88-379 WHIT�E — CITV CLERK
PINK — FINANCE G I TY O SA I NT PA LT L Council
CANARV — DEPARTMENT 7
BLUE — MAVOR File NO. �• �
Counc Resolution 35
Presented By
Referred To Committee: Date
Out of Committee By Date
_ _ .
RESOLVED: That Application (I.D. #45331) for the renewal of a State Class A
Gambling License appli d for by Give, Inc. DBA Custom Contracts
and Services, Inc. at 324 E. Rose be and the same is hereby approved�
�•
COUNCIL MEMBERS Requested by Department of:
Yeas' Nays
Dimond
Long In Favo
Goswitz �/
Rettman �J'
�� _ Against BY
s��
wi�soa
Adopted by Council: Date
MAR 15 198�3 Form Appro e by City Att rney
Certified Y•: d b} Council Se tar BY
By �
t�ppro b � avor: Date ` , Approved b ayor Eor S ission to Council
B 'Z"-'� BY
6"Ea��L�t361�� ISi;niil !! ' ���
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.��M+r���.dR'�i..iVi�lf . . . i �� �� ' .. �
. . . �' FM�NCE 6 MpiMiE1B�l�SER'VIC�OriE(.TOR ��CITV�CIEAIC�� .
. t., �� �� . �S.d.�4A.�:5� �
Fis�I1� & �tlt. 29�5056 �cmr nrrowaer _
R�. applicatian for a State of . ta Cl.ass ,A Qsaritable Ga�tb�.irbg T3c�e.
I�3►PTFICAT�t�1I�AZEs '2/29/88
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11EI:b�1710M8:(I�Pp��fN a Rqect(R1:) RESEAHCFI REPORT:
. ... . . . Pl�1MIN0 COYAIBBION CML 9EpVICE COM�M8810N ...DATE � DATE - � AN^ALY$T . . .- %iOFE ND:� . . .
. . � . �.� : r. '�:/-.� . . . _ . . .
, . r�_ZOPMNf�OOAM�NBSION � . f�6P6�MOOL 80ARD � � � -- ..
_ SiAFF . �. . � � pMRTER�M8810N : . � A8�IS �_-ADD'!.MIRO.AODED*� . _���.MIfO.'� __F��ADb�,D•
� � DIBTPICT l:OUNCII . . .. t � - . . . .. � � ..
� . .ffi1PfOR19 YMiG113011NCN.Cl�I�TIVE7 - . . ' � � � - � �� . . � � . . . � .
CrOUf'�I� �@S�fCh Crd'1t@I'
�
4 MAR 8 �;�
- � : ; : _
.Rw►T.«a�os�...u.�t��aesurrr tw►a.wnaa.wne�,,vn,....whr�: _ . _
Mr. Micha�el 3. Sarafolean, oa� behalf of .I.V.E., Inc. dba �st,cm C7or�t#acts &. �tiic�es, Inc,
: . r�ts C�x�c*a.I �pproval �f their- -applivatir� for' a Sfa�te �f I�nr�ota G�ing`
_. I�ic�nse: ' A Cl�ss "A" 7.io�x�se allvws b� Bi,ngb �i1d Pulltabs. Tt�e ses$ia�s a� h�.d � '
. `Thur�day�afternoons bet:ween the hr�urs of 1:00 p.i�t. and 5:Q4 p.m. at ].��4 East Ri�se S�,reet. �
Pz�ooeeds are used to provide vocational aining at�d habilitatia� se�v�oes tio adults w�.th
mental reta�+d�ati.oai.
�u�e�a►noN toen,B«�.a�;�wwn�,�: -
r' All req.u�red applicatic�s and fees have sutxni.tted. If Coveycil appz�val is c�ranted,
G.I.V.E. , Inc. aba Cust�am C�ontrc-�cts atid .t�, IreC.. whiCh has be�i:�n exi.st�m�e �'
` 22 Years.. wi1T }�e�`atla�d_to oaritinue . ;spon�rship. , ;
�.t�.t wn�+.«+a ro wno�i . _ _ _
If Co�cil app�roval is mt giv�a, C'�isficm C'bntra�cts will be forc�ed to disc�oriti.�ue t�eir _
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DIVISION OF LICENSE ANI) PERMIT A.DMINI TRATION DATE °?r�Q$g / OZ "'o��"� �
INTERDF.PARTMFNTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicant � � Ghd,e,� J. �r ��n Home Address � �10 £t�t�g� T"A��. �
Rusiness Name �r�, Home Phone (� y� � Iµ$_••
Business Address 3�� �.. 2 Type of License(s)
Business Phone 5�},�,'}�(, �tQ�'i4 � �lAyMb��Mp 1etnCwal
Public Hearing Date � ls g � License I.D. 4� L( � $��
at 9:00 a.m. in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. �� N I/Q�
llate Notice Sent � Dealer �� N�a
to Applicant (�
� Federal Firearms 46 �V (�
Public Hearing
DATE IIv'SP CTION
REVIEW VERFIED (C MPUTER) COMMENTS
A roved N t A roved
�
Bldg I & D �
�,IA ;
Health Divn. '
N �,oi► ►
�
Fire Dept. �
� N �a i
Yolice Dept. 5��� I a '�
�
License Divn. �
�
City Attorney � ��
1
Date Received:
Site Plan °—"'
To Counril Research 3 � ��
ea or Letter � Date
f rom Landlord w�� �9'°�
---� - � � � -� (v,,`�-�7�
�- ..;��,:.., Charitable Gambling Control Board For Board Use Onry
. Rm N-475 Griggs-Midway Bidg.
1821 University Ave. Paid Amt:
-' St. Paul, MN 551043383 Check No.
':....:'� (612)642-0555 •
Date:
GAMBLING UC NSE RENEWAL APPLICATION
LICENSE NUMBER: q /EFF. DA E: ru,�� • /AMOUNT OF FEE: �
1.Applicant-Legal Name of Organization 2.Street Address
6FVE INC 14a4 En?rev Park Dr Suite 1�
3. City,State,Zip 4.Counry 5. Business Phone
St Paui. MN SS10d Rarisev 61E b41-1482
6. Name of Chief Executive Officer 7. Business Phone .
6earoe Ruth �U" �V� �
8. Name of Treasurer or Person Who Accounts for Revenues 9. Business Phtlne : "
�7(.� !, �i;���/ (,ul='��1�sZ'.
10. Name of Gambling IiAanager 11. Bond Number 12. Business Phone
�Iichaei Saraialean §40fi5&5U8 .(�1:,- ;s U 1 ,�5�•�-�-
13. Name of Establishment Where Gambling Will Take Place 14.County 15. No.of Active Members
� Phalen Asrk aalls St Paul �a+�se�� 17
i 6. Lessor Name 17. Monthly Rent:
Phalen Aark Hails #7�g
18. If Bingo will be conducted with this license, please specify day and times of Bingo.
Days Times Da s Times Days Times
��,;i.y��,� t_ C �
=;::;.: � •
l �.` 19. Has license ever been: ❑ Revoked Date: ❑ Suspended Date: 0 Denied Date:
s�` 20. Have intemal controls been submitted previously? �Yes ❑ No(If"No,"attach copy)
�,��", 21. Has current lease been filed with the board? ,,0'Yes ❑ No pf"No,"attach copy)
j 22. Has current sketch been filed with the board? �es ❑ No pf"No"attach copy) •
r�.Y;.!._ _ . ,,, ... . . .. . .,_ .: . '_ ., . . . - • f - -- , �
�'�','� � ' GAMBLIN SITE AUTHORIZATION ` ' "
`'; `�' By my signature below, local law enforcement officers or agents of he Board are hereby authorized to enter upon the site,at arry time,gambling is
being conducted,to observe the gambling and to enforce the law f r any unauthorized game or practice.
BANK RE ORDS AUTHORIZATION
���� By my signature below,the Board is hereby authorized to inspect t e bank records of the General Gambling Bank Account whenever necessary to "
�"` fulfilt requirements of current gambling rules and law.
��', OATH
I hereby declare that:
`=` 1. I have read this application and all information submitted to the oard;
�` '' 2. All information submitted is true,accurate and complete;
"-' 3. All other required information has been fully disclosed;
4. I am the chief executive officer of the organizetiom,
5. I assume full responsibility for the fair and lawful operation of alf activities to be conducted;
6. I will familiarize myself with the laws of the State of Minnesota r specting gambling and rules of the board and agree, if ticensed,to abide by those
Iaws and rules,including amendments thereto.
23.Official Legal Name of Organization Sig ture(Chi f Executive Officer) Date Title
�I UC^ ,�r�t -�� �'� s i c�� ;�_{--
,
ACKNOWLEDGEMENT O NOTICE BY LOCAL GOVERNING BODY
1 hereby acknowledge receipt of a copy of this application. By ackn wledging receipt, I admit having been served with notice that this application will
be reviewed by the Charitable Gambling Control Board and if appr ed by the Board,will become effective 30 days from the date of receipt(noted
below), unless a resolution of the local governing body is passed w ich specifically disallows such activity and a copy of that resolution is received by
the Charitable Gambling Control Board within 30 days of the below oted date.
24.C�'��ty/County Name(Local Gc��cerning Body) Township: If site is located within a township, please complete items 24
�-,�- r� �I� +�t<< I and 25:
Signature of Person Receiving Application: 25.Signature of Person Receiving Application
� , 1
�;� ��. %+..,�.c ;�.; .c�.;, �`��
Title -� Date Received�this date begins 30 day,perKi � Title:
I ' �,� ''-�'�, _`,`�c;' C 7 r"•�, � '��c'�'!)
Name.pf Person Delivering Application tq�Local Governing Body: Township Name
, �
//r, . :+ Q�. r �,^ �l.�
CG-00022-01 (5/8� � �i� White Copy-Board Canary-Applicant Pink-Local Goveming Body
' ' City of Saint Paul �
Department of ance and Management Services � C �3
' Licen e and Permit Division J
� ', 203 City Hali q
St. Paul Minnesota 55102-298-5056 ����/
APPLIC TION FOR LICENSE
CASH CFiECK CIASS NO. New Renew
Q o ����� - ca o � -
r.. , f�.
Date .x — I 1 19_
Code No. Title of License � — ",=;� ^ �; _ ; =t �
From 19�_To 19
',�,�' y �-�,�t �.. r � (�;,� � ' - --
v / ...
1� t""i � 1_: � � �1('
1 `
f�,(', . , t, �, ^ x-: �.% ;..��� 1 �'` -� I. � l� APPUcanUCompany Name
�J 100
;-'4� ,x ,.. .. �-ti , �:, .... ,, � T
100 eualness Name
`/
M � a � ✓ J .
�W
Buafneas Addreas Phon�Na
100 �'�` . `
, =• + V.=} ��j i4; y�
100 Mail to Addross Phone Na
N ',
_ - . �,�
,oo ��l , � F,� .� I . :, � ,-r� �-�, �
ManapedOw�x•Nama
100 � �
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i `� ' tJ - ,, . i, i,� '^ �.,,c_ �r—
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100 htanager/Gwner-Homs Address -• PAOne Na
4098 AppliCatlon Fee �r: , ^ .- ' .�
2. 50 �
Reeefved the Sum of �_100 "— �c:l �.: f � .� . , j =i � (:U�
- ManageNOwner•City,Slate 3�p Cods
100 T tal 100
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, ( �i���f..J�.c��' _'��'.°;f� U i „
UC8n3@ InSpeCtOf J� By: ��� SlgnaturootApplicant�" ''
. �
Bond•
Company Name Policy No. Expintian Oate
Insurance:
Company Name Poliey No. Expiration Date
Minnesota State Identiftcatlon No. Social Security No.
Vehicle Information:
Ssrial Numbsr ale WianOar
Other.
THIS IS A RE E1PT FOR APPLlCAT10N
THIS IS NOT A LICEtVSE TO OPERATE.Your application for li �enss wili either be granted or rejected sub�ect to the provisions of the zoning
o�dinanCe and completion of the inspeciions by the Health, ire,Zoning and/or License Inspectors.
$15.00 CHARGE F ALL RETURNED CHECKS
�� � .
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� -� �►.+� �.as-�Y
a -as-S �
, ' , ' ' City f Saint Paul ����
� Deparcment oE Fina ce and Management Services
Division of Licen e and Yermit Registration
INFORMATION RE UIRED WITH APPLICATION FOR PERMIT TO CONDUCT CHAR.ITABLE GAMBLI�G GAME IN
SAINT PAUL
1. Full and complete name of organizati n which is apPlying for license
G.I.V.E. , Inc; dba Custom Contract & Services, Inc.
2. Address where games will be held 13 4 E Rose
vumber Screec City Zip
3. Name of manager signing this applica ion who will conduct, operate and manage
Gambling Games Michael J. Sarafol an Date of Birth 9/13/56
(a) Length of time manager has been ember o= appl.icant organization 7 vears
4. Address of Manager 973 Linwood Ave. St. Paul 55105
Number Screet City Zip
5. Day, dates, and hours this applicati n is for �ursday, 1 — S p.m.
6. Is the applicant or organization org nized under the laws o: the State of �i? Yes
7. Date of incorporati�n May 27, 196
8. Date when registered with the State f �l.innesota May, 1966
9. How long has organization been ia es tence? 22 years
10. How long has organization been in ex teace in St. Paul? 22 years
11. What is the purpose of the organizati n? to provide services to adults wi.th
Mental Retardation
12. Officers of applicant organization
Name George Ruth ��e David Aune
Address 23221 Woodland Rd. , Lakevi le Address 4869 Churchill, Shoreview
Title President DOB 9/14/48 Tit?e Vice—President DOB 4/25/56
Name Polly Sidney Name
Address 188 E. Morton, St. Paul address
Title Secty./Treasurer DOB 10/19/51 Title DOB
13. Give names of officers, or any ot:�er ersons who paid for se-�vices to tne organization.
Name N�A Vame
Address �ddress
Title ?'i�le
(Attach separate sae�� ��r acd:=;or.s� ,a=as. '.
14. Attached hereto is a Iist of names and addresses of all members of the organization.
15. In whose custody will organization's records be kept? � .
Name Michael J. Sarafolean Address 1410 Ener$y Park Drive, Suite 12
16. Persons who will be conducting. assisting in conducting, or operating the games:
Name See attached list Date of Birth
Address
Name of Spouse Date of Birth
Dates when such person will conduct, assist, or operate
Name Date of Birth
Address
Name of Spouse Date of Birth
Dates when such person wi11 con�uct, ass�st, or ope-ate All sessions
17. Have you read and do vou thoroughly unde:stand the provisions of all laws, ordinances,
and regulatior.s governing the operat=on of Charitable Gambling �ames? Yes
18. Attached hereto on t�e for� furafshed bv the City o� St. Paul is a Financial Report
which itemizes aIl rece:pcs, expenses, and disbursemencs oi the applicant organization
as we11 as ali organ=zatjons who have :ece�ved `unds zor the orecediag calendar year
whfch �as been s=�ned, prepared, and ve:if�ed by Michael J. Sarafolean
�ame
1410 Energy Park Drive, Suite 12, St. Paul, MN 55108
�adress
who is the Executive Director oF the aoplicant Organization.
Yame oz Off�ce
19. Operator of premises where Aames �il� oe held:
Name Richard Mangini
Business Address 1324 E. Rose, St. Paul, MN 55106
Home Address
20. Amount of reat paid by aopiicsnc Organi�acion ror renc or che hall; specify amount
paid per 4-hour se�sion $175/session
� . , ����7�
�-:�/'
�� 21. The proceeds oi the games will be d sbursed after deducting prize layout costs and
operating expenses for the followin purposes and uses:
all lawful purposes
22. Has the premises where the games ar to be held been certified for occupancy by the
City of Sainc Paul? yes
23. Has your organization riLed iederal form 990—T? no If answer fs yes, please atcach
a copy with this application. If an wer is no, explain why:
not required
Any changes desired bv tE�e applicant �.sso iac{on may be made only with the consent of the
City Council.
• � Custom Contracts & Services, Inc.
Organizacion
Date Z� (� �� gy;
yv
Manag in ch rge of game
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� :ty of Saint Paul �j�i ��C
, _ • ' D!par:ment of FL^anee and Managemenc Se^ri-es ��a0 � /
. Division of L ense and Permit Adminisc;ac:on
,.
UNIFORN CNARI BLE GAMBLINC FINANCIAL P.F?ORT
uace 2/15/88
i. Name of Organizacion GIVE c. dba Custom Contracts & Services, Inc.
2. Addreaa vhere Charitable Gamblin is conducted 1324 E.. Rose
3. Report for period covering 4 1 (g 8� through DeC. 31 �g$7
4. Total number of days played 3
5. Crosa receipcs for above period ; 172,156.�1
6. Crosa prize payoucs for above pe iod S ],23,793.80
7. Nec reeeipcs - llne S ainus 11ne 6 S �+$.362.21
8. Expenses incurred in conducting nd operating gau�:
A. Crosa vages paid. Attseh vo ker liat vith
namea, aderess aod groas vsg s, i 8,195.00
8. Rent for 34 �eeks �' utl i.t123 : ��,��,_5�
C. Lie�nss faa = —Q—
D. Insuranee ; _�_
E. Bond ; _�_
F. Dishonored chscka noc reeover d ; —Q_
C. Employers F.I.C.A. ; _�_
H. Sales Tax ; —�—
I. Minn. U.C. 'fax = —�—
J. Faderal U.C. Tax ; �
K. Hiseellsneous Expenses. Idea ify che aaount
and co vhom paid.
t. Cost of Goods ; 1,260.74
Z, Advertising ; 298.39
3, Accounting ; 200.00 �
4, Gambling tax f 4,987.65
- 9. To c�1 gxyR s.s 138.iorni. = 21,442.39
10. Nac Ineome - line 7 minus line 9 ; 26,919.82
11. Chetkbook balanee b�ginning of pe od S —Q—
12. Tocal of lin� 10 and 11 f �(,�9�9_F�2
11. Tota: eontribucions froa liae 17 S 22.500.00
14. Checkbook balance end of reporting peziod -
liae 12 less line I3 f 4,419.82
15. Spseify ure made of awounc on llne 13:
ed b Custom Contracts & Services to provide vocational
trainin and habilitatio services to adults with mental retardation.
COMPl.li1' TIIE ItEVFRSH S1f:E
� . .. . .;urse:-e^.s ..�a a_a�a- =a �e .2: �� ���
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Vame rYYI (,G?'t�'QC�S � . �C� Name ( l(ST�'YYI Cu��1�%"� � �YVrC�S'��C..
� Addreas l yl6 Ll�(_t,y� TcEr�' �. Address i cl/� f�1e rl, cl �Y,� �/'_
o . i
Date Rtc'd 0 c�.r�• Dace R�c'd �LZ�3/��
?urposs �r Q c n�n C(,�1:G� cv /L1P�l.f�L Purpose 7�CC��u.x�.�y A..�i.cC�(s W/f12�tt Q r�C�i✓rf+���
S ignacure ,��r,�-�Q,,�,y,S igna cure
oE Recipienc� vt�1�-/ of Recipienc
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Amounc �� �. – Amounc /aioa0. —
Name Nama
Address Addreat
Dsc• Rec'd Dac• Rac'd
Purpasa Purpose
Signa�ura Signacure
of R�cipianc of R�cipi�nc
Amount Amount
Name Nama
Address Address
Dace Rat'd _ Date Rec'd
Purpose Purpose
Slgnacur� Signature
of Reciplent of Reeipient
Amounc Amount
Name Name
Addz�as Addtesa -
Dace Ree'd Date Ree'd
� Purpose Purpose
Signacure Signacure
of Recipianc of Recipient
Aaounc Amcunt
17. Tocal Disbursasancs d •
'fHIS REPQRT MTST BE FILLID•ZN COl4L EI.Y TO QUALIl^! APPLZCAMOH P'aR CHARITABLE GA2�LINC
LICENSE.
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_ `�,_... , C1TY OF SAINT PAUL
'' ' DEPA TMENT OF FINANCE AND MANAGEMENT SERVICES
:�w0.
, �� � DIVISION OF LICENSE AND PERMIT ADMINISTRATION
���� Room 203, City Hall
Saint Paul,Minnesota 55102
George Latimer
Mayor -
2/25/88
To: Virginia Baisley
From: Christine Rozekl�
Re: Record Check �
In connection with an applicati n for a State Class A Gambling License at
1324 E. Rose, a record check is requested on the following:
Michael J. Sarafolean Gearge Ruth
973 Linwood Avenue 23221 Woodland Road
St. Paul Lakeville
Birthdate: 9/13/56 Birthdate: 9/14/48
Polly Sidney David Aune
188 E. Morton 4869 Churchill
St. Pau1 Shoreview
Birthdate: 10/19/51 Birthdate: 4/25/56
A copy of the application is en Tosed.
CR/car
Attachment
������
�._.,, CITY OF SAINT PAUL
-� `'' � DEPA TMENT OF FiNANCE AND MANAGEMENT SERVICES
: �,� :.
, „ DIVISiON OF LICENSE AND PERMIT ADMINISTRATION
'� ,��� Room 203, City Hall
Saint Paul,Minnesota 55102
�� George latimer
MaYor
February 29, 1988
Michael J. Sarafolean (GIVE, Iac.)
1410 Energy Park Drive, Suit 12
St. Paul, MN 55I08 _
Dear Mr. Sarafolean:
Your application for a State Charitable Gambliag License has beea
received in this office.
A hearing on your applicatio for C1ass A Gambling License ID �(s) 45331
will be held before the St. aul City Couacil on March 15, 1988 at 9:00
A.M. , Third Floor of the Ci and County Court House. This date may be�
changed wi.thout the License Permit Divfsion`s consent and/or
knowledge. Therefore, it is suggested that you call the City Clerk's
Office at 298-4231 to confi this hearing date.
You are hereby notified that your attendance is required at this
meeting. Failure to appear y result in deaial of your application.
Very truly qours,
,� � f ��_r r/r,',,� - .�,
�;�• ' --'
' �/`-�+'� � �.�,i':�..��:
J eph 1r. Carchedi
License Inspector
JFC/lk