Minnesota Department of Public Safety ALCOHOL AND GAMBLING ENFORCEMENT DIVISION445 Minnesota St., Suite 222, St. Paul, MN 55101(651)201-7500 FAX (651)297-5259 TTY (612)282-6555 APPLICATION FOR CATERER'S PERMIT PERMIT FEE $300 Please check if application is an original or a renewal. Federal Tax ID # Applicant Name (Individual, Partnership, Corporation 226 (If Corporation State full Corporate Name ) (DOB) (Social Security #) Trade Name or DBA of Restaurant Address of RestaurantTelephone # City or county where on-sale license issued I certify that the above information provided by the applicant is true, complete, correct and made in good faith and agree to comply with the above paragraph222s requirements and all other applicable law in the use of the caterer222s permit. Signature - Authorized Applicant Date Print Full Name of Person Signing TO AVOID DELAYS OR DENIAL OF THIS APPLICATION, ALL ITEMS MUST BE COMPLETED IN FULL OR IT WILL BE RETURNED FOR COMPLETION MAKE CHECK PAYABLE TO: DIRECTOR OF ALCOHOL AND GAMBLING ENFORCEMENT Cash Check To obtain a Caterer's Permit, applicant must currently hold a valid retail on-sale intoxicating liquor license at a restaurant. All liquor laws and rules apply to both the on-sale license as well as this caterer's permit. Liquor liability and workers compensation insurance are mandatory and a certificate showing off premises coverage must accompany this application for a caterer's permit. Cancellation or suspension of the on-sale license invalidates the caterer's permit also. You, as the licensee, are required to notify the city police chief or county sheriff (if located outside city limits) before any catered events take place in their jurisdiction. Only the licensee holding the caterer222s permit shall provide food and liquor at catered events. A pre-license inspection will be conducted by this office prior to caterer222s permit approval. Please attach the following documents to this form: 1) A copy of the applicant222s valid on-sale intoxicating liquor license 2) A copy of the applicant222s valid restaurant license issued by local Health Department 3) A certificate of liquor liability insurance that states 223off premises coverage included224 (No applications, binders or declarations) 4) $300.00 check or money order payable to the Alcohol and Gambling Enforcement Division Valid e-mail address American LegalNet, Inc. www.FormsWorkFlow.com