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Home My WebLink About2015 06.02 City Council Regular Agenda IN Ea. <L7•r.p� Meeting location City of Apache Junction, Arizona t�' r `yy City Council Chambers at City Hall Agenda 300E Superstition Blvd Apache Junction,AZ 85119 City Council Meeting www ajcity net Ph (480)982-8002 Tuesday,June 2,2015 7.00 PM City Council Chambers A. CALL TO ORDER B. INVOCATION AND PLEDGE OF ALLEGIANCE C. ROLL CALL D. CONSENT AGENDA The council may, at this time, take single action on any or all items listed as consent agenda items These 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 pnor to the meeting Any member of the council may remove any item from the consent agenda for discussion and cause a separate vote on the matter later in the agenda 1. Consideration of acceptance of agenda 2 Consideration of approval of minutes of special meeting of May 18, 2015 3 Consideration of approval of regular meeting minutes of May 19, 2015. 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 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. City manager's report City of Apache Junction,Arizona Page 1 Printed on 5/26/2015 City Council Meeting Agenda June 2,2015 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 appeanng before the council 5. Consideration of an application for acquisition of control for the liquor license of Safeway#253 located at 3185 W Apache Trail The next step in the process is for the council to have a public hearing and make a recommendation for approval or denial to be forwarded to the Arizona Department of Liquor Licenses and Control OLD BUSINESS The council shall consider any business that has been previously considered and which is still unfinished to include those items previously postponed or tabled No member of the public shall be permitted to speak on these items unless invited to do so by the mayor after first submitting a written request-to-speak form with the city clerk J NEW BUSINESS The council shall consider any business not yet considered No member of the public shall be permitted to speak on these items unless invited to do so by the mayor after first submitting a written request-to-speak form with the city clerk 6. Presentation, discussion and consideration of Resolution No 15-21, supporting the development of U S Bicycle Route 90 through the City of Apache Junction K. COUNCIL DIRECTION TO STAFF This item allows the mayor and city council to direct staff on specifically listed matters L. SELECTION OF MEETING DATES, TIMES, LOCATIONS, AND PURPOSES 7. Executive Session at 5.45 P M and Work Session at 7.00 P M for Monday, June 15, 2015 8 Executive Session at 5 45 P.M and Work Session at 7.00 P M will be held on Tuesday, June 16, 2015 Other meetings if necessary City of Apache Junction,Arizona Page 2 Printed on 5/26/2015 City Council Meeting Agenda June 2,2015 M. CALL TO PUBLIC At this time the public has the privilege to address the council with requests, communications, comments or suggestions relating to city business that are not listed on the agenda All speakers must have already submitted a written "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 Amok any member thereof The mayor is authorized to ask a speaker to stop speaking and leave the podium or to adjourn the meeting if anyone becomes disorderly, uncivil, makes personal attacks or continues to speak about items that are not within the jurisdiction of the city after being warned such issues are beyond the jurisdiction of the city to act The council may not answer questions of the speaker, discuss the matter with one another, but may, at the conclusion 1)respond to criticism by a speaker;2)ask the city manager to review a matter, 3)ask the city manager to place the matter on a future agenda Each speaker must approach the podium, speak into the microphone,provide their name and address There is a three(3)minute time limit per speaker N. ADJOURNMENT Copies of this agenda and additional information on any of the items listed above may be obtained from the City Clerk's office located at 300 E Superstition Blvd,Apache Junction, AZ 85119, Monday through Thursday from 7 00a-6 00p, excluding holidays The City of Apache Junction invites and welcomes people of all abilities to use our programs, sites and facilities Specific requests may be made by contacting the Human Resources Office at(480)474-2617 or TDD(480)983-0095 City of Apache Junction,Arizona Page 3 Printed on 5/28/2015 CITY COUNCIL SPECIAL MEETING MAY 18, 2015 The special meeting of the City Council of the City of Apache Junction, Arizona, was held on May 18, 2015, at the Apache Junction City Council Chambers pursuant to the notice Ask required by law. CALL TO ORDER Mayor Insalaco called the meeting to order at 7 . 00 p.m. ROLL CALL Councilmembers Present• Mayor Insalaco Vice Mayor Barker Councilmember Evans Councilmember Rizzi Councilmember Waldron Councilmember Wilson (Councilmember Serdy was absent. ) Staff Present. Assistant City Manager Bryant Powell City Clerk Kathleen Connelly City Attorney Joel Stern Public Safety Director Tom Kelly Public Works Director Giao Pham Library Director Spencer Paden Parks and Recreation Director Jeff Bell Finance Director Donna Meinerts Development Services Director Larry Kirch Human Resources Director Liz Riley Assistant to the City Manager Matt Busby Others Present : City Magistrate James Hazel RESOLUTION NO. 15-14, DECLARING AS SPECIAL MEETING OF THE CITY COUNCIL MAY 18, 2015 PAGE 1 OF 5 A PUBLIC RECORD AND ADOPTING CERTAIN DOCUMENTS ENTITLED "CLASSIFICATION PLAN FOR FISCAL YEAR 2015-2016", "CIVILIAN COMPENSATION PLAN FOR FISCAL YEAR 2015-2016" AND "RECRUIT AND SWORN COMPENSATION PLAN FOR FISCAL YEAR 2015-2016" emN ) Assistant City Manager Bryant Powell briefed the council on the item. Assistant to the City Manager Matt Busby stated when they adopt the resolution the council needs to include adding the Water Safety Instructor in their motion. City Clerk Kathleen Connelly stated they also need to add the pay group. Assistant City Manager Bryant Powell stated it is salary group 6. Mayor Insalaco closed the discussion with no further comments and called for a motion. Vice Mayor Barker MOVED THAT RESOLUTION NO. 15-14, A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, DECLARING AS A PUBLIC RECORD AND ADOPTING CERTAIN DOCUMENTS FILED WITH THE CITY CLERK ENTITLED "CITY OF APACHE JUNCTION CLASSIFICATION PLAN FOR FISCAL YEAR 2015-2016"; "CITY OF APACHE JUNCTION CIVILIAN COMPENSATION PLAN FOR FISCAL YEAR 2015-2016"; AND "CITY OF APACHE JUNCTION RECRUIT AND SWORN COMPENSATION PLAN FOR FISCAL YEAR 2015-2016"; AND DECLARING AN EMERGENCY, BE APPROVED WITH THE FOLLOWING CHANGES : THAT WE ADD THE POSITION OF WATER SAFETY INSTRUCTOR AT SALARY GROUP 6. Councilmember Waldron SECONDED THE MOTION VOTE: Unanimous. SPECIAL MEETING OF THE CITY COUNCIL MAY 18, 2015 PAGE 2 OF 5 Alwak Ask The motion carried. RESOLUTION NO. 15-13, ADOPTION OF TENTATIVE BUDGET FOR FISCAL YEAR 2015-2016 AND GIVING NOTICE OF FINAL BUDGET ADOPTION ) City Clerk Kathleen Connelly briefed the council on the item. Mayor Insalaco commented with the adoption of this budget they can later take away but they cannot add. Finance Director Donna Meinerts stated that is correct . Assistant City Manager Bryant Powell stated that is correct. City Clerk Kathleen Connelly stated after the tentative budget is adopted they cannot increase. Assistant City Manager Bryant Powell stated it has not been adopted yet . There have been no changes since the last time they looked at it except for those required by the intergovernmental agreement with the school district where they added some revenue they would be receiving and expenditures of $25, 000 that have been placed in the budget . It is a conservative budget. They will continue to see rises in the Public Safety Retirement System and more will follow on that Amik from his office . They will continue to invest in the streets and roads . They will see several presentations from staff on what has been spent on the roads brought in by the . 2 percent sales tax increase They are very pleased with the effort so far The department directors are in attendance for any questions . He thanked the budget staff and the finance director for all the work done to get to this point with a balanced budget. It is a line item budget already on the Internet for everyone to view. Tonight there is an opportunity for public comment. SPECIAL MEETING OF THE CITY COUNCIL MAY 18, 2015 PAGE 3 OF 5 Mayor Insalaco commented he would like to thank them for their hard work. He knows it was not easy. After going over it, he does not believe they could have done any better. Councilmember Rizzi agreed. Councilmember Wilson .00114. commented he wanted to thank them for the council being able to move some funds around to cover the intergovernmental agreement with the school so that the city is able to take on the expenses and keep the place open for the community. Councilmember Rizzi commented she wanted to thank the staff for being available. Any questions they had were answered thoroughly no matter what question it was on what line item. They had the answers lickity-split and were very detailed. She appreciated it very much. 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 Evans MOVED THAT RESOLUTION NO. 15-13, A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, FOR THE ADOPTION OF THE TENTATIVE BUDGET FOR THE CITY OF APACHE JUNCTION, ARIZONA, FOR FISCAL YEAR 2015-2016, HEREWITH SETTING FORTH THE TENTATIVE ESTIMATES FOR THE MONIES NECESSARY FOR THE PUBLIC EXPENSES OF THE CITY OF APACHE JUNCTION, ARIZONA, FOR THE FISCAL YEAR 2015-2016 AND GIVING NOTICE OF THE TIME AND PLACE FOR HEARING TAXPAYERS FOR THE ADOPTION OF THE FINAL BUDGET, AND DECLARING AN EMERGENCY, BE APPROVED. Councilmember Waldron SECONDED THE MOTION VOTE: Unanimous SPECIAL MEETING OF THE CITY COUNCIL MAY 18, 2015 PAGE 4 OF 5 The motion carried. ADJOURNMENT ) Mayor Insalaco adjourned the meeting at 7 : 10 p.m. ACCEPTED THIS 2ND DAY OF JUNE, 2015, BY THE MAYOR AND CITY Amok COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA. SIGNED AND ATTESTED TO THIS 2ND DAY OF JUNE, 2015 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 special meeting of the City An\ Council of the City of Apache Junction, Arizona, held on the 18th day of May, 2015. I further certify that the meeting was duly called and held and that a quorum was present. Dated this 19th day of May, 2015. KATHLEEN CONNELLY City Clerk SPECIAL MEETING OF THE CITY COUNCIL MAY 18, 2015 PAGE 5 OF 5 CITY COUNCIL REGULAR MEETING MAY 19, 2015 The regular meeting of the City Council of the City of Apache Junction, Arizona, was held on May 19, 2015, 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 : 00 p m INVOCATION Councilmember Waldron gave the Invocation. PLEDGE OF ALLEGIANCE Councilmember Wilson led the Pledge of Allegiance. ROLL CALL Councilmembers Present: Mayor Insalaco Vice Mayor Barker Councilmember Evans Councilmember Serdy Councilmember Waldron Councilmember Wilson Am* (Councilmember Rizzi was absent . ) Staff Present: Assistant City Manager Bryant Powell City Clerk Kathleen Connelly City Attorney Joel Stern Public Safety Director Tom Kelly Public Works Director Giao Pham Assistant to the City Manager Matt Busby Others Present : Management Assistant Anna McCray REGULAR MEETING OF THE CITY COUNCIL MAY 19, 2015 PAGE 1 OF 8 ACCEPTANCE OF CONSENT AGENDA Vice Mayor Barker MOVED THAT THE CONSENT AGENDA BE ACCEPTED AS PRESENTED; AND THAT ITEM NUMBER 8 BE DELETED FROM THE AGENDA AS IT IS NO LONGER NEEDED (intergovernmental agreement with the school district) . Councilmember Wilson SECONDED THE MOTION. VOTE: Unanimous. The motion carried. AWARDS, PRESENTATIONS AND PROCLAMATIONS Mayor Insalaco read a proclamation designating May 17 through May 23 as National Public Works Week and presented it to Public Works Director Giao Pham. Public Safety Director Tom Kelly presented the Elks Enrique Camarena Award for Arizona officer of the year to Officer Marshall Harshman for recognition of his significant contribution in the field of drug prevention. ANNOUNCEMENT OF CURRENT EVENTS Councilmember Serdy announced his daughter graduated from Central Arizona College on Friday. Vice Mayor Barker commented most of the council who were able to attended the D.A.R.E. ceremonies and watched the fifth gradersAimmkk graduate this year. Mayor Insalaco commented that after the graduation ceremony at Superstition Mountain Elementary School some of the students came up to him and asked why the district is closing their school and requested the city stop them. It is a sad situation when these kids have to leave their school after being there since kindergarten and go to another school for the sixth grade. CITY MANAGER' S REPORT REGULAR MEETING OF THE CITY COUNCIL MAY 19, 2015 PAGE 2 OF 8 Assistant City Manager Bryant Powell congratulated Officer Harshman and commented Chief Kelly will give a presentation on a new badge for the police department. Public Safety Director Tom Kelly gave a presentation on the history of the police department and the badge that is currently in use. He presented a sample of the proposed new badge that /miS represents the city today The costs associated will be covered by RICO funds and officers wishing to purchase their current badges . Councilmember Evans commented she thinks the police department does such a fabulous job. She feels bad they have to buy their badges . She asked if there are enough funds in the RICO funds to cover the purchase. Public Safety Director Tom Kelly stated this was actually brought forth by the officers in order to support it. In the past the city had used citizens' money to buy them so they thought there would be less complaints from anybody about receiving citizens' money. Actually, the officers had requested to purchase them back. Again, it is a decision of the city council. Mayor Insalaco commented they made the decision; that is fine. Public Safety Director Tom Kelly stated another reason to change the current badge is they do not have numbers on them. In the old days when they had low numbers, they had numbers on them that identified the officer. For some reason they did away with that The new badges will have their badge number on it so that /11 if they retire in good standing the badge can be retired. If they leave for any reason they can send it back in and they can insert a new number It also helps because, currently, if a badge is lost or stolen they cannot enter it into the National Crime Information Center as it has no number They can now be entered and if someone comes up with it they can recover the badge and hold people accountable. PUBLIC HEARINGS OFF TRACK WAGERING FACILITY AT MIRAGE SPORTS GRILL BY TURF REGULAR MEETING OF THE CITY COUNCIL MAY 19, 2015 PAGE 3 OF 8 e 1 PARADISE RACE COURSE City Clerk Kathleen Connelly briefed the council on the item. Mayor Insalaco requested the applicant address the council. He asked if they have this now. Mr. Erik Buckles, 1002 EemN Hondo, Apache Junction, addressed the council He stated they have had the license Vice Mayor Barker asked how long the facility has had the racetrack license Mr Eric Buckles stated they picked it up when they were on Idaho. He believes this is their sixth year. It was right after A. J. ' s shut down. 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 Vice Mayor Barker MOVED THAT THE REQUEST FOR AN OFF TRACK WAGERING FACILITY AT MIRAGE SPORTS GRILL BY TURF PARADISE RACE COURSE, SUBMITTED BY DAVID JOHNSON, FOR THE PERIOD FROM JUNE 1, 2015 THROUGH MAY 31, 2018, BE RECOMMENDED FOR APPROVAL TO THE ARIZONA RACING COMMISSION. Councilmember Wilson SECONDED THE MOTION. /INS VOTE. Unanimous. The motion carried. OLD BUSINESS None. NEW BUSINESS REGULAR MEETING OF THE CITY COUNCIL MAY 19, 2015 PAGE 4 OF 8 None. DIRECTION TO STAFF DEVELOPMENT OF A DIVERSITY PLEDGE ) Management Assistant Anna McCray briefed the council on the item Auk Mayor Insalaco opened the discussion on the item. There being no discussion, he called for a motion. Councilmember Serdy commented he thinks they should look into getting it. There were some other versions from other cities that were all encompassing. That is not an official motion. He asked if Anna would work one up and bring it back for them to approve. Management Assistant Anna McCray stated they can discuss it at the next work session. Vice Mayor Barker commented they like the one from Mesa. It is very wide-ranging and covered all . Mayor Insalaco called for a motion. Vice Mayor Barker MOVED THAT THE FOLLOWING DIRECTION BE GIVEN TO STAFF REGARDING THE DEVELOPMENT OF A DIVERSITY PLEDGE: THAT THE STAFF WORK ON A Aso► PLEDGE THAT IS SOMEWHAT SIMILAR TO THE MESA PLEDGE IN ITS ABILITY TO COVER ALL BASES AND YET IS UNIQUE TO APACHE JUNCTION. Councilmember Evans SECONDED THE MOTION. VOTE: Unanimous. The motion carried. FORMATION OF A YOUTH COUNCIL Management Assistant Anna REGULAR MEETING OF THE CITY COUNCIL MAY 19, 2015 PAGE 5 OF 8 1 McCray briefed the council on the item. Vice Mayor Barker commented it is her understanding that parks and recreation has been heavily involved in youth participation. She asked if they would be the logical area to develop a structure for such a program. Management Assistant Anna McCray stated that is correct. At the May 4 work session it was brought to the council' s attention that the parks and recreation director has been working on the idea of a youth council for quite some time now. Council also discussed a collaborative effort between parks and recreation and the library to develop a youth council because both departments deal with the youth in the community on a regular basis and have programs for youth. Mayor Insalaco closed the discussion with no further comments and called for a motion. Vice Mayor Barker MOVED THAT THE FOLLOWING DIRECTION BE GIVEN TO STAFF REGARDING THE FORMATION OF A YOUTH COUNCIL. THAT THE STAFF OF BOTH PARKS AND RECREATION AND THE LIBRARY DEVELOP A STRUCTURE AND GUIDELINES FOR THAT TYPE OF BOARD. Councilmember Wilson SECONDED THE MOTION. VOTE: Unanimous. The motion carried. eIN MODIFICATIONS TO THE CITY' S TALENT BANK APPLICATION FOR BOARD AND COMMISSION APPLICANTS, MODIFICATIONS TO THE ONLINE APPLICATION AND APPLICATION PROCESS Management Assistant Anna McCray briefed the council on the item. REGULAR MEETING OF THE CITY COUNCIL MAY 19, 2015 PAGE 6 OF 8 Councilmember Waldron MOVED THAT THE FOLLOWING DIRECTION BE GIVEN TO STAFF REGARDING MODIFICATIONS TO THE CITY' S TALENT BANK APPLICATION FOR BOARD AND COMMISSION APPLICANTS, MODIFICATIONS TO THE ONLINE APPLICATION AND APPLICANT PROCESS: THAT WE INCLUDE THE CHANGES THAT THE COUNCIL HAD REQUESTED AND COME BACK WITH A FORM THAT ENHANCES THE USER' S EXPERIENCE ONLINE SO WE CAN HOPEFULLY GET IT Amk SUBMITTED ONLINE Councilmember Evans SECONDED THE MOTION. VOTE: Unanimous . The motion carried. SELECTION OF MEETING DATES, TIMES, LOCATIONS, AND PURPOSES Vice Mayor Barker MOVED THAT AN EXECUTIVE SESSION AT 5: 45 P.M. AND A WORK SESSION AT 7 : 00 P.M. BE HELD ON MONDAY, JUNE 1, 2015, 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, JUNE 2, 2015, IN THE CITY COUNCIL CONFERENCE ROOM. Councilmember Waldron SECONDED THE MOTION. VOTE: Unanimous . Amok The motion carried. CALL TO THE PUBLIC Ms . Tess Nesser, 1511 S. Cactus, Apache Junction, addressed the council regarding the boys and girls club car raffle and their upcoming rock concert fundraiser on Saturday ADJOURNMENT ) Mayor Insalaco adjourned the meeting at 7 : 31 p.m. REGULAR MEETING OF THE CITY COUNCIL MAY 19, 2015 PAGE 7 OF 8 Consent Agenda Items are as follows : 1 . Consideration of acceptance of agenda. 2 . Consideration of approval of minutes of regular meeting of May 5, 2015. ACCEPTED THIS 2ND DAY OF JUNE, 2015, BY THE MAYOR AND CITY __ COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA. SIGNED AND ATTESTED TO THIS 2ND DAY OF JUNE, 2015. 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 19th day of May, 2015. I further certify that the meeting was duly called and held and that a quorum was present. Dated this 20th day of May, 2015 KATHLEEN CONNELLY City Clerk REGULAR MEETING OF THE CITY COUNCIL MAY 19, 2015 PAGE 8 OF 8 ROLL CALL VOTE NOTES' I jiri vo i,\, ,). 04, (3 _, ITEM # MEETING OF EP 0,1 MOTION BY r V SECONDED BY 7S NO ABSTAINED 1. COUNCILMEMBER WILSON � COUNCILMEMBER SERDY COUNCILMEMBER WALDRON COUNCILMEMBER RIZZI / VICE MAYOR BARKER // COUNCLMEMBER EVANS V MAYOR INSALACO UNANIM9US IN FAVOR OPPOSED ABSTAINED TOTAL f CONSENT AGENDA ITEM NOS. 1-3 I MOVE THAT THE CONSENT AGENDA BE ACCEPTED AS PRESENTED ..11b, G�,t--- City of Apache Junction, Arizona 300 E Superstition Boulevard rz a Agenda Item Cover Sheet Apache Junction,AZ 85119 Y� • f/f� Agenda Item No 4 2 File ID 15-32 Sponsor: Bryant Powell Agenda Date.6/2/2015 Index. In Control. City Council Meeting Amok City manager's report Attachments Auk City of Apache Junction,Arizona Page 1 Printed on 5/26/2015 PUBLIC HEARING 1. For APPLICATION FOR ACQUISITION OF CONTROL FOR THE LIQUOR LICENSE OF SAFEWAY#253 AT 3185 W. 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. City of Apache Junction, Arizona 300E Superstition �11 Boulevard Agenda Item Cover Sheet Apache Junction,AZ 85119 • -Or Agenda Item No 5 x F File ID 15-168 Sponsor. Kathy Connelly Agenda Date:6/2/2015 Index. Local/State/Federal Statutory Requirement In Control.City Council Meeting p Consideration of an application for acquisition of control for the liquor license of Safeway#253 located at 3185 W Apache Trail The next step in the process is for the council to have a public hearing and make a recommendation for approval or denial to be forwarded to the Arizona Department of Liquor Licenses and Control Attachments City of Apache Junction,Arizona Page 1 Printed on 5/26/2015 MAY 21, 2015 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 JUNE 2, 2015: APPLICATION FOR AN ACQUISTION OF CONTROL FOR SAFEWAY #253 LIQUOR LICENSE An application for an Acquisition of Control of the Safeway #253 Liquor License has been submitted by Ms. Andrea Dahlman Lewkowitz for the Safeway located at 3185 W Apache Trail, Apache Junction, Arizona. Correspondence has been received from the police department, planning division and the fire district, a copy of which is attached. The recommendation from the building division is still pending and will be forwarded upon receipt 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 Print Form ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL 800 W Washington 5th Floor Phoenix-AZ 85007-2934 www.azliquor.gov (602) 542-5141 NOTIFICATION TO LOCAL GOVERNING BODY AGENT CHANGE ❑ ACQUISITION OF CONTROL AND AGENT CHANGE ❑ ACQUISITION OF CONTROL Liquor License No. Fl HOD" D Application accepted by t A.R.S. § 4-203.F If a person other than those persons originally licensed acquires control over a license or licensee, the person shall file notice of the acquisition with the Director within fifteen business days after such acquisition of control and a list of officers, directors or other controlling persons on a form prescribed by the Director. All officers, directors or other controlling persons shall meet the qualifications for licensure as prescribed by this title On request, the director shall conduct a preinvestigation prior to the assignment, sale or transfer of control of a license or licensee, the reasonable costs of which, not to exceed one thousand dollars, shall be borne by the applicant. The preinvestigation shall determine whether the qualifications for licensure as prescribed by this title are met On receipt of notice of an acquisition of control or request of a preinvestigation, the Director shall forward the notice within fifteen days to the local governing body of the city or town, if the licensed premises is in an incorporated area, or the county, if the licensed premises is in an unincorporated area. The Local Governing Body of the city, town or county may protest the acquisition of control within sixty days based on the capability, reliability and qualification of the person acquiring control. If the Director does not receive any protests, the Director may protest the acquisition of control or approve the acquisition of control based on the capability, reliability and qualification of the person acquiring control. Any protest shall be set for a hearing before the Board. Any transfer shall be approved or disapproved within one hundred five days of the filing of the notice of acquisition and control. The person who has acquired control of a license or licensee has the burden of an original application at the hearing, and the board shall make its determination pursuant to section 4-202 and this section with respect to capability, reliability and qualification. LIC 1C25 4/2009 ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL 800 W Washington 5th Floor Phoenix AZ- 85007-2934 ww'w azliquor'gov, (602) 542-5141 APPLICATION FOR AGENT CHANGE -ACQUISITION OF-CONTROL -RESTRUCTURE 'a r Check Boxropriate ctiAgent Change k Acquisition of Control ] Restructure 1:: Complete Sections 12,3,4,6 Complete Sections 1,2,(3,4 if changing Agent),6 �omplete Sections 1,2,(3,4 if changing Agent),5,6 3 (See Note 1 on back) (See Note 2 on back) R) SECTION 1 (COMPLETE THIS SECTION FOR AGENT CHANGE,ACQUISITION OF CONTROL OR RESTRUCTURE) tC;',A.`` 1. Name(INDIVIDUAL OR EXISTING AGENT(if no agent change)OR NEW AGENT OR CORPORATE OFFICER OR L L C CONTROLLING MEMBER) Lewkowitz Andrea Dahlman 09110030 Last First Middle Liquor License# 2. M Corporation ❑ L L C ❑ N/A Safeway,Inc Corp File# F 0037205 0 (Exactly as it appears on Articles of Inc or Articles of Org) 3 Business Name SAFEWAY#253 (Exactly as it appppears on license) 4. Business Address. 3185 W APACHE TRAIL APACHEJUNCTION FINAL 85220 (Do not use P 0 Box Number) City COUNTY Zip 5 Is the business located within the incorporated limits of the above city or town? INYes ❑No 6 Mailing Address 2600 N Central Avenue,Suite 1775 Phoenix AZ 85004 City State Zip 7 Business Phone. ( 520 894-4100 Residence Phone ( 602 ) F 200-7222 8. Does this transaction involve the sale of any portion of the corporate stock? EYES ❑NO n N/A If yes, submit a certified copy of minutes 9 Has there been any change of officers?OYES ONO ❑N/A If yes,submit a certified copy of minutes SECTION 2 (COMPLETE THIS SECTION FOR AGENT CHANGE,ACQUISITION OF CONTROL OR RESTRUCTURE) Each person listed in Section II must submit a personal questionnaire(Form LIC0101)and a Department approved fingerprint card which may be obtained at the Dept. A person appearing in both lists need only submit one questionnaire and fingerprint card. 1 List individual owner or partners or all directors,officers in corp.,members in LLC Last First Middle Title Residence Address City State Zip See attached (ATTACH ADDITIONAL SHEET(S)IF NECESSARY) 2. List stockholders or controlling members owning 10%or more of Corp/LLC Last First Middle %Owned Residence Address City State Zip See attached (ATTACH ADDITIONAL SHEET(S)IF NECESSARY)1/7/20 1 3 Disabled individuals requiring special accommodations please call the Department Date Received v CSR OIN ritd °15 18 L1 ', Lit. "I" ,41 Safeway Inc. AB Acquisition LLC(B) (12(6105 DE) OFFICERS: Robert haler Exec Chairman Robert Edwards: Pres/CEO Justin Dye: EVP/C00 Richard Navarro: EVP "CLASS a MEMBERS"(Safeway DNLY) Safeway Group HG(dlnas Inc,(94.29%parent entity far AB Acquisition LLC"Class B'members only) Robert Miller.Executive Chairman Robert Edwards:President/CEO Justin Dye:COO Robert Gordon:EVP/SecJGC Cerperusfcobera,LLC(39.22%) (Stephen Feinberg.Director reported on CP Affidavit) Cerberus Partners,LP(62.45%) GP: Cerberus Associates,LLC. Corborus Institutional Partners V,LP(31.73%) GP: Cerberus Institutional Associates II L.LC. (No other member owns 10%or greater of licensee Safeway Inc.) .Jubiloo A136'Holding,LLC(16.11%) (Joy Schottenstein,Director reported on CP Affidavit) (No member owns 10%or greater of licensee Safeway Inc.) Hie ft Markets Holdings,LLC(16.11%) (Hersch Kieft,Director reported on CP Affidavit) (No member owns 10%or greater of licensee Safeway Inc.) Le:berr-Adler$AN Aggreqnfpr,1..P,(16.11%) (Dean Adler,Director reported cn CP Affidavit) General Partner(s(: Lubert-Adler Group SAN LLC (No limited partner owns 10%or greater of licensee Safeway Inc.) ?MS AB Acaulsf((orr,LLC-15.11%(David Henry,Director reported on CP Affidavit) (No member owns 10%or greater of lice nee°Safeway Inc.) (No other member owns 10%or greater of CLASS B Interest In AB Acquisition LLC) Albortsons Holdings LLC(8) ACC dR-1 77 9 44 6-8(Delaware LLC) (Sole Member AB Acquisition LLC) OFFICERS. Robert M:I:er-Exec Chairman Richard Navarro-EVP Robert Edwards-Pros/CEO Robert Gordon-EVP/SocfGC Safeway Inc (LICENSEE) Acc 0f-0037205-0(Delaware Corp) (Sole Shareholder. Albertaons Holdings LLC) OFFICERS' Robert Edwards-Pres/CEO Robert Gordon-EVPISECIGC Bradley Fox-VPRross 0998-002{204575) Print Form ARIZONA DEPARTMENT OF LIQUOR LICENSES AND CONTROL 800 W Washington 5th Floor Phoenix AZ 85007-2934 www.azliquor.gov (602) 542-5141 APPLICANT/CONTROLLING PERSON AFFIDAVIT TO BE COMPLETED BY THE ORGANIZATION'S PRESIDENT IF THIS IS A CLUB, PARTNERSHIP, OR OTHER TYPE OF ORGANIZATION,A SIGNATURE OF EQUAL LEVEL IS REQUIRED. Organization' Safeway,Inc Affidavit of Andrea Dahlman Lewkowitz Position/Title: Agent and Attorney for Applicant State of Arizona AZ Corp./L.L.C.#. F-0037205-0 County of: Maricopa State Incorporated' Delaware The undersigned, Andrea Dahlman Lewkowitz being first sworn under oath declares 1. In connection with this organization's application to obtain a liquor license for our operation(s) in Arizona, I have completed and delivered to the Arizona Department of Liquor Licenses and Control the required questionnaire and fingerprint card 2. The required questionnaires and fingerprint cards of all officers, directors, regional managers, managing members,partners,etc.,who direct or are involved in the direction of the management of the policies involving spirituous liquor in the State of Arizona, and all stockholders who own ten percent (10%) or more of the corporation or limited liability company have also been completed and delivered to the Arizona Department of Liquor Licenses and Control. Name and title of such individuals areas follows(or list attached)' (1) Robert L Edwards Pres/CEO of Safeway Inc.,Albertsons Holdings LLC,AB Acquisition LLC+Safeway Group Holdings Inc (2) Robert A.Gordon EVP/Sec of Safeway Inc,Albertsons Holdings LLC+Safeway Group Holdings Inc. (3) Bradley S.Fox. VP/Treas of Safeway Inc (4) Robert G Miller Exec Chairman of Albertsons Holdings LLC,AB Acquisition LLC+Safeway Group Holdings Inc (on file) (5) Richard Navarro EVP of Albertsons Holdings LLC and AB Acquisition LLC(on file) (6)Justin Dye. EVP/COO of AB Acquisition LLC+COO of Safeway Group Holdings Inc(on file) *Disabled Individuals requiring special accommodations,please call(602)542-9027. L Ic o107 4/2009 3 There are, in addition to those submitting questionnaires and fingerprint cards, other officers, limited liability members, and/or board members of this organization who are not submitting such information to the Arizona Department of Liquor Licenses and Control None of these individuals directs or is involved in the direction of the management of policies of this organization involving spirituous liquor in the State of Arizona. Such members and positions, along with date and place of birth, are as follows(or list attached) (1) Stephen Feinberg,Director of Cerberus Iceberg,LLC DOB. 3/29/60 POB New York,NY (2) Hersch Klaff,Director of Klaff Markets Holdings,LLC DOB. 9/21/53 POB Johannesburg,South Afnca (3) Jay Schottenstein,Director of Jubilee ABS Holding,LLC DOB. 6/11/54 POB• Columbus,OH (4) Dean Adler,Director of Lubert-Adler SAN Aggregator,LP DOB 1/23/57 POB. Cleveland,OH (5) David Henry,Director of Kimco Realty Corporation DOB• 3/8/49 POB New York,NY 4. None of the individuals listed under item#3 possesses the power to vote ten percent(10%) of the outstanding voting secunties of this organization,nor can any of them control the election of one or more of the Board of Directors or managing members of the organization 5. Finally, on information and belief, none of the individuals listed under item #3 have at any time been convicted of a felony, had a liquor license revoked, or violated any provisions of a liquor hcense issued to that member DATED this 110> day of March 2015 Day Month Year Andrea Dahlman Lewkowitz ,declare that I am the APPLICANT filing this notification I have (Print full name) read this document and the contents and all statements are true,correct and complete. State of Arizona County of Mancopa X ° The foregoing instrument was acknowledged before me this (Signature) day of March 2015 Day Month Year My co • y.i t _ _.�l� \1 IttT Notary Public-Ar tael (nature of NOT• a:LIC) Maricopa County . - My Commission Expires ires ".ai.% February • (COMPLETE THIS SECTION FOR AGENT CHANGE) 1. If the corporation/L L C I another entity,ATTACH AN OWNERSHIP AND DIRECTOR/OFFICER/MEMBER DISCLOSURE for the parent entity. ional sheets as necessary in order to disclose real people. As an Agent,will you be physically present and operating the licen es? E YES E NO If you answered YES,you must provide proof of attendance of a Department appro r Law Training Course within the last five years before our a lication for A ent can be submitted. If"no"a mana er wl ed training must be submitted. TION 4 (COMPLETE THIS SECTION FOR AGENT CHANGE) • -- completed by the INDIVIDUAL OR EXISTING AGENT OR CORPORATE OFFICER OR L.L.0 CONTROLLING MEMBER: 1 License Num.- • Date of last renewal 2 Current Licensee or Agen : (Exactly as it appears on license) First Middle I. , hereby consent to the agent appointment named herein and (Print full name) agree to immediately assign a new agent in the event of the . - h, resignation, or discharge of this agent. I also understand that If the background report shows that I, the corporation, or any officer, . -ctor, member, or stockholder have been convicted of a felony in the past five(5)years, I will Immediately surrender the license to : •rizona Department of Liquor Licenses and Control and hereby waive all rights to appeal such action State of -.unty of X The foregoing instrument w. - knowledged before me this (Signature of INDIVIDUAL/CORPORATE/CLUB OFFICER/MEMBER) day of 2014 Day Month Year My commission expires on (Signature of NOTARY PUBLIC) ION 5 (COMPLETE THIS SECTION FOR RESTRUCTURE) Is there more than o • ensed premises involved? D YES D NO If yes, SEPARATE APPLICATIONS must be filed and fees paid for each license/location Type of current ownership. Type of new ownership: ❑ JT.W.RO.S. ❑ JTWROS ❑ INDIVIDU AL ft • P IVIDUAL ❑ PARTNERSHIP ❑ PART - ❑ CORPORATION ❑ CORPORATION ❑ LIMITED LIABILITY CO ❑ LIMITED LIABILITY CO ❑ TRUST ❑ TRUST ❑ OTHER Explain ❑ OTHER Explain SECTION 6 (COMPLETE THIS SECTION FOR AGENT CHANGE,ACQUISITION OF CONTROL OR RESTRUCTURE) To be completed by INDIVIDUAL OR EXISTING AGENT(if no agent change) OR NEW AGENT OR CORPORATE OFFICER OR L.L.C.CONTROLLING MEMBER as listed in Question 1 Section 1: I, Andrea Dahlman Lewkowitz , hereby declare that I am the APPLICANT filing this application (Print full name) have read II tion and th contents and all statements are true, correct and complete State of Arizona County of Mancopa X '-' The foregoing instrument was acknowledged before me this (Slgnatur IN IVIDU GENT) at✓r �uh 1 F /• �,� Notary Public Ariri zona 20 day of March 2015 Mar:.1-0pa County My C,,rnnnssicn Ezp.res!` Day nth Year 07/ 2017 rebruarp 12 2017 My commission expires on: (Sign tur NOTARY PUBLI NOTE 1. The fee for an agent change MUST be submitted with this application. 00 00 for the first ap cation and$50.00 for each additional application, not to exceed$1,000 00 (A.R S 4-209 H) NOTE 2. The $100.00 fee for restructure/acquisition of control MUST be submitted with this application.(A.R.S 4-209 A) SAFEWAY INC. UNANIMOUS WRITTEN CONSENT OF THE BOARD OF DIRECTORS TO ACTION IN LIEU OF SPECIAL MEETING January 30,2015 Pursuant to the provisions of Section 141(f) of the General Corporation Law of the State of Delaware and consistent with the provisions of the Certificate of Incorporation of Safeway Inc., a Delaware corporation (the "Corporation"), the undersigned, constituting the entire membership of the Board of Directors of the Corporation, hereby consent to the adoption of the following resolutions and to the taking of the actions contemplated thereby, in each case with the same force and effect as if presented to and adopted at a meeting of said Board of Directors: Appointment of Officers WHEREAS, the Board of Directors desires to appoint officers of the Corporation, in each case to hold the position and serve as an officer of the Corporation until his or her successor shall have been duly elected and qualified or until his or her death, resignation or removal NOW THEREFORE, IT IS HEREBY RESOLVED, that, effective as of the date hereof, the following persons be, and they hereby are, elected to the office or offices of the Corporation set forth opposite their respective names (collectively referred to herein as the "Authorized Officers"), to hold office at the pleasure of the Board of Directors and otherwise in accordance with the Bylaws of the Corporation and the law of the State of Delaware, until their respective successors are elected and shall have qualified or until their earlier death, resignation or removal. Name Title Robert Edwards President and CEO Robert Gordon EVP, General Counsel &Secretary Bradley Fox Vice President, Treasurer Peter Bocian EVP & Chief Financial Officer Thomas Hanavan Vice President,Real Estate Law Dennis Dunne Vice President, Corporate Accounting Eastern Division Transaction and Related Agreements WHEREAS, the Corporation has been involved in discussions regarding a proposed series of transactions as a result of which (i) the Corporation would transfer DOC ID-22259000.4 State of Delaware Secretary of State Davision of Corporations Delivered 07:57 AM 01/30/2015 FILED 08:00 AM 01/30/2015 SRV 150119464 - 2096948 FILE CERTIFICATE OF MERGER OF SATURN ACQUISITION MERGER SUB, INC. WITH AND INTO SAFEWAY INC. Under Section 251 of the General Corporation Law of the State of Delaware Pursuant to Section 251(c)of the General Corporation Law of the State of Delaware(the "DGCL"), Safeway Inc,a Delaware corporation,in connection with the merger of Saturn Acquisition Sub,Inc ,a Delaware corporation,with and into Safeway Inc (the"Merger"),hereby certifies as follows FIRST• The names and states of incorporation of the constituent corporations to the Merger(the"Constituent Corporations")are. Name State of Incorporation Safeway Inc Delaware Saturn Acquisition Merger Sub, Inc Delaware SECOND. An Agreement and Plan of Merger,dated as of March 6,2014,as amended by and among Safeway Inc,AB Acquisition, 1.I.C,Albertson's Holdings,LLC,Albertson's LLC, and Saturn Acquisition Merger Sub, Inc,as amended(the"Merger Agreement"),setting forth the terms and conditions of the Merger, has been approved,adopted,certified,executed and acknowledged by each of the Constituent Corporations in accordance with Section 251 of the DGCL. THIRD' Safeway Inc.shall be the surviving corporation of the Merger The name of the surviving corporation is"Safeway Inc "(the "Surviving Corporation") FOURTH. The Certificate of Incorporation of Safeway Inc in effect immediately prior to the Merger shall be amended and restated to read as set forth on Exhibit A hereto,and,as so amended,shall be the Certificate of Incorporation of the Surviving Corporation FIFTH: The Merger shall become effective immediately upon the filing of this Certificate of Merger with the Secretary of State of the State of Delaware. SIXTH An executed copy of the Merger Agreement is on file at the office of the Surviving Corporation located at 5918 Stoneridge Mall Road, Pleasanton,CA 94588-3229. A copy of the Merger Agreement will be furnished by the Surviving Corporation,on request and without cost,to any stockholder of either of the Constituent Corporations EN WITNESS WHEREOF,this Certificate of Merger has been executed on this 30th day of January,2015. SAFEWAY INC. By: .4'(4''' /1-4 Name: Robert A.Gordon Title: Senior Vice President Secretary&General Counsel [Signature Page to Certificate of Merger] fDe[aware PAGE 1 (Te First State I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF DELAWARE, DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF THE CERTIFICATE OF MERGER, WHICH MERGES: "SATURN ACQUISITION MERGER SUB, INC. ", A DELAWARE CORPORATION, WITH AND INTO "SAFEWAY INC. " UNDER THE NAME OF "SAFEWAY INC. ", A CORPORATION ORGANIZED AND EXISTING UNDER THE LAWS OF THE STATE OF DELAWARE, AS RECEIVED AND FILED IN THIS OFFICE THE THIRTIETH DAY OF JANUARY, A.D. 2015, AT 8 O'CLOCK A.M. A FILED COPY OF THIS CERTIFICATE HAS BEEN FORWARDED TO THE NEW CASTLE COUNTY RECORDER OF DEEDS. _ „ Jeffrey W Bullock,Secretary of State 2096948 8104M . AUTHEN C TION: 2080990 150119464 der�w�� DATE: 01-30-15 You may verify this certificate online at corp delaware gov/authver.shtml ) SEE RESTRICTIVE LEGENDS ON REVERSE SIDE HEREOF t,: -�•--i•,... 1,../will,„ -� •ter. % .i...., .ram+f`e'f ".417•=.. +`ia Y, .: .:r1! :i•7.:•. air{Jt .k.+V.:::., .r:i,.(f ttly;;-... ,jiY: 11�;+}:i f�! .a. :1: ;+ti', •' , .1i;7.11•, ,r, ". .i.,a Asi ,;i;;,r i;h...:,! pa t.: •.,1/{ li..• .r?a•:e 11 \ <sr.4',1 ,•s sy 7.tw : :, '+ i`Z. �+, r .t c..tyr. +•.. 7,1'.��.:, °l ;?� .;� \� •y n y asiL,: q y\•a:, ,:f / .y", !:; ,171 .`1�„ c :i111 \\\�r�''•a,!•r:.4.v Hi \1�'''•.�,t, :., /fN1 \11��•,•. f14 :•Y.i.� � .,y'.:; 1 .•�\ fl�t ,1\ Ji „`�` ` t1: ^ 5 email: },i..! •��4 ! ;y: ,,, i'7s.:'i�, ,£. 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' ry * SAFEWAY INC. *1*Shares aR. - , , = =r • ,' 10000I c: .fir_ 4.- A Delaware Corporation Common Stock •`�"gl";' A* lE•� S 6 s lr Wi :5�.\l\_,. i l�••i 2 +t b 1i. n Jr T; THIS CERTIFIES THAT Albertsons Holdings LLC is the record holder of ONE (1) fully aid and non-assessable shares -:4,• 0 / y..-V.3 -�'=�, of Common Stock, par value $0 01 per share, of Safeway Inc.t 1 (the"Corporation"), transferable only on the share register of the y ;�` r : s Corporation bythe holder, inperson orsuch holder's dulyauthorized attorney, upon surrender of this Certificate properly l T a ,;_ rP by Y P P P Y <y la....-„ .•,-,.-......„. �'.:`g;r� _:• . endorsed or assigned a "y-' rt`" c `'v" ' 1 ' X This Certificate and the shares represented herebyshall be held subject to all of theprovisions of the Certificate of ' �''{`''- {" .,..---:'•,,' "'•.: t. P -. •`'fin;;`;::; '. �?' 1., b Incorporation and the Bylaws of said Corporation and any amendments thereto, a copy of each of which is on file at the office of p u•>'-;33- '. '. 1 r`.,{:1 , the Corporation and made a part hereof as fully as though the provisions of said Certificate of Incorporation and Bylaws were 1 , '4,4 : :F.: X:, ,;,t:) imprinted in full on this Certificate,to all of which the holder of this Certificate, by acceptance hereof, assents and agrees to be 1 gyy; ;,- =t'y` "'" bound ' :• '� ' `* � ,'ei.t`' ` IN WITNESS WHEREOF, the Corporation has caused this Certificate to be signed by its duly authorized officers this ,�;" '��F ' \:0`:�x;:',... day ofJanuary,2015. ,' . '; ' fi`t»1:r3 �ri -Cr�� J sue. t• "• .x•4u. ... t, e �'r t. .y-;.; p Robert A Gordon, Secretary l Robert Edwards,President �i•�' 3 . / J ' :a a r'-,,: n 1i;'i 1 < ter, ;.,� Om.:eseserewe.. seye.e:'wrest,e...,. :see•e a can:;;s;•.+.,..:ta,j. 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't+�.=., n�:'�,,, �q •�,2. .s;nc ��,", �•:}�•:>•,`% ;• " ., 1�;;, „1t I a:,( .�� ' ' . a"• .... ter:' is ,. ,0,s .,.r , J k. \ �r+••"w� li?. ,�'1r\:�> 41,331, ',py:.a,?t ��.r, k�tiiL'S:•tic' K.:? .C.•/„i :�.,.,,�'s''tt•, t\•�.� h.. ,ti- +yMtit>c:/fir q:r ;1•�':7. `;R.lr:y,/!i/ r•.:}'r�i�;i¢•r>>\> ':�/jl'., ^;f?i; ta��. . /!1 " ,s,,p� sa`. /„•�ii` .W !H} ft; nes Cs 111j.'i,•i.wt;l:*. if t }y.J� Jl1/,,,,.. •,..t. 111 nY yb.P A.. \ f/f`ttif.•. .uls. C // L- di4 � y ' ' i.A! ;sW p'$ 7.?•a�� lea +. A lti if :;A! j`o-r '•1.y\ /a;WI a ll, '.L ::F h ?!.- . !.:__-..• .,1t (::::_, -':. ,e , •,y � Ae.A• •.,\5, �^\�.� JsclJ .1, -V�\`'. / LITHO 1N U.5 A`__/ `_ ARIZONA DEPARTMENT OF LIQUOR LICENSES& CONTROL 800 VVWashington 5th Floor al/MO In(f'—tt,t tp) Phoee nix AZ 85007-2934 (602) 542-5141- QUESTIONNAIRE TIVC6ial Attention all Local Governing Bodies. Social Security and Birthdate Information is Confidential. This information may be give 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. r-- 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 BE COMPLETED BY EACH CONTROLLING PERSON,AGENT,OR MANAGER. EACH PERSON COMPLETING THIS FORM MUST SUBMIT AN "APPLICANT"TYPE FINGERPRINT CARD AVAILABLE AT THIS OFFICE FINGERPRINTS ON FBI-APPROVED CARDS ARE ACCEPTED FROM LAW-4 ENFORCEMENT AGENCIES, BONA FIDE FINGERPRINT SERVICES,OR THE DEPARTMENT OF LIQUOR THE DEPARTMENT CHARGES A$13 FEE? In addition to other fingerprint fees,a$22 DPS background check fee will be charged for each r-'s fingerprint card Liquor License # -" The fees allowed by A.R.S.4 44-6852 will be charged for all dishonored checks. 09110030 (If the location Is currently licensed) 1 Check 0 Controlling Person t 1Agent 0 Manager(Only) appropriate (Complete Questions 1-19) (Complete All Questions except#14,14a&21) box ---fp. Controlling Person or Agent must complete#21 for a Manager Controlling Person or Agent must complete#21 2 Name- Lewkowitz Andrea Dahlman Date of Birth aiiiiiiall Last First Middle (NOTa Public Record) 3 Social Security Number fiEliallIMIP Drivers License# . State Arizona (NOT a public record) (NOT a public record) 4 Place of Birth Mankato MN USA Height: 5 8 Weight 135 Eyes Hzl Hair Blonde City State Country (not county) 5 Marital Status 0 Single® Married 0 Divorced 0 Widowed 6 Name of Current or Most Recent Spouse. Lewkowirz Harold Jerome N/A Date of BirthM_ (List all for last 5 years-Use additional sheet if necessary) Last First Middle Maiden (NOT a public record) 7 You are a bona fide resident of what state? Arizona If Arizona, date of residency 04/1961 8 Telephone number to contact you during business hours for any questions regarding this document. (602)200 7222 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 registration card 10 Name of Licensed Premises. Safeway#253 Premises Phone (520)894-4100 — 11 Physical Location of Licensed Premises Address 3185 W Apache Trail Apache Junction Ptnal 85220 Street Address (Do not use PO Box#) City County Zip 12 List your employment or tyae 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 Month/Year Month/Year OR BUSINESS (street address,city,state&zip) 04/2009 CURRENT Attorney Lewkowitz Law,2600 N Central Avenue,Suite 1775,Phoenix,AZ 85004 ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION^ 13. Indicate your residence address for the last five (5)years. V FROM TO Rent or RESIDENTIAL Street Address Month/Year Month/Year Own If rented,attach additional sheet with name,address and phone number of landlord , City State Zip 02/1998 CURRENT Own 5745 N 25th Street Phoenix AZ 85016 . 1 April 16,2012 Disabled individuals 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 14 As a Controlling Person or Agent,will you be physically present and operating the licensed premises? OYES IN NO If you answered YES, how many hrs/day? ,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) EYES ENO lithe 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 cited,arrested. indicted or summoned into court for violation of ANY law or ordinance, ❑YES ®NO regardless of the disposition, even if dismissed or expunged,within the past ten (10) years? In addition, please include all traffic tickets and complaints within the last ten (10)years that resulted in a warrant for arrest AND any traffic tickets and complaints that are alcohol or drug-related ...16.Are there ANY administrative law citations, compliance actions or consents,criminal arrest, indictments ❑YES ® NO or summonses PENDING against you or ANY entity in which you are now involved'? Include only criminal traffic tickets and complaints 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 liquor application or license rejected. denied, revoked, suspended or fined in this or any other state? 18 Has anyone EVER filed suit or obtained a judgment against you, the subject of which involved fraud or OYES NO misrepresentation? 19 Are you NOW or have you EVER held ownership, been a controlling person, been an officer, member, EYES ®NO 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 20 I, Andrea Dahlman Lewkowitz , hereby declare that I am the APPLICANT/REPRESENTATIVE (print full name of Applicant) filing this questionnaire I have read this questionnaire and all statements are true, correct and complete X __ _ State of Arizona County of Maricopa nature of Applicant) The foregoing instrument was acknowledged before me this 20 day of March , 2015 C;HROFF AMY l s Arizona r Month Year Nota 148. - ' Y \ My commission expires on �#2i M }apa county '�{a�th My C�mm�PublIc $°12 2017ires get. Fel�t�jyry (Sig�e f NOTARYPUBQS$ • COMPLETE THIS SECTION ONLY IF YOU ARE A CONTROLLING PERSON OR AGENT APPROVING A MANAGER'S APPLICATION 21 The applicant here. .uthorizes the person named on this questionnaire to act as manager for the named liquor license The manager named mu ,- at least 21 years of age State of County of The foregoing instrument was acknowledged before me this X day of Signature of Controlling Person or Agent(circle one) Month ' Year (Sign- . - of NOTARY PUBLIC) Flint Name My commission expires on Day Month Year 2600 North Central Avenue Lam..E VV K O t ' I TZ Suite 1775 i `�.. Y Y Phoenix;Anzona 85004 LAW OFFICE, PLC C 602.200 7222 602.200.7234 www.lewkowitzlaw corn Andrea D.Lewkowitz H.J Lewkowitz March 20,2015 Connie Wagner,Director of Licensing Department of Liquor Licensing&Control 800 West Washington Street,5th Floor Phoenix,Arizona 85007 Re. Alien Status Form and Passport Dear Connie. My completed Alien Status form and a copy of my passport are on file at the Arizona Department of Liquor Licenses and Control If you require more information from me,please call Thank your Sincerely, An ea D.Lewkowitz ADL/als ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL 800 W Washington 5th Floor h Phoenix AZ 85007-2934 f (602)542 5141 QUESTIONNAIRE r U 4 Attention all Local Governing Bodies: Social Security and Birthdate Information is Confidential. This Information may be giver local law enforcement agencies for the purpose of background checks only but must be blocked to be unreadable prior to postiq 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 derklal or subsequent revocation of a license or permit r— TO BE COMPLETED BY EACH CONTROLLING PERSON,AGENT OR MANAGER. EACH PERSON COMPLETING THIS FORM MUST SUBMIT AN "APPLICANT"TYPE FINGERPRINT CARD AVAILABLE AT THIS OFFICE FINGERPRINTS ON FBI-APPROVED CARDS ARE ACCEPTED FROM LAW ENFORCEMENT AGENCIES,BONA FIDE FINGERPRINT SERVICES,OR THE DEPARTMENT OF LIQUOR THE DEPARTMENT CHARGES A$13 FED In addition to other fingerprint fees,a 522 DPS background check fee will be charged for each fingerprint card. Liquor License # The fees allowed by A.R.S.6 44-6852 will be charged for all dishonored checks. 09110030 (If the location is currently licensed) 1 Check ®Controlling Person ❑Agent ❑ Manager(Only) appropriate (Complete Questions 1-19) (Complete All Questions except#14,14a&21) box —9 Controlling Person or Agent must complete#21 for a Manager Controlling Person or Agent must complete#21 2 Name Gordon,Jr Robert Allen Date of Birth111111111.111111MP1 Last First Middle (NOT a Public Record) 3 Social Security Number Drivers License#: 11111.11.1111State. California (NOT a public record) (NOT a public record) 4 Place of Birth Evanston IL USA Height: 5'11 Weight 170 Eyes Ern Hair Brown City State Country (not county) 5 Marital Status ❑Single❑Married®Divorced❑Widowed 6. Name of Current or 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) 7 You are a bona fide resident of what state? California If Arizona,date of residency N/A 8 Telephone number to contact you during business hours for any questions regarding this document. (925)467-3231 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 registration card 10 Name of Licensed Premises Safeway#253 Premises Phone (520)894-4100 1 Physical Location of Licensed Premises Address 3185 W Apache Trail Apache Junction Pmal 85220 Street Address (Do not use PO Box#) City County Zip 12 List your employment or type 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 Month/Year Month/Year OR BUSINESS (street address city,state&zip) 05/1999 CURRENT General Counsel/SVP/Secretary Safeway,Inc.,5918 Stonendge Mall Road,Pleasanton,CA 94588 ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION 13 Indicate your residence address for the last five(5)years FROM TO Rent or RESIDENTIAL Street Address Month/Year Month/Year Own If rented attach additional sheet with name address and phone number of landlord City State Zip 12/2003 CURRENT Own 24 Robert Road Onnda CA 94563 April 16 2012 Disabled individuals requiring special accommodations,please call the Department (602)542-9027 If you checked the Manager box on the front of this form skip to#15 114.As a Controlling Person or Agent,will you be physically present and operating the licensed premises? YES v NO If you answered YES, how many hrs/day? ,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) YES 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 cited.arrested, indicted or summoned into court for violation of ANY law or ordinance, YES ✓ NO regardless of the disposition, even if dismissed or expunged, within the past ten (10)years? In addition, please include all traffic tickets and complaints within the last ten (10)years that resulted in a warrant for arrest AND any traffic tickets and complaints that are alcohol or drug-related 16 Are there ANY administrative law citations, compliance actions or consents, criminal arrest, indictments YES ✓ N( or summonses PENDING against you or ANY entity in which you are now involved? Include only criminal traffic tickets and complaints 17 Have you or any entity in which you have held ownership, been an officer, member, director or manager ✓YES NO EVER had a business, professional or liquor application or License rejected._denied, revoked.suspended or fined in this or any other state? 18 Has anyone EVER filed suit or obtained a judgment against you, the subject of which involved fraud or YES v NO misrepresentation? 19 Are you NOW or have you EVER held ownership,been a controlling person, been an officer, member, ✓YES NO 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 20 I, Robert Allen Gordon, Jr. ,hereby declare that I am the APPLICANT/REPRESENTATIVE (print full name of Applicant) filing this questionnaire I have read this questionnaire and all statements are true, correct and complete X State of e -L/1-r)f )/fq County of Ai G/= Ira% (Signature of Applicant) The foregoing instrument was acknowledged before me this // day of DFGE((13Cg__ , 0)42/� onth Year My commission expires on 0,2// V1/3-At 40/ ��=ia ( )'&'// (mot, k-) Day Month Year (Signatuof NOTARYPUBLIC) 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 acknowledged before me this X day of Signature of Controlling Person or Agent(circle one) Month ' Year Print Name (Signature of NOTARY PUBLIC) My commission expires on %•`r r�<^ Commission# 1964866 Day Month Year z ,:_t Notary Public- California \\ Alameda County a My Comm Expires Jan 21,2016 AZ Supplement to Questionnaire #17+ 19—YES I serve as a "controlling person" for many corporate liquor licenses, some of which may have been cited for alleged liquor violations. I have not been cited personally for a liquor violation. Iz1i1 �i�l Sign Date Robert A. Gordon, Jr. Print ARIZONA DEPARTMENT OF LIQUOR LICENSES&CONTROL 800 W Washington 5th Floor ( • 3 Phoenix AZ 85007-2934 --- (602)542-5141 QUESTIONNAIRE ' ttil t Attention all Local Governing Bodies: Social Security and Birthdate Information is Confidential This information may be givenrp local law enforcement agencies for the purpose of background checks only but must be blocked to be unreadable prior to posti4g or any public view. C. 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.) TO BE COMPLETED BY EACH CONTROLLING PERSON AGENT,OR MANAGER EACH PERSON COMPLETING THIS FORM MUST SUBMIT AN 2 "APPLICANT TYPE FINGERPRINT CARD AVAILABLE AT THIS OFFICE FINGERPRINTS ON FBI-APPROVED CARDS ARE ACCEPTED FROM LAW ENFORCEMENT AGENCIES,BONA FIDE FINGERPRINT SERVICES,OR THE DEPART'MIENT OF LIQUOR THE DEPARTMENT CHARGES A$13 FEE In addition to other fingerprint fees,a$22 DPS background check fee will be charged for each fingerprint card. Liquor License # The fees allowed by A.R.S.4 44-6852 will be charged for all dishonored checks. 09110030 (If the location is currently licensed) 1 Check ®Controlling Person Agent ❑ Manager(Only) appropriate (Complete Questions 1-19) (Complete All Questions except#14, 14a&21) box -÷ Controlling Person or Agent must complete#21 for a Manager Controlling Person or Agent must complete#21 2 Name Edwards Robert Lynn Date of Birth elialliMilliiiIiiir Last First Middle (NOT a Public Record) 3 Social Security Numbei41/11111111111P Dnvers License#- a State California (NOT a public record) (NOT a public record) 4 Place of Birth Milford UT USA Height 6'3 Weight 275 Eyes Brn Hair: Brown City State Country (not county) 5 Marital Status ❑Single®Married 0 Divorced❑Widowed 6 Name of Current or Most Recent Spouse Edwards Joanne Price Date of Birth (List all for last 5 years-Use additional sheet if necessary) Last First Middle Maiden (NOT a public record) 7 You are a bona fide resident of what state? Cahforma If Arizona,date of residency N/A 8 Telephone number to contact you during business hours for any questions regarding this document (925)467-3068 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 registration card 10 Name of Licensed Premises Safeway#253 Premises Phone (520)894-4100 .nk 11 Physical Location of Licensed Premises Address 3185 W Apache Trail Apache Junction Pinal 85220 Street Address (Do not use PO Box#) City County Zip 12 List your employment or type 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 Month/Year Month/Year OR BUSINESS (street address,city,state&zip) 05/2013 CURRENT President+CEO Safeway,Inc.,5918 Stonendge Mall Road,Pleasanton,CA 94588 03/2004 05/2013 Executive VP f CFO Safeway,Inc.,5918 Stonerdge Mall Road,Pleasanton,CA 94588 ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTIONS 13 Indicate your residence address for the last five(5)years FROM TO Rent or RESIDENTIAL Street Address Month/Year Month/Year Own If rented,attach additional sheet with name,address and phone number of landlord City State Zip 12/2013 CURRENT Own 750 El Pintado Road Danville CA 94526 08/2003 12/2013 Own 3654 Pontina Court Pleasanton CA 94566 April 16 2012 Disabled individuals 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 14.As a Controlling Person or Agent,will you be physically present and operating the licensed premises? YES ✓ NO If you answered YES,how many hrs/day? ,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) YES 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 cited,arrested. indicted or summoned into court for violation of ANY law or ordinance, YES ✓ NO regardless of the disposition,even if dismissed or expunged,within the past ten(10)years? In addition, please include all traffic tickets and complaints within the last ten (10)years that resulted in a warrant for arrest AND any traffic tickets and complaints that are alcohol or drug-related. '^16 Are there ANY administrative law citations, compliance actions or consents, criminal arrest, indictments YES ✓ NO or summonses PENDING against you or ANY entity in which you are now involved? Include only criminal traffic tickets and complaints 17. Have you or any entity in which you have held ownership, been an officer, member, director or manager ✓YES NO EVER had a business, professional or liquor application or license rejected, denied. revoked, suspended or fined in this or any other state? 18 Has anyone EVER filed suit or obtained a judgment against you, the subject of which involved fraud or YES ✓ NO misrepresentation? 19 Are you NOW or have you EVER held ownership, been a controlling person, been an officer, member, ✓YES NO 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 20. I, Robert Lynn Edwards , hereby declare that I am the APPLICANT/REPRESENTATIVE (print full name of Applicant) filing this questionnaire. ave read ' uestionnaire .nd all statements are true, correct and complete • .4411 X -- —- - - ---— J2Lv � -- -- - — State of egh .m,LA.. County of(.L OALI AP /. (Signature ofAP..Y U��o CAROLINEA ERICKSON • e foregoing instni nt was acknowledged before me this te:•,,,:1%.)1 �K Commission# 1961827 day of �/7 ✓ , o�O/qNotary Public California z 1 A eda County - Mont „ • Year , My C• u Expires Dec 23, 1 / My commission expires on - „a_ 2� 5 .�- 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 named liquor license The manager named must be at least 21 years of age State of County of The foregoing instrument was acknowledged before me this X day of Signature of Controlling Person or Agent(circle one) Month ' Year (Signature of NOTARY PUBLIC) Print Name My commission expires on. Day Month Year AZ Supplement to Questionnaire #17+ 19—YES I serve as a "controlling person" for many corporate liquor licenses, some of which may have been cited for alleged li quo r violations I have not been cited personally for a liquor violation. Si (_t________ i -- .,"(.,,e4 lz.. iii.—t Date Robert L. Edwards Pnnt • ARIZONA DEPARTMENT OF UQUOR UCENSES&CONTROL 800 W Washington 5th Floor CAI �� Phoenix AZ 85007-2934 (602)542-5141 QUESTIONNAIRE fb1 g619 a Attention all Local Governing Bodies: Social Security,and Birthdate Information is Confidential This information may be givedto local law enforcement agencies for the purpose of background checks only but must be blocked to be unreadable prior to posig or any public view. —‹C Read carefully. This instrument is a sworn document. Type or print with BLACK INK. -- Am. 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 r "APPLICANT"TYPE FINGERPRINT CARD AVAILABLE AT THIS OFFICE. FINGERPRINTS ON FBI-APPROVED CARDS ARE ACCEPTED FROM LAW n ENFORCEMENT AGENCIES,BONA FIDE FINGERPRINT SERVICES,.OR THE DEPARTMENT OF LIQUOR. THE DEPARTMENT CHARGES A$13 FE In addition to other fingerprint fees,a$22 DPS background check fee will be charged for each " fingerprint card. Liquor License # N The fees allowed by A.R.S.6 44-6852 will be charged for all dishonored checks. 09110030 (If the location is currently licensed) 1 Check ®Controlling Person ❑Agent ❑ Manager(Only) appropriate (Complete Questions 1-19) (Complete All Questions except#14,14a&21) box — Controlling Person or Agent must complete#21 for a Manager Controlling Person or Agent must complete#21 2 Name Fox Bradley Stuart Date of Birth Last First Middle (NOT a Public Record) 3 Social Security Number Drivers License# 1 State California (NOT a public record) (NOT a public record) 4 Place of Birth Evanston IL USA Height. 6.0 Weight: 160 Eyes Blue Hair Blonde City State Country (not county) 5 Marital Status E Single®Married 0 Divorced 0 Widowed 6 Name of Current or Most Recent Spouse Fox Robin Schoettler Date of Birlld.IIIIMIII. (List all for last 5 years-Use additional sheet if necessary) Last First Middle Maiden (NOT a public record) 7 You are a bona fide resident of what state? California If Arizona,date of residency' N/A 8 Telephone number to contact you during business hours for any questions regarding this document (925)467-3352 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 registration card A„„'LO Name of Licensed Premises Safeway#253 Premises Phone (520)894 4100 , 1 Physical Location of Licensed Premises Address. 3185 W Apache Trail Apache Junction Pinal 85220 Street Address (Do not use PO Box#) City County Zip 12 List your employment or type 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 MonthfYear Month/Year OR BUSINESS (street address,city,state&zip) 09/1999 CURRENT VP+Treasurer Safeway,Inc.,5918 Stoneridge Mall Road,Pleasanton,CA 94588 ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION 13 Indicate your residence address for the last five(5)years FROM TO Rent or RESIDENTIAL Street Address Month/Year Month/Year Own If rented,attach additional sheet with name,address andphone number of landlord City State Zip 10/1999 CURRENT Own 315 Lowell Lane West Layfayette CA 94549 April 16,2012 Disabled individuals 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 14 As a Controlling Person or Agent,will you be physically present and operating the licensed premises? YES v NO If you answered YES,how many hrs/day? ,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) YES iNO If the answer to#14a is"HO",course must be completed before issuance of a new license or approval on an existing license. 15 Have you been cited. arrested. Indicted or summoned into court for violation of ANY law or ordinance, YES ✓ NO regardless of the disposition, even if dismissed or expunged,within the past ten (10)years? In addition, please include all traffic tickets and complaints within the last ten (10)years that resulted in a warrant for arrest AND any traffic tickets and complaints that are alcohol or drug-related. /. 16 Are there ANY administrative law citations, compliance actions or consents, criminal arrest, indictments YES v or summonses PENDING against you or ANY entity in which you are now involved? Include only criminal traffic tickets and complaints 17 Have you or any entity in which you have held ownership, been an officer,member, director or manager ✓YES NO EVER had a business, professional or liquor application or license rejected.denied.revoked. suspended or fined in this or any other state? 18 Has anyone EVER filed suit or obtained a judgment against you, the subject of which involved fraud or YES v NO misrepresentation? 19 Are you NOW or have you EVER held ownership, been a controlling person, been an officer, member, ✓YES NO 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 20 I, Bradley Stuart Fox , hereby declare that I am the APPLICANT/REPRESENTATIVE (print full name of Applicant) filing this questionnaire. I have read this questionnaire and all statements are true, correct and complete X /5-4-6G- w__ ------- State of County of CE, _,:t41/trdeL (Signet re of Applicant) The foregoing instru nt was ackn wiedged before me this ,a,+Q CAROLINrri A ) 1 . day of ��, - ^Month Year ■ Notary Public-Calibrnia (f11 My commission expires on: ^�~�� Alameda County . m ,i .c 23,2015 �.Z4�1. _ _ _ _ _ __� (Signature of NOTARYPUBLIC) 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 acknowledged before me this X day of Signature of Controlling Person or Agent(circle one) Month Year (Signature of NOTARY PUBLIC) Print Name My commission expires on. Day Month Year AZ Supplement to Questionnaire #17+ 19—YES I serve as a "controlling person" for many corporate liquor licenses, some of which may have been cited for alleged liquor violations. I have not been cited personally for a liquor violation. //u77e 710 '24"�ltA Sign Date Bradley S. Fox Print PQAH ray OPlitild24-11/Ftetiall/ Home of the Superstition Mountains q+ oNP NOTICE The attached application for Acquisition of Control for the Liquor License for Safeway #253 located at 3185 W Apache Trail, Apache Junction, Arizona, was posted on the 12th day of May, 2015, at 3.00 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, June 2, 2015, at the City Council Chambers, 300 E. Superstition Blvd , Apache Junction, AZ at TOO 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 • FAX (480)982-7018•TDD(480)983-0095 •www way net 300 E Superstition Boulevard, Apache Junction,AZ 85119 i PQ AC ik Home of the Superstition Mountains q - oN May 12, 2015 Ms. Andrea Dahlman Lewkowitz Safeway#253 2600 N. Central Avenue Suite 1775 Phoenix, AZ 85004 Dear Ms. Lewkowitz: Please be advised that the application for Acquisition of Control for the Liquor License for Safeway #253 located at 3185 W Apache Trail, Apache Junction, Arizona, was posted on May 12, 2015, in accordance with state law. The Apache Junction City Council will hold a public hearing on June 2, 2015, 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 $50 non-refundable application fee that is due and must be received prior to Wednesday, May 20, 2015, 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 Sincerely, Kathleen Connelly City Clerk • Voice(480)982-8002 • FAX (480)982-7018 • TDD(480)983-0095 • www ajcity net 300 E Superstition Boulevard, Apache Junction,AZ 85119 MAY 11, 2015 MEMORANDUM TO: DEPARTMENT OF PUBLIC SAFETY PLANNING DIVISION APACHE JUNCTION FIRE DISTRICT BUILDING DIVISION THROUGH: KATHLEEN CONNELLY, CITY CLERK FROM JANET R. MASON, DEPUTY CITY CLERK SUBJECT APPLICATION FOR ACQUISITION OF CONTROL FOR SAFEWAY#253 LIQUOR LICENSE Ms. Andrea Dahlman Lewkowitz has submitted an application for Acquisition of Control for Liquor License for the Safeway #253 Liquor License located at 3185 W. Apache Trail, Apache Junction Please conduct the necessary inspections and submit your recommendation by email no later than Wednesday, May 20, 2015, in order for this item to be on the agenda for the City Council meeting of June 2, 2015 Janet Mason From: Rudy Esquivias Sent: Tuesday, May 12, 2015 5 47 PM To: Janet Mason, Dave Zellner;Jeff Robinson;John Suniga (John suniga@sfmd az.gov) Cc: Larry Kirch Subject: RE Application for Acquisition of Control for Safeway#253 ""k Jan. The Planning Division has no objections to this Application for Acquisition of Control The Safeway Store at Apache Trail and Meridian is a long standing Apache Junction business and we wish the new owners/operators continued success in the community. cRu4 04Soptivia!' Senior Planner/Zoning Administrator City of Apache Junction 300 E. Superstition Blvd Apache Junction, AZ 85119 480-474-2645 resquivias@ajcity net SERVICE OVER AND ABOVE THE REST (Development Services Department office hours: Monday through Thursday from 7:00am to 6 OOpm, closed Fridays and Holidays ) From: Janet Mason Sent: Monday, May 11, 2015 2:24 PM To: Rudy Esquivias, Dave Zellner, Jeff Robinson; John Suniga (john.suniga@sfmd.az gov) Cc: Larry Kirch Subject: Application for Acquisition of Control for Safeway #253 Ask . have received an application for acquisition of control for the liquor license of Safeway#253 Please have your department recommendations to me no later than Wednesday, May 20, by noon in order for this to be on the agenda for June 2. Thanks Ja w MaM0 V Deputy City Clerk City of Apache Junction 300 E Superstition Boulevard Apache Junction, AZ 85119 (480)474-5068 imason@aicity net 1 "ft. Almik Janet Mason From: Jeff Robinson Sent: Friday, May 15, 2015 7.47 AM To: Janet Mason Subject: RE.Application for Acquisition of Control for Safeway#253 The police department has no objections to the acquisition of control for the liquor license for Safeway#253. From: Janet Mason Sent: Monday, May 11, 2015 2:24 PM To: Rudy Esquivias, Dave Zellner; Jeff Robinson; John Suniga (john.suniga@sfmd az.gov) Cc: Larry Kirch Subject: Application for Acquisition of Control for Safeway #253 I have received an application for acquisition of control for the liquor license of Safeway#253 Please have your department recommendations to me no later than Wednesday, May 20, by noon in order for this to be on the agenda for June 2. Thanks Jaw Maio-w Deputy City Clerk City of Apache Junction 300 E. Superstition Boulevard Apache Junction,AZ 85119 (480)474-5068 imason@aicity.net AM. Anak r,V Acc,. Aj # Superstition Fire & Medical District c ;Fkl °e4 ��.�f 4 y 1 n 3700 E 1611'Avenue, Apache Junction, AZ 85119 fi c Phone (480) 982-1299, Fax (480) 982-3268 �,Q.Zo�0 �..�" www sfmd.az.gov MEMORANDUM TO Janet Mason,Deputy City Clerk City of Apache Junction 300 E Idaho Road Apache Jct.,AZ. 85219 FROM John Sumga, Deputy Fire Marshal DATE. May 18, 2015 SUBJECT. Application for Liquor License for 3185 W.Apache Trail,Apache Jct.,AZ The Superstition Fire/Medical District has reviewed the application as noted above regardmg the facilities at 3185 W. Apache Trail, (Safeway #253). We 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- e'1 1299. Thank You JOS ATTN Application ROLL CA VOTE / NOTES: OV ciir 1 ITEM # 0 MEETING OF 6 ' 1 MOTION BY SECONDED BY �N YES NO ABSTAINED COUNCILMEMBER RIZZI I COUNCILMEMBER WILSON VICE MAYOR BARKER I COUNCILMEMBER SERDY if COUNCILMEMBER EVANS MAYOR INSALACO 1 UNANIMOUS IN FAVOR OPPOSED ABSTAINED I TOTAL eIN ITEM NO. 5 I MOVE THAT THE APPLICATION FOR ACQUISITION OF CONTROL FOR THE LIQUOR LICENSE OF SAFEWAY#253, SUBMITTED BY ANDREA DAHLMAN LEWKOWITZ, BE RECOMMENDED (FOR APPROVAL) OR(FOR DENIAL)TO THE ARIZONA DEPARTMENT OF LIQUOR LICENSES AND CONTROL I City of Apache Junction, Arizona 300 E Superstition T Boulevard Agenda Item Cover Sheet Apache Junction,AZ 85119 Agenda Item No.6 Illkiiio, , , ,- {�?=1- File ID: 15-160 Sponsor Larry Kirch Agenda Date 6/2/2015 Index. Budgetary Approval not Required In Control. City Council Meeting Presentation, discussion and consideration of Resolution No 15-21, supporting the development of U S Bicycle Route 90 through the City of Apache Junction Attachments. City of Apache Junction,Arizona Page 1 Printed on 5/26/2015 es ems O� PQACNf�� j �� _�Z City of Apache Junction s �f $ Development Services Department ',' 11 ARI CITY COUNCIL STAFF MEMORANDUM DATE : May 12 , 2015 SUBJECT. Presentation and Discussion of a Resolution of the mayor and council of the City of Apache Junction, Maricopa and Pinal counties, Arizona, stating its support for the development of U . S . Bicycle Route 90 through the City of Apache Junction . PRESENTATION: This project is part of a national effort to build a U.S Bicycle Route System ("USBRS") The system will be made up of roads and shared-use paths for bicycle travel and will bring economic benefits to communities in the form of bicycle tourism. Nationally, the project is being coordinated by Adventure Cycling Association, a national non-profit organization specializing in bicycle travel and route development for cyclists. The routes are being numbered and catalogued by the American Association of State eIN Highway and Transportation Officials ("AASHTO") The Arizona Department of Transportation ("ADOT") will nominate the route for AASHTO designation once all the agreements and letters of support are in place. The general route for USBR 90 is from the Arizona/New Mexico border north of Douglas, AZ to the Arizona/California border near Ehrenburg, AZ and Blythe, CA. DISCUSSION. Attached is a draft Resolution for consideration supporting USBR 90 through Apache Junction The east/west route will enter/exit the City along U.S. 60 to Goldfield Road, then travel along Old West Highway and Apache Trail, then along Delaware Drive to Teepee Road then entering/exiting the City. 4 The City Development Services Department recommends that the Council adopt the proposed resolution. The identified route through the City takes advantage of the soon-to-be fully resurfaced Apache Trail which now accommodates bicycle travel This route also brings cross country travelers through the local business district which supports the local merchants and offers services and support. Lawrence Kirch, AICP Director of Development Services Attachments• Correspondence with ADOT Dated November 10 Draft Resolution and Proposed Route Map HF�y�� City of Apache Junction aR,Zo�P Development Services Department II' November 10,2014 Mr Michael Sanders ADOT Bicycle and Pedestnan Programs Coordinator 206 S 171 Avenue Phoenix,AZ 85007 Subject:Comments on U.S.Bicycle Route System in Apache Junction Dear Michael Thank you for the opportunity to make comments on the proposed United States Bicycle Route System through Arizona The City of Apache Junction has reviewed the proposed route through the Phoenix Metro area and fully supports Route 90 as proposed The proposed route designation travels through Apache Junction via U S 60,Goldfield Avenue,Old West Highway, Apache Trail(Old U.S 60)and Meridian Drive I brmg to your attention that the City is plannmg on reconstructing Apache Trail in 2015/16 This reconstruction project is bemg designed to provide a much unproved transportation facility for bicyclists All three options currently being considered include designated bicycle facilities During construction,the City will work with ADOT to designate an alternative route either along Superstition Boulevard(University Avenue)or Broadway Please let me know if you have any questions Sincerely, Lawrence J Kirch,AICP Director of Development Services cc George Hoffman,City Manager Bryant Powell,Assistant City Manager Giao Pham,Director of Public Works RESOLUTION NO. 15-21 A RESOLUTION OF THE MAYOR AND COUNCIL OF THE CITY OF APACHE JUNCTION, MARICOPA AND PINAL COUNTIES, ARIZONA, STATING ITS SUPPORT FOR THE DEVELOPMENT OF U S. BICYCLE ROUTE 90 THROUGH THE CITY OF APACHE JUNCTION. Auk WHEREAS, bicycle tourism is a growing industry in North America, presently contributing approximately $47 billion dollars a year nationally to the economies of communities that provide facilities for such tourists; and WHEREAS, the American Association of State Highway and Transportation Officials ("AASHTO") has designated a corridor that crosses Arizona and connect the Arizona/New Mexico Border north of Douglas, AZ to the Arizona/California border near Ehrenburg, AZ and Blythe, CA to be developed as United States Bike Route 90 ("USBR 90") ; and WHEREAS, the Arizona Department of Transportation is supportive of AASHTO designated bicycle routes through Arizona, subject to ongoing collaboration with affected Jurisdictions to designate specific facilities the routes will traverse; and WHEREAS, the proposed USBR 90 traverses through the City of Apache Junction and a map (set forth in Exhibit A) depicting the preferred route is herein incorporated into this resolution by reference and is expected to provide a benefit to local residents and businesses; and WHEREAS, the City of Apache Junction has duly considered the proposed USBR 90 route and found it to be a suitable route through the Arizona corridor and desires that the route be formally designated so that it can be appropriately mapped and potentially signed, thereby promoting bicycle tourism in the Apache Junction area. NOV, THEREFORE, RF IT RESOLVED BY THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA, THAT: Resolution No. 15- Page 1 of 2 1) It hereby expresses its approval and support for the development of USBR 90 through the City of Apache Junction as depicted on the attached map (Exhibit A) and requests that the appropriate government officials take action to officially designate the route accordingly as soon as possible. 2) The City of Apache Junction may choose to post and maintain signs for the bicycle route once the designation has been made. PASSED AND ADOPTED BY THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, ARIZONA THIS DAY OF 2015. SIGNED AND ATTESTED TO THIS DAY OF , 2015. JOHN S. INSALACO Mayor ATTEST. KATHLEEN CONNELLY City Clerk APPROVED AS TO FORM• R. JOEL STERN City Attorney Resolution No. 15- Page 2 of 2 EXHIBIT A Apache Junction USBR 90 Tepee St4 N,T.S. cc Apache Trail Old, tt .1604 CITY OF APACHE JUNCTION USBR 90 •• o ROLL CALL VOTE NOTES \'L7 (Z)11)1 ?..91 ITEM # MEETING 0 tO 9)1 MOTION BY: tfrA SECONDED BY YES NO ABSTAINED VICE MAYOR BARKER I C E COUNCILMEMBER WILSON J COUNCILMEMBER EVANS COUNCILMEMBER RIZZI J COUNCILMEMBER SERDY MAYOR INSALACO UNANIMO/S IN FAVOR OPPOSED ABSTAINED TOTAL V' ITEM NO. 6 I MOVE THAT RESOLUTION NO. 15-21, A RESOLUTION OF THE MAYOR AND CITY COUNCIL OF THE CITY OF APACHE JUNCTION, MARICOPA AND PINAL COUNTIES, ARIZONA, STATING ITS SUPPORT FOR THE DEVELOPMENT OF U.S. BICYCLE ROUTE 90 THROUGH THE CITY OF APACHE JUNCTION, (BE APPROVED) OR (BE DENIED) ROLL CALL VOTE NOTES V' f 1 \ t_,A VV ITEM # MEETING OF � MOTION BYIPX.Illf) r) ) SECONDED BY N YES NO ABSTAINED COUNCILMEMBER SERDY COUNCILMEMBER RIZZI COUNCILMEMBER EVANS J / COUNCILMEMBER WILSON V COU A AL'DRJA- / VICE MAYOR BARKER �// MAYOR INSALACO UNANI O S IN FAVOR OPPOSED ABSTAINED TOTAL ITEM NOS. 7-8 I MOVE THAT AN EXECUTIVE SESSION AT 5.45 P M.,AND A WORK SESSION AT 7.00 P M , BE HELD ON MONDAY, JUNE 15, 2015, IN THE CITY COUNCIL CONFERENCE /'1 ROOM AND CITY COUNCIL CHAMBERS RESPECTIVELY; AND THAT AN EXECUTIVE SESSION AT 5.45 P.M BE HELD ON TUESDAY, JUNE 16, 2015, IN THE CITY COUNCIL CONFERENCE ROOM. i ADJOURNMENT: 1 11 I MOVE THAT THE MEETING BE ADJOURNED AT P.M. ROLL CALL • ws �' I REG SPEC. CITY COUNCIL: P / A P / A P / A MAYOR INSALACO VICE MAYOR BARKER 1/ V COUNCILMEMBER EVANS COUNCILMEMBER RIZZI tf' COUNCILMEMBER SERDY 1 ✓ / COUNCILMEMBER WALDRON �� '✓ COUNCILMEMBER WILSON I,� V TOTAL (e) CITY STAFF: City Manager George Hoffman 'fir Assistant City Manager Bryant r� Powell City Clerk Kathleen Connelly City Attorney Joel Stern Public Safety Director Tom Kelly Public Works Director Giao Pham Parks & Recreation Director Jeff Bell Library Director Spencer Paden Finance Director Donna Meinerts City Engineer Emile Schmid Development Svcs Director Larry Kirch Human Resources Director Liz Riley Assistant to the City Manager / Matt Busby OTHERS $ Date: 1 CITY OF APACHE JUNCTION Please select an option: REQUEST TO SPEAK FORM Item No. OR Call to The Public /f (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 I m. ❑ I am opposed to the proposed Item. /(%t/ phf,/ Name (Print) lqgtO / / CUA /e S)c57/ Address City Zip Code 80-- ?83-EXf1� `��' C'4/5 '/Q 4 ho7 44 / , Cv 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. . ,.onsent for Minor to be Audio and/or Video Recorded: I, , 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 Date:W2120/S 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? Yesv No❑ Only If Necessary ❑ ❑ I am in favor of the proposed Item. ❑ I am opposed to the proposed Item. Name (Print) Address City Zip Code 1-frc) - 7.3 L/y/ Z SGhdz 0-e (1 e/c- vt).17-/),17c)61-' , q S G/yra.l -f 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. ,onsent 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 Dat �LJ 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❑ Nor Only If Necessary ❑ ❑ I am in favor of the proposed Item. ❑ I am opposed to the proposed Item. "--5 y Name (Print) 403--0 Address City Zip Code/ Telephone Email dress 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. 'onsent for Minor to be Audio and/or Video Recorded: I, , 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 c Date: 4CITY OF APACHE JUNCTION Please select an option: REQUEST TO SPEAK FORM Item No. OR Call to The Public 1 (One Form Per It ) 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? Yeso Non Only If Necessary o o I am i favor of the proposed Item. o I am opposed to the proposed Item. Name (Print) Address City Zip Code 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. f-nsent for Minor to be Audio and/or Video Recorded: I, , 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