Comptroller of Maryland MATT Regulatory Division Alcohol and Tobacco Tax Louis L. Goldstein Treasury Building P.O. Box 2999 Annapolis, Maryland 21404-2999 410-260-7327 888-784-0145 Office use only Approved Date License # Stub # Office use only Check Number Check Amount Deposit Date Application for a Statewide Caterer's (SCAT) License (See back page for guidelines and instructions.) For the use of: (Check One) An individual 9 Partnership 9 Corporation 9 Limited Liability Co.9 Check Type of License desired: General 9 Limited 9 If applying for a Limited License, list the three contiguous political subdivisions of the state in which you plan to operate: General SCAT License Limited SCAT License - More than 600,000 but less than 1,000,000 total population Limited SCAT License - More than 300,000 but less than 600,000 total population Limited SCAT License - Not more than 300,000 total population Annual Fee Annual Fee Annual Fee Annual Fee $2,000.00 $1,500.00 $1,000.00 $750.00 Do not remit any license fee with this application. If your application is approved, you will be advised of the appropriate license fee based upon provisions of the law. Date Application is made by the undersigned under the provisions of Article 2B, as amended, title “Alcoholic Beverages”, for the type of license checked above, and the applicant(s) submit and certify to the following information required by law: 1. Applicants* (1) (2) (3) Name Residence Home Phone Date of Birth Place of Birth Social Security Number** Position Qualifying Maryland Resident?*** * ** *** 9 9 No Yes MD Resident Since 9 Yes MD Resident Since 9 No 9 Yes MD Resident Since 9 No In the case of a corporation, the law requires three officers to apply as license applicants, unless less than three exist. (In the latter case, submit supporting documentation.) The disclosure of applicant's Social Security Number is mandatory and will be used for background investigations pursuant to Section 10-201 of Article 2B of the Annotated Code of Maryland. At least one applicant must be a voter and taxpayer in Maryland presently and for the two immediately preceding years. In case of partnership, all individuals must meet this requirement. 2. Name and/or trade name 3. Location of desired licensed premises/principal office 4. Description of premises to be covered under license applied for (lot, type, size, and construction of building) COM/ATT-011 Rev. 7/07 American LegalNet, Inc. www.FormsWorkflow.com 5. Business phone number(s) Fax number E-mail address 6. a. Date business began b. Type of accounting period (calendar yr., fiscal yr., etc.) Month FY begins c. If corporation, date chartered State d. Federal employer identification number e. Maryland Central Registration number 7. The name and address of the owner of premises is: 8. The applicants are presently the holders of the following alcoholic beverages licenses or permits issued by the state of Maryland, any other state or jurisdiction, or the United States government. If more space is needed, attach additional sheet. If none, so state. Issuing authority Type Expiration date Number 9. The applicants have previously held the following alcoholic beverage licenses or permits: 10. The applicants have applications pending for the following alcoholic beverage licenses or permits: 11. Please answer each of the following questions applicable to all individual applicants; (attach explanation if “Yes” to questions A, B, and C) A. Has any applicant ever been convicted of a felony by any state or federal court?................................................................. 9 Yes 9 No B. Has any applicant ever been convicted of a violation of the laws of the United States, Maryland, or any other state concerning alcoholic beverages, gaming, or gambling?......................................................................................................... 9 Yes 9 No C. Has any applicant ever been denied or had revoked an alcoholic beverage license or permit?.............................................. 9 Yes 9 No D. Do the applicants agree to conform to all the laws, rules and regulations of the state of Maryland relating to the business in which they propose to engage under this license?................................................................................................ 9 Yes 9 No E. Do the applicants authorize the comptroller and his duly authorized personnel to search without warrant any premise or vehicle used in the business to be conducted under this license at any and all hours agreeable to the state of Maryland? 9 Yes 9 No F. Do the applicants meet all state and local requirements and hold all requisite licenses relating to the catering business conducted? ............................................................................................................................................................................. 9 Yes 9 No G. Do the applicants hold the requisite health department permit or certification to engage in catering activities in the jurisdiction where their principal office is located? (If yes, attach a copy of license or certification. If no, attach documentation from the appropriate authority indicating no permit or certification is required.) ......................................... 9 Yes 9 No H. Do the applicants hold a retail alcoholic beverage license solely for the privilege of catering alcoholic beverages or do they pay an additional local fee for the privilege of catering alcoholic beverages? (If yes, attach documentation).............. 9 Yes 9 No I. Do the applicants agree to have an employee who has completed a certified alcohol awareness program present at all times during catered events under this license? ..................................................................................................................... 9 Yes 9 No 12. Section 9-104 of Article 2B of the Annotated Code of Maryland titled “Workers' Compensation Compliance” requires the evidence of such compliance prior to the issuance of any license by this office. The applicant hereby affirms (complete one): 9 a. the applicant is not an employer required to provide coverage by the Maryland Workers' Compensation Law; or 9 b. the applicant is an employer required to provide employee coverage by the Maryland Workers' Compensation Law and has secured such coverage as evidenced by the certificate of compliance attached herewith; or 9 c. the applicant is an employer required to provide employee coverage by the Maryland Workers' Compensation Law and has secured such coverage. As evidence of such coverage, the following is submitted: 1. Name of Insurance Co. 2. Policy or Binder No. American LegalNet, Inc. www.FormsWorkflow.com 13. All applicants must complete this section Affidavit I do solemnly declare and affirm under the penalties of perjury that the contents of this document are true and correct to the best of my knowledge, information and belief. Give name(s) and address(es) of officer(s): (Note: All officers must be listed - attach separate sheet if necessary.) Name Title Residence Name Title Residence Name Title Residence Name Title Residence Signature of president or vice-president Signature of applicant Note: If president or vice-president is one of the applicants, he/she must sign both as president/vice president and as applicant. Signature of applicant (Corporation Seal) Signature of applicant This Section Must be Completed by the Owner of the Licensed Premises 14. Statement of owner of premises required in connection with alcoholic beverages law of Maryland (I,we) hereby certify, that (I am, we are) the owner(s) of the property known as named in this application made to the State Comptroller under the Alcoholic Beverages Law of Maryland; that (I,we) assent to the granting of the license applied for, and that (I,we) hereby authorize the State Comptroller, his duly authorized deputies, inspectors and clerks, the Board of License Commissioners of the jurisdiction in which the place of business is located, its duly authorized agents and employees, and any peace officer of such jurisdiction to inspect and search, without warrant, the premises upon which the business is to be conducted, and any and all parts of building in which said business is to be conducted, at any and all hours. Affidavit I do solemnly declare and affirm under the penalties of perjury that the contents of this document are true and correct to the best of my knowledge, information and belief. Signature Type or print name Title Date American LegalNet, Inc. www.FormsWorkflow.com STATEWIDE CATERER'S (SCAT) LICENSE GENERAL GUIDELINES AND INSTRUCTIONS A SCAT license may be issued to a person who: (1) is engaged in the business of catering; (2) meets all State and local licensing requirements; (3) holds any catering license that may be required by a local political subdivision; and (4) holds an existing permanent retail alcoholic beverages license other than a Class C license or does not hold an alcoholic beverages license but has a permanent office and storage facility for alcoholic beverages in the State. A SCAT licensee may acquire alcoholic beverages through a licensed wholesaler, if the licensee also holds a retail license, or through a retail dealer in the State. A SCAT licensee may serve alcoholic beverages at a catered event throughout the State to persons of legal drinking age on unlicensed premises or on temporarily licensed premises. A licensee may store unused alcoholic beverages at the principal place of business for use at future catered events. A licensed retailer who operates solely in a political subdivision under the authority of the local Board of License Commissioners need not acquire a SCAT license. Local boards are authorized to monitor SCAT licensees and report violations of alcoholic beverages law to the Comptroller's Office. A SCAT licensee is required to supply service personnel, and ensure that the personnel are present at all times during the catered event. The personnel must be present for deliveries of alcoholic beverages, and at least one individual must be certified by an alcohol awareness program that is licensed by the State Comptroller. All unused alcoholic beverages must be returned at the end of a catered event to the principal place of business. The sale of food must represent at least 70% of the total cost of the event. A SCAT licensee may not serve alcoholic beverages at its office, or at any event for which the holder is a sponsor, except when operating under a permanent on-premises retail alcoholic beverages license. A SCAT licensee may sell and serve alcoholic beverages only during the hours and days that the holder of a Class B license may operate in the jurisdiction where the catered event is conducted. A person or establishment may have only one SCAT license. The SCAT license may be issued as a general or limited license. A general SCAT license authorizes the holder to operate in any political subdivision of the state and a limited SCAT license authorizes the holder to operate in not more than three contiguous designated political subdivisions provided that the total population of the designated political subdivisions does not exceed 1,000,000. The annual fee for a general SCAT license is $2,000.00. For a limited SCAT license, the fee is based upon the most recent applicable records of the designated political subdivisions as compiled by the Department of Health and Mental Hygiene as follows: 1. 2. 3. A population of at least 600,000 A population of more than 300,000 but less than 600,000 A population of not more than 300,000 $1,500.00 $1,000.00 $750.00 An applicant for a SCAT license who holds a permanent retail license and a special catering license, or who pays an additional fee for the privilege of catering in the applicant's political subdivision, shall be entitled to a license fee credit not to exceed the additional catering fee paid. However, there must be a minimum license fee payment of $250 for a general or limited SCAT license. American LegalNet, Inc. www.FormsWorkflow.com