97-656� ���..��, �. ��� �-1 � \°la `7
�`''' ` Council File # ���
�-+��+�1���4aTe� b � �( ` -\� Green Sheet # ��
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
Presented By
Referred To
Committee: Date
RESOLVED, that the Licensee, Governor's, Inc. d/b/a Governor's (License ID No.
16874), located at 459 Arcade Street in Saint Paul is hereby ordered to pay a fine of $200.00 far
the violation of the sale of tobacco or tobacco products to a minor.
Said firAe shall be paid to the Office of License, Inspections and Environmental Protection
within flurty (30) days of the adoption of this resolution by the Council and signature by the
Mayor.
This resolution and the action of the Council in this matter are based upon the facts
contained in the Notice of Violation letter to the licensee, the investigation report, and such
arguments as may haae been presented to the Council at the public heazing. The facts were not
contested by the licensee.
Requested by Department of:
�
By:
Form Ap� oved by Ci Attorney
By:
�:gproved by Mayor for Submission to Council
� �
Approved by M� Date � te S�}—
By:
�
By:
Adopted by Council: Date �' �
i
Adoption Certified by Counc 5ecretary
3��44
DEPAHiMENT/OFFlCE/COUNdL DATE INITIATED �� ��J'�
r.tEP Ma �2, �99� GREEN SHEE
CON7ACf PERSON 8 PHONE INITIAVDATE INITIAL/DATE
O DEPARTMENT DIRECTOR � CITV CAUNdL
Christlne Rozek, 266-9108 A���N O CRYATTORNEV � CfTYCLERK
MUST BE ON COUNCIL AGENDA BY (DATEJ �V�R FOR � BUDGEf DIRECTOR � FIN. & MGT. SERVICES DIR.
NOU'IING
M8 28 1997 Public Hearin OflUEN O MAYOR (OR ASSISTAPIT) �
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTEO:
Concerning adverse action against license held by Govemor's, 959 Arcade Street.
RECOMMENDATIONS: Approva (A) or Reject (R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_ PLANNIN6 COMMIS5IQN _ CNIL SERVICE COMMISSION �� �� �'s personlfirm ever worked untler a contrad for tfiis tlepartment?
_ CIB CAMMITfEE _ YES NO
2. Has this person/firm ever been a city employee?
_ S7AFF
— YES NO
_ DIS7R�C7 COURi _ 3. Does this person/firm possess a skill not normall �
y possesseU by any curtent ciry employee.
SUPPOFRS WHICH COUNCIL OBJEC71VE7 YES NO
Ezptain all yes answers on separate sheet an0 attach to green sheet
INITIATING PROBLEM, ISSUE, OPPO�UNIN (Wfio, What, When, Whe�e, Why):
ADVANTAGESIFAPPROVEO:
DISADVANTAGES IFAPPROVED
��._�^ap;°i ? y
-.,._ .,'i' ?
{t{?��.1 � lc l'�+'`��
DISADVANTACaES IF NOTAPPROVED:
TOTAL AMOUNT Of TRANSACTION $ CASTIREVENUE BUDGEtED (CIRCLE ONE) YES NO
FUNDIfiG SOURCE ACTIVITV NUMBEH
FINANCIAI INFORHiATION� (EXPLAIN)
�jl- �S�
Interdepartmental Memorandum
CITY OF SAINT PAUL
DATE: May 30, 1997
TO: Councilmember Daniel Bostrom
FROM: Stephen J. Christie, Assistant City Attorney
RE: Reconsideration of the Governor's resolution as amended and adopted
Attached please find the amended resolution which was adopted on May 2ff`' suspending the fine
against Governor's for a sale of cigarettes to a minor. This resolution, while adopted by the
Council, has not been forwarded to the Mayor for approval because its reconsideration is
appropriate.
I mistakenly advised the Council that it was considering the imposition of a$200 fine against the
new owner (Louie Lentsch) although the violation was committed by the prior owner (Marty
Bertzyk). The new owner has a new license which is NOT subject to this adverse action, but he
was rightfully concerned for his reputation in the community.
While the Bertzyk license under consideration is no longer active, the Council may still unpose
the usual $200 fine as originally requested. As you know, Bertzyk already owes the City much
more for violations at the Gopher Bar. Any unpaid fines would eventualiy be reduced to
registered balls for collection efforts and could affect Bertzyk's future ability to obtain certain City
services.
Accordingly, I have also inciuded anoffier clean copy of the original resolution as submitted by
LIEP requesting adverse action against the old Bertzyk license.
If you have any more questions about this matter, please do not hesitate to contact me. You
should know that attorney Virginia Palmer will be present for the reconsideration on June 4�' and
is aware of the situation.
cc: Ginger Palmer
Presented By _
Referred To
A • � f�r�� � �/��/9�ouncil File # ��5�
� 2G
Green Sheet # > o ���
RESOLUTION /
CITY OF SAINT PAUL, MINNESOTA .!�
Committee:
RESOLVED, that the Licensee, Governor's, Inc. d/b/a Gov or's (License ID No.
16879), located at 959 Arcade Street in Saint Paul is hereby ordered pay a fine of $200.00 for
the violation of the sale of tobacco or tobacco roducts to a mino .however, such fine shal
suspended in its entiretv for the subst�ntial and con 1
�Vl�ybr.
This resolution and the action of the Counc' in this matter are based upon the facts
contained in the Notice of Violation letter to the icensee, the investigation report, and such
arguments as may have been presented to the Co cil at the public hearing. The facts were n
contested by the licensee.
contractual defaulti after the
date of the violation.
Requested by Department of:
By: �,�,�-�� a-��
Form Approved by City Attomey
Adopted by Co cil: Date
Adoption Ce tified by Council S retary B �, : ���P
� `
B �' = Approved by Mayor for Submission to Council
by Mayor: Date
By:
OFFICE OF THE CITY ATTORNEY
Peg Bir75 Ciry Anamey ��bC �.
J
CITY OF SAINT PAUL
Civi1 Division
I Norm Coleman, Mayor 400 Ciry Hall Tekphone: 612166-8710
IS West KeZ7ogg Blvd Faavnile: 672 298-5619
Samt Pau� M'mnesota 55702
• May 7, 1997
��� .��h
NOTICE OF COUNCIL HEARIbIG ��"��.�°s, �,''.�g��
Owner/Manager .
Governor's �NF.�� (��y j���
959 Arcade Street
Saint Paul, Minnesota 55106
RE: Cigarette license held b
for the premises located
License ID No.:16879
Our File Number: G97-0132
Dear Sir/Madam:
y Governor's, Inc. d/b/a Governor's
at 959 Arcade Street in St. Paul
Please take notice that a hearing concerning the above-named
establishment has been scheduled for 4:30 p.m., Wedneaday, May 28,
1997 in the City Council Chambers, Third Floor, Saint Paul City
Hall and Ramsey County Courthouse.
Enclosed are copies of the proposed resolution and other documents
which will be presented to the City Council for their
consideration. This is an uncontested hearing, in that the facts
contained in the report concerning the unlawful sale of cigarettes
have not been disputed. You will have an opportunity at the
Council hearing to present oral and/or written remarks as to the
penalty, if any, to be imposed. The recommendation o£ the license
office will be for a$200.00 fine.
If you have any questions, please call me at 266-5710.
Very truly yours,
(/Ci`c:`3�(/�+-�'�- �� �cc,0-��
U
Virginia D. Palmer
Assistant City Attorney
cc: Nancy Anderson, Assistant Council Secretary
Robert Kessler, Director, LIEP
Christine Rozek, LIEP
Sue Vannelli, Community Organizer, Payne Phalen Dist. 5
Planning Council, 1014 Payne Ave., St. Paul, MN 55101
�'1 bS�
UNCONTESTED LICENSE HEARING
Licensee Name: Governor's, Inc. d!b/a Governor's
Address: 959 Arcade Street
Councii Hearing Date: May 28, 1997
Violation: Sale of Cigarettes to a Minor
Minn. Stat. § 609.685
St. Paui Legislative Code § 324.07
Date: February 19, 1997
Pface: Licensed Premises
Presumptive Penalty: $200.00 Fine
Recommendation of Assistant City Attorney on behalf of client, Office
of License, lnspections and Environmental Protection:
$200.00 fine (first offense}
Attachments:
1. Proposed resolution
2. Notice of Violation and foilow-up fetter
3. License information
4. Compliance Report
5. City Attorney License Adverse Action Summary
OFFICE OF THE CITY ATTORNEY
Peg BirJt Gry Attorney �""t t_ c-� �
`O ✓
CITY OF SAINT PAUL cn�;r oN;.�ron -
Norm Coleman, Mayor 400 Ciry FIaU Telephone: 612 166-8710
IS IVest KeIIogg Blvd Fatsimik: 612 298-5619
Sanu Pme� .11vvmesora 55701
March 28, 1997
230TICE OF VIOLATION
Owner/Manager
Governor`s
959 Arcade Street
Saint Paul, Minr_esota 55105
RE: Cigarette license held by Governor's, Inc. d/b/a Governor's
for the premises located at 959 Arcade Street in St. Paul
License ID No.: 16879
Our File Number: G97-0132
Dear Sir/Madam:
Our office sent you a letter dated February 27, 1997, in which you
were notified of a violation involving the sale of cigarettes to a
minor on February 19, 1997, at your licensed establishment. The
letter asked that you contact this office to let us know whether
you disputed that fact.
If we have not heard from you in writing by April 7, 1997, we will
assume that you do not intend to dispute the violation. We will
then schedule this matter for hearing before the Saint Paul City
Council to determine what penalty will be imposed.
If you have any questions, I can be reached at 266-8710.
Sincerely,
�%�� ��� �
Virginia D. Palmer
Assistant City Attorney
cc: Robert Kessler, Director, LIEP
Christine Rozek, Deputy director, LIEP
Sue Vannelli, Community Organizer, Payne Phalen Dist. 5
Planning Council, 1014 Payne Ave., St. Paul, MN 55101
G�-e5b
STATE OF MINNESOTA
) ss_ AFFIDAVIT OF SERVICE BY MAIL
COUNTY OF RAMSEY
JOANNE G. CLEMENTS, being first duly sworn, deposes and says
that on April 2, 1997, she served the attached NOTICE OF VIOLATION
on the following named person by placing a true and correct copy
thereof in an envelope addressed as follows:
Owner/Manager
Governor's
959 Arcade Street
Saint Paul, MN. 55106
which is the last known address of said person) and depositing the
same, with postage prepaid, in the United States mails at St. Paul,
Minnesota.
Subscribed and sworn to before me
this 2nd day of April, 1997.
:�
No u i
.�,�,,,, �
� !<nThRYN J, "�',P l �t�:.i� �
� 'OTARYPCc_, -!'I
�� a:+;�ssev ccu;a i v
My Comm. Espires Jzn 31, 2G00
1
CITY OF SAINT PAUL
Norm Colemart, Mayor
February 27, 1997
NOTICS OF VIOLATION
Owner/Manager
Governor's
959 Arcade Street
Saint Paul, Minnesota 5510'
OFFICE^? TI� CITY ATTORNEY
Peg Bisk � _ Attorney �� ��
`O
c;�:r Drvu;o„
400 Ciry Ha71
IS West Kellogg Blvd
Safnt PauZ Munesom 55701
Telephone: 611266-8710
Facsimik: 6I219&5619
RE: Cigarette license held by Governor's, Inc. d/b/a Governor's
for the premises located at 959 Arcade Street in St. Paul
License ID No.:16879
Dear Sir/Madam:
The Director o£ the Ofzice of License, Inspections and
Environmental Protection will recommend that adverse action be
taken against your cigarette license held at the above-named
premises. This recommendation is based on the following:
On February 19, 1997, you or another emgloyee sold
cigarettea to a minor under the age of 1S years in the
licensed premises. This is an offense under Minn. Stat.
§609.685 and Saint Paul Legislative Code §324.07.
If you do not dispute the above facts, and send me a letter to that
effect within 5 days, the case will be set before the City Council.
You will have a chance to appear and make a statement before the
Council as to the proper penalty, if any, to be imposed. Licensing
is recommending a$200.00 fine for this first offense.
If you do dispute th=_ above =acts, a hearing will be set before an
Administrative Law Judge. At that hearing both you and the City
will be able to appear and present witnesses, evidence and cross-
examine the other's witnesses. The Council will ultimately decided
the case. If this is your choice, please advise my legal assistant,
Peter Pangborn, within 5 days, and we will take the necessary steps
to set up that ALJ hearing. =e can be reached at 266-8710. '
Page 1
_ � �� esb
I£ you have any questions, you may contact me at 266-8710.
Sincerely,
CS�° -U �r�w�L'l
Virgin3a D_ Palmer
Ass City Attorney
cc: Robert Kessler, Director, LIBP
Christine Roze'.�, LIEP
Sue Vannelli, Community Organizer, Payne Phalen Dist. 5
Planning Council, 1014 Payne Ave., St. Paul, MN 55101
Page 2
1
STATE OF MINNESOTA )
) ss.
COUNTY OF RAMSEY
�1-bSb
AFFIDAYIT OF SERVICE SY MAII,
JOANNE G. CLEMENTS, being first duly sworn, deposes and says
that on February 28, 1997, she served the attached NOTICE OF
VIOLATION on the following named person by placing a true and
correct copy thereof in an envelope addressed as follows:
Owner/Manager
Governor's
959 Arcade Street
St. Paul, MN. 55106
(which is the last known address of said person) and depositing the
same, with postage prepaid, in the United States mails at St. Paul,
Minnesota.
Subscribed and sworn to before me
this 28th day of February, 1997.
�� '�
� ��
P�o ary, Pu "r
� �.
.�M .
'� KATHRYN J. McLAUGHL}N
.- NOTARYFUBLIC-MiNYfSOTA
RAMSEY COUNTY
My Comm. Expires Jen. 31, 2000
a •
°�� �Sb
Lic ID ................... 16879
STAT ..................... RS
Business Name..........._ GOVERNOR'S INC
Doing Business As......,. GOVERNOR'S
Address .................. 959 ARCADE ST
Zip ...................... 55106
Exp Date ................. 02/28/97
License Name ............. CIGARETTE
. ENTERTAINMENT - CLASS A
• . RESTAURANT (BJ-MORE THAN 12
SEATS
. SUNDAY ON SALE LIQUOR
. LIQ-ON SALE-100SEATS/LESS-C
NOTE AREA ................ 12920
. 1/17/95 ENTERTAINMENT CHANGED FROM CLASS 2 TO A
. PER C.F. #94-1447
. PH NOTICE SENT 12/30/94 SET 2/15/95
. 30 EMAIL, 130 MAILED
. 2/15/95 PH ON APP FOR NEW ON SALE LIQUOR, SUNDAY
. ON SALE LIQUOR, ENTERTAINMENT-II, & RESTAURANT-B
. LICENSE APP'D W/CONDITIONS C.F. #95-155
. 1995-7o DISC ON LIQ FEE APPLIED TO 2ND 1/2-LAP-LIC
. 1996-7o DISC ON LIQ FEE APPLIED TO 2ND 1/2-LAP-LIC
. 4/30/96 CIG CODE ADDED FR/ID #19094--LAP-LIC
. 9-1-95 - Owner given extension to 10-15-95 to comp
. lete improvements to parking lot per LZ CAR/LIC
. 2f11f97 WARNING LETTER SENT RE: STABBING INCIDENT
. AT THE BAR ON 12/25/96. 2ND INCIDENT COULD RESULT
. IN ADVERSE ACTIOI3.
Bond Policy Number.......
Bond Company .............
Bond Effective Date......
Bond Expiration Date....,
Insurance Carrier........
Ins. Policy Number.......
Insurance Effective Date.
Ins. Expiration Date.....
Associated Stock Holder..
Dealer No ................
TaxId ...................
Worker Comp Exp Date.....
Telephone ................
PARK GLEN NAT'L
BINDER1025
02/29/96
02/28/97
MARTIN R BERTZXK
DANIEL A MAHER
1809360
778-3742
TOBACCO COMPLIANCE CF�CK FORM _`�bs�
DATE: � r, T1ME: ���. n S LICINSE I.D. NUMBER: I! PSC �I �_
NAME OF COMPLIANCE CHECKII2: ��,•_ � NAME pp pFFICER:� ;, �
NAMEBcADDRFSSOFLICENSEDVENDpgR �7r�s.�y,�,YS --
A'AS THE TOBACCO: SELF-SERVEI _. ASSISTIDT _ MACHIIdE7 X
�
DID Tf� MACHINE Hp,VE THE pROPER REMOTE DEVICE9 �
SALE WAS MADE: YES � NO BRAND: l 1 � it,/�j
NAME OF CLERK: � 11 t3i- '� f� � 1 R E� �P . SEX: M/� F
DESCRiPTION: t-�-�=='- �L4 5 � � `
. ��� �� �
�
CHECKABORTED: YES NO
ADDIITONAL COMMENT'S:
%
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�`''' ` Council File # ���
�-+��+�1���4aTe� b � �( ` -\� Green Sheet # ��
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
Presented By
Referred To
Committee: Date
RESOLVED, that the Licensee, Governor's, Inc. d/b/a Governor's (License ID No.
16874), located at 459 Arcade Street in Saint Paul is hereby ordered to pay a fine of $200.00 far
the violation of the sale of tobacco or tobacco products to a minor.
Said firAe shall be paid to the Office of License, Inspections and Environmental Protection
within flurty (30) days of the adoption of this resolution by the Council and signature by the
Mayor.
This resolution and the action of the Council in this matter are based upon the facts
contained in the Notice of Violation letter to the licensee, the investigation report, and such
arguments as may haae been presented to the Council at the public heazing. The facts were not
contested by the licensee.
Requested by Department of:
�
By:
Form Ap� oved by Ci Attorney
By:
�:gproved by Mayor for Submission to Council
� �
Approved by M� Date � te S�}—
By:
�
By:
Adopted by Council: Date �' �
i
Adoption Certified by Counc 5ecretary
3��44
DEPAHiMENT/OFFlCE/COUNdL DATE INITIATED �� ��J'�
r.tEP Ma �2, �99� GREEN SHEE
CON7ACf PERSON 8 PHONE INITIAVDATE INITIAL/DATE
O DEPARTMENT DIRECTOR � CITV CAUNdL
Christlne Rozek, 266-9108 A���N O CRYATTORNEV � CfTYCLERK
MUST BE ON COUNCIL AGENDA BY (DATEJ �V�R FOR � BUDGEf DIRECTOR � FIN. & MGT. SERVICES DIR.
NOU'IING
M8 28 1997 Public Hearin OflUEN O MAYOR (OR ASSISTAPIT) �
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTEO:
Concerning adverse action against license held by Govemor's, 959 Arcade Street.
RECOMMENDATIONS: Approva (A) or Reject (R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_ PLANNIN6 COMMIS5IQN _ CNIL SERVICE COMMISSION �� �� �'s personlfirm ever worked untler a contrad for tfiis tlepartment?
_ CIB CAMMITfEE _ YES NO
2. Has this person/firm ever been a city employee?
_ S7AFF
— YES NO
_ DIS7R�C7 COURi _ 3. Does this person/firm possess a skill not normall �
y possesseU by any curtent ciry employee.
SUPPOFRS WHICH COUNCIL OBJEC71VE7 YES NO
Ezptain all yes answers on separate sheet an0 attach to green sheet
INITIATING PROBLEM, ISSUE, OPPO�UNIN (Wfio, What, When, Whe�e, Why):
ADVANTAGESIFAPPROVEO:
DISADVANTAGES IFAPPROVED
��._�^ap;°i ? y
-.,._ .,'i' ?
{t{?��.1 � lc l'�+'`��
DISADVANTACaES IF NOTAPPROVED:
TOTAL AMOUNT Of TRANSACTION $ CASTIREVENUE BUDGEtED (CIRCLE ONE) YES NO
FUNDIfiG SOURCE ACTIVITV NUMBEH
FINANCIAI INFORHiATION� (EXPLAIN)
�jl- �S�
Interdepartmental Memorandum
CITY OF SAINT PAUL
DATE: May 30, 1997
TO: Councilmember Daniel Bostrom
FROM: Stephen J. Christie, Assistant City Attorney
RE: Reconsideration of the Governor's resolution as amended and adopted
Attached please find the amended resolution which was adopted on May 2ff`' suspending the fine
against Governor's for a sale of cigarettes to a minor. This resolution, while adopted by the
Council, has not been forwarded to the Mayor for approval because its reconsideration is
appropriate.
I mistakenly advised the Council that it was considering the imposition of a$200 fine against the
new owner (Louie Lentsch) although the violation was committed by the prior owner (Marty
Bertzyk). The new owner has a new license which is NOT subject to this adverse action, but he
was rightfully concerned for his reputation in the community.
While the Bertzyk license under consideration is no longer active, the Council may still unpose
the usual $200 fine as originally requested. As you know, Bertzyk already owes the City much
more for violations at the Gopher Bar. Any unpaid fines would eventualiy be reduced to
registered balls for collection efforts and could affect Bertzyk's future ability to obtain certain City
services.
Accordingly, I have also inciuded anoffier clean copy of the original resolution as submitted by
LIEP requesting adverse action against the old Bertzyk license.
If you have any more questions about this matter, please do not hesitate to contact me. You
should know that attorney Virginia Palmer will be present for the reconsideration on June 4�' and
is aware of the situation.
cc: Ginger Palmer
Presented By _
Referred To
A • � f�r�� � �/��/9�ouncil File # ��5�
� 2G
Green Sheet # > o ���
RESOLUTION /
CITY OF SAINT PAUL, MINNESOTA .!�
Committee:
RESOLVED, that the Licensee, Governor's, Inc. d/b/a Gov or's (License ID No.
16879), located at 959 Arcade Street in Saint Paul is hereby ordered pay a fine of $200.00 for
the violation of the sale of tobacco or tobacco roducts to a mino .however, such fine shal
suspended in its entiretv for the subst�ntial and con 1
�Vl�ybr.
This resolution and the action of the Counc' in this matter are based upon the facts
contained in the Notice of Violation letter to the icensee, the investigation report, and such
arguments as may have been presented to the Co cil at the public hearing. The facts were n
contested by the licensee.
contractual defaulti after the
date of the violation.
Requested by Department of:
By: �,�,�-�� a-��
Form Approved by City Attomey
Adopted by Co cil: Date
Adoption Ce tified by Council S retary B �, : ���P
� `
B �' = Approved by Mayor for Submission to Council
by Mayor: Date
By:
OFFICE OF THE CITY ATTORNEY
Peg Bir75 Ciry Anamey ��bC �.
J
CITY OF SAINT PAUL
Civi1 Division
I Norm Coleman, Mayor 400 Ciry Hall Tekphone: 612166-8710
IS West KeZ7ogg Blvd Faavnile: 672 298-5619
Samt Pau� M'mnesota 55702
• May 7, 1997
��� .��h
NOTICE OF COUNCIL HEARIbIG ��"��.�°s, �,''.�g��
Owner/Manager .
Governor's �NF.�� (��y j���
959 Arcade Street
Saint Paul, Minnesota 55106
RE: Cigarette license held b
for the premises located
License ID No.:16879
Our File Number: G97-0132
Dear Sir/Madam:
y Governor's, Inc. d/b/a Governor's
at 959 Arcade Street in St. Paul
Please take notice that a hearing concerning the above-named
establishment has been scheduled for 4:30 p.m., Wedneaday, May 28,
1997 in the City Council Chambers, Third Floor, Saint Paul City
Hall and Ramsey County Courthouse.
Enclosed are copies of the proposed resolution and other documents
which will be presented to the City Council for their
consideration. This is an uncontested hearing, in that the facts
contained in the report concerning the unlawful sale of cigarettes
have not been disputed. You will have an opportunity at the
Council hearing to present oral and/or written remarks as to the
penalty, if any, to be imposed. The recommendation o£ the license
office will be for a$200.00 fine.
If you have any questions, please call me at 266-5710.
Very truly yours,
(/Ci`c:`3�(/�+-�'�- �� �cc,0-��
U
Virginia D. Palmer
Assistant City Attorney
cc: Nancy Anderson, Assistant Council Secretary
Robert Kessler, Director, LIEP
Christine Rozek, LIEP
Sue Vannelli, Community Organizer, Payne Phalen Dist. 5
Planning Council, 1014 Payne Ave., St. Paul, MN 55101
�'1 bS�
UNCONTESTED LICENSE HEARING
Licensee Name: Governor's, Inc. d!b/a Governor's
Address: 959 Arcade Street
Councii Hearing Date: May 28, 1997
Violation: Sale of Cigarettes to a Minor
Minn. Stat. § 609.685
St. Paui Legislative Code § 324.07
Date: February 19, 1997
Pface: Licensed Premises
Presumptive Penalty: $200.00 Fine
Recommendation of Assistant City Attorney on behalf of client, Office
of License, lnspections and Environmental Protection:
$200.00 fine (first offense}
Attachments:
1. Proposed resolution
2. Notice of Violation and foilow-up fetter
3. License information
4. Compliance Report
5. City Attorney License Adverse Action Summary
OFFICE OF THE CITY ATTORNEY
Peg BirJt Gry Attorney �""t t_ c-� �
`O ✓
CITY OF SAINT PAUL cn�;r oN;.�ron -
Norm Coleman, Mayor 400 Ciry FIaU Telephone: 612 166-8710
IS IVest KeIIogg Blvd Fatsimik: 612 298-5619
Sanu Pme� .11vvmesora 55701
March 28, 1997
230TICE OF VIOLATION
Owner/Manager
Governor`s
959 Arcade Street
Saint Paul, Minr_esota 55105
RE: Cigarette license held by Governor's, Inc. d/b/a Governor's
for the premises located at 959 Arcade Street in St. Paul
License ID No.: 16879
Our File Number: G97-0132
Dear Sir/Madam:
Our office sent you a letter dated February 27, 1997, in which you
were notified of a violation involving the sale of cigarettes to a
minor on February 19, 1997, at your licensed establishment. The
letter asked that you contact this office to let us know whether
you disputed that fact.
If we have not heard from you in writing by April 7, 1997, we will
assume that you do not intend to dispute the violation. We will
then schedule this matter for hearing before the Saint Paul City
Council to determine what penalty will be imposed.
If you have any questions, I can be reached at 266-8710.
Sincerely,
�%�� ��� �
Virginia D. Palmer
Assistant City Attorney
cc: Robert Kessler, Director, LIEP
Christine Rozek, Deputy director, LIEP
Sue Vannelli, Community Organizer, Payne Phalen Dist. 5
Planning Council, 1014 Payne Ave., St. Paul, MN 55101
G�-e5b
STATE OF MINNESOTA
) ss_ AFFIDAVIT OF SERVICE BY MAIL
COUNTY OF RAMSEY
JOANNE G. CLEMENTS, being first duly sworn, deposes and says
that on April 2, 1997, she served the attached NOTICE OF VIOLATION
on the following named person by placing a true and correct copy
thereof in an envelope addressed as follows:
Owner/Manager
Governor's
959 Arcade Street
Saint Paul, MN. 55106
which is the last known address of said person) and depositing the
same, with postage prepaid, in the United States mails at St. Paul,
Minnesota.
Subscribed and sworn to before me
this 2nd day of April, 1997.
:�
No u i
.�,�,,,, �
� !<nThRYN J, "�',P l �t�:.i� �
� 'OTARYPCc_, -!'I
�� a:+;�ssev ccu;a i v
My Comm. Espires Jzn 31, 2G00
1
CITY OF SAINT PAUL
Norm Colemart, Mayor
February 27, 1997
NOTICS OF VIOLATION
Owner/Manager
Governor's
959 Arcade Street
Saint Paul, Minnesota 5510'
OFFICE^? TI� CITY ATTORNEY
Peg Bisk � _ Attorney �� ��
`O
c;�:r Drvu;o„
400 Ciry Ha71
IS West Kellogg Blvd
Safnt PauZ Munesom 55701
Telephone: 611266-8710
Facsimik: 6I219&5619
RE: Cigarette license held by Governor's, Inc. d/b/a Governor's
for the premises located at 959 Arcade Street in St. Paul
License ID No.:16879
Dear Sir/Madam:
The Director o£ the Ofzice of License, Inspections and
Environmental Protection will recommend that adverse action be
taken against your cigarette license held at the above-named
premises. This recommendation is based on the following:
On February 19, 1997, you or another emgloyee sold
cigarettea to a minor under the age of 1S years in the
licensed premises. This is an offense under Minn. Stat.
§609.685 and Saint Paul Legislative Code §324.07.
If you do not dispute the above facts, and send me a letter to that
effect within 5 days, the case will be set before the City Council.
You will have a chance to appear and make a statement before the
Council as to the proper penalty, if any, to be imposed. Licensing
is recommending a$200.00 fine for this first offense.
If you do dispute th=_ above =acts, a hearing will be set before an
Administrative Law Judge. At that hearing both you and the City
will be able to appear and present witnesses, evidence and cross-
examine the other's witnesses. The Council will ultimately decided
the case. If this is your choice, please advise my legal assistant,
Peter Pangborn, within 5 days, and we will take the necessary steps
to set up that ALJ hearing. =e can be reached at 266-8710. '
Page 1
_ � �� esb
I£ you have any questions, you may contact me at 266-8710.
Sincerely,
CS�° -U �r�w�L'l
Virgin3a D_ Palmer
Ass City Attorney
cc: Robert Kessler, Director, LIBP
Christine Roze'.�, LIEP
Sue Vannelli, Community Organizer, Payne Phalen Dist. 5
Planning Council, 1014 Payne Ave., St. Paul, MN 55101
Page 2
1
STATE OF MINNESOTA )
) ss.
COUNTY OF RAMSEY
�1-bSb
AFFIDAYIT OF SERVICE SY MAII,
JOANNE G. CLEMENTS, being first duly sworn, deposes and says
that on February 28, 1997, she served the attached NOTICE OF
VIOLATION on the following named person by placing a true and
correct copy thereof in an envelope addressed as follows:
Owner/Manager
Governor's
959 Arcade Street
St. Paul, MN. 55106
(which is the last known address of said person) and depositing the
same, with postage prepaid, in the United States mails at St. Paul,
Minnesota.
Subscribed and sworn to before me
this 28th day of February, 1997.
�� '�
� ��
P�o ary, Pu "r
� �.
.�M .
'� KATHRYN J. McLAUGHL}N
.- NOTARYFUBLIC-MiNYfSOTA
RAMSEY COUNTY
My Comm. Expires Jen. 31, 2000
a •
°�� �Sb
Lic ID ................... 16879
STAT ..................... RS
Business Name..........._ GOVERNOR'S INC
Doing Business As......,. GOVERNOR'S
Address .................. 959 ARCADE ST
Zip ...................... 55106
Exp Date ................. 02/28/97
License Name ............. CIGARETTE
. ENTERTAINMENT - CLASS A
• . RESTAURANT (BJ-MORE THAN 12
SEATS
. SUNDAY ON SALE LIQUOR
. LIQ-ON SALE-100SEATS/LESS-C
NOTE AREA ................ 12920
. 1/17/95 ENTERTAINMENT CHANGED FROM CLASS 2 TO A
. PER C.F. #94-1447
. PH NOTICE SENT 12/30/94 SET 2/15/95
. 30 EMAIL, 130 MAILED
. 2/15/95 PH ON APP FOR NEW ON SALE LIQUOR, SUNDAY
. ON SALE LIQUOR, ENTERTAINMENT-II, & RESTAURANT-B
. LICENSE APP'D W/CONDITIONS C.F. #95-155
. 1995-7o DISC ON LIQ FEE APPLIED TO 2ND 1/2-LAP-LIC
. 1996-7o DISC ON LIQ FEE APPLIED TO 2ND 1/2-LAP-LIC
. 4/30/96 CIG CODE ADDED FR/ID #19094--LAP-LIC
. 9-1-95 - Owner given extension to 10-15-95 to comp
. lete improvements to parking lot per LZ CAR/LIC
. 2f11f97 WARNING LETTER SENT RE: STABBING INCIDENT
. AT THE BAR ON 12/25/96. 2ND INCIDENT COULD RESULT
. IN ADVERSE ACTIOI3.
Bond Policy Number.......
Bond Company .............
Bond Effective Date......
Bond Expiration Date....,
Insurance Carrier........
Ins. Policy Number.......
Insurance Effective Date.
Ins. Expiration Date.....
Associated Stock Holder..
Dealer No ................
TaxId ...................
Worker Comp Exp Date.....
Telephone ................
PARK GLEN NAT'L
BINDER1025
02/29/96
02/28/97
MARTIN R BERTZXK
DANIEL A MAHER
1809360
778-3742
TOBACCO COMPLIANCE CF�CK FORM _`�bs�
DATE: � r, T1ME: ���. n S LICINSE I.D. NUMBER: I! PSC �I �_
NAME OF COMPLIANCE CHECKII2: ��,•_ � NAME pp pFFICER:� ;, �
NAMEBcADDRFSSOFLICENSEDVENDpgR �7r�s.�y,�,YS --
A'AS THE TOBACCO: SELF-SERVEI _. ASSISTIDT _ MACHIIdE7 X
�
DID Tf� MACHINE Hp,VE THE pROPER REMOTE DEVICE9 �
SALE WAS MADE: YES � NO BRAND: l 1 � it,/�j
NAME OF CLERK: � 11 t3i- '� f� � 1 R E� �P . SEX: M/� F
DESCRiPTION: t-�-�=='- �L4 5 � � `
. ��� �� �
�
CHECKABORTED: YES NO
ADDIITONAL COMMENT'S:
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�`''' ` Council File # ���
�-+��+�1���4aTe� b � �( ` -\� Green Sheet # ��
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
Presented By
Referred To
Committee: Date
RESOLVED, that the Licensee, Governor's, Inc. d/b/a Governor's (License ID No.
16874), located at 459 Arcade Street in Saint Paul is hereby ordered to pay a fine of $200.00 far
the violation of the sale of tobacco or tobacco products to a minor.
Said firAe shall be paid to the Office of License, Inspections and Environmental Protection
within flurty (30) days of the adoption of this resolution by the Council and signature by the
Mayor.
This resolution and the action of the Council in this matter are based upon the facts
contained in the Notice of Violation letter to the licensee, the investigation report, and such
arguments as may haae been presented to the Council at the public heazing. The facts were not
contested by the licensee.
Requested by Department of:
�
By:
Form Ap� oved by Ci Attorney
By:
�:gproved by Mayor for Submission to Council
� �
Approved by M� Date � te S�}—
By:
�
By:
Adopted by Council: Date �' �
i
Adoption Certified by Counc 5ecretary
3��44
DEPAHiMENT/OFFlCE/COUNdL DATE INITIATED �� ��J'�
r.tEP Ma �2, �99� GREEN SHEE
CON7ACf PERSON 8 PHONE INITIAVDATE INITIAL/DATE
O DEPARTMENT DIRECTOR � CITV CAUNdL
Christlne Rozek, 266-9108 A���N O CRYATTORNEV � CfTYCLERK
MUST BE ON COUNCIL AGENDA BY (DATEJ �V�R FOR � BUDGEf DIRECTOR � FIN. & MGT. SERVICES DIR.
NOU'IING
M8 28 1997 Public Hearin OflUEN O MAYOR (OR ASSISTAPIT) �
TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE)
ACTION REQUESTEO:
Concerning adverse action against license held by Govemor's, 959 Arcade Street.
RECOMMENDATIONS: Approva (A) or Reject (R) PERSONAL SERVICE CONTRACTS MUST ANSWER THE FOLLOWING QUESTIONS:
_ PLANNIN6 COMMIS5IQN _ CNIL SERVICE COMMISSION �� �� �'s personlfirm ever worked untler a contrad for tfiis tlepartment?
_ CIB CAMMITfEE _ YES NO
2. Has this person/firm ever been a city employee?
_ S7AFF
— YES NO
_ DIS7R�C7 COURi _ 3. Does this person/firm possess a skill not normall �
y possesseU by any curtent ciry employee.
SUPPOFRS WHICH COUNCIL OBJEC71VE7 YES NO
Ezptain all yes answers on separate sheet an0 attach to green sheet
INITIATING PROBLEM, ISSUE, OPPO�UNIN (Wfio, What, When, Whe�e, Why):
ADVANTAGESIFAPPROVEO:
DISADVANTAGES IFAPPROVED
��._�^ap;°i ? y
-.,._ .,'i' ?
{t{?��.1 � lc l'�+'`��
DISADVANTACaES IF NOTAPPROVED:
TOTAL AMOUNT Of TRANSACTION $ CASTIREVENUE BUDGEtED (CIRCLE ONE) YES NO
FUNDIfiG SOURCE ACTIVITV NUMBEH
FINANCIAI INFORHiATION� (EXPLAIN)
�jl- �S�
Interdepartmental Memorandum
CITY OF SAINT PAUL
DATE: May 30, 1997
TO: Councilmember Daniel Bostrom
FROM: Stephen J. Christie, Assistant City Attorney
RE: Reconsideration of the Governor's resolution as amended and adopted
Attached please find the amended resolution which was adopted on May 2ff`' suspending the fine
against Governor's for a sale of cigarettes to a minor. This resolution, while adopted by the
Council, has not been forwarded to the Mayor for approval because its reconsideration is
appropriate.
I mistakenly advised the Council that it was considering the imposition of a$200 fine against the
new owner (Louie Lentsch) although the violation was committed by the prior owner (Marty
Bertzyk). The new owner has a new license which is NOT subject to this adverse action, but he
was rightfully concerned for his reputation in the community.
While the Bertzyk license under consideration is no longer active, the Council may still unpose
the usual $200 fine as originally requested. As you know, Bertzyk already owes the City much
more for violations at the Gopher Bar. Any unpaid fines would eventualiy be reduced to
registered balls for collection efforts and could affect Bertzyk's future ability to obtain certain City
services.
Accordingly, I have also inciuded anoffier clean copy of the original resolution as submitted by
LIEP requesting adverse action against the old Bertzyk license.
If you have any more questions about this matter, please do not hesitate to contact me. You
should know that attorney Virginia Palmer will be present for the reconsideration on June 4�' and
is aware of the situation.
cc: Ginger Palmer
Presented By _
Referred To
A • � f�r�� � �/��/9�ouncil File # ��5�
� 2G
Green Sheet # > o ���
RESOLUTION /
CITY OF SAINT PAUL, MINNESOTA .!�
Committee:
RESOLVED, that the Licensee, Governor's, Inc. d/b/a Gov or's (License ID No.
16879), located at 959 Arcade Street in Saint Paul is hereby ordered pay a fine of $200.00 for
the violation of the sale of tobacco or tobacco roducts to a mino .however, such fine shal
suspended in its entiretv for the subst�ntial and con 1
�Vl�ybr.
This resolution and the action of the Counc' in this matter are based upon the facts
contained in the Notice of Violation letter to the icensee, the investigation report, and such
arguments as may have been presented to the Co cil at the public hearing. The facts were n
contested by the licensee.
contractual defaulti after the
date of the violation.
Requested by Department of:
By: �,�,�-�� a-��
Form Approved by City Attomey
Adopted by Co cil: Date
Adoption Ce tified by Council S retary B �, : ���P
� `
B �' = Approved by Mayor for Submission to Council
by Mayor: Date
By:
OFFICE OF THE CITY ATTORNEY
Peg Bir75 Ciry Anamey ��bC �.
J
CITY OF SAINT PAUL
Civi1 Division
I Norm Coleman, Mayor 400 Ciry Hall Tekphone: 612166-8710
IS West KeZ7ogg Blvd Faavnile: 672 298-5619
Samt Pau� M'mnesota 55702
• May 7, 1997
��� .��h
NOTICE OF COUNCIL HEARIbIG ��"��.�°s, �,''.�g��
Owner/Manager .
Governor's �NF.�� (��y j���
959 Arcade Street
Saint Paul, Minnesota 55106
RE: Cigarette license held b
for the premises located
License ID No.:16879
Our File Number: G97-0132
Dear Sir/Madam:
y Governor's, Inc. d/b/a Governor's
at 959 Arcade Street in St. Paul
Please take notice that a hearing concerning the above-named
establishment has been scheduled for 4:30 p.m., Wedneaday, May 28,
1997 in the City Council Chambers, Third Floor, Saint Paul City
Hall and Ramsey County Courthouse.
Enclosed are copies of the proposed resolution and other documents
which will be presented to the City Council for their
consideration. This is an uncontested hearing, in that the facts
contained in the report concerning the unlawful sale of cigarettes
have not been disputed. You will have an opportunity at the
Council hearing to present oral and/or written remarks as to the
penalty, if any, to be imposed. The recommendation o£ the license
office will be for a$200.00 fine.
If you have any questions, please call me at 266-5710.
Very truly yours,
(/Ci`c:`3�(/�+-�'�- �� �cc,0-��
U
Virginia D. Palmer
Assistant City Attorney
cc: Nancy Anderson, Assistant Council Secretary
Robert Kessler, Director, LIEP
Christine Rozek, LIEP
Sue Vannelli, Community Organizer, Payne Phalen Dist. 5
Planning Council, 1014 Payne Ave., St. Paul, MN 55101
�'1 bS�
UNCONTESTED LICENSE HEARING
Licensee Name: Governor's, Inc. d!b/a Governor's
Address: 959 Arcade Street
Councii Hearing Date: May 28, 1997
Violation: Sale of Cigarettes to a Minor
Minn. Stat. § 609.685
St. Paui Legislative Code § 324.07
Date: February 19, 1997
Pface: Licensed Premises
Presumptive Penalty: $200.00 Fine
Recommendation of Assistant City Attorney on behalf of client, Office
of License, lnspections and Environmental Protection:
$200.00 fine (first offense}
Attachments:
1. Proposed resolution
2. Notice of Violation and foilow-up fetter
3. License information
4. Compliance Report
5. City Attorney License Adverse Action Summary
OFFICE OF THE CITY ATTORNEY
Peg BirJt Gry Attorney �""t t_ c-� �
`O ✓
CITY OF SAINT PAUL cn�;r oN;.�ron -
Norm Coleman, Mayor 400 Ciry FIaU Telephone: 612 166-8710
IS IVest KeIIogg Blvd Fatsimik: 612 298-5619
Sanu Pme� .11vvmesora 55701
March 28, 1997
230TICE OF VIOLATION
Owner/Manager
Governor`s
959 Arcade Street
Saint Paul, Minr_esota 55105
RE: Cigarette license held by Governor's, Inc. d/b/a Governor's
for the premises located at 959 Arcade Street in St. Paul
License ID No.: 16879
Our File Number: G97-0132
Dear Sir/Madam:
Our office sent you a letter dated February 27, 1997, in which you
were notified of a violation involving the sale of cigarettes to a
minor on February 19, 1997, at your licensed establishment. The
letter asked that you contact this office to let us know whether
you disputed that fact.
If we have not heard from you in writing by April 7, 1997, we will
assume that you do not intend to dispute the violation. We will
then schedule this matter for hearing before the Saint Paul City
Council to determine what penalty will be imposed.
If you have any questions, I can be reached at 266-8710.
Sincerely,
�%�� ��� �
Virginia D. Palmer
Assistant City Attorney
cc: Robert Kessler, Director, LIEP
Christine Rozek, Deputy director, LIEP
Sue Vannelli, Community Organizer, Payne Phalen Dist. 5
Planning Council, 1014 Payne Ave., St. Paul, MN 55101
G�-e5b
STATE OF MINNESOTA
) ss_ AFFIDAVIT OF SERVICE BY MAIL
COUNTY OF RAMSEY
JOANNE G. CLEMENTS, being first duly sworn, deposes and says
that on April 2, 1997, she served the attached NOTICE OF VIOLATION
on the following named person by placing a true and correct copy
thereof in an envelope addressed as follows:
Owner/Manager
Governor's
959 Arcade Street
Saint Paul, MN. 55106
which is the last known address of said person) and depositing the
same, with postage prepaid, in the United States mails at St. Paul,
Minnesota.
Subscribed and sworn to before me
this 2nd day of April, 1997.
:�
No u i
.�,�,,,, �
� !<nThRYN J, "�',P l �t�:.i� �
� 'OTARYPCc_, -!'I
�� a:+;�ssev ccu;a i v
My Comm. Espires Jzn 31, 2G00
1
CITY OF SAINT PAUL
Norm Colemart, Mayor
February 27, 1997
NOTICS OF VIOLATION
Owner/Manager
Governor's
959 Arcade Street
Saint Paul, Minnesota 5510'
OFFICE^? TI� CITY ATTORNEY
Peg Bisk � _ Attorney �� ��
`O
c;�:r Drvu;o„
400 Ciry Ha71
IS West Kellogg Blvd
Safnt PauZ Munesom 55701
Telephone: 611266-8710
Facsimik: 6I219&5619
RE: Cigarette license held by Governor's, Inc. d/b/a Governor's
for the premises located at 959 Arcade Street in St. Paul
License ID No.:16879
Dear Sir/Madam:
The Director o£ the Ofzice of License, Inspections and
Environmental Protection will recommend that adverse action be
taken against your cigarette license held at the above-named
premises. This recommendation is based on the following:
On February 19, 1997, you or another emgloyee sold
cigarettea to a minor under the age of 1S years in the
licensed premises. This is an offense under Minn. Stat.
§609.685 and Saint Paul Legislative Code §324.07.
If you do not dispute the above facts, and send me a letter to that
effect within 5 days, the case will be set before the City Council.
You will have a chance to appear and make a statement before the
Council as to the proper penalty, if any, to be imposed. Licensing
is recommending a$200.00 fine for this first offense.
If you do dispute th=_ above =acts, a hearing will be set before an
Administrative Law Judge. At that hearing both you and the City
will be able to appear and present witnesses, evidence and cross-
examine the other's witnesses. The Council will ultimately decided
the case. If this is your choice, please advise my legal assistant,
Peter Pangborn, within 5 days, and we will take the necessary steps
to set up that ALJ hearing. =e can be reached at 266-8710. '
Page 1
_ � �� esb
I£ you have any questions, you may contact me at 266-8710.
Sincerely,
CS�° -U �r�w�L'l
Virgin3a D_ Palmer
Ass City Attorney
cc: Robert Kessler, Director, LIBP
Christine Roze'.�, LIEP
Sue Vannelli, Community Organizer, Payne Phalen Dist. 5
Planning Council, 1014 Payne Ave., St. Paul, MN 55101
Page 2
1
STATE OF MINNESOTA )
) ss.
COUNTY OF RAMSEY
�1-bSb
AFFIDAYIT OF SERVICE SY MAII,
JOANNE G. CLEMENTS, being first duly sworn, deposes and says
that on February 28, 1997, she served the attached NOTICE OF
VIOLATION on the following named person by placing a true and
correct copy thereof in an envelope addressed as follows:
Owner/Manager
Governor's
959 Arcade Street
St. Paul, MN. 55106
(which is the last known address of said person) and depositing the
same, with postage prepaid, in the United States mails at St. Paul,
Minnesota.
Subscribed and sworn to before me
this 28th day of February, 1997.
�� '�
� ��
P�o ary, Pu "r
� �.
.�M .
'� KATHRYN J. McLAUGHL}N
.- NOTARYFUBLIC-MiNYfSOTA
RAMSEY COUNTY
My Comm. Expires Jen. 31, 2000
a •
°�� �Sb
Lic ID ................... 16879
STAT ..................... RS
Business Name..........._ GOVERNOR'S INC
Doing Business As......,. GOVERNOR'S
Address .................. 959 ARCADE ST
Zip ...................... 55106
Exp Date ................. 02/28/97
License Name ............. CIGARETTE
. ENTERTAINMENT - CLASS A
• . RESTAURANT (BJ-MORE THAN 12
SEATS
. SUNDAY ON SALE LIQUOR
. LIQ-ON SALE-100SEATS/LESS-C
NOTE AREA ................ 12920
. 1/17/95 ENTERTAINMENT CHANGED FROM CLASS 2 TO A
. PER C.F. #94-1447
. PH NOTICE SENT 12/30/94 SET 2/15/95
. 30 EMAIL, 130 MAILED
. 2/15/95 PH ON APP FOR NEW ON SALE LIQUOR, SUNDAY
. ON SALE LIQUOR, ENTERTAINMENT-II, & RESTAURANT-B
. LICENSE APP'D W/CONDITIONS C.F. #95-155
. 1995-7o DISC ON LIQ FEE APPLIED TO 2ND 1/2-LAP-LIC
. 1996-7o DISC ON LIQ FEE APPLIED TO 2ND 1/2-LAP-LIC
. 4/30/96 CIG CODE ADDED FR/ID #19094--LAP-LIC
. 9-1-95 - Owner given extension to 10-15-95 to comp
. lete improvements to parking lot per LZ CAR/LIC
. 2f11f97 WARNING LETTER SENT RE: STABBING INCIDENT
. AT THE BAR ON 12/25/96. 2ND INCIDENT COULD RESULT
. IN ADVERSE ACTIOI3.
Bond Policy Number.......
Bond Company .............
Bond Effective Date......
Bond Expiration Date....,
Insurance Carrier........
Ins. Policy Number.......
Insurance Effective Date.
Ins. Expiration Date.....
Associated Stock Holder..
Dealer No ................
TaxId ...................
Worker Comp Exp Date.....
Telephone ................
PARK GLEN NAT'L
BINDER1025
02/29/96
02/28/97
MARTIN R BERTZXK
DANIEL A MAHER
1809360
778-3742
TOBACCO COMPLIANCE CF�CK FORM _`�bs�
DATE: � r, T1ME: ���. n S LICINSE I.D. NUMBER: I! PSC �I �_
NAME OF COMPLIANCE CHECKII2: ��,•_ � NAME pp pFFICER:� ;, �
NAMEBcADDRFSSOFLICENSEDVENDpgR �7r�s.�y,�,YS --
A'AS THE TOBACCO: SELF-SERVEI _. ASSISTIDT _ MACHIIdE7 X
�
DID Tf� MACHINE Hp,VE THE pROPER REMOTE DEVICE9 �
SALE WAS MADE: YES � NO BRAND: l 1 � it,/�j
NAME OF CLERK: � 11 t3i- '� f� � 1 R E� �P . SEX: M/� F
DESCRiPTION: t-�-�=='- �L4 5 � � `
. ��� �� �
�
CHECKABORTED: YES NO
ADDIITONAL COMMENT'S:
%
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