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89-174 WMITE - C�TV CLERK CO�II1C11 PINK - FINANCE G I TY O F SA I NT PAU L CANARV - OEPARTMENT �/� BLUE -MAVOR File NO• o.0 cil Resolution ,,---�. �.�� ; Presented By � � Referred To Committee: Date Out of Committee By Date RESOLVED: Th t application (ID #96153) for a State Class B Gambling Li ense by The Minnesota AIDS Project at Rumours, 49 N. Robert Street, be and the same is hereby approved/ COUNCIL MEMBERS Requested by Department of: Yeas Nays Dimond I.o� In Favor Goswitz Rethnan � Scheibel A gai n s t BY Sonneu Wilson JAN 3 1 i989 Form Approved by City Attor ey Adopted by Council: Date ' Certified Yas uncil Se tary By /_// '� gy, hlpprov d by Mavor: Date FC8 " J �'�� Approved by Mayor for Submission to Council By �t'�`�� _ �. �. ��89 c�eaw► o.te.�ar�T.o a�,eca+�ue�ec. (:r0��►�7 Mr. J. Carche ' �iR�� 3�� t�.��2�8 ooMrACi o�r�n,�,r o�cro� �ra��on�sr�vrn : � Christine Roz �ER� �a��► 3«r«� A . ,�. � — �� .; _, _ , 2 Councii R�search 6�� Fi na e & mt. � _5 6 ono�: 1 ��,�� . Application f r a State Class B Gamb1ing License. . Notification ate: 1-I9-89 Hearr3ng Date: 1-31-89 �s:c�oam�s�a>or�J•«cR)) ca,ncx.nES�+nErooirrr: . , �PLAIIlIf�CCMMISBION CNIL 3 COMMI$SION . DATE M � DATE OUT - . ANALVST � � � � Pllf)f�N0.� _ - � . � . � mNNf�OOIM�ION . IBD 6� BOARD . . . - � � - . . �. . BTAFF.. . � .. GIARTER O�MM1981QN . . . COMPLE7E AS IS � - ADDL N�O.ADOED* - . F1E7'D TO�COMTA�T �. . CONiRRIEM . .. . � . , _ � _fOR�AODL R1F0. _F�DBIICK�AODED+. . . . . ��T��' *DfPLAW1TI0N: � . . - � � � . . . . SUPPOHTS-WHICM f�INrCIL OBJ�TIVE7� . . - � � . _ . . . � .� . . � - M�IIA7�lO NIO�LEM.1�lIlR G�OR11lIfT�Y VW1ef.W1Mn.yUhxs:YVI1y): Stephen Roch ord, on behalf of the Minnesota AIQS Project, requests � Counci:l . app al of his_application for a State Class B Gambling License , , (pulltabs & ipbaards) at Rumours, 49U N. Rob�ert Street. Pr�ceeds from •. the pulltab les 'wiil be used for health and eduE�tion servic-es related to arresting the transmission of the AIDS virus. �c+�,�o��(�.dee�r:nd�.. ,:. .. : A11 fees and applacations have been submitted. : COI�M�b'�.'MIIrM.af�d'.7dNRqm): - If CQUncil a proval is given, MAP wi11 sponsor a pulltab booth at Rumaurs. . . N.�a.a,�n: , . . �nos _ �s - , : . Counc�i Research Cenfer _ AN 2 01�89 ��: _ ��: , . � �=��7� T�.tVISION OF LICENSE D PERMIT ADMINISTRATION llATE ` 9/ � � �� • INT�;RDF.PARTMFNTAL RE IEW CHECKLIST Appn P oc ssed/Rece' ed by Lic Enf Aud Applicant ✓Te-" h�h �OG��i�� Home Address f�j�'7 r,()ps-�`Yl/i'►S�rr Rusiness Name 1�11�Q"r �Z�S YolP�'�'Home Phone � � � ' J Business Address �0 ,�. p�Qr'� Type of License(s) ��C(,�+n -�(^Gt Business Phone �U ` � 7 � 3 � ��h (�l C�I'iS�� Public Hearing Date � � License I.D. 4{ L �� at 9:00 a.m. in the ouncil hauibers, 3rd floor City Ha11 nd Courthouse State Tax I.D. �� ' llate I�otice Sent; ' � � � Dealer 4l ��" to Applicant rederal Pi_rearms 4� �U�jg' Public Hearing DATE II�'SPECTIUN REVIEW VEKFIED (COMPUTER) CUMMENTS A proved Not A roved � Bldg I & D � �r�- Health Divn. ; ti �� , � Fire Dept. i � ; u�a' I � � Police Dept. �n� � � g �'IC� � � I I � �i License Divn. ; ' C3 �, ' vic� City �ttorney � � � � ' Vl� Date Received: Site Plan � �� j � � To Council P.PSearch � 1 3 Lease or Letter Date from Landlord � � � � i �- -�� Charitab Gambling Cont�ol 8oard FOR BOARD USE ONLY Room N- 75 Griggs-Midway Building �� , 1821 Un versity Avenue • St. Paul, Minnesota 55104-3383 PAID (612) 6 2-0555 AMT � CHECK# DATE GAMBLIN LICENSE APPLICATION INSTRUCTIONS: , A. Type or print in ink. B. Take completed application o local governing body,obtain signature and date on all copies,and leave 1 copy.Applicant keeps 1 copy and sends original to t e above address with a check. C. Incomplete applications ma be returned. ' , D. Enctose license fee with ap lication. Type of Application: . ❑Class A - Fee S 100.00 IBin�o,Raffles,Paddlewheels,Tipboards,Pull-tabs) ' QClass B - Fee 8 50.00(Ra les,Paddlewheels,Tipboards,Pull-tabs) Ma�"�"'*sp'�"a°t°° OClass C - Fee 5 50.00(Bin o only) Mt�wt.cnsrjesw.cm�mtn9convaeomd ❑Class D - Fee S 25.00(Ra les only) � Check one: ❑1 A. Organizatio has never been lice�sed. �1 B. New site - ive base license number. `��' � 01 C. Renewal of xisting license-Give complete license number. � - � - � ❑1 D. Change in cl ss of an existing license-Give complete license number. � - �� - � ❑Yes�No 2. Has organi2ati n ever received a Lawful Gambling Exemption Permit from the Board? If yes,give complete permit numbe �� ❑Yes ONo 3. Have Internal ontrols been submitted previously on a form provided by the Board7 If no,please attach copy. 4. Applicant(Official,legal na e of organization) 5. Business Address of Organization � :..�' � Y. ,t;. �;_ ^�,��. -�[ r �r� t ,r 1.•an�i-� '��'1 , 6. City,State,Zip 7. County 8. Business Phone Number ^t 7. u"i =�=.:1 [! a, � ( �%.1 � "�^_''"" � 9. Type of organization: ❑ aternal ❑Veterans OReligious QOther nonprofit" 'If organization is an"other n nprofit"organization,answer questions 10 through 12.If not,go to question 13."Other nonprofit"organizations must document its tax-exem t status. �Yes�No 10. Is organizati n incor orated as a nonprofit organization?If yes,give number assigned to Articles or page and book numb r: �•3'7`��::J 5 Attach copy of certiflcate. �1.Yes�No 11. Are articles iled with the Sec�etary of State? ;�}Yes❑No 12. Is organizat on exempt from Min�esota or Federa4 income tax?If yes,please attach lette�from IRS or Depanment of Revenue de laring exemption. � ❑Yes�No 13. Has license ever been denied,suspended o�revoked7 If yes,check all that a ly: ❑Denied ❑Suspended ❑Revoked Give date: - - � 14. Number of active membe s � 15. Number of years in existence Note: Attach evidence of 2 2 i�l e in^e� B a a�3 / three years existence. 50�+ !�JiLi2t��t� � ` ' 16. Name of Chief Executive fficer(Cannot be 17. Name of treasurer or person who accounts for other revenues ' Gambli�g Manager) of the organization(Cannot be Gambling Manager) �.�� ..�• :lCl:i�.:C?.' ,7 •`n � � r' rtie rtie r L A��"1.C�..'.,�L -� ,�� .'� C f'p`�' '� Business Phone Numbe Business Phone Number ( 'i'z: 1 -37�-�' 1 ? 1 �2 ? 1 a;^_;?7 � 18. Name of establishment here gambling will be 19. Street address(not P.O. Box Number) conducted i CUiaZOL:C�,, .�,. � ij:a� •-••� ;1�-,ar�- „-. .,�� 20. City,State,Zip ' I 21. County(where gambling premises is located) S t. `��u 1 i�t'V � �1 -� �� CG-0001-03(8/881 White Copy-Board Canary-Applicant Pink-Local Goveming Body Page 1 of 2 - ----{ -- - _...-- ----_ __Y � ___.-------- ----------- - . � � �� Gambling License Applicatio Type of Application: O Cla A �Class B ❑Class C �Class D OYes�No 22. Is gambling pr mises located within city limits? C7Yes�No 23. Are all gambli g activities conducted at the premises listed in�18 of this applicationl If not, complete a separate application fo each premises(except raffles)as a separate license is required for each premises. ❑Yea ONo 24. Does organiz ion own the gambli�g premises7�f no,attach copy of the kass with terms of at least one year, and attach a sket h of the premises indicating what portion is being leased. A lease and sketch are �ot required for Class D applicatio s. 25. Amount of Rent Per 2 . Do you plan on conducting bingo with this license?If yes,give days and times of bingo occasions. Month or Bin o Occasion Day Time Day Time Day Time S ,.� � � 1�3 " .1C: 1': L7[: 1G i0 �Yes ONo 27. Has the 510,0 0 fidelity bond required by Minnesota Statutes 349.20 been obtained7 28. Insurance Company Name(n t agency name) 29. Bond Number .:1:. _ _�. _ '�� . _a_.._.1! _ ! _..,.'' :3: `! ]�.-!�i��? 30. Lesso�Name 31. Address 32. City,State,Zip ?��:�(� .i .� l -�, j?�" �..:� t}.' 7 ) � !� �:. 1 33. Gambling Manager Name 34. Address 35. City,State,Zip - :a �.-1 _ � � 1-1 .H ... ��' _il= ."� � '?i.. )l. } J �'`��' 36. Gambling Manager Business Phone 37. Date gambliag manager became (. .;; ` , � ; � ,__�� member of organization: Month � � Year ;��: �Yes.�JNo 38. Has the licens termination form been completed?Attach copy. �Yes ONo 39. Has the comp nsation schedule been approved bY the organization?Attach aopy. 40. List the day and time of the r gular meeting of the organization.Day "L�� "`�. `�i `n"�``�Time '��""�T` 41. Bank Name 42. Bank Address 43. Bank Account Number :.•'�r:5;. ,,.... . .,? _ .. ": ' •, _� _ .-'_: . . ' _y,.3 �, 35�� . _.�� _ .. ilL:.:l�.�?Ji: . _:e. _`S_r .::i'�-�%3V .{}�J` J'•J�3 �_ GAMBLING SITE AUTHORIZATION By my signature below,local I w enforcement officers or agents of the Board are hereby authorized to enter upon the site at any time gambling is being condu ted to observe the gambling and to enforce the law for any unauthorized game or practice. BANK RECORDS AUTHORIZATION By my signature below, the oard is hereby authorized to inspect the bank records of the gambling bank account whenever necessary to fulfill requireme ts of current gambling rules and law. I hereby declare that: OATH 1. I have read this applicati n and all information submitted to the Board; 2. All information submitte is true,accurate and complete; 3. All other required inform tion has been fully disclosed; 4. I am the chief executive fficer of the organization; 5. I assume full responsibili for the fair and lawful operation of all activities to be conducted; 6. I will familiarize myself ith the laws of the State of Minnesota respecting gambling and rules of the Board and agree, if licensed,to abide by tho e laws and rutes,including amendments thereto; 7. Membershi list of the o anization will be available within seven da s after it is re uested b the board. 44. Official,Legal Name of rganization 45. Signature(must be�signed by,Chief Executive Officer) M1i1C12�0�3 a.. Z. ?J.�..'i ?•_^O��Ct X . � " �.� �.,_ Title of Si ner Date .,, �� -- ;� �Xt`'ir:l9i'�3 :.1�3C�� ' `� ;�,.y%`.t_ .. ; �.. ACKNOWLEDGEMENT OF NOTICE BY LOCAL GOVERNING BODY I hereby acknowledge receip of a copy of this application.By acknowledging receipt,I admit having been served with notice that this application will be revie ed by the Charitable Gambling Control Board and if approved by the board,will become effective 60 days from the date of re eipt (noted below) unless a resolution of the local governing body is passed which specifically disallows such activity and a copy of that resolution is received by the Cha�itable Gambling Control Board within 60 days of the below noted date. 46. Name of City or County( ocal Governing Body) If site is located within a township,item 47 must be completed,in addition to the county signature. If township is not organized, C�.t'! ::� �� . ' =.: I county must sign. Signature of person receiving pplication 47. Name of Township X Title Date received (60 day period Signature of person receiving application begins from this date) ,' �; '� _ ' ._ . i �, ! ! X 48. Name of person delivering pplication to Local Govemi�g Body Title Sr-, �rr, . f . -.��:�� , CG-0001-03 (8/881 White Copy-Board Canary-Applicant Pink-local Goveming Body Page 2 of 2 - , City of Saint Paul ��` �� Department of Finance and Management Services /J� Gy+��l� . • Licensa and Permit Division U"4 203 City Halt . St. Paul, Minnesota 55102•29&5056 APPL1CATlON FOR LICENSE CASH CNECK CLASS NO. New Renew a � � � � Date / � t� " i Code No. Title of Lice se J / From ` � 19�To � 19�` �3 y� .,� c � �- t�v� c 3 y�� `I"�N-'� ��J� ��us�?� .a��u, �-� �. 100 �' Yll Y:')U�?2 `>�'��c �r 1 CC.{ �.+:�r�:•L1tn'�{ � ApplieanUComPany Name -�1 • �oo � �-Y o j��t' � �� n1urtfS .�� 100 Bualnesa Name ioo ��'l�� . �� .�� o. � Business Address Phone Na �� 4�G �.� �► , ,��1;� S��'�� 100 Maii to Address ^ Phons No. � 100 � '�"��}1 -2 r1 �. ��p C ll l� ?� ManaqedOwner•Name �� / , 100 . C� - � �S `� �t/ �'S'�rn r ,,; �o!�� 100 AtanagerlGwner•Home Address Phons No. d098 Applicatfon Fee 2. 50 � s `, Fieeeived the Sum of 3sa.'a� Managerl0wner•Gt�tat�d ZlpvCode ��(V� 100 Total 700 �� % License Inspector By: �� '"y `.� ,�/ uie or n{�p�icant / � � Bond• C mpa�y Name Policy No. Expiration Date Insurance: C mpany Name Policy No. ExDiration Oate Minnesota State Identificatfon No. S tl Social Security No. Vehicle Infarmation: Serial Number �ats Number Other. � THIS IS A RECEIPT FOR APPLlCAT10N tHIS IS NOT A LICENSE TO OP RATE.Your application for license will eithe�be granted or rejected subject to the provisions of the zoning o�dinance and completion of th inspections by tha Health, Fire.Zoning and/or License Inspectors. $15.00 CNARGE FOR ALL RETURNED CHECKS 4�� ,j,�j� . ;�t� � �u�r ��ss � c� ►��s .� ,a �� ...o � 700 oZ ��' -'J � Col!�' t " C , � s ;�,r� S S'ac� �� , �. , �-b� .�-� �• f � • � �ity of Saint Paul �� '! „ � Department of Finance and ManagemenC Services T Division of License and Permit Registration � INFORMATION REQUIRED WITH APPLICATION FOR PERMIT TO CONDUCT PULLTA.B/TIPBOARD SALES IN SAINT PAUL (Class B Gambling License in Liquor Establishments - New Application) 1. Full and .comple e name of organization which is applying for license The Minnesota A uired Immune Defici n 2. Does your orga ization meet the definition of a "large" organization as outlined in the November, 1988 revision of Section 409.21 of the Legislative Code? No Attach to this application pertinent financial and/or organizational information to support your a swer to this question. NOTE: Only 5 large organizations will be allow ed to open pul tab operations under the revised city ordinance. If more than 5 organi zations apply, qualified applicants will be selected randomly by the City Council. 3. Address where �ames will be held 490 North Robert Street St. Pau]� 55101 Number Street City Zip 4. � Name of manage signi.ng this application who will conduct, operate and manage Gambling Games ��}�E,� -r u��►,ofnrr� Date of Birth 6/7/53 (a) Length of ime manager has been member of applicant organization 4 years '"; � 5. Address of Manager �1�i Westminster St Paul 55101 Number Street City Zip 6. Day, dates, a d hours this application is for Annual StaL'ting 3/1/89 7. Is the applic nt or organization organized under the laws of the State cf i4I�T? Yes 8. Date of incor oration April 27, 1983 9. Date when reg stered with the State of Minnesota April 27� 1983 L0. How Iong has rganization been in existence? 5 1/2 years 11. How long has rganization been in existence in St. Paul? 5 1/2 years servinG clients 12. What is the p rpose of the organization?�p is dedicated to arresting transmission of the AIDS viru , eliminating discrimination against people affected with the AIDS virus, and in available hi h ualit , co rehensive and coordinated services to persons af ected by AIDS illnesses. • 13. Officers of pplicant organization: Name Eric L. strom Name Addres$59 W. t . Rod G-2 ' w Address ,.Title Execu �ve D' DOB 9/5/58 Title DOB � Name Name Address Address Title DOB Title DOB � � � ��7� . 14. Give names of o ficers, or any other persons who paid for services to the • organization. Name See attach membershi Name Address Address Title Title (Attach separate sheet for additionai names.) 15. Attached hereto is a list of names and, addresses of all members of the organization. 16. In whose custo y will organization`s records be kept? Name Janice Se ler Address 2025 Nicollet AvenueS. , Mpls, 1�T . 55404 17. List all perso s with the authority Co sign checks for dispersal of gambling proceeds: Name Janice S ller Name Sig Peck Address 6 Address 501 Parkview Terrace Member of Member of DOB 1 Organization? yos DOB 9/21/52 Organization?yes Name Eric L. ngstrom Name Kris Wayne Address859 W. Cty. Rod G-2, Shroeview Address 5009 Excelsior Blvd. #126 Membez of Member of' DOB 9/5/58 Organization? Yes DOB 8/12/51 Organization?yes 18. Have you read and do you thoroughly understand the provisions of all laws, ordinances, and regulatio s go��erning the operation of Charitable Gambling games? vas 19. Will your org nization`s pulltab operation be operated/managed solely by members of your organiz tion? yes Yes no 20. Has your org nization 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 N� If answer is yes, give the name and address of the person and/or company contracted. Name N A Address Name Address If answer is yes, how will such a consultant be paid? (percentage, flat fee, gambling funds, gene al funds, etc.) Attach a copy of said contract to this application. 21. � Operator of premises where games will be held: Name Riuno rs, Inc., Moll Kauffman, owner Business Ad ress 490 N Robert Street Home Addres 4900 31st Avenue, MirLnea�lis (�I 5�417 � I . . . ��-,�� ?2. a) Does your �rganization �pay or intend to pay accounting £ees out of gambling funds? yes no b) If you do pa accounting fees, to whom will such fees be paid? � Name �n Address 2025 Nicollet Avenue South, Mpls. DOB Member of Organization? , c) How are the accounting fees charged out? (flat fee, houxly, etc.) H � d) What do you anticipate will be your average monthly deduction for' accounting fees? 400 mon h � � . 23. Amount of rent aid by applicant organization for rent of the hall: � - $400/month for a rox' � 24. The proceeds of the games will be disbursed after deducting prize layout costs and operating expen es for the following purposes and uses: � To su rt the rograms and services of the Mi nneGOta Ams Prn�c�c�t- � 41� (St. Paul + 0$ outh S . P = � - 49� rest of Mi esota = 100� 25. Has the premise where the games are to be held been certified for occug�:_cy by �he City of Saint P ul? Yes 26. Has your organi�ation filed federal form 990-T? YPG If answer is yes, please attach a copy with thi application. If answer is no, explain why: � Any changes desired y the applicant association may be made only with the consent of the City Council. The Minnesota A I D.S Pro�ar`t Organization Nam Date Dec. 12, 1988 BY� ana er in charge of game • �'l/�' . C� f i � Organization President or CEO I : . ��-�� , � . � � State of Minnesota ) , ) ss County o Ramsey ) i� D �?� . /Cd GN6Fd/Q„� being d ly sworn, say _that_�he�,rs� (are) t e petitioner,s in the above appli- � cation; that �tie�has��read the forego- ing pet tion and know the contents thereof; that th same is true of �hGrown knowledge. Subscri ed and sworn to before me this fowe.i�N day of tGAnJLtA.t�Jil 19 �`� y tary Publ.ic, Fj�.�.��.County, Minnesota My co ission e�ipir Z� i99e R r"� 11WiCE L SEILER • �NQl'ARY PUBUC fdINNESOTA `�.R�' HENNEPIN C�tlNTY I M Cort►mission Ex _s June^�S, 1990 r a►� . _ I . �. �f-�-/�� .� #17. Authr ity to sign checks. Ellen Benevides D. 0. B. 7/24/58 4136 ueen Avenue South, ,#100 �inne polis , MN 55410 Mi nesota AIDS Project Employees (Rumours) 1. David N Maytum D. 0. B. Feb. 2Q, 1964 2221 B1 isdell Avenue South Sunday - Thursday #28 Minneap lis , MN 55404 2. Rand Re terath D. U. B. Mar. 19 , 196Q 8235 Ta arack Trail Friday - Saturday Eden Pr ire, MN 55344 :� . � �� - ��i�� TO BE COMPLETED BY ORGANIZATION PRESIDENT AND GAMBLING MANAGER I understand and will upho?.d Saint Paul Ordinance 409, Sect�ons 40°.?.1 and 409.22 r lating to pulltabs and tipboards in bars. Further, I u derstand that my jarbar must meet city standards; that ?Oro of the net p ofit from pulltab sales must be returned to the City-Wide . Youth Fund o a monthly basis; that monthly financial statements must be filed with t e C��y; and tiiat 51� .o,f net proceeds must remain in St. Paul or be used to support St. Paul resi�dents. Signature - M ager � . • �� ► � Signature - Organizati President - Minnesota .I.D.S. Pr ' c _ rganizat�o ame 490 N. R � � Gamb ing Location Date . Please retain the attached ordinance for your records.