90-1489 0 1 � � V I.N A L � � Council File � Q � /
Green Sheet # 10.526
RESOLUTION r �-�'j
CITY OF SAINT PAUL, MINNESOTA §!'`r' ,�;
Presented By
�� �" ��R�
Referred To Committee: Date
RESOLVED: That application (ID 4�45751) for renewal of a State Class B
Gambling License by Frost Lake Booster Club at Arcade Bar,
932 Arcade, be and the same is hereby approved/�d.
Ye s Navs Absent Requested by Department of:
o �osw
on License & Permit Division
� cca ee
e man
—3'iune
�Ti son �`— BY�
J
Adopted by Council Date AUG 2 3 1990 Form Approved by City Attorney
Adoption Certified by Council Secretary gy: , ,,. �/�q
SY� ` � � �'��� � Approved by Mayor for Submission to
Approved by Mayor: Date
AUG 2 7 199Q coun�i�
g 'G��� '�,�j`/ By:
Y�
PUBIlSNEO S t P - 11990
. . . . � � ��o-�����
DEPARTMENT/OFFICElCOUNCIL DATE INITIATED
Finance License GREEN SHEET N° _10526
CONTACT PER30N 8 PHONE INITIAUDATE INITIAUDATE
�DEPARTMENT DIRECTOR �CITV COUNCIL
Christi e Rozek-298-5056 Ass�a" �CITYATTORNEY �CITYCLERK
NUMBER FOR
MUST BE ON COUNCIL AGENDA BY( ATE) City Clerk ROUTING �BUDGET DIRECTOR �FIN.8 MGT.SERVICES DIR.
Hearing/ 23 � By� $ �� ORDER �MAYOR(OR ASSISTAN� Q (',rninri 1
TOTAL#OF SIGNATURE P GES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION RE�UE3TED:
Approva of an application for renewal of a State Class B Gambling License.
Hearin : � �� Notification:
RECOMMENDATIONS:Approve(A)or eject(R) PER80NAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING�UESTIONS:
_PLANNINO COMMiSS10N CIVIL SERVICE COMMISSION �• Has this personlfirm ever worked under a contract for this department?
_CIB COMMITfEE YES NO
2. Has this person/firm ever been a city employee?
_37AFF YES NO
_DISTRICT COURT 3. Does this person/firm possess a sklll not normally possessed by any current city employee?
SUPPORT3 WHICH COUNCIL OBJE E? YES NO
Explaln ali yes answers on separete shset and attach to 9reen shaet
INITIATINO PROBLEM,133UE,OPPO NITY(Who,What,When,Where,Why):
John Pet is on behalf of Frost Lake Booster Club requests City Council
approval of their application for a State Class B Gambling License at
Arcade B r, 932 Arcade. Proceeds from the pulltab sales are used to
support outh athletics and activities. Investigative fee of $375.75 has
been sub itted.
A�VANTAOES IF APPROVED:
If Counc 1 approval is given, Frost Lake Booster Club will continue to
operate pulltab booth at Arcade Bar, 932 Arcade.
DISADVANTAOES IF APPROVED:
DISADVANTAQE3 IF NOT APPROVED:
R�c�iv�u
Cou�a�s=1 �����a� ��►�t��:
AUG0719�90 �..�M �����o
CITY CLERK ��� �
TOTAL AMOUNT OF TRANSACTI N s COST/REVENUE BUDGETED(CIRCLE ONE) YES NO
FUNDINQ SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION:(EXPLAIN) ��
NOTE: COMPLETE DIRECTIONS ARE INCLUDED IN THE GREEN SHEET INSTRUCTIONAL
MANUAL AVAILABLE IN THE PURCHASING OFFICE(PHONE NO. 298-4225).
ROUTING ORDER:
Below are correct routings for the five most frequent types of documents:
CONTRACTS(assumes authorized budget exists) COUNCIL RESOLUTION (Amend Budgets/Accept. Grants)
1. Outside Agency 1. Department Director
2. Department Director 2. City Attorney
3. City Attorney 3. Budget Director
4. Mayor(for contracts over$15,000) 4. Mayor/Assistant
5. Human Rights(for contracts over$50,000) 5. City Council
6. Finance and Management Services Director 6. Chief Accountant, Finance and Management Services
7. Finance Accounting
ADMINISTRATIVE ORDERS(Budget Revision) COUNCIL RESOLUTION (all others, and Ordinances)
1. Activity Manager 1. Department Director
2. Department Accountant 2. City Attorney
3. Department Director 3. Mayor Assistant
4. Budget Director 4. City Council
5. City Clerk
6. Chief Accountant, Finance and Management Services
ADMINISTRATIVE ORDERS(all others)
1. Department Director
2. Ciry Attorney
3. Finance and Management Services Director
4. City Clerk
TOTAL NUMBER OF SIGNATURE PAGES
Indicate the#of pages on which signatures are required and paperclip or flag
eaCh of these pages.
ACTION REQUESTED
Describe what the projecVrequest seeks to accomplish in either chronologi-
cal order or order of importance,whichever is most appropriate for the
issue.Do not write complete sentences. Begin each item in your list with
a verb.
RECOMMENDATIONS
Complete if the issue in question has been presented before any body,public
or private.
SUPPORTS WHICH COUNCIL OBJECTIVE?
Indicate which Council objective(s)your projecUrequest supports by listing
the key word(s) (HOUSING, RECREATION, NEIGHBORHOODS, ECONOMIC DEVELOPMENT,
BUDGET,SEWER SEPARATION). (SEE COMPLETE LIST IN INSTRUCTIONAL MANUAL.)
PERSONAL SERVICE CONTRACTS:
This information will be used to determine the ciry's liability for workers compensation claims,taxes and proper civil service hiring rules.
INITIATING PROBLEM, ISSUE, OPPORTUNITY
Explain the situation or conditions that created a need for your project
or request.
ADVANTAGES IF APPROVED
Indicate whether this is simply an annual budget procedure required by law/
charter or whether there are specific ways in which the City of Saint Paul
and its citizens will benefit from this projecUaction.
DISADVANTAGES IF APPROVED
What negative effects or major changes to existing or past processes might
this projecUrequest produce if it is passed(e.g.,traffic delays, noise,
tax increases or assessments)?To Whom?When?For how long?
DISADVANTAGES IF NOT APPROVED
What will be the negative consequences if the promised action is not
approved? Inability to deliver service?Continued high traffic, noise,
accident rate?Loss of revenue?
FINANCIAL IMPACT
Although you must tailor the information you provide here to the issue you
are addressing, in general you must answer two questions: How much is it
going to cost?Who is going to pay?
. � � yo-i�f�'9
DiVISION OF LICE SE AND PERMIT ADMINISTRATION DATE � O�8 �� / � 01� ��
INTERDF.PARTMFI�'TA' REVIEW CHECKLIST App Processed/Received by
j� �.ic Enf Aud
/ r�� `_ I �p J�r� �t-f-1 S
Applicant � � 1�.� �GLS`t�►����tp Home Address f�7� jpbn�.�
Rusiness Name � � ArCu.� ��'lZ... Home Phone '� �c�- 73I a-
Business Address -I�a �-��Q-�S-�" Type of License(s) l.. 1QSS �
Business Phone � �yy� �j��nti C�l CQin C..F_ /��hpLu�-I
Public Hearing D te �j � License I.D. 4i �7 �7� �
at 9:00 a.m. in he Counci Chambers,
3rd floor City H 11 and Courthouse State Tax I.D. �� �'S � �o��c( _
llate Notice Sent; Dealer �f flJ�/-�-
to Applicant
rederal Firearms 4� ��A'
Public He�.�ring
DATE INSPECTIUN
REVIEW VERFIED (COMPUTER) CUMMENTS
A proved Not A roved
Bldg I & D 1
N j4
Health Divn.
�
; N
Fire Dept. �
i �, q. I
� d;�,►�I ��a°� �C�
Yolice Dept. I
'� � 1? I�o ��--
�
License Divn. '
�� � �u o�.
City Attorney �
� 1l �1(.) + ��
Date Re eived:
Site Plan ta a-� l� � ,.- � � ��
To Council Research
Lease or Letter � ��) �r.,� Date
from Landlord � �/
CURRENT INFORMATION NEW INFOKMATION
Current Corporation Name: �ew Corporation Name:
Current DBA: New DBA:
Currer.t Officers: Insurance:
Bond:
Workers Compensation:
New Officers:
' Stockholders:
. � �?��d,i��9
• , City of Saint Paul
' Department of Finance and Management Services
Division of License and Permit Registration
INFORMATION RE UI WITH APPLICATION FOR PERMIT TO SELL PULLTABS & TIPBOARDS IN SAI.TT PAiJL
(Class B Gambling License in Liquor Establishments - Renew)
1. Full and com lete name of organization which is applying for license
r0 � C.�u -_
2. Address wher games will be held 9�Z A-6�Q��i ��,Pa U�
Number Street City Zip
3. Name of mana er signing this application who will conduct, operate and manage
l� D �
Gambling Gam s �O`ti� 1 E� t S Date of Birth J Z. �j S1
(a) Length o time manager has been member of applicant organization
4. Address of M nager (��q („eOvl� �`.�-,pq�}� Ss'/Q(p
Number Street City Zip
5. Is the appli ant or organization organized under the laws of the State of MN? �g S
6. Date of inco poration `] (PR
�—
7. How long has organization been in existence? 2� y t'S
8. How long has organization been in existence in St. Paul? z�
9. WIzat is the p rpose of the organization? p �j p� Y- �(`O'�M,
OU \� ����� 1 `��
10. Officers of a plicant organization:
Name �*i � P � \S Name �j v� Re���,�'
Address � �,Of�G . C��►� Address r�„/� ��rsc'1 i�;. \ , � ����,• �
Title ` � DOB Title e �q r DOB
� ,
, Name �J �(� Name � J 1
Address �� �� � 5���� Address t t0�� �, 1
�'�}� i
Title �� � ` ,��OB Title �' �,C,� �,,•�,�OB
11. Give names of officers, or any other persons who paid for services to the
organization.
Name Name
Address Address
Title Title
(Attach separate sheet for additional names.)
, � (�' l�/�/�'l
12. + Atta::hed he eto is a list of names and addresses of aIl members of the organization.
13. In whose cu tody will organization's pulltab records be kept?
Name JO �(�, \ 5 Address 5 7 � � �p
P�0 � � Gl�
14. List all pe sons with the authority to sign checks for dispers 1 of ambling proceeds:
Name � � e. ` 5 Name n � � �, 5
� � P, l
Address 7 � Address 7q �Q,1}� �,�QU l
Member of Member o
DOB S Organization? j(/p,� DOB �pD Organization? �
_�.."`
Name Name
Address Address
Member of Member of
DOB Organization? DOB Organization?
15. Have you re d and do you thoroughly understand the provisions of all laws, ordinances,
and regulat ons governing the operation of Charitable Gambling games? V Pi 5
�
16. Attached he eto on the form furnished by the city of Saint Paul is a Financial Report
which itiem zes all receipts, expenses, and disbursements of the applicant organiza-
tion, as we 1 as all organizations who have received funds for the preceding calendar
year which as been signed, prepared, and verified bp J O V�1/� �e�1S
S7 �80�'l � �
Address
who is the `
6 Yh Q,'� of the applicant organization.
Name
17. Will your o anization's pulltab operation be operated/mana d solely by members of
your organiz tion? yes no
18. Has your org ization signed, or does it intend to sign, a consulting agreement or a
managerial a reement with any person or company to assist your organization�with the
pulltab sale and/or recording keeping? yes no �/
} If answer is yes, give the name and address of the person and/or company contracted.
Name Address
Name Address
If answer is yes, how will such a consultant be paid? (percentage, flat fee, gambling
funds, gener 1 funds, etc.) Attach a copy of said contract to this application.
19. Operator of remises where games will be held:
Name /"l �� C' ^ `�
Business Add ess q32 �(`GQC+.� �'�,lZ�U 1
� �
Home Address ��� � �jG2'Y'!' ' Zt.t�� ���. � �,j�j
� �
. - �-C�p-/�/1��1
20. a) Does your org,�nization pay or intend to pay accouating fees out of gambling funds?
yes ✓ no -
b) If you do pay accounting fees, to whom will such fees be paid?
Name Address
DOB Member of Organization?
c) How are he accounting fees charged out? (flat fee, hourly, etc.)
d) Wh� do ou anticipate will be your average monthly deduction for accounting fees?
S ?
21. Amount of re t paid by applicant organization for rent of the pulltab sales area:
� �(� p
22. The proceeds of the games will be disbursed after deducting prize layout costs and
operating ex enses for the following purposes and uses:
v� �` �� c�, � � �s �n �av� �
. r �
e - r Y` � 1 vu�
�
r ��-
23. Has your org nization filed federal form 990-T? ��� If answer is yes, please attach
a copy with his application. If answer is no, explain why:
1 r_
�� � �, �,� � UJ�� � � a�� _ � .
Any changes desir d by the applicant association maq be made only with the consent of the
City Council.
. ' �' �" �,��s� Bo eY C�v �
� ' 0 iz o Name
Date �Q Z� Q By:
Ma�ager in charge of game
,'
Organization President or EO
r Citq of Saint Paul Page l
� � Departm�at of Finanee and rianagemenc Servieee � //�/�'i y
' Division of Licenaa snd Perm.tc Adainieeratian ' �D f Y� �
UNIFORlt CHARITABLE GAl�LINC fINANCIAL REPOR?
Data D
1. N ot Organizatloa S� �P� C�OS � �
2. dres• vhere Chsricabl� Ca�bliag is e ueted �- �• '�1
3. R pore for period covas2n= !9� chrou;h 19�
4. T cal numbsr of days played /��
5. G o�• reeeipts for abov• period s J� l ���
6. C oas prize payouca for abova period (inelud� eai6 ahort) ! �� � 1 ( C.%
7. N c r�eaipts - liae S minus line 6 ! - ��� 11�
8. psnas� iacurred in conduetiag and operating `s�:
Croas vagea paid. Aetaeh vorksr liat vith (
nam�s, addresssa. gro�s vages, au�Eer of hours i � ��^l.� '
vorked, and amouac paid par hour.
Rent for �� vee{u ; Z / ��
Llcenee Eee f �
Insuranee � `
. Bond = `L C
Dishonotad checks not retov�red ; �r �
Aceountln� Expease ; �
Employ�ss F.l.C.A. f �
Pulltib Ta�c Paid to Dspartatae oL R�v�au� � ��U
Kinn. U.C. ruc ; ^
' Yed�sal Excias Tu 3 Sea�p ;
Stat� Ca�blin� 'Iu = ��
Mi�cellanaous Expsnasa. 2d�aeit7 tha aounc
and to rho� paid.
�. �-c,�� �..��' s 3.�3 �
Z = . .� � -
3. ;
; 4 , ; Z�f`f73
9. oul E�eaws . TOtAL i �
10. �t IneoN - lia� 7 aina• lins 9 i , ���7?
11. sckbook balane• bs`inain� of p�riod = `��
12. otal of line 10 and 11 f �����
" 13. a ul eoneribueions (fzoa aecachad voetsh��e) i �O 2 S
14. heekbook balancs ead o! reporcing pariod - : ���C1�
ine 11 leaa lins 13 --.-- �
�. � ur �� . rhVv
� ' • UNIFQRM CNARI7A8L� Cu�,M8liN6 �i�ANC i�l RE?ORT
. . , � LA�lFUL PURPdSE CONTRIBUTIONS - WORKSHE_T ��0�/���
Line #I3 - Tctal Lawful Purpose Contributions. - S /OZ�.3�1
Lis beTow all checics written from gambling funds which are
cha itable lawful purpose contributions. The total dollar
amo nts of these chetks must match the artwunt claimed in
lin #13. Use additional sheets as necessary.
CHECK # OA E PAYEE CHECK AMOUN PURPOSE
� � � ��. ; -�'
�. /'l�f 3/� �'o �a��i�� `�i�1�A- Sz�.?o 0 0 �� , o+�.
2. �'l��" 3�i' ��, l`fuz�� ��c �o��rCf�� SoG.c�c �� �,
3. .
4.
5 .
6.
7.
8.
9.
10.
11. .
12. �
13. �
TOTAL CHECK ANqUNT 3 �QL�^�3�
NOTE: These xpenditures wi11 be provided to Council Members at your Council hearing.
Be su that your financial report is complete and accurate.
. � ♦ + � s �
� ��
� i i T O� � � ��(� .. • s C�
+nMnr �,NM■ � a1 ' � '�J r 3
� ; - • ^� i .r� r R ` . � j � 4 � �. +_
� • a
O
j �:• � C • � � p ! • O • �
i� • O • _ ! • • �
? �''� s i • • � � • `� ,. • � � - �
�
< � s � � s � ef s �. � t � � i
' > _ � Z = O • �i 1�
� n � � . � • � N � ' � - • a i � --1
< o s > s � � � � � � � +Y J
<<� 3 � < � '� � � w 7 i s • � • • • n
3 ' r � ' � � � , � � � ° � ' �/
G m� C f" > �1 + � � � � 2 w � � .r�r.r i + J.
< >
< y{ r,� ` r / � r... • �•r�r '� ,� 1 s � • � �V
� a � � � > . .1' : � • ° : =� � � •
� PZa � � � �� � � � . � 'e � � - ./
s
5 ?< NU� � " : 'a � ;"^ � � +' ',
Z � . � .
'� ° > ' s � i.
� � � � r � � � i_1�, = � I- i
� � c
i � �. � � .
■WVWVVW■ � I � a� i
n � y a � , a� �
� � � � I s
s� • l,
�� i �W �
�
I