. Employer Contributions paid or accrued to the order of the Fund through Entity Premiums shall not constitute or be deemed wages due employees, nor shall such contributions in any manner be subject to the debts, contracts or liabilities of the Participating Entity. No Participating Entity, Employee, or Beneficiary under the Plan shall have any rights, title or interest in the Fund, except as specifically provided in this Trust Agreement. 5.04 Employee Contribution. Employees may be required to contribute a portion of the Entity Premium in amounts to be determined by each Participating Entity as appropriate for the benefits to be provided hereunder. Nothing in this paragraph shall be deemed to preclude a Participating Entity from making all or any portion of Employee Contribution payments on behalf of its employees. 5.05 Payment in Lieu of Benefits. No employee shall have any right to receive any part of his/her own Employee Contributions or any part of Employer Contributions paid to such Employee in lieu of benefits. 5.06 Payroll Deductions. All Employee Contributions shall be paid by payroll deductions The Participating Entity shall remit all monies obtained through payroll deductions in a lump sum to the Fund as part of the Entity Premium described herein 5.07 Manner of Payment. All Entity Premiums and other payments to the fund shall be payable to the name of the Trust and shall be paid in the manner and form determined by the Board. 5.08 Wage Reports/Audits. The Participating Entity shall provide to the Trust or make available to the Trust for inspection all payroll or wage reports required by the Board upon request. The Board may at any time vote to have an audit of a Participating Entity's payroll records performed by an independent Certified Public Accountant or other qualified individual or organization as determined by the Board to confirm the accuracy of required reports and to confirm the correct levels of contributions 5.09 Contributions Irrevocable. Subject to the provisions of Article XVII with respect to 9 _/111%. p termination of this Trust Agreement, Article XVI with respect to suspension and expulsion and Article XV with respect to voluntary termination of membership in the Trust, all Contributions to the Fund shall be irrevocable and under no circumstances shall any monies properly paid into the Fund, or any part of the Fund, be recoverable by or payable to a Participating Entity or any Employee, nor shall any of the same be used for or diverted to purposes other than for the exclusive program of benefits for Employees and other covered persons as provided in this Trust Agreement 5.10 Assessments. In the event a deficit shall develop which is creditable to any plan or fiscal year, the Board shall specifically notify each Participating Entity of such deficit and vote to order an assessment to the Participating Entities sufficient to cure the deficit Assessments shall be distnbuted among the Participating Entities on a pro-rata basis, as calculated by the amount of each member's contnbutions for the plan or fiscal year to which the deficit is credited. Assessments shall not exceed the amount of the member's annual contribution to the pool All such assessments shall be made to comply with applicable provisions of A R S § 11-952.01 et seq. ARTICLE VI. PAYMENT OF BENEFITS 6.01 Benefits Liability. Subject to the terms and conditions set forth in this Trust Agreement, the Summary Plan Descnption and other procedures, rules, regulations and conditions established by the Board, the Trust shall pay all claims for which each Participating Entity's Beneficiaries would be liable and would be entitled to receive benefits under the Employee Benefit Program 6.02 Discharge of Liability. Subject to the terms and conditions set forth in this Trust Agreement, the Summary Plan Description and other procedures, rules, regulations and conditions established by the Board, liabilities incurred for claims for services rendered to the Beneficiaries of Participating Entities under the Employee Benefit Program will be relieved only by payment of claims by the Trust, by the Beneficiary or by such other party who may be deemed responsible for payment of such claims 6.03 Method of Payment. The Board shall arrange for disbursement of benefits under the Employee Benefit Trust through a Benefits Administrator appointed by the Board. 6.04 Summary Plan Description. The Benefits to be provided pursuant to the Trust Agreement, whether by self-funding or by insurance contract, shall be set forth in one or more Summary Plan Descriptions which shall also explain the eligibility rules for coverage for employees and dependents. 6.05 Protection of Employees. Pnor to payment to an Employee or other Beneficiary, all assets of the Trust shall be owned by the Trust and shall not be liable in any way for any debt or obligation of any Employee. To the extent permitted by law, all Trust benefits shall be exempt from attachment, garnishment, levy of execution, bankruptcy proceedings, or other legal process at any time subject to the Trustee's possession and control, but in any event, such assets shall be 10 subject to such process only to the extent of such Employee's benefits hereunder as they come due. 6.06 Employee Claims to Benefits. No Employee or other Beneficiary shall have any right or claim to benefits under the Employee Benefit Plan except as specified in the policy or policies or contract or contracts or self-funded benefits procured or entered into pursuant to Articles II and IV of this Agreement and as set forth in the Summary Plan Description Any disputes as to eligibility, time, amount, or duration of benefits shall be resolved by the appropnate insurance carrier or Benefits Administrator, under and pursuant to the applicable policy or contract; and the Employee or other Beneficiary shall not have the right or claim in respect thereto against the Fund or The Board. Any dispute as to eligibility, type, amount, time or duration of benefits provided by the Fund as self-funded shall be decided by the Board, and all disputes shall be finally settled pursuant to Article VII of this Agreement 6.07 Maintenance of Reserves. The Board shall maintain, as part of the Trust Fund, claim reserves in an amount at least equal to known incurred losses and reasonable estimates of claims incurred but not reported. 6.08 Failure to Pay Benefits. Neither the Participating Entities nor the Board shall be liable for the failure or omission, for any reason, to pay any benefits under the Employee Benefit Program If for any reason, including, but not limited to, epidemics, catastrophes, or normal depletion, the Board determines that self-insured funds are insufficient to pay current claims, the amount of benefits payable to an eligible Employee or other Beneficiary shall, in all events, be limited to the extent that sufficient funds are available to the Board for the payment of all such claims, and, in such event, benefits payments to each eligible Employee or other Beneficiary shall be limited to the extent that sufficient funds are available from the Trust Fund, and shall be further prorated in such amounts that all such claims shall be treated proportionally equal to the ratio that such total claims bear to the funds that are available for such payment. If any controversy or dispute exists concerning such matters, they shall be settled in accordance with the provisions of Article VII of this Agreement ,^ ARTICLE VII. CONTROVERSIES AND DISPUTES 7.01 Interpretation of Trust Documents. The Board of Trustees shall have the power to construe, interpret and apply the provisions of the Agreement and Declaration of Trust or any amendments, rules or regulations adopted pursuant thereto and the terms used herein and any construction, interpretation or application adopted in good faith shall be final and binding upon the Participating Entities, and upon Employees and their respective families, dependents, successors, assigns, executors, administrators and/or their legal representatives. 7.02 Settlement of Benefit Claims. The Board may, in its sole discretion, compromise or settle any disputed benefits claim controversy in such manner as it deems appropnate and consistent with applicable law and regulation. All decisions made by the Board shall be conclusive and binding upon all parties. 11 ARTICLE VIII. RESPONSIBILITIES AND LIABILITIES 8.01 Responsibilities and Liabilities of the Board of Trustees. The Board shall only be responsible for monies when and if said monies are received in accordance with the provisions of this Trust Agreement. The Trustees shall only be responsible for any liability arising from their respective gross negligence, bad faith or willful misconduct in handling of the monies received in hand by them for execution and administration of the terms of the Fund. The Trustees shall not be responsible for the actions or omissions of their Co-Trustees, nor for the acts or omissions of other agents, or for any of the acts or omissions of any insurance company or its agents, servants or representatives, including, but not limited to non-payment of claims by an insurance company or companies for any reason. No Trustee shall be entitled to any indemnifications of court costs or attorneys' fees from any liability arising from his/her own willful misconduct, bad faith or gross negligence. To the extent that their actions do not constitute willful misconduct, bad faith or gross negligence, Trustees shall not be liable for actions taken on advice of counsel for the Trust as provided in Section 4 03 8.02 Successors' Liability. No Successor Trustee shall be liable or responsible for any acts or defaults of his/her predecessor(s), or for any losses or expenses resulting from or occasioned by acts or omissions of the prior administration of the Fund or the Trust A Successor Trustee is responsible solely for his/her actions as set forth in Section 8 01 herein. ARTICLE IX. AMENDMENT OF THE TRUST AGREEMENT 9.01 Powers. It is anticipated that in the administration of this Trust, conditions may arise that are not foreseen at the time of execution of this Trust Agreement and it is the intention of the Participating Entities that the power of amendment which is herein granted be exercised in order to carry out the spirit, object and purposes of the Trust. Therefore the general power is granted by the Participating Entities to amend this Agreement in accordance with the procedures set forth in Article IX of this Trust Agreement. All parties to the Trust and all persons claiming any .�. interest hereunder are and shall be bound thereby. 9.02 Procedures. Prior to amendment of this Trust Agreement, the Board shall notify each Participating Entity not less than thirty (30) calendar days prior to the date on which such proposed amendments are to be considered by the Board of Trustees Such notice shall set forth in sufficient detail the nature of the proposed amendments and shall invite questions or comments Amendments to the Trust Agreement shall require a 2/3 vote of the Board of Trustees. Approved amendments shall be signed by the Chairperson of the Board of Trustees. Amendments to the Trust Agreement shall be filed with the governmental entity or entities as required by law and in the manner provided by law for such agreements. Proposed amendments to the Trust Agreement shall be reviewed and approved in writing as to form by counsel for the Trust prior to consideration by the Board of Trustees Following approval by the Board of Trustees, proposed amendments shall be submitted to the Governing Boards of the Participating Entities. A proposed amendment shall become effective on the date specified after approval by the Governing Boards of no less than 3/ of the total number of Participating Entities Upon 12 approval of a proposed amendment by the requisite number of Governing Boards as provided herein, a Participating Entity whose Governing Board fails to approve the proposed amendment may elect to voluntanly terminate its membership in the Trust pursuant to the provisions of Article XV of this Trust Agreement ARTICLE X. NON-VESTING OF RIGHTS 10.01 Rights Not Vested. No Employee, family, dependent, Beneficiary nor any other person or group nor their respective successors, assigns, nor legal representatives, shall have any nght, title or interest, vested or otherwise, in or to the Fund, its corpus (income or increments thereto), insurance dividends, cash value, if any, or any insurance or benefits or monies payable therefrom, payments from the Fund, or in or to the eligibility requirements for benefits as changed or altered. Any participating Employee who withdraws or ceases to participate in the Employee Benefit Program shall be deemed to expressly waive and forfeit any right, title or interest in and to the Fund, its corpus and assets No Employee, family, dependent, Beneficiary nor any other person or group nor their respective successors, assigns nor legal representatives shall have any nght in or to the Trust Fund, corpus, insurance dividends, cash value, if any, of insurance, interest, income, benefits, or any benefits or money payable therefrom, or anything ansing out of or in this Trust dunng the term of this Agreement and any benefit he or they may have is forever terminated and discharged upon the Employee's termination of employment with the Participating Entity (voluntary or involuntary discharge or otherwise), or when this Trust Agreement is terminated, wound up or dissolved No benefit, nght or interest of the forgoing is transferable by the Employee to another Employee or person, corporate or otherwise except to physicians, hospitals and any other person or institution furnishing medical services within the terms of this Trust Agreement No monies, property or equity of any nature in the Fund, nor insurance policies or benefits or monies payable therefrom, nor investments, nor deposits nor any part or portion of the Fund, shall be subject in any manner by any Employee, or person claiming through such employee, ownership, anticipation, alienation, sale, transfer, assignment, pledge, encumbrance, garnishment, attachment, execution, mortgage lien or charge of whatsoever nature or kind and any attempt to cause the same is and shall be null and void ARTICLE XI. PROVISIONS RELATING TO INSURANCE COMPANIES 11.01 Status of Insurance Companies. No insurance company that issues any policies or contracts for the purpose of fulfilling the terms of the Agreement shall be deemed to be a party to this Agreement, nor shall it be responsible for the validity of this Agreement, nor is this Agreement in any manner for the benefit of any insurance company or companies. No insurance company shall be required to determine the validity of this Agreement or to question the authonty of or action of the Board, or be responsible to confirm that any action taken by the Board is authonzed by the terms of this Agreement ARTICLE XII. PROGRAM ADMINISTRATION 12.01 Allocation of Administrative Duties. The Board shall have the full obligation and 13 ... .., responsibility for administration of the Employee Benefit Program but may designate any person, firm, corporation or other entity as an agent or representative, for purposes of carrying out the objectives of the Trust. The Board shall designate an administrator to carry out the policies established by the Board and to provide day to day management. An administrator appointed pursuant to Section 12.03 may also serve in this capacity. 12.02 Termination of Agents. The Board may remove any agent for administration at any time, '^ without cause, after thirty (30) calendar days written notice to the agent unless otherwise provided in contracts for employment of such agents that were approved by the Board. 12.03 Consultant/Administrator. The Board shall retain a Benefits Administrator and a Trust Administrator, both of whom must be licensed pursuant to Title 20, Chapter 2, Article 3 or 9 or such other law as may be applicable Such licensing shall be verified by the Board pnor to any appointment pursuant to this section. The Board shall keep minutes of its actions and shall reflect in those minutes the retention of these Administrators and the areas of their authority as required by A.R.S. § 11-952.01(H)(5). 12.04 Duties of Agents. Agents shall perform all designated duties in a workmanlike and professional manner and shall keep accurate and complete records of activities as prescribed by the Board Any agent designated as Benefits Administrator shall, in addition to the other duties set forth in this section, keep its records open for examination at reasonable times during business hours by any person authorized by the Board of Trustees and shall, within sixty (60) calendar days after the end of each Trust year or such other date as determined by the Board, file with the Board a complete statement of its administrative activities during the period of time since the closing date of the previous statement. 12.05 Business Offices. The Trust may establish offices within the State of Arizona as required for the conduct of business and may employ necessary staff to carry out the purposes of the Trust. ARTICLE XIII. ADDITIONAL MEMBERS 13.01 Eligibility for Membership. Effective July 02, 2012, cities, towns, counties, fire distracts, municipal corporations and any other political subdivisions of these types of entities as may be eligible for membership pursuant to A.R.S. § 11-952 et seq. located within the State of Arizona shall be eligible to be considered for membership as a Participating Entity 13.02 Application for Membership. An entity desiring membership in the Trust may petition the Board for permission to become a Participating Entity. Applicants shall submit application forms as prescribed by the Board and shall provide such additional information as may be requested in order to fully evaluate the application Completed applications and supporting data shall be submitted no later than the deadlines established by the Board Applications deemed incomplete by the established deadlines may be rejected at the sole discretion of the Board. 14 13.03 Approval of Applications. Completed applications will be reviewed and evaluated based on standards established by the Board to ensure that approvals of applications are based on the best interest of the Trust, its Participating Entities and their Employees. Decisions of the Board may be based upon recommendations of their employees or agents The Board, in a regularly convened meeting, may, by two-thirds vote, approve the application for membership subject to such terms and conditions as may be established by the Board in their sole discretion. Decisions of the Board with respect to membership applications will be final If accepted for membership, an entity will be bound by all applicable terms and conditions of this Agreement and Declaration '^ of Trust as well as all policies, procedures and regulations established pursuant to this Agreement Representatives of Participating Entities approved for membership may attend meetings of the Board of Trustees, but will not be allowed to vote or otherwise formally participate in the governance or benefits of the Trust until the date on which the Entity's Employees become eligible to receive benefits under the Employee Benefit Program ARTICLE XIV. DURATION OF AGREEMENT 14.01 Term of Agreement. This Declaration of Trust shall continue in full force and effect until terminated as provided in accordance with the procedures set forth in Article XVII of this Trust Agreement 14.02 Initial Term of Participation; Renewals. The initial membership term for new members shall be for a period of not less than thirty six (36) calendar months The length of the initial term shall be set to align the Participating Entity's membership term with the July 01 to June 30 Fiscal Year of the Trust at the earliest possible date. Membership in the Trust may not be terminated by any Participating Entity during the initial membership term except as expressly provided herein Notwithstanding these limitations on voluntary termination, coverage under the Employee Benefit Plan may be suspended or terminated as provided herein for nonpayment of Entity Premiums or other violations of the terms of this Agreement and Declaration of Trust. After expiration of the initial membership term, a Participating Entity may terminate its participation as provided in Article XV herein or may request that the Board of Trustees approve an additional Renewal Term Renewal terms shall be for thirty six (36) calendar months Approval of Renewal Terms requires a 2/3 vote of the Board of Trustees Membership in the Trust may not be voluntarily terminated dunng Renewal Terms except as expressly provided herein. 14.03 Non-Appropriation Penalty. In the event a Participating Entity fails to appropriate the funds for any particular plan year, or portion of a plan year, within that Participating Entity's initial term of participation, or the current renewal term, which is applicable, the Participating Entity agrees to pay a penalty in an amount equal to what that Participating Entity's obligations would have been for the entire remainder of the initial term of participation, or the current renewal term, whichever is applicable, had the appropriation been made. The "initial term of participation" and the "renewal term" are set forth in Section 14.02 above. 15 ARTICLE XV. VOLUNTARY TERMINATION OF MEMBERSHIP 15.01 Procedure. Membership in the Trust may be voluntarily terminated by a Participating Entity upon conclusion of its Initial Term of Participation or a subsequent Renewal Term, subject to the following conditions. (a) Written notice of voluntary termination must be received no later than ninety (90) calendar days prior to the last day of the Participating Entity's Initial Term of Participation or current Renewal Term, as applicable. (b) Termination will be effective as of the last day of the Participating Entity's Initial Term of Participation or current Renewal Term, as applicable. (c) Once termination is effective, a former Participating Entity shall not be eligible for readmission to the Trust for a minimum of three fiscal years. Application for readmission shall be made according to the procedures set forth in Article XIII of this Agreement. (d) Termination will not relieve a former Participating Entity of any obligations, financial or otherwise, imposed upon Participating Entities pursuant to this Agreement for the period during which the former Participating Entity was a member of the Trust (e) Participating Entities terminating their membership in the Trust in accordance with this Article shall receive surplus amounts due them and shall remain liable for deficits owed by them to the Trust in accordance with Article 18.02 of this Agreement. 15.02 Termination Due to Amendment of the Trust Agreement. Notwithstanding the ,.� provisions of Article 15 01 a Participating Entity may elect to voluntarily terminate its membership prior to the end of their Initial Term of Participation or their subsequent Renewal Term provided the Participating Entity provides a ninety (90) calendar days advance notice as required by A.R.S. § 11-952 01(L), under the following conditions- (a) The Governing Board of the Participating Entity wishing to terminate its membership pursuant to this Article must have failed to approve a proposed amendment to the Trust Agreement which was approved by the requisite number of Governing Boards pursuant to Article 9.02 of this Trust Agreement (b) The approved amendment to the Trust Agreement is to become effective pnor to the end of the current renewal period (c) The proposed date of termination of membership is to be on or before the effective date of the approved amendment to the Trust Agreement or upon such later date as 16 may be approved by the Board of Trustees during which period the terminating entity shall not be subject to the provisions of the approved amendment to the Trust Agreement (d) Any voluntary termination pursuant to this Article 15.02 shall also be subject to the provisions of Article 15 01(c) of this Trust Agreement (e) Participating Entities voluntarily terminating their memberships in the Trust in accordance with this Article shall receive surplus amounts due them and shall remain liable for deficits owed by them to the Trust in accordance with Article 18.02 of this Trust Agreement. ARTICLE XVI. SUSPENSION AND EXPULSION 16.01 Suspension. In the event that any Participating Entity shall fail to make its contributions as specified herein, or shall fail to comply with any other terms or conditions of this Trust Agreement or other requirements established by the Board, the Board may suspend benefits provided to the Beneficiaries of that Participating Entity Prior to any suspension, the Board shall provide written notice of default to the Participating Entity. The notice of default shall advise the Participating Entity that- (a) Unless the default is cured within ten (10) calendar days of receipt of the notice, coverage may be suspended for a period of up to eighty (80) calendar days without further notice or administrative process. (b) During the eighty(80) day suspension period, the Board of Trustees shall determine if the Participating Entity should be expelled as a Participating Entity effective ninet (90) calendar days following receipt of notice of expulsion. (c) That prior to removal of any previously-imposed suspension, the Board may impost specific reasonable conditions for reinstatement of coverage and continue. ..... membership in the Trust (d) That the defaulting Participating Entity will be liable for unpaid premiums and/o benefit payments, administrative costs and other costs incurred by the Trust betwee the date that premium payments became in arrears and the date of suspension o' benefits plus interest accrued as provided in Section 5.02 of this Trust Agreement 16.02 Expulsion. Participating Entities may only be expelled from the Trust upon a majority vote of a quorum of Trustees and upon the statutory required ninety calendar (90) notice prior to the effective date of expulsion. Participating Entities that are expelled from membershi. in accordance with this Article shall receive surplus amounts due them and shall remain liable for deficits owed by them to the Trust in accordance with Article 18.03 of this Agreement. 17 ARTICLE XVII. TERMINATION OF TRUST 17.01 Termination by the Trustees. The Trust created by this Agreement and Declaration of Trust may be terminated at any time by formal resolution approved by majority vote of the Board of Trustees. 17.02 Notice of Termination. Upon termination of the Trust as provided herein, the Board shall "` forthwith notify all Employees and all other necessary parties. 17.03 Duration after Termination. Notwithstanding any provision set forth in this Trust Agreement regarding duration and termination of the Trust, the Trust shall continue in existence for as long a period as may be required to wind up its business Upon termination, the Board shall continue in its capacity as a Board of Trustees for so long a period as may be required to wind up the business of the Trust. 17.04 Disposition of Trust Assets and Final Accounting. Upon termination of this Trust, any and all monies remaining in the Fund shall be disposed of in accordance with Article 18 01 At such time as the business of the Trust is wound up, the Board shall render a final accounting of the affairs of the Trust to the Participating Entities. Thereafter, there shall be no claim or action against the Board except as expressly provided herein and they shall have no further responsibility or duties and they shall be discharged. ARTICLE XVIII. DISTRIBUTIONS OF SURPLUSES AND DEFICITS UPON TERMINATION OF THE TRUST, VOLUNTARY TERMINATION OF MEMBERSHIP OR EXPULSION 18.01 Termination of the Trust. Upon termination of the Trust, the Board shall, by majority vote, provide for the development of a plan (the termination plan) to wind up the Trust's business over the course of a period not to exceed thirty six (36) calendar months from the ,Ink effective date of the Trust's termination The termination plan shall provide for at least the following: (a) Payment of all administrative and other costs reasonably required to wind up the Trust's operations, (b) Payment of all outstanding claims liabilities of the Trust including, without limitation, all known claims and incurred but not reported liabilities; (c) Payment to the Trust of any deficits owed to it by any current or former Participating Entities; and (d) Payment of any outstanding amounts due to former Participating Entities that have previously voluntarily terminated their memberships in the Trust in accordance with Articles 15 01 or 15 02 of this Trust Agreement 18 Ink 18.02 Voluntary Termination of Membership For entities voluntarily terminating membership as provided under Article 15.01 or 15.02, surpluses and deficits allocated t the Participating Entity during the term of its membership, including adjustments for admmistrhtive expenses associated with the termination, shall be paid in accordance with the following schedule. (a) Surpluses payable to the former Participating Entity shall be paid in two (2) installments, with the first installment comprised of an amount not to exceed seventy five percent (75%) of the total estimated amount due being paid no later than on hundred eighty (180) calendar days after the effective date of such termination, an c any remaining surplus balances due being paid not later than twenty seven (27) months after the effective date of such termination, or in accordance with such other schedule as may be agreed to between the former Participating Entity and the Board. (b) Deficits payable to the Trust from the former Participating Entity shall be paid in two (2) installments, with the first installment comprised of an amount not to exceed seventy five percent (75%) of the total estimated amount due being paid no later than one hundred eighty (180) calendar days after the effective date of such termination and any remaining deficit balances due being paid not later than twenty seven (27), months after the effective date of such termination, or in accordance with such other schedule as may be agreed to between the former Participating Entity and the Trustees (c) At the time of the final distribution of surpluses or deficits as provided for in this section 18.02, the Board shall render a final accounting of the affairs of the Trust to the former Participating Entity whose membership terminated as provided hereunder. 18.03 Expulsion. In the event that a Participating Entity is expelled and membership involuntarily terminated in accordance with Article 16.02 above, surpluses and deficits allocated to the Participating Entity during the term of its membership, including adjustments for �. administrative expenses associated with the termination, shall be paid in accordance with the following schedule. (a) Former Participating Entities shall remain liable for the full amount of contributions that would otherwise have been due to the Trust during the penod of time between the date of such Entity's expulsion and the scheduled end of such Entity's Initial or Renewal Term of Participation. Amounts due to the Trust under this Article may be collected through reduction of any surpluses otherwise due to the former Participating Entity in accordance with Article 18.03 (b) or, in the event the former Participating Entity has no surplus due to it, or that the amount due to the Trust under this Article exceeds the amount of surplus due to the former Participating Entity, through assessment in accordance with Article 18.03(c) of this Trust Agreement (b) Surpluses payable to former Participating Entities that were expelled in accordance 19 with Article XVI shall be reduced by the amount of the Member Contnbutions that would otherwise have been due to the Trust during the period of time between the date of such Entity's expulsion and the scheduled end of such Entity's Initial or Renewal Term of Participation The balance of any remaining surpluses due to the former Participating Entity after making such adjustment shall be paid in two (2) installments, with the first installment comprised of an amount not to exceed seventy five percent (75%) of the remaining total estimated amount due being paid no later than one hundred eighty (180) calendar days after the effective date of such expulsion, and any remaining surplus balances due being paid not later than twenty seven (27) months after the effective date of such expulsion, or in accordance with such other schedule as may be agreed to between the former Participating Entity and the Board. (c) Deficits payable to the Trust from an expelled former Participating Entity shall be paid in two (2) installments, with the first installment comprised of an amount not to exceed seventy five percent (75%) of the total estimated amount due being paid no later than one hundred eighty(180) calendar days after the effective date of such termination and any remaining deficit balances due being paid not later than twenty seven (27) months after the effective date of such termination, or in accordance with such other schedule as may be agreed to between the former Participating Entity and the Board. (d) At the time of the final distribution of surpluses or deficits as provided for in this section 18 03, the Board shall render a final accounting of the affairs of the Trust to the former Participating Entity whose membership terminated as provided hereunder ARTICLE XIX. MISCELLANEOUS 19.01 Prosecution and Defense of Lawsuits. In the event any claim, suit, action or legal or administrative proceeding is brought against the Trust, the Board of Trustees, one or more Trustees or the Fund, in connection with any matter arising out of the administration of the Trust or Fund or in connection with this Trust Agreement or in connection with any act or omission of the Board of Trustees or one or more of the Trustees, or in the event of any suit, action or proceeding commenced by the Board, including, but not limited to, a request for a judicial settlement of accounts, a suit for construction, a bill of interpleader, or any other matter relating to the Trust, the Board shall have the power and authority to employ legal counsel to represent it in any such suit, action or proceeding Expenses, including legal counsel fees and other costs shall be paid from the Fund as long as the Board has acted in good faith and not with gross negligence, bad faith or willful misconduct, it being the intent to indemnify the Trustees, individually and as a Board, against all honest mistakes in judgment and all acts or omissions that are not deliberate or willful violations of the duties of the Board. In addition, the Board shall have the right to commence and prosecute such suits, actions or proceedings as it may determine are necessary and proper in order to protect the interest of the Trust or Fund, and, in this connection, the Board shall have the same rights and entitlement to reimbursement for costs and expenses as heretofore described for the defense of lawsuits. 20 19.02 Fiduciary Liability. The fiduciary liability and funding of all eligible benefits as determined by the Plan Document shall be the sole responsibility of the Board acting in their official capacity and shall not be determined to be a fiduciary duty of any Participating Entity 19.03 Worker's Compensation. The insurance coverage contemplated by this Trust Agreement shall not apply in any case which is compensable under Worker's Compensation 19.04 Situs of Trust. The City of Phoenix, County of Maricopa, State of Anzona, shall be deemed the situs of the Trust created hereunder All questions pertaining to validity, construction and administration shall be determined in accordance with the laws of such State and County. This Trust Agreement is deemed made, executed and delivered in such State. 19.05 Interpretation of Trust Agreement. Whenever any words are used in this Trust Agreement in the masculine gender, they shall be construed as though they were also in the feminine or neuter gender in all situations where they would so apply and wherever any words are used in this Trust Agreement in the singular form, they shall also be construed as though they were also used in the plural form in all situations where they would so apply, and whenever any words are used in this Agreement in the plural form they shall be construed as though they were also in the singular form in all situations where they would so apply 19.06 Captions. It is understood and agreed that the captions and headings contained in this Trust Agreement are included for convenience only and that they are not and shall not be deemed a part of the Agreement and that they shall in no way define, limit or expand any of the terms, obligations or conditions set forth herein 19.07 Severability. The parties agree that, to the extent that any provision of this Trust Agreement is in conflict with any applicable statute, regulation or rule, that provision shall be deemed unenforceable and the applicable statute, regulation or rule shall govern Should any provision or term in this Trust Agreement be deemed or held to be unlawful or invalid for any reason, such a determination will not adversely affect the remaining provisions contained herein unless such a determination will make the operation of the Trust impossible or impractical. In such a case, the appropriate parties shall immediately adopt such provisions as may be required to facilitate the proper functioning of the Trust 19.08 Taxation of Contributions, Assets, Income and Benefits. This Trust Agreement is being entered into and contnbutions are being made based upon the expectation that contnbutions made hereunder will not be subject to taxation and that benefits received by employees or other beneficiaries will not be deemed compensation in determination of federal, state or local tax liability The parties hereto, individually and collectively, agree to take or cause to be taken any and all steps that may be necessary or advisable in order to obtain and/or maintain a tax-exempt status for this Trust In the event that any provisions of this Trust Agreement are determined to impose tax obligations on any Participating Entity or Employees or other Beneficiaries, any steps necessary to eliminate such obligations shall be taken immediately Nothing in this section shall be deemed to impose liability on the Board, the Trust or Participating Entities in the event that 21 IN Pak Aft. contributions or benefits are deemed taxable or in the event that investment income received by the Trust is determined to be subject to taxation. 19.09 Cancellation. This Agreement is subject to cancellation pursuant to A.R S § 38-511. ARTICLE XX. STOP LOSS PROVISIONS "� 20.01 Stop Loss Requirement. Specific stop-loss reinsurance shall be an integral part of any self-funded benefit program established pursuant to this Trust Agreement. It is the intent of the parties to this Trust Agreement that stop-loss coverage, with such attachment points and policy limits as may be deemed necessary to protect the loss fund and allow complete and timely payment of benefits, be provided by an authorized carrier licensed to execute contracts in the State of Arizona. ARTICLE XXI. LOSS CONTROL PROGRAM 21.01 Loss Control Program. The Board shall provide for the development and implementation of a program of loss control for each plan year of Trust operations. The loss control program shall be further described in the Plan of Risk Management approved each year and may include one or combinations of: (a) Specific and/or aggregate reinsurance, (b) Conventional insurance, partial or full self-insurance; (c) Access to Preferred Provider Organizations (PPO) for benefit offerings, (d) Medical pre-certification, concurrent and/or post discharge review, (e) Large case management, (f) Health and wellness promotion, (g) Employee assistance programs, and (h) Such other loss control programs as the Board may determine to be appropnate ARTICLE XXII. USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION BY PARTICIPATING ENTITIES 22.01 The Participating Entities in the Metropolitan Phoenix Municipal Employee Benefit Trust shall only use protected health information ("PHI") to the extent of and in accordance with the uses and disclosures permitted by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Specifically, the Participating Entities may use and disclose PHI for purposes 22 related to health care treatment, payment for health care and health care operations. 22.02 Payment includes activities undertaken by the Participating Entities individually or through the Benefits Administrator to determine or fulfill its responsibility for coverage and provision of plan benefits that relate to a Beneficiary to whom health care is provided. These activities include, but are not limited to, the following: (a) Determination of eligibility, coverage and cost sharing amounts (for example, cost of a benefit,plan maximums and copayments as determined for an individual's claim), (b) Adjudication of health benefit claims (including appeals and other payment disputes), (c) Subrogation of health benefit claims; (d) Establishing Employee Contnbutions; (e) Risk adjusting amounts due based on enrollee health status and demographic characteristics, (f) Billing, collection activities and related health care data processing; (g) Claims management and related health care data processing, including auditing payments, investigating and resolving payment disputes and responding to Beneficiary inquiries about payments; (h) Obtaining payment under a contract for reinsurance (including stop-loss and excess of loss insurance), (i) Medical necessity reviews or reviews of appropriateness of care or justification of charges; (j) Utilization review, including precertification, preauthonzation, concurrent review and retrospective review, (k) Disclosure to consumer reporting agencies related to the collection of premiums or reimbursement (the following PHI may be disclosed for payment purposes: name and address, date of birth, Social Security number, payment history, account number and name and address of the provider and/or health plan); and (1) Reimbursement to the Trust. 22.03 Health Care Operations include, but are not limited to, the following activities. (a) Quality assessment; 23 Mk IN Ik. (b) Population-based activities relating to improving health or reducing health care costs, protocol development, case management and care coordination, disease management, contacting health care providers and patients with information about treatment alternatives and related functions; (c) Rating provider and plan performance, including accreditation, certification, licensing or credentialing activities; ... (d) Underwriting, premium rating and other activities relating to the creation, renewal or replacement of a contract of health insurance or health benefits, and ceding, securing or placing a contract for reinsurance of nsk relating to health care claims (including stop- loss insurance and excess of loss insurance), (e) Conducting or arranging for medical review, legal services and auditing functions, including fraud and abuse detection and compliance programs, (f) Business planning and development, such as conducting cost-management and planning- related analyses related to managing and operating the Trust, including formulary development and administration, development or improvement of payment methods or coverage policies; (g) Business management and general administrative activities of the Trust, including, but not limited to. (i) Management activities relating to the implementation of and compliance with HIPAA's administrative simplification requirements, or (ii) Customer service, including the provision of data analyses for Employees, the Trust or other Beneficiaries; and (h) Resolution of internal grievances 22.04 The Participating Entity agrees to. (a) Not use or further disclose PHI other than as permitted or required by the Plan Document or as required by law, (c) Ensure that any agents, including a subcontractor to whom the Participating Entity provides PHI received from the Plan agree to the same restrictions and conditions that apply to the Participating Entity with respect to PHI, (d) Not use or disclose PHI for employment-related actions and decisions unless authorized by a Beneficiary; (e) Not use or disclose PHI in connection with any other benefit or employee benefit plan of 24 the Participating Entity unless authonzed by a Beneficiary; (f) Report to the Trust any PHI use or disclosure that is inconsistent with the uses or disclosures provided for of which it becomes aware; (g) Make PHI available to a Beneficiary in accordance with HIPAA's access requirements; (h) Make PHI available for amendment and incorporate any amendments to PHI in accordance with HIPAA; (i) Make available the information required to provide an accounting of disclosure; 0) Make internal practices, books and records relating to the use and disclosure of PHI received from the Plan available to the HHS Secretary for the purposes of determining the Trust's compliance with HIPAA; and (k) If feasible, return or destroy all PHI received from the Trust that the Participating Entity still maintains in any form, and retain no copies of such PHI when no longer needed for the purpose for which disclosure was made (or if return or destruction is not feasible, limit further uses and disclosures to those purposes that make the return or destruction infeasible) 22.05 In accordance with HIPAA, only the following employees or classes of employees of a Participating Entity may be given access to PHI- (a) The human resources director or the individual assigned by the governing body of a Participating Entity to perform said function; and (b) Staff designated by the person assigned pursuant to Article 22.05(a). 22.06 The persons described in Article 22.05 may only have access to and use and disclose PHI for plan administration functions that the Trust performs for the Participating Entity 22.07 If the persons descnbed in Article 22.05 do not comply with the Plan Document, the Trust may provide a mechanism for resolving issues on noncompliance, including disciplinary sanctions 25 ... ... EXHIBIT A Participating Entities — Metropolitan Phoenix Municipal Employee Benefit Trust as authorized and approved by the Board of Trustees as of July 1, 2012 including Initial Terms of Participation established pursuant to Article 14 02 of the Trust Agreement. Participating Entity Membership Term 1. City of Apache Junction July 01, 2012 - June 30, 2015 2 City of Avondale July 01, 2012 - June 30, 2015 3. City of El Mirage July 01, 2012 - June 30, 2015 4 Town of Youngtown July 01, 2012 - June 30, 2015 .•. 26 METROPOLITAN PHOENIX MUNICIPAL EMPLOYEE BENEFIT TRUST Conflict of Interest Policy This Policy will provide direction for compliance with Chapter 3, Article 8 of the /'N Arizona Revised Statutes(A R S § 38-501 et seq.) with respect to the purchase of goods and services from Trustees, officers or employees of the Metropolitan Phoenix Municipal Employee Benefit Trust (hereinafter "The Trust"). This document is not a complete statement of your obligations under the provisions of A R S § 38-501, et seq., but is only a reminder of certain obligations imposed upon you as a matter of law and good business practices. You should refer to the Statutes themselves for a complete statement of the law Trustees, officers and employees of the Trust, or their agents, shall abide by all provisions of the above-referenced statutes when acting within the scope of their responsibilities on behalf of the Trust The sale to the Trust of equipment, materials, supplies or services by Trustees, officers or employees of the Trust, or their agents, is prohibited unless such sales are made in compliance with State Law and the procedures set forth in this Policy. If there is a conflict between this Policy and the applicable State Law,the State Law will govern. Upon approval, copies of this Policy shall be provided to each Trustee, officer, employee or agent of the Trust and to Trustees, officers, employees or agents who may subsequently be appointed or selected to serve the Trust Each recipient shall acknowledge receipt of the Policy by executing a copy of the affidavit attached hereto as Exhibit 1 The signed affidavits shall be retained in the official records of the Trust and shall be available for public inspection upon reasonable notice. Pursuant to A.R.S. § 38-503, Trustees, officers or employees of the Trust who wish to enter into contracts for the sale of goods or services to the Trust, must not participate in the selection of vendors and must make their interest in the proposed contract known in the official records of the Trust. Any Trustee, officer or employee wishing to competitively bid on contracts for the procurement of goods and services, of any monetary amount, must annually sign a copy of the affidavit attached hereto as Exhibit 2. The signed affidavit will be filed in the official records of the Trust and shall be available for public inspection upon reasonable notice In addition, any Trustee, officer, employees or agent of the Trust who participates in the expenditure of Trust funds shall perform his/her duties in a manner consistent with their obligations to the Trust and in accordance with sound business practices In complying with these requirements, Trustees, officers, employees or agents agree to the following. 1 Solicitation of gratuities, favors or anything of value from contractors, potential contractors or parties to sub-agreements is strictly prohibited Acceptance of gratuities, favors or anything of monetary value in excess of fifty ($50) dollars from contractors, potential contractors or parties to sub-agreements is discouraged. 2. Participation in awards or administration of contracts to firms in which the Trustee, officer, employee or agent or his/her immediate family has a financial or other interest is strictly prohibited In addition, any Trustee, officer, employee or agent who is a paid consultant, or who has a relative who is a paid consultant (as defined in A R S. § 38-502) for any firm that transacts business with the Trust, or which may bid on a future contract for goods or services with the Trust, is prohibited from participating in a decision process which may lead to the award of a contract involving such firm Any person violating this policy may be subject to termination, removal or other disciplinary action and may be subject to additional penalties as provided by State Law The words "participation" and/or "participate" as used herein include, without limitation, determining whether or when a product or service is to be awarded with or without competitive process such as request for proposals and/or bid, establishing criteria for evaluating and/or awarding business and/or any associated contracts or agreements, evaluating and/or comparing companies, products and/or service offerings, offering opinions and/or lobbying Participating Entity staff, elected officials and/or trustees as to the evaluation, award or non-award of any business and any associated contracts and/or agreements and voting on any award of business and any associated contracts and/or agreements. Exhibit 1 ACKNOWLEDGEMENT OF RECEIPT OF CONFLICT OF INTEREST POLICY (To be executed by all Trustees, officers,employees and agents of the Trust) /1 By my signature below, I acknowledge that I have received a copy of the Conflict of Interest Policy of the Metropolitan Phoenix Municipal Employee Benefit Trust and that I have read it in its entirety My signature also acknowledges that I understand the provisions of the Policy and that I am aware that it contains important information regarding legal obligations arising from my activities on behalf of the Trust I have, or have had the opportunity to (►) read the provisions of A R S § 38-501 et seq. and(ii) consult with an attorney before signing this document. Date Signature Printed Name Exhibit 2 AFFIDAVIT REGARDING SALES OF GOODS OR SERVICES TO THE /_ METROPOLITAN PHOENIX MUNICIPAL EMPLOYEE BENEFIT TRUST I am currently a Trustee, officer or employee of the Metropolitan Phoenix Municipal Employee Benefit Trust ("the Trust") During the fiscal year, I intend to furnish the Trust with (specify the goods or services) which will be procured by, or on behalf of, the Trust's Board of Trustees through (name of company/entity) I have read the Trust's Conflict of Interest Policy and am familiar with its provisions I certify that I am not participating, and have not previously participated, in any discussion or vote that would influence the decision regarding the purchase of any goods or services that I may furnish to the Trust I understand that any false statement on this affidavit or any violation of the Trust's Conflict of Interest Policy may be grounds for termination, removal or other disciplinary action by the Trust and may also subject me to additional penalties as provided by State Law. I have, or have had the opportunity to (i) read the provisions of A R S § 38-501 et seq. and(ii) consult with an attorney before signing this document Dated this day of (Signature) HIPAA TRUSTEE CONFIDENTIALITY AGREEMENT FOR THE METROPOLITAN PHOENIX MUNICIPAL EMPLOYEE BENEFIT TR UST Name of Trustee. The Metropolitan Phoenix Municipal Employee Benefit Trust (the "Trust"), as a health plan, is required by the Health Insurance Portability and Accountability Act of 1996, as amended ("HIPAA") Privacy Rule (the "Privacy Rule") to make reasonable efforts to limit access to "individually identifiable health information" by Trustees to those Trustees, agents, or employees of the Trust whose functions require such access, and to limit the amount of "individually identifiable health information" to which they have access to the minimum necessary to carry out their functions for the Trust The Privacy Rule also requires the Trust to train its Trustees in the policies and procedures governing the use of and access to "individually identifying health information" It is requested that you sign this form as an acknowledgment of the Trust's intent to fully comply with the Privacy Rule and as an indication of your intent to participate in the implementation of the policies and procedures relating to"individually identifying health information"that are required by the Privacy Rule. Signature of Trustee/Agent/Employee• Date ROLL CALL VOTE NOTES: i ITEM# MEETING OF N MOTION BY ' SECONDED BY YES NO ABSTAINED COUNCILMEMBER WILSON f COUNCILMEMBER SERDY V VICE MAYOR DIETZ V COUNCILMEMBER BARKER �/ COUNCILMEMBER SMITHSON v/ MAYOR INSALACO UNANIMOUS/ IN FAVOR OPPOSED ABSTAINED TOTAL a► AO. ITEM NO. 9 I MOVE THAT RESOLUTION NO. 12-07, A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, AUTHORIZING THE CITY OF APACHE JUNCTION TO ACCEPT MEMBERSHIP IN THE METROPOLITAN PHOENIX MUNICIPAL EMPLOYEE BENEFIT TRUST, (BE APPROVED) OR(BE DENIED). PgACHf✓G Q City ofpache Junction �U 2 Home of the .S IIpei:riitzoll .\IO1111td1JlI Print TO: City Manager's Office FROM: Bryant Powell, Assistant City Manager DATE: March 6, 2012 Agenda Type : Regular Agenda Council Priority Focus Area: Community Development TITLE OF AGENDA ITEM: COUNCIL DIRECTION TO STAFF ON THE TRAIL OF FLAGS CONCEPT IN DOWNTOWN. ACTION REQUESTED: Direction to Staff DISCUSSION / BACKGROUND INFORMATION: Staff seeks direction on the frequency and maintenance/replacement options of flags for the new concept for the Trail of Flags at the NW corner or Apache Trail and North Apache Trail After direction is provided, staff will prepare a resolution for council's consideration FISCAL IMPACT: OPTIONS/ALTERNATIVES: 1ECOMMENDATION: ATTACHMENTS: Click to download L3 Staff Memo //11. ,401--1 ` kcnot urrof: 5 DATE February 22, 2012 MEMORANDUM TO The Honorable Mayor and City Councilmembers MEMORANDUM THROUGH. George Hoffman, City Manager MEMORANDUM FROM: Bryant Powell, Assistant City Manager SUBJECT: Trail of Flags— Direction to Staff For a number of years, the "Trail of Flags" have been present along Apache Trail at various designated times during the year While never formally established through a Resolution, tracing back through meeting notes reveal that the community and Council over the years supported the concept and to date we've practiced a relatively predictable process for flying the flags Recently, staff began brainstorming ideas about challenges related to the Trail of Flags and the opportunity to take these challenges and actually improve on the concept. Available resources to put up and take down the flags have diminished, the median improvements will impact the current placement of sleeves in the ground to deal with landscaping, curbing and drainage issues, and the responsibility for tattered flag replacement has become ever more difficult to manage as years have passed. At your February 21, 2012 council meeting, Nick Blake provided an update on the concept of relocating the "Trail of Flags" to a new, permanent home at the NW corner of Apache Trail and North Apache Trail Mayor Insalaco and Dave Waldron, both very active with our local Veteran's organizations, had done some initial vetting of the idea to various Veterans' groups and received very positive support. So much so, that they have begun a fundraising campaign that already has raised nearly all the funds to install the new poles, lighting, and initial flag purchases. With Council's recent positive reception of the concept and indication that they'd like staff to move forward, staff respectfully asks for City Council formal direction on the following matters related to this project 1 Would Council like staff to proceed with the concept of installing seven flagpoles, these flagpoles to fly the US flag, State flag, and each of the five active-duty services (Army, Marine Corps, Navy, Air Force, and Coast Guard) with the option of flying the POW/MIA flag with the US flag? 2 Would Council like to maintain the current schedule utilized for the existing Trail of I Flags which would include having the flags raised at the following times / S , u''11 • Statehood Day, February 14th M k iv t �1' • Lost Dutchman Days, last weekend in February ,✓ • Memorial Day, last Monday in May O' ti � d . • Flag Day, June 14th � 1 • Fourth of July, July 4th • Veterans' Day, November 11th OR are there alternate dates at which the flags should be flown'? •) 3 Would Council like to refer to this area as the Trail of Flags, or call it something else'? If something else, how should it be referenced'? 4 Would Council like to budget in the General Fund monies for flag replacement'? Iw 5. Would Council like to have a permanent plaque placed at the new location that recognizes all our community's Veterans and our appreciation for their generosity and sacrifices? Staff respectfully requests direction on how to proceed on these items related to the Trail of 10, Flags. c)c,up'uf'04,:,))? s V ti 4 i fit97 (\-\(6. a ROLL CALL VOTE , \91 ;1/i) NOTES I cr) ,,P' fy,,:,3 F , ti). ITEM # \() MEETING OF filb\\'V '6 MOTION BY SECONDED BY: k V k YES NO ABSTAINED COUNCILMEMBER SMITHSON l COUNCILMEMBER BARKER '// VICE MAYOR DIETZ / COUNCILMEMBER SERDY i. / COUNCILMEMBER WILSON V MAYOR INSALACO i UNANIMOUS IN FAVOR OPPOSED ABSTAINED TOTAL ITEM NO. 10 I MOVE THAT THE FOLLOWING DIRECTION BE GIVEN TO STAFF REGARDING THE TRAIL OF FLAGS CONCEPT IN DOWNTOWN. PpACkf i °� Gyro City of Apache Junction U z "loll/C of the .S upel:otio1? Mountains gR,2ot Print TO: City Manager's Office FROM: Janine Solley, Business Advocate DATE. March 6, 2012 Agenda Type : Regular Agenda Council Priority Focus Area: Community Development TITLE OF AGENDA ITEM: COUNCIL DIRECTION TO STAFF ON PUBLIC ART FOR THE OLD WEST HIGHWAY MEDIAN ENHANCEMENT PROJECT, ACTION REQUESTED: Direction to Staff DISCUSSION/ BACKGROUND INFORMATION: Staff seeks direction on the public art alternatives for the Old West Highway pedestals. FISCAL IMPACT: OPTIONS/ALTERNATIVES: RECOMMENDATION: ATTACHMENTS: Click to download Sta`f PAcr,o Y r • L4nr DATE February 22, 2012 MEMORANDUM TO The Honorable Mayor and City Councilmembers MEMORANDUM THROUGH George Hoffman, City Manager Bryant Powell, Assistant City Manager MEMORANDUM FROM Janine Solley, Business Advocate SUBJECT. Public Art Direction to Staff—Old West Highway Median Enhancement Project At the February 21, 2012 council meeting, staff sought to have council engage in dialog of how/if to advance public art As per the recommendation in the DRIS, staff had explored concepts for the median enhancement project with Superstition Area Cultural Alliance (SACA) While this initial effort was intended to engage local artists to share concepts (insomuch as they were willing to without any funding source identified) we've since begun to explore, as a community relatively new to integrating public art into public projects, how we might opt to advance and/or procure public art. Staff respectfully asks for City Council direction on the following matters related to this project. To Proceed or Not to Proceed 1 Would City Council like staff to continue an effort to consider options for public art, which at this time would specifically address public art for the Old West Highway t` median enhancement pedestals? All bk. Concept Options 1. Would Council like staff to move forward with the art committee's recommendation of Mr. Coplin's concept (presented at the December 5, 2011 City Council Work Session)? 2. Would Council like staff to move forward with finding alternative public art options? ut 3 Would Council like staff to move forward with the original City proposed concept of incorporating iron art pieces (design, fabrication, construction, installation, etc ) all done or arranged for by in-house by City staff? Procuring Options 1. Would Council like to consider a direct selection of an artist? 2. Would Council like to have staff release a formal Request for Qualifications? 3. Would Council like to pursue the idea of seeking donations of existing pieces of public art? Who would you prefer take the lead to find pieces and who would act as the selection panel for donations offered? Art Selection Process 1. Would Council like to act as the selection panel should an RFQ be released? 2. Would Council like the City Manager to appoint a selection panel to make a recommendation to the Council? Funding Options 1 Would Council like to have staff research, explore, and apply for public art grants and other possible funding sources? 2 Would Council like to ask that other interested groups (i e SACA, Friends of Apache Junction, the Focal Point and Tourism Committee) explore and apply for public art grants and other possible funding sources insomuch as they are willing and/or able? Future Process 1 Would Council like to begin to establish a more formal Public Arts Committee to take the lead on making recommendations for future public art projects with a more structured and predictable process? Staff respectfully requests direction on how to proceed on these items related to public art ON ROLL CALL VOTE i' ` )j)( L� , )6j ‘: Of / NOTE �r \7 - ) ' $A4 \11/ v.( ''' \)i k.i \ t f 40- ly „p, \‘ . 4 ‘ 4j ( ,i,V kiv II,cuu j.„v c '' \, , L \I/ C ',1 v ' ' .l.\ fil)\U 0 ITEM # A .f z..,,,, MEETING OF 1 MOTION BY Q '4,. SECONDED BY. OA YES NO ABSTAINED i COUNCILMEMBER SMITHSON i COUNCILMEMBER SERDYif COUNCILMEMBER BARKER �/` COUNCILMEMBER WILSON Vz VICE MAYOR DIETZ c/ MAYOR INSALACO ,/ f UNANIMOUS IN FAVOR OPPOSED ABSTAINED TOTAL X \ V1-) rry///n/ :0 pt,k 2()(\ f4 )/::1/ .\J4 i ig (P r � �e, - ,,` „II ), , . 41 fil t ITEM NO. 11 I MOVE THAT THE FOLLOWING DIRECTION BE GIVEN TO STAFF REGARDING PUBLIC ART FOR THE OLD WEST HIGHWAY MEDIAN ENHANCEMENT PROJECT. ROLL CALL VOTE ->\l'it) NOTES: 16\1U\, c 7 4' ,, II( ITEM # 0247 MEETING OF MOTION BY il' j‘l ki SECONDED BY f....,00;.4 YES NO ABSTAINED COUNCILMEMBER SERDY V VICE MAYOR DIETZ I COUNCILMEMBER SMITHSON v COUNCILMEMBER WILSON •I COUNCILMEMBER BARKER U/ ) MAYOR INSALACO V UNANIMOUS IN FAVOR OPPOSED ABSTAINED TOTAL '' ITEM NO. 12-13 I MOVE THAT AN EXECUTIVE SESSION AT 5.45 P M AND A WORK SESSION AT 7.00 P.M. BE HELD ON MONDAY, MARCH 19, 2012, 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, MARCH 20, 2012 IN THE CITY COUNCIL CONFERENCE ROOM. ADJOURNMENT: I MOVE THAT THE MEETING BE ADJOURNED AT P M ROLL CALL WS: 6 1�+! REG•/ ) SPEC 1 CITY COUNCIL P / A P / A P / A MAYOR INSALACO , Jf f VICE MAYOR DIETZ ,./ t COUNCILMEMBER BARKER , COUNCILMEMBER SERDY COUNCILMEMBER SMITHSON i/ . /V J COUNCILMEMBER WILSON V TOTAL .) ,4, CITY STAFF ?ky i / City Manager George Hoffman Assistant City Manager Bryant Powell b✓ City Clerk Kathleen Connelly 7 v City Attorney Joel Stern ✓ f Public Safety Director Jerald Monahan Interim Public Works Director/ City Engineer Giao Pham Parks & Recreation Director Jeff Bell Library Director Spencer Paden Finance Director Donna Meinerts Development Svcs Director Brad Steinke Human Resources Director Liz , 7 Riley Economic Development Director Steve Filipowicz >if2Assistant to the City Manager 1%� , r Matt Busby PO r Q OTHERS \U../��'" i) t t:kr, \14),011 I Ci .J Date: CITY OF APACHE JUNCTION Please select an option: REQUEST TO SPEAK FORM Item No. OR Call to The Public (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 ❑ ❑ I am in favor of the proposed Item. ❑ I am opposed to the proposed Item. k l'/C/7-//i Name (Print) . f>/f/t J I/i1 Addresg City Zip Code ?E)-- lea Telephone Email address This information will be used by staff for follow-up, if necessary. Speakers shall make comments directly to the Mayor and City Council when called up to speak at the podium. Note: Call to the Public comments have a three minute limit and Public Hearing comments have a five minute limit. Consent for Minor to be Audio and/or Video Recorded: , as the parent/guardian of (minor(s)), a minor(s), agree to allow said minor(s) to appear and/or participate in the City of Apache Junction City Council Meeting I further understand that this activity may be audio and/or video recorded and I hereby consent to the minor being audio and/or video recorded during his/her participation with the likelihood that their image will appear on cable TV and the Internet video stream showing their participation. Signature of Parent/Guardian Date 02/23/12