FOOD & BEVERAGE, RAILWAY DINING CAR, SHIPS/BOATS TRADE NAME: FORM L-101-FB (12/2007) FOOD AND BEVERAGE CERTIFICATE 1A. If your basic primary license or permit at this location is a Wine and Beer Retailer’s Permit or Beer Retail Dealer’s On-Premise License, is food service your primary business at this location? 1A. B. If your basic primary permit at this location is a Mixed Beverage Permit or any type of Private Club Permit, do you maintain food service at this location? B. 2. Does the licensed premises have food service facilities that allow you to cook or assemble food 2. on premises primarily for on-premise consumption? Are at least eight multiple entrees available to customers for each meal period? 3. 3. If “NO,” explain operation of business. 4A. Are the hours of operation for the sale and service of food and alcoholic beverages the same? B. Hours of sale/service of food (indicate A.M. or P.M.): SUNDAY MONDAY TUESDAY WEDNESDAY 4A. YES NO YES NO YES NO YES NO YES NO THURSDAY FRIDAY SATURDAY THURSDAY FRIDAY SATURDAY C.Hours of sale/service of alcoholic beverages (indicate A.M. or P.M.): SUNDAY MONDAY TUESDAY WEDNESDAY 5. Have you attached a copy of all your menus to this application (appetizers, brunch, etc.)? If a menu is not available, list food and beverage items below, including prices. NOTE: Application will not be approved without menu or food list. (If you need more space, attach additional page.) 5. YES NO 7. YES NO 6. List the equipment used to prepare and serve food. (If you need more space, attach additional page.) RAILWAY DINING CAR 7. Have you attached copies of floor plans of the proposed licensed location indicating areas devoted primarily to the preparation and service of food (including placement of tables, chairs, fixtures and furniture) and those devoted primarily to the preparation and service of alcoholic beverages? WINE AND BEER RETAILER’S PERMIT FOR RAILWAY DINING CAR 8A. Designate type of car and give total number of cars: Type Total Number of Cars B. This car will operate between and (City) (City) EXCURSION BOAT/SHIP MIXED BEVERAGE PERMIT/WINE AND BEER RETAILER’S PERMIT FOR EXCURSION BOAT 9. Have you attached a copy of the Certificate of Documentation issued by the U.S. Coast Guard? 9. YES NO 10A. YES NO B. At least 35 gross tons? B. YES NO C. At least 55 feet? C. YES NO D. YES NO 10. Is the boat/ship a regularly scheduled excursion boat/ship licensed by the U.S. Coast Guard: A. To carry passengers? D. A boat with a minimum capacity of 45 passengers? 11. If applying for a Mixed Beverage Permit does the applicant own the boat for which this application is filed? 11. YES NO MIXED BEVERAGE PERMIT FOR EXCURSION SHIP FOR VOYAGES IN INTERNATIONAL WATERS 12A. Does the boat or ship carry at least 350 passengers? 12A. YES NO B. Does the boat or ship weigh at least 90 gross tons? B. YES NO C. Is the boat or ship at least 80 feet long? C. YES NO American LegalNet, Inc. www.FormsWorkflow.com