UTAH DEPARTMENT OF ALCOHOLIC BEVERAGE CONTROL 1625 South 900 West • PO Box 30408 • Salt Lake City, UT 84130-0408 • (801) 977-6800 • FAX (801) 977-6888 www.abc.utah.gov “TEMPORARY SPECIAL EVENT BEER PERMIT” (FOR SPECIAL EVENTS THAT DO NOT LAST LONGER THAN 30 DAYS) APPLICATION CHECKLIST The items below must be completed and submitted by the 10th of the month before any action may be taken by the Alcoholic Beverage Control Commission. The Commission meets monthly. Call the Licensing & Compliance Division at 977-6800 for the date of the next Commission meeting. 1.__ Application (form enclosed). 2.__ Local consent (or local permit) from either city/town council if the event is to be held in an incorporated area, or county commission if in an unincorporated area. 3.__ Copy of local beer permit. If not required by local authority, obtain written consent from either city/town council or county commission to sell beer at the event (form enclosed). 4.__ $500 cash or corporate surety bond (form enclosed). If the bond is in the form of a check, it must be left on deposit with the department until 30 days after the event. If the check is issued by other than the applicant or organization, the attached third party liability agreement form must also be completed. 5.__ Scaled floor plan (8-1/2" x 11") of the event premises, highlighting areas for storage, sale and consumption of beer. 6.__ $75 permit fee (refundable if permit is not granted). Make check payable to the Department of Alcoholic Beverage Control. Enclosed are copies of the Utah Code and Commission Rules pertaining to temporary beer special events. If you have any questions please contact our Licensing and Compliance Division at (801) 977-6800. Rev. 5.23.08 American LegalNet, Inc. www.FormsWorkflow.com UTAH DEPARTMENT OF ALCOHOLIC BEVERAGE CONTROL APPLICATION FOR “TEMPORARY SPECIAL EVENT BEER PERMIT” 1. Name of person/organization: _____________________________________________________ 2. Address:______________________________________________________________________ 3. Phone number: __________ Fax: __________ Person to contact:__________________________ 4. Name of event: _________________________________________________________________ 5. Purpose of event: _______________________________________________________________ 6. Date(s) and hours of event: _______________________________________________________ 7. Name of location of event: ________________________________________________________ 8. Address of event: ________________________________________________________________ Street City Zip 9. Admission charge: __________ and/or Drink prices: Total Attendance ________ 10. [ ] Included [ ] Beer $ _________ Attendance per day if multi-day event: __________ List any private or public schools, churches, public libraries, public playgrounds or parks located within 600' of the premises of the event: Property Address Measured Distance __________________________________________________________________________ __________________________________________________________________________ Rev. 5.23.08 American LegalNet, Inc. www.FormsWorkflow.com 11. Is this event a “large scale public event” where the attendance is estimated to be in excess of 1000 people OR an outdoor event (any size) that is open to the public? [ ] NO (if “no”, skip to question #12) [ ] YES If “yes” the following control measures are required: a. A separate location at the event where those wanting to purchase beer must show proof of age and either have their hand stamped or be issued a non-transferable wristband. b. The proof of age location(s) must be separate from the beer sales and dispensing location(s). c. Any person assigned to check proof of age shall have completed the alcohol server-training seminar outlined in Utah Code 62A-15-401. d. Beer sales and dispensing location(s) shall be separate from food and non-alcoholic beverage concession locations. However, if the consumption of beer at the event is limited to a confined, restricted area within the event (such as a "beer garden"), then beer, food and non-alcoholic beverages may be sold at the same sales locations within the confined, restricted area. e. Beer beverages shall be served in readily identifiable cups or containers distinct from those used for non-alcoholic beverages. f. No more than two beers shall be sold to a customer at a time. g. At least one person who has completed the alcohol server training seminar outlined in Utah Code 62A-15-401 shall be at each location where beer is sold and dispensed to supervise the sale and dispensing of beer. h. If minors may attend the event, all dispensing and consumption of beer shall be in a designated, confined, and restricted area where minors are not allowed without being accompanied by a parent or guardian, and where beer consumption may be closely monitored. To request a waiver of any of the above control measures: • Indicate the control measure(s) for which you are requesting a waiver: ________________ _________________________________________________________________________ • Please provide a written request and a reason as to why the commission should consider relaxing any of those requirements. List below any additional control measures as may be required in R81-7-2(4)(c) and (5) that will be taken at the event to reduce the possibility of minors being furnished beer and adults being over-served beer at the event (use a separate sheet of paper if necessary). Additional control measures can include but are not limited to the following: (i) Defining the premises by way of perimeter fencing with controlled entry/exit points (ii) Requiring a certain minimum number of law enforcement and/or security personnel at the event (iii) Requiring that beer products be distinguishable in appearance from non-alcoholic beverages. [ ] perimeter fencing, number of controlled entry/exit points: _______________________ [ ] number and type of security personnel: ______________________________________ [ ] other: _________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ Rev. 5.23.08 American LegalNet, Inc. www.FormsWorkflow.com 12. Criminal History. The law prohibits any person who has been convicted of a felony under any federal or state law or any violation of any federal or state law or local ordinance concerning the sale, manufacture, distribution, warehousing, adulteration, or transportation of alcoholic beverages from holding a temporary beer permit. The law also prohibits any person who has been convicted of any crime involving moral turpitude or, on two or more occasions within the last five years, has been convicted of driving under the influence of alcohol, any drug, or the combination of alcohol and any drug from holding a temporary beer permit. This proscription also applies to any officers, partners, managers, managing agents, directors, stockholders who hold at least 20% of the total issued an outstanding stock of an applicant corporation, members who own at least 20% of an applicant limited liability company and to any person employed to act in a supervisory or managerial capacity. Please list all criminal offenses other than minor traffic offenses of which you or any of the above persons have ever been convicted: (also include any pending criminal charges). If none, the undersigned applicant attests that the above persons have not been convicted of any disqualifying criminal offense. NAME CRIMINAL OFFENSE DATE OF CONVICTION _____________________________________________________________________________ _____________________________________________________________________________ 13. The commission may not grant a temporary special event permit to an applicant that is a partnership, corporation, or limited liability company if any of the following is a minor: A partner or managing agent of the applicant partnership; a managing agent, officer, director, or stockholder who holds at least 20% of the total issued and outstanding stock of the applicant; or a manager or member who owns at least 20% of the applicant limited liability company. The undersigned attests that no minor serves in any of the aforementioned capacities. 14. Have you as an applicant, or any proprietor, partner, managing agent, director, officer, stockholder owning at least 20% corporation stock, or if a limited liability company, any member owning at least 20% of the company, had a state alcoholic beverage license, permit, or agency revoked within the last three years? __________ If so, please explain. ______________________________________________________________________________ ______________________________________________________________________________ 15. By signing below, the applicant attests that: • The information contained in this application is true and correct; • No minor is applying for the permit and that no minor is a partner or managing agent of the applicant partnership; a managing agent, officer, director, or stockholder who holds at least 20% of the total issued and outstanding stock of the applicant; or a manager or member who owns at least 20% of the applicant limited liability company; • No gambling or any other violation of law or ordinance will be allowed on the premises serviced by the temporary special event beer permittee; • The applicant does not and will not discriminate against persons on the basis of race, color, sex, religion, ancestry, or national origin at the event; • He/she has read and will abide by the provisions of 32A-10-301-306 & 32A-14a, Utah Code, and all Rules of the Commission and directives of the Department of Alcoholic Beverage Control; and Rev. 5.23.08 American LegalNet, Inc. www.FormsWorkflow.com understands that failure to adhere thereto or to no longer possess the qualifications of a temporary special event beer permittee may result in immediate suspension and/or revocation of the permit and forfeiture of the compliance bond; • Consent is given that authorized representatives of the commission, department, or any law enforcement officers will have unrestricted right to enter the premises during the event; and • That the person signing this application is authorized to act on behalf of the applicant. Dated this ______ day of________________, _______. State of ____________________________ County of __________________________ Subscribed & sworn to before me this __________ ________________________________ Authorized Signature ________________________________ Name/title Rev. 5.23.08 day of ____________________, _________. ______________________________________ Notary Public SEAL: American LegalNet, Inc. www.FormsWorkflow.com UTAH DEPARTMENT OF ALCOHOLIC BEVERAGE CONTROL “TEMPORARY SPECIAL EVENT BEER PERMIT” LOCAL CONSENT Date: ____________________ Utah Department of Alcoholic Beverage Control Licensing & Compliance Section 1625 South 900 West PO Box 30408 Salt Lake City, Utah 84130-0408 ________________________________________(City) (Town) (County) hereby grants its consent to the issuance of a state temporary special event beer permit for ______________________________, owned by ___________________________________ and located at _____________________ ____________________________________________ day(s) and hours of event________________ pursuant to the provisions of 32A-10, Utah Code, for the purpose of the storage, sale, and consumption of beer on the premises of the event. __________________________________________ Authorized signature ____________________________________ Name/Title Rev. 5.23.08 American LegalNet, Inc. www.FormsWorkflow.com UTAH DEPARTMENT OF ALCOHOLIC BEVERAGE CONTROL 1625 S 900 W • PO Box 30408 • Salt Lake City, UT 84130-0408 • Phone (801) 977-6800 • Fax (801) 977-6889 “TEMPORARY SPECIAL EVENT BEER BOND” BOND # _______________ KNOW ALL PERSONS BY THESE PRESENTS: That Principal, __________________________________, a temporary special event beer permittee, doing business as _____________________________________, and Surety, _____________________________________, a corporation organized and existing under the laws of the state of ______________________ and authorized to do business in Utah, are held and bound unto the Utah Department of Alcoholic Beverage Control in the sum of $500, for which payment will be made, we hereby bind ourselves and our representatives, assigns, and successors firmly by these presents. Dated this _______ day of ___________________, _______. THE CONDITION OF THIS OBLIGATION IS SUCH THAT: WHEREAS, the above principal has made application to the Utah Alcoholic Beverage Control Commission for a temporary special event beer permit pursuant to the provisions of 32A-10, Part 3, Utah Code. NOW, THEREFORE, if said principal, its officers, agents and employees shall faithfully comply with the provisions of Title 32A, Utah Code, and the rules and directives of the Utah Alcoholic Beverage Control Commission and the Utah Department of Alcoholic Beverage Control, then this bond shall be void; but, if said principal, its officers, agents and employees fail to comply with the provisions of the laws, rules and directives or orders as the commission or department may issue, then this bond shall be in full force and effect and payable to the Utah Department of Alcoholic Beverage Control. This bond shall run for a continuing term effective ________________________ unless canceled by service of written notice upon the Utah Department of Alcoholic Beverage Control, which cancellation shall be effective 30 days after receipt of such notice; provided however, that no part of this bond shall be withdrawn or canceled while violations, legal actions or proceedings are pending against said permittee / principal. ________________________________ Surety ______________________________ Principal / Licensee ________________________________ Attorney in fact ______________________________ Authorized signature { Corporate Seal } ______________________________ Name / Title Rev. 5.23.08 American LegalNet, Inc. www.FormsWorkflow.com STATUTORY AFFIDAVIT FOR CORPORATE SURETY STATE OF: ____________________________ COUNTY OF: ____________________________ On the ________ day of _____________________, ______, personally appeared before me, ___________________________________, who, being by me duly sworn, did say that he / she is the attorney in fact of ____________________________________, Surety, and that said instrument was signed in behalf of said surety by authority, and acknowledged to me that he / she as such attorney in fact executed the same. ___________________________________ Notary Public Signature & Seal Note: Corporate surety's own affidavit also acceptable Rev. 5.23.08 American LegalNet, Inc. www.FormsWorkflow.com UTAH DEPARTMENT OF ALCOHOLIC BEVERAGE CONTROL Temporary Special Event Beer $500 BOND THIRD PARTY LIABILITY AGREEMENT The undersigned hereby consents to the use of this $500 check for the purposes of a temporary special event beer permit compliance bond on behalf of: Temporary special event permitee: _______________________________________ Name of event: _______________________________________________________ Date of Event: ________________________________________________________ Name on check: _______________________________________________________ Furthermore, it is understood that said $500 must be left on deposit with the department for 30 days following said event, and that if said permit is rescinded, the $500 may be forfeited. ___________________________________ Authorized Signature ___________________________________ Name Rev. 5.23.08 American LegalNet, Inc. www.FormsWorkflow.com