® CITY OF BULLHEAD CITY

COUNCIL COMMUNICATION MEETING DATE: October 16, 2018 *

SUBJECT: Series 12 Liquor License Application- Firehouse Coffee

DEPT OF ORIGIN: City Clerk's Department

DATE SUBMITTED: October 3, 2018

SUBMITTED BY: Susan Stein, MMC, CPM, City Clerk

SUMMARY:

John Paul Hassett has submitted an application for an Interim Permit and new Series 12 Liquor License #29855 to be used at an establishment known as Firehouse Coffee Company located at 2350 Miracle Mile Road, Suite 306, in Bullhead City, Arizona. The owner is KevCo Group LLC.

The property was posted according to law, and no objections to this application were received by the City Clerk's office. The Planning and Zoning Division has reviewed the application and does not have any objections. The Bullhead City Police Department has reviewed the application and does not have any objections to the issuance of the liquor license.

~

FISCAL IMPACT: REVIEWED BY: ~ 1\\ A It ~ance Department

$200 application fee received.

ATTACHMENTS:

1. Liquor License Application 2. Memo from the Bullhead City Planning & Zoning Division 3. Memo from the Bullhead City Police Department 4. Affidavit of Posting from City Clerk

LEGAL REVIEW:

APPROVED AS TO FORM(/['L~tl r 2 ~} ~ ~ttorney

_j -~ RECOMMENDATION:

COUNCIL TO MAKE A RECOMMENDATION TO THE ARIZONA DEPARTME1u~ LIQUOR LICENSES AND CONTROL TO APPROVE THE APPLICATION FOR AN INTERIM PERMIT AND NEW SERIES 12 LIQUOR LICENSE NO. 29853 SUBMITTED BY JOHN PAUL HASSETT FOR FIREHOUSE COFFEE COMPANY LOCATED AT 2350 MIRACLE MILE ROAD, SUITE 306, IN BULLHEAD CITY.

APPROVED FOR SUBMITTAL BY: CITY CLERK'S USE ONLY

AldMJ/VJJ )2;/ LUte~ COUNCIL ACTION TAKEN

~epartment Director Resolution No. Continued To:

//-!& ~~- Ordinance No. Referred To: Approved Denied

Other FileNo. (r J City Manager

,, _ _/

@)BHC-16 (10/2001) j:\forms\council comm form.doc

Arizona De~T.'¥'\.oWqu~lt§c n~es and Control Oi)N~~t;Jng n · th y

Pht>eniX:O.Ai£ a · o 4

SECTION 1 Type oF License

OOinterlrn Permit JL9New License 0Person Transfer (series 6, 7 and 9) Olocatlon Transfer (series 6, 7 and 9)

www.azllquor.gov

0Probate/ Will Assignment! Divorce Decree (No Fees) Oseasonal

0 Apply to become Arizona lottery retailer

SECTION 2 Type of Ownership []J.T.W.R.O.S. Oindlvldual Dartnershlp Dcorporatlon ISZfumlted Liability Co CJ:;iub 0Government Dr rust Olribe Dother (Explain)

SECTION 3 Type of Pnvllege 0 Add Sampling Privilege For Series 9 and 10 only (Complete Sampling Privilege application) A.R.S.§4-206.01 (G), (H), (I) & (L)

0 Add Growler privileges (restaurant, series 121icense only. 300-foot restriction applies) A.R.S.§4-207(A) & (B)

<! 1.Type of license (Series of license): :~-e .. ,(teJ' 2. LICENSE II'" 7) of>_ ·tp 'J']_ %'S'3

8.

9. Total Price paid for Series 6 Bar, Series 7 Beer & Wine Bar or Series 9 Liquor Store (Ucenseonly) $

Application

l 0() -<:/9- oewrtment ~Only '1? 1\ 'f "SP. :7"' .Q,tft\:1~

lnlerlm Permit Site Inspection Anger Print $

'([")75-'-Y--Totat or All Fees

Fees

Is Arizona Statement of Citizenship & Allen Status for State Benefits complete? Yes DNa

1/11/2018 page 1 of6 Individuals requlrtng ADA accommodations please call (602)542-2999

. -fl·\ ?·0(~1 SECTION 51nterlm Permit '18 fi\J(; 31 Uq;', L1C, ~ ~~~·><<:< If you intend to operate business while the application is pending, you will need an interim permit pursuant to A.R.S.§4-203.01. For approval of an Interim permit:

• There must be a void license of the same series issued to the current location you are applying lor, OR • A Hotel/Motel license is being replaced with a restaurant license pursuant to A.R.S.§4-203.01 (A)

l. Enter license number currently at the location: _1_2_0_8_3_5_3_0 ______________ ,--,--

2. Is the license currently In use? [Z]Yesj8jNo

NOTARY

1 (PrintFunNameJ Kathleen Christine Macfarlane Controlling Person on the staled lie se and location.

hereby declare that I am the Agent, Current Owner, or

State of CA County of (J (' a. v-. S -t. The foregoing instrument was acknowledged before me this

-~·:2-:::.I __ Day of AUE\l)"'>.f· Day Ml,nth

:2018 Year

of Notary

SECTION 6 Check

EACH PERSON LISTED MUST SUBMIT A QUESTIONNAIRE. FINGERPRINT CARD, AND $22 PROCESSING FEE PER CARD. · 1. If the applicant is an entity, and not an individual, answer questions 1 a-b.

a) Date Incorporated/Organized: _______ State where Incorporated/Organized: _______ _

b) AZ Corporation or AZ L.L.C. File No: ______ Date aut~t~J~ t~~t91\4 E NT 2. list any individual or entity that owns a beneficial interest of 10% or more and/or controls the applicant or licensee. If the applicant is owned by another entity, attach an organizational chart showing the ownership structure. Attach additional sheets as needed. Disclose all controlling persons and members, shareholders or general partners who own a beneficial Interest of l O% or more of the applicant or licensee.

Last First Middle nile %Owned Mailing Address City State ZIP

{AHoch addlffonal sheet 1f necessary)

SECTION 7 Probate, Receiver, Bankruptcy Trustee, Assignment, or Divorce Decree of an existing liquor license A.R.S.§4-204

EACH PERSON USTED MUST SUBMIT A QUESTIONNAIRE, FINGERPRINT CARD, AND $22 PROCESSING FEE PER CARD.

1. Current Ucensee's Name:-,---.,-:-------------::-;-----------=-:-::----(Exactly as it appears on the license) Last First Mtddle

2.Assignee's Name: -------;-.,-------------::-:-------------:-::-:-::----Last First Middle

3.License Number:------------------

ATTACH A COPY OF THE DOCUMENT THAT SPECIFICALLY ASSIGNS THE liQUOR LICENSE TO THE ASSIGNEE.

1/11/2018 page2of6 Individuals requiring ADA accornmodaflons please call {602)542-2999

SECTION 5 Interim Permit If you Intend to operate business while the application Is pending, you will need an Interim permit rsuant to A.R.S.§4-203.01. For approval of an Interim permtt:

• There must be a valid license of the same series Issued to the current location you applying for, OR • A Hotel/Motel license Is being replaced with a restaurant license pursuant to .. §4-203.01 (A)

-.3 "2 [) 1. Enter license number currently at the location: +.(;t..J.Lu=-::.;.,<....:::7..1:....__7 :::.... _____ .,_.,,---------

s It been out of use? _]....Lf/-"3'-'l'-j(~t,_..fl,__ ___ _ 2. Is the license currently In use70Yes!SpNo IF no, how long

State oF kn ·t..Dl'\ Ll. County oF J'..-t V ~flV e._., The foregoing instrument was acknowledged before me this

w Day of AlA.~ I st '~017 D~y M lh Vear

"fj(AI.J.lUL S~\.~v SigNature of Notary

SECTION 6 Background Check

EACH PERSON LISTED MUST SUBMIT A QUESTIONNAIRE, FINGERPRINT CARD, AND $22 PROCESSING FEE PER CARD. 1. If the applicant is an entity, and not an Individual, answer questions la-b.

a) Date Incorporated/Organized: ~ Z .. I l \ lP State where Incorporated/Organized: --'·*-'~""--;---::o-;,----b) AZ Corporation or AZ L.LC. File No: LZ01 \S l()C\", Date authorized to do business In AZ: 5(&/tte

2. List any Individual or entity that owns a beneficial Interest of 10% or more and/or controls the applicant or licensee. IF the applicant Is owned by another entity, attach an organizational chart showing the ownership struclure. Attach additional sheets as needed. Disclose all controlling persons and members, shareholders or general partners who own a beneficial Interest of 10% or more oF the applicant or licensee.

SECTION 7 Probate, Receiver, Bankruptcy Trustee, Assignment, or Divorce Decree of an existing liquor license A.R.S.§4-204 EACH PERSON USTED MUST SUBMIT A QUESTIONNAIRE, FINGERPRINT CARD, AND $22 PROCESSING FEE PER CARD.

1. Current Licensee's Name:--.,.---,---,-------------=---------------,,..,----(ExacUy as Jt appeal'S on the license) last Frst Middle

2.Asslgnee's Name: ------;=-----------.::-:-----------:c::-:-::---tast First Middle

3.License Number:-------------------

ATTACH A COPY OF THE DOCUMENT THAT SPECIFICALLY ASSIGNS THE LIQUOR LIC~NSE TO THE ASSIGNEE.

1/11/2018 page 2 of6 Individuals requlr1ng ADA accommodations. please call (602)542-2999

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STATE OF ARIZONA

DEPARTMENT OF LIQUOR LICENSES AND CONTROL

ALCOHOllC BEVERAGE llCENSE

. --·· .:~ .. ···

License 12083530 Issue Date: 8/31/2018

Issued To: KATHLEEN CHRISTINE MACFARLANE, Agent FlREHOUSE COFFEE SHOP LLC, Owner

Location: FlREHOUSE COFFEE COM:P ANY 2350 MIRACLE MILE SUITE306 BULLHEAD CITY, AZ 86442 USA

'--.. >; .,;.,;,.

.-: ... ._.:.:.;::._,_.·

·.'·

Expiration Date: 7/31/2019

Mailing Address: KATHLEEN CHRISTINE MACFARLANE FIREHOUSE COFFEE SHOP LLC FlREHOUSE COFFEE COM:P ANY 2350 MIRACLE MILE STE306 BULLHEAD CITY, AZ 86442 USA

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. POST TillS LICENSE IN A CONSPICUOUS PLACE l,i ?l

'i~O'i"''"'"""*"'"""'--s~"=T'"""SOC.""'EJ<:7.£L-~"Oi""''"'"'''::SC<=7C<o=.";:,.c;=""2"-"i ""''> ;;<·;oo··, 0:~·-·<:"tr:'o':O.;o:C.C:·;O""C. "'"'''-'""'·'·•"'c.='ECiC :c:;_;;o '"'" ;;;;c.;;c;o="-'C2"-i';i;';;i>in,co;;, '""'"'-'"'"'·"i.i20"-S'2i.i•'•'"'-'' :,.-~o:-,.,-,o;J

SECTION 8 Government (for Cities, Towns or Counties only)

1. Government Entity:-------------------------------

2. Person/Designee:--,-,---------=----------:-::-:-:-----,---,--------Last First Middle Daytime Contact Phone #

SECTION 9 Person to Person Transfer ARS§4-203(C), (D), (G) (Bar and Liquor Stores only- Series 06, 07, and 09)

1. license#: ______________ _

2.lndlvldual Owner/Agent Name: ---;---,-----------=:-:------------,-,,..,.-,,---Last First Middle

3. Ownership Name:---------=:-:---::-----:--,---:---------------­(Exactly as It appears an the license) .

4. Current Business Name:-------=---=-:--::--------:;-,.,-;;--;----------------­(Ex:actly as It appears on the license)

5. Business Location Address:---::--:-------------=-------::--,-----=--:---.,.--Street City State County Zip

6. Current Daytime Phone: __________ Prtmaty Email Address:---------------

7. Does current licensee Intend to operate the bu~ness while this application Is pending? DYes 0 No

8. I, (signature):-------------------- authorize the transfer of this license to the applicant.

NOTARY

I (Print Full Name) hereby declare that I am the Individual Agent, Owner, Or Controlling Per.;on on the stated license and location.

Signature: State of County of::cc:-;-......,-,--;---::-:-The foregoing instrument was acknowledged before me this

My Commission Expires on: Day of ___________ _ Date Day Monlh Year

Signature of Notary

SECTION 10 Location Transfer- Current Licensee Information ARS§4-203(C), (D), (G) (Bar and Liquor Stores only- Series 06, 07, and 09)

1.Current Business:

2.New Business:

1111/2018

Name: __________________________ ___

Address:------:=-:--:::---::---=-:-:::--::----------­(exactly as It appears on license)

Name: ____________________________________________________ ___

Address:-------------------------------

page 3 of6 Individuals requiring ADA accommodations please caU (602)542-2999

SECTION 11 Proximity to Church or School- Questions to be completed by 6, 7, 9, 10 and 12G applicants.

A.R.S.§4-207. (A) and (B) state that no retailer's license shall be Issued for any premises which are at time the license application Is received by the director, within three hundred (300) horizontal feet of a c ch, within three hundred (300) horizontal feet of a public or private school building with kindergarten pro s or grades one (1) through (12), or within three hundred (300) horizontal feet of a fenced recreational adjacent to such school building.

The above paragraph DOES NOT apply to: e) Government license (A.R.S. §4-205.03) Series 05 a) Restaurants that do not sel growlers (A.R.S.§4-205.02) Se!les 12 Q Playing area of a golf course (A.R.S.§4-207 (B)(5)) b) HoteVmotelllcense (A.R.S.§4-205.01) Senes 11 g) Wholesaler/Disllibutor Sertes 04 c) Mlcrobrewery (A.R.S.§4-205.08) Series 03 h) Farm Winery Sertes 13 d) Craft Distillery (A.R.S.§4-205.10) Series 18

0 Pto;~:~1lli~<;(/~) Name ofSchool:j• :.2--' AddressW&J ~4t\_') bu..ll ~)\=iJft,lji/ Name of Church. ' ~- tr<{Jj- f'I'O..(T(S Address: //o9/ ()J,O ~ kt Ui

SECTION 12 Business Financials A.R.S.§4-202(F)

1.1 am the:

"ffirenant: a person who holds the lease of a property; a lessee. 1:!] Sub-tenant: a person who holds a lease which was given to another person (tenant) for all or part of a property. Downer 0 Purchaser 0 Management Company

2. If the premises Is leased give lessors:

3. What Is the penalty If the lease Is not fulfilled?$ ___ -J.J-c.._ ____ or Other: ----------~-

4. Total money bOrrowed for the Business, not Including lease?$ ------'.f"'--------------

Please List Lenders/People you owe money to for business.

Last R~t Middle Amount Owed Mailing Address City Stale lip

(Atlach additional sheet If necessary)

5. Has a license or a transfer license for the premises on this application been denied by the state within the past year?

0 Ye~ No If yes, attach explanation.

6. Does any splr~~ous liquor manufacturer, wholesaler. or employee have an Interest In your business?

0 Ye~ No If yes, attach explanation .

1/11/2018 . page4of6 Individuals requ1rlng ADA accommodations please call (602)542-2999

SECTION 13 Diagram of Premises

Check ALL boxes that apply to your business:

0 Walk-up or drive-through windows

~ Patio: Contiguous 0 Pallo: Non-Contiguous within 30 feet

1. Is your licensed premises now closed due to construction, renovation or redesign or rebuild?

Oves -~No If yes, what is your estimated completion date?____;___; __

2. What type of business will this license be used for? (be Specific) JSO::.mu Y[iL \-r 3. Please attach a diagram of the premises which clearly shows only the areas where spilituous liquor will be sold, served, consumed, dispensed, possessed or stored. include entrances, exits, Interior walls, bar areas, dining areas, dance ftoor, stage, game room and kitchen.

DO NOT INCLUDE

Parking lots, living quarters or areas where business Is not conducted under this liquor license. Please Identify which orientation is North on the diagram.

4.Provlde the square footage or outside dimensions of the licensed premises. Please do not Include non-licensed areas such as parking lots, living quarters, etc.

ATTACH DIAGRAM

IMPORTANT NOTE: As stated In A.R.S.§4-207.01 (B), It Is the licensee's responsibility to notify the Department of Liquor Licenses and Control when there are changes to the service areas or the square footage of the licensed premises, either by Increase or decrease.

RESTAURANTS AND HOTELS/MOTELS ONLY (IMPORTANT NOTE: A site Inspection must be conducted prior to activation of the license. A $50.00 fee for the Inspection will be due and payable upon submitting this application.)

5a. Provide a detailed drawing of the kitchen and dining areas, Including the locations of all kitchen equipment and dining furniture. These are required as part of the diagram. A.R.S.§4-205.02(C)

5b. Provide a restaurant operation plan.

1111/201 B page5of6 Individuals requiring ADA accommodations please call (602)542-2999

NOTARY

-'--'-'--'-'-''-l-'-\-"-i'I-7_,-+4 '..:S:;.,S"-.e:-"+'-'-t:...,-,. ___ hereby declare that I am the Individual Agent, Owner, t d ~nse and location.

state of Af\7,0)'\(..L county of (\il DY\tlv'IL The foregoing Instrument was acknowledged before me thls

-ff-zo""-·- Day of At#,~J S t ~!.~ Yl\rvJ.tQG_::)

A.R.$.§41-1030. lnvaildllV of rules not made according to this chapter: prohibited agency action: prohibited acts by state employees: enforcement: notice

B. An agency shall not base a licensing decision In whole or In part on a licensing requirement or condition that Is not specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority In statute does not constitute a basis for Imposing a licensing requirement or condition unless a rule Is made pursuant to that general grant of authority that specifically authorizes the requirement orcondltlon.

D. THIS SECTION MAY BE ENFORCED IN A PRIVATE CIVIL ACTION AND RELIEF MAY BE AWARDED AGAINST THE STATE. THE COURT MAY AWARD REASONABLE ATTORNEY FEES, DAMAGES AND ALL FEES ASSOCIATED WITH THE LICENSE APPLICATION TO A PARTY THAT PREVAILS IN AN ACTION AGAINST THE STATE FOR A VIOLATION OF THIS SECTION.

E. A STATE EMPLOYEE MAY NOT INTENTIONALLY OR KNOWINGLY VIOLATE TIHIS SECTION. A VIOLATION OF THIS SECTION IS CAUSE FOR DISCIPLINARY ACTION OR DISMISSAL PURSUANT TO THE AGENCY'S ADOPTED PERSONNEL POLICY.

F. THIS SECTION DOES NOT ABROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.01 OR 12-820.02.

1/11/2018 page6 of6 Individuals requlr1ng ADA accommoda11ons please call (602)542-2999

CJ

0

'i0 ~IC .... (,f • '18 Alb:; 31 Li9!', Lit. Pl-112(!8 '-' ·~ 'C'-t Uq;·. iJ<tt f'l112:44

Arizona Department of liquor Licenses and Control 800 W Washington 5th Floor

Phoenix, A!, 85007-2934 www.azliquor.gov

(602) 542-5141

RESTAURANT OPERATION PLAN

1. Name of restaurant (Please print): cfl'(L-~1 c;-f C<\\£-eg_ ,C,]')::>V 2. List by Make, Model, and Capacity of your. (If you altached a legible copy of your equipment list, only

provide the following items:)

Grill

Oven

Freezer

Refrigerator

Sink

Dish Washing Facilities

Other

3. Attach a copy of your full menu Including prices (examples: Breakfast. Lunch, Dinner. and Nonalcoholic beverages).

4. List the sealing copodtv for.

5.

a. Restaurant dining area of your premises: (Do not include polio sealing)

b. Bar area of your premises:

c. Total dining and bar seating capacity of your premises:

What Type of dinnerware and utensils are utilized within your~touront? 0 Reusable 0 Disposable 'j.J Both

~qo

[+ 1·0 l= ( Gb

6. Does your restaurant hove a bar area that is distinct and separate from the dining area? (If yes, what percentage of the public floor space does this area cover?) %

7. What percentage of your public premises is used primarily for restaurant dining? (Do not Include kitchen. bar, hi-fop fables, or game area.) [r9 0 %

8/11/2015

Individuals requiring ADA accomrnodollons caQ (602) 542-9027.

OY~No

8. Does your restaurant contain any games, televisions, or any other entectainment?O YES Af No (If yes, specify what types and how many (examples: 4-lV's, 2-Pool Tables, !-Video Game, etl)i

9. Do you have live entertainment or dancing? 0 YES M No (If yes, what type and how often (example: DJ-2 x a week, K6r'aoke-2 x a month, Uve Band-! x a month, etc.)

1 D. Use space below to list how many employees for each position to fully staff your bu~ness.

Position How many

Cooks 1-; Bartenders

Hostesses --cr Managers ;;._ Servers '? Other ( )

Other ( )

Other ( )

I, , hereby declare that I am the APPLiCANT filing this application.

Stateof ~~ p

8/1 l/2015

d the contents and all statements true, correct and complete.

NOTARY

County of ~;J/Cu--{'~ <><iv' v

Page2of2

lndlvlduals requiring ADA accommodatlons call (602) 542-9027.

f;'a/ldW/C/Jt?S

Served Whole or Half on choice of French Roll, Twelve Grain, Sourdough or Croissant & choice of one side; pasta salad, green salad, kettle chlps, or soup of the

w ...

Turkey Sliced turkey breast, jack cheese, mayo, tomato,

red onion, & alfalfa sprouts $9/$7

Ham Ham, swiss cheese~ sweet & spicy murtard, iulcy

tomato, onion & alfatfa sprouts $8/$6

Roast Beef Roast Beef, sharp cheddar cheese, zesty

horseradish mayo, tomato, red onions, & alfalfa sprouts $9}$7

Tuna House made a/bacon~ tQna, swiss cheese,

tomato,. red onion, & alfalfa sprouts $9/$1

Firehouse BLT Served on either sourdough or twelve grain,

chlpotle aloll, crispy bacon, tomato & romaine lettuce. $8

Turkey Bacon Avo Turkey, crispy bacon, avocado, mayo & jac:k

cheese $10

Firehouse Club Three pteces of twelve grain bread stacked wlt:h

ham, turkey~ crispy bacon, mayo~ tomato & romaine lettuce $10/$8

panini (.setved whole only)

Tuna Panini Signature albacore tuna salad, topped with

melteQ Swls!> cheese, served on toasty sourdough bread. $10

Spicy Chicken Panini Shredded chicken <dl sauced tlp In buffalo sauce,

red onions., blue cheese., on sourdough bread wlth a side of buffalo ranch $10

Chipotle Panini French Roll, shredded chicken, red onions, jack

Served Daily 11am - 3pm

,, Served Whole or half with toasted sourgoud:J roll on

th.e.slde

Chicken caesar Freshly chopped roinalne, with twice baked

croutons, parmesan cheest;, seasoned chicken, & Caesar dressing $l2/$8

Chicken Waldorf Red apple slices, house baked candled walnuts,

crumbly feta cheese, dried cranberries, seasoned chlcken,served atop a bed of spring mix green with a side of our house made dljon

vinaigrette. $12/$8

White Albacore Tuna Crisp romaine, sUr:e.d cucumbers$ chopped tomatoes & carrots, topped with tasty tuna

$l2/$8

Firehouse Wedge Salad A wedge of crisp iceberg lettuce, with baron,

red onion, sliced grape tomatoes, & bleu cheese crumbles. Served with a side of balsamic

vinaigrette and homemade bleu cheese dressing $l2/$8

Summer Pear Salad Fresh spring mix topped with sweet asian pears, dried cranberries; homemade candled walnuts,

bleu cheese crumbles served with balsamtc vinaigrette $11/$1

Seasonal Berry Salad Fresh spring ml~ seasoned chicken, seasonal berries, sprinkled with almond sllces,drlzzled

With our homemade glnger·lime dressing $12/$8

Taco Salad Chopped romaine, black beans, swe.et corn, tomatof & shredded chlcken garnished with sour cream, crlspytortllla chips & chiptole

ranch dressing (no roll) $12/$8

Garden Green Fresh romaine, cucumber slices# chopped

tomatoes, carrots, cheddar, crunchy croutons $11/$7

Add chicken orturkey for $1.75

Kfds o-Kids@ Heart Menu *lllnchserved with a tbolte ofthlps or fruit

PB&J*· Served on twelve grain bread, cut1nto fourths, with creamy peanut butter, & sweet grape Jelly.

Have It warm and toasty or served normal $7

Classlc Grilled Cheese* A classic: served on sourdough or twelve grain bread wrth perfectly melted cheese, cut Into

QrihkS Espresso1 lattes, Cold Brew, Frappes, FrultSmoothies,lced and Hot Teas,

Sodas (Coke Products), Craft Beer and Wine Selection 1

Eft..J:!H Bacon $1.75 Chicken $1.75 Avocado $1.50 Cheese $1.00 Egg $1.00 Dell Meat $1.50 Chicken $1.75 Toast $1.50

Veggles $1.50

Quiches Served all day- check bakery case

for today's offering

PaStr!eS/@XJds Served all day- check bakery case

for today's offering

Checf.;: the Chait<\ board

near the counter For this weeK'S

special ofFerir,gs!

TJ~E+f .. ~ Coffee· Shop

: . ·nn~Ml..ii'rJt i"!:'t" . . . _,_. -:e.: -~ - ~ •' c • - - - - -' 1 '

Served 7am-11am Monday thru Friday and 7am-lpm Weekends

Breakfast Burrito Fluffy eggs, potato, sharp cheddar, & choice of

bacon, ham, or chorizo served with sizzling house sa Jsa $7

Breakfast Sandwich A choice of fresh bacon or ham wlth scrambled eggs, a slice oftomato, & sharp cheddar cheese squeezed between a warm croissant or bagel $6

Firehouse 1st Alarm A Firehouse original with ham, scrambled eggs,

cream cheese, ffre.y Jalapef'los, & a slice of tomato all in between a toasted bagel $7

Veggle Breakfast Sandwich Alfalfa sprouts, refreshing cucumber, &

tomatoes with soft cream cheese spread on a bagel or croissant $6

Eggs Benedict A fan favorite I A buttery croissant topped with ham, poached eggs, & our smooth homemade

hollandalsesauce$9

Bagel Lox A bagel of your choice toasted with cream

cheese, smoke9 salmon, capers, tomatoes & onlons$8

Benny Burrito Bacon or ham, potatoes, egg, cheddar cheese,

& a light spread of our savory hollandaise sauce $8

Burrito Bowl Hearty potatoes topped wlth scrambled eggs,

avocado, onions, cheddar cheese, & your choice of bacon, ham, or chorlzo $7

(1/aJ·nJng consultJ/n.ffraw or undercoo!red hJIJfltSr

.reafnod snei/Fish or e..,'f[?S /naY Increase rls!f oF Food borne illness

;<ids 4- !(lets@ Heart Menu

Bagel & Parfait Combo Your choice of bagel with a fresh made parfait

cup with a choice of peach or mixed beny frult and crunchy granola $7

Kiddy Croissant Sandwich Warm fluffy croissant with ham topped off

with melted sharp cheddar cheese $4 (Add a scrambled egg before llam for $1)

Drinks

Espresso, lattes, Cold Brew, Frappes, Fruit Smoothles, Iced .and Hot Teas,

Sodas (Coke Products), Craft Beer and Wine Selection I

EXtras

Bacon $1.75 Chicken $1.75 Avocado $1.50 Cheese $1.00 Egg $1.00 Deli Meat $1.50 Chicken $1.75 Toast $1.50

Veggles $1.50

CheCk' the chalK board

near the counter fOr this weeK's

special Of'ferings!

Served All DaY

Pascries/@odt

.;. Bagels & Cream Cheese $3.00 <!• Cinnamon Roll $4.00

..z .. Mint Dessert $1.25 or 2 for $2.00 •!• Bear craw $3.55 '.• Muffins $3.45 •!• Scones $2.95

·~ Yogurt parfait $4.25 •!• Fresh Fru~ $4.25

•:-• Bottled Water $1.00

Pastry crust filled with fluffy eggs whipped together with savory fillings

(Served all day) $5.50

Veggie Fresh tomato, onion & mushrooms

Ham & Cheddar Classic Black Forest ham & cheddar

cheese

Spinach & Bacon Fresh spinach, bacon, & cheddar cheese

Mexican style Potatoes, bacon, jalapeftos, red onions,

tomato, & cheddar cheese

Spinach & Feta · Fresh spinach & feta cheese

Sun-dried Tomato sun-dried tomatoes, spinach, &

mozzarella cheese

Bacon Green Chile Bacon, sliced green chill, & Cheddar

cheese

Arizona Department of liquor L'llieRkiis::;lrld"ii'' Lie. ?l~i2~),] Control

800 W Washington 5th Floor Phoenix, AZ 85007-2934

www.azliquor.gov (602) 542-5141

RECORDS REQUIRED FOR AUDIT Applies to Series 11 (Hotel/Motel W/Restaurant) & Series 12 (Restaurant) Only

MAKE A COPY OF THIS DOCUMENT AND KEEP IT WITH YOUR DllC RECORDS

In the event of an audit, you will be asked to provide to the Department any documents necessary to determine compliance with A.R.S. §4-205.02(G). Such documents requested may Include however, are not limited to:

1. All invoices and receipts for the purchase of food and splrltuous liquor for the licensed premises.

2. A list of all food and liquor vendors

3. The restaurant menu used during the audit period

4. A price list for alcoholic beverages durtng the audit period

5. Mark-up figures on food and alcoholic products during the audit period

6. A recent, accurate inventory offood and liquor (taken within two week~ ofthe Audit Interview Appointment)

7, Monthly Inventory Figures - beginning and ending figures for food and liquor

8. Chart of accounts (copy)

9. Financial Statements-Income Statements-Balance Sheets

1 o. General ledger

A. Sales Journals/Monthly Sales Schedules

1) Dally sales Reports (to Include the name of each waitress/walter, bartender, etc. with sales for that day)

2) Dally Cash Register Tapes- Journal Tapes and Z-tapes

3) Dated Guest Checks

4) Coupons/Specials/Discounts

5) Any other evidence to support Income from food and liquor sales

B. Cash Receipts/Disbursement Journals

1) Dally Bank Deposit Slips

2) Bank Statements and canceled checks

11. Tax Records

A. Transaction Privilege Sales, Use and Severance Tax Return (copies)

B. Income Tax Return- city, state and federal (copies)

C. Any supporting books, records, schedules or documents used In preparation oftax returns

12. Payroil Records A. Caples of all reports required by the State and Federal Government

B. Employee log (A.R.S. §4-119)

C. Employee time cards (actual document used to sign In and out each work day)

D. Payroll records for all employees showing hours worked each week and hourly wages

9/4/2015 Individuals requiring ADA accommodations please caU (602)542~9027

13. Off-site Catering Records (must be complete and separate from restaurant records)

A. All documents which support the Income deriVed from the sale of food off the license premises.

B. All documents which support purchases made for food to be sold off the licensed premises.

c. All coupons/specials/discounts

The sophistication of record keeping varies from establishment to establishment. Regardless of each licensee's accounting methods, the amount of gross revenue derived from the sale of food and liquor must be substantially documented.

REVOCATION OF YOUR LIQUOR LICENSE MAY OCCUR IF YOU FAIL TO COMPLY WITH A.R.S. §4·210(Al7 AND A.R.S. §4-205.02(G).

A.R.S. §4-210(A)7

The licensee falls to keep for two years and make available to the department upon reasonable request all Invoices, records, bills or other papers and documents relating to the purchase, sale and delivery of spirituous liquors and, In the case of a restaurant or hotel-motel licensee, all invoices, records, bills or other papers and documents relating to the purchase, sale and delivery of food.

A.R.S. §4-205.02(G)

For the purpose of this section:

1 ."Restaurant" means an establishment which derives at least forty percent (40%) of Its gross revenue ftom the sale of food 2."Gross revenue" means the revenue dertved from all sales of food and spirituous liquor on the licensed premises, regardless of whether the sales of spirituous liquor are made under a restaurant license Issued pursuant to this section or under any other license that has been Issued for the premises pursuant to this article.

NOTARY

State of A-n ~0 1'\t:'L County of ~oh.a...Lie., the foregoing lnstrumenl was acknowledged before me this

My commission expires on: \..j \,LNl. \ ~ 1 '?JiYLO Year

MAKE A COPY OF THIS DOCUMENT AND KEEP IT WITH RECORDS REQUIRED BY THE STATE

9/4/2015 tndMduals requiring ADA accommodations please call (602)542-9027

'' ') I.\...-,_..!

"18 AUG 31 Lio/. Lit, PN12!t}3 '18\iUG 24 Li'j!'. lleyt PiH244

Arizona Department of Liquor Licenses and Control 800 W Washington 5'h Floor

Phoenix, AZ 85007-2934 www.azllquor.gov

(602) 542-5141

QUESTIONNAIRE A.R.$.§4-202, 4-210

Type or Print with Black Ink

The fees allowed byR19·1·102 will be charged for all dishonored checks.

ATTENTION APPLICANT: This Is a legally binding document. Please type or print In black jnk. An Investigation oF your background will be conducted. Incomplete applications will not be accepted. False or misleading answers may result In the denial or revocation of a license or oermlt and could result In criminal prosecution.

Attention local governments; Social security and birth date Information Is confidential. This Information may be given to law enforcement a encles for back round checks onl .

QUESTIONNAIRE IS TO BE COMPLETED BY EACH CONffiOLLING PERSON, AGENT AND MANAGER BEING DISCLOSED TO THE DEPARTMENT. EACH PERSON COMPLETING THIS FORM MUST SUBMIT A BLUE OR BLACK LINED FINGERPRINT CARD ALONG WITH A $22 FEE. FINGERPRINTS MUST BE DONE BY A LAW ENFORCEMENT AGENCY OR BONA FIDE FINGERPRINT SERVICE. FOR AN ADDITIONAL $13 FEE, FINGERPRINTS MAY BE DONE AT THE DEPARTMENT OF LIQUOR WHEN ACCOMPANIED BY A COMPLETED APPLICATION .

1. Check the Appropriate Box

3. Social Securtty #;

.¢ Con~olling Person

.blquor LlceRse;!'.

~gent 0Premlses Manager

Privacy Interest

'. . . State; --1-fr__.__,&,;:::_ __ _

I It 4. Place of birth: --"<:£=-4W-"=';~I-'-"'---'-"=~;.±:~L.c!-~- Height: {p I Weight: I ~0 Eyesbf C) Hal,@:..ot0-"'---

5. Name of current/most recent spouse: --.,..+''--'-'--------=-o----------:=:c--- Birth Date: ___f'j)_A I __ last AT$1 Middle (NOT a public record)

DESCRIBE POSITION OR BUS1NESS

(AlTACH ADDITIONAl SHEET IF NECESSARY)

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12. As a Controlling Person or Agent, will you be physically present and operating the licensed premises? ·dyesQJo If you answered YES, then answer#13 below. If NO, skip to #14. "'/"'

13. Have you attended a DLLC approved Basic & Management Uquor Law Training Course within the past 3 'MivesONo years? ~·

14. Have you been cited, arrested, Indicted, convicted, or summoned Into court for violation of~ criminal O'fe51V:fMo law or ordinance, regardless ofthe disposition, even If dismissed or expunged. within the past five (5) years? ('( •

15. Are there ANY administrative law citations, compliance actions or consents, criminal arrests, Indictments or OYesftJNo summonses pending against you? (Do not Include civil traffic tickets.) A.R.S.§4-202,4-210

16. Has anyone EVER obtained a judgement against you the subject of which Involved fraud or misrepresentation? oYes~No

17. Have you had a liquor application or license rejected, denied, revoked orsuspended In or outside of Arizona oYe~lo within the last five years? A.R.S.§4-202(D) -,...., •

18. Has an entity In which you are or have been a controlling person had an application or license rejected. Ores~o denied, revoked or suspended In or outside of Arizona within the last five years? A.R.S.§4-202(D)

If you answered ''YES" to any Question 14 through 18 YOU MUST attach a signed statement. Give complete details Including dates, agencies involved and dispositions.

CHANGES TO QUESTIONS 14-18 MAY NOT BE ACCEPTED

NOTARY

"-"-"'-'.t'-'---J'--'=C"-'~--'-'""'7""'""'-"--'~-- hereby declare that I am the Agent/ Controlling Person I lion. I 'Ire read this document and veritY the contents and all statements are true,

knowledge.

State of t4Vl'l. 0 l\bl County of ~\ohttv e., The foregoing lnslrument was acknowledged before me this

thO Day of AtiCIU .s-1: Wl ~ ~onlh Year

The Licensee has authorized the person named on this questionnaire to act as manager for the above License.

SIGNATURE: _______________ _

1/11/2018 Page2of2 Individuals requlrlng ADA accommodatlons please can (602)542~2999

State of Arizona Department of liquor licenses and Control

800 W. Washington 51h Floor Phoenix, AZ 85007

(602) 542-5141

ARIZONA STATEMENT OF CITIZENSHIP OR ALIEN STATUS FOR STATE PUBLIC BENEFITS

Title IV of the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (the "Act"), 8 U.S.C. § 1621, provides that, with certain exceptions, only United States citizens, United States non-citizen nationals, non-exempt "qualified aliens" (and sometimes only particular categories of qualified aliens}, nonimmigrant, and certain aliens paroled Into the United States are eligible to receive state, or local public benefits. With certain exceptions, a professional license and commercial license Issued by a State agency Is a State public benefit.

Arizona Revised Statutes§ 41-1080 requires, in general, that a person applying for a license must submit documentation to the license agency that satisfactorily demonstrates the applicant's presence In the United States Is authorized under federal law.

Directions: All applicants must complete Sections I, II, and IV. Applicants who are not U.S. citizens or nationals must also complete Section Ill.

Submit this completed Form and a copy of one or more document(s) from the attached "Evidence of U.S. Citizenship, U.S. National Status, or Allen Status" with your application for license or renewal. If the document you submit does not contain a photograph, you must also provide a government Issued document that contains your photograph. You must submit supporting legal documentation (i.e. marriage certificate) if the name on your evidence is not the same as your current legal name.

SECTION 1- APPLICANT INFORMATION

INDIVIDUAL OWNER/ AGENT NAME (Print or !YP•) _--_,_)Lt:.=h.l.!.JQL....~I-'C'-'wj=+--'-l.Lb::I!SJ.6"'"-·"-ed!---4----------------

SECTION II- CITIZENSHIP OR NATIONAl STATUS DEClARATION

• Are you a citizen or national of the United States? ISlJves

If Yes, Indicate place of birth:

State (or equivalent) _,_fl.J..v-=:.. _______ Country or Terrltory_U--'-0=--------

If you answered Yes, 1) Attach a legible copy of a document from the attached list.

2) Name of document: =:D--cM {"\ 5 ( J CJZA&-R Go to Section IV.

If you answered No, you must complete Section Ill and rv.

12/9/2015 Page 1 of3 Individuals requiring ADA accommodations please call (602)542-9027

SECTION Ill- ALIEN STATUS DECLARATION

To be completed by applicants who are not citizens or nationals of the United States. Please Indicate allen status by checking the appropriate box. Attach a legible copy of a document from the attached list or other document as evidence of your status.

Name of document provided

Qualified Alien Status (8 U.S.C.§§ 1621 (a)(1),-1641 (b) and (c))

D 1. An allen lawfully admitted for permanent residence under the Immigration and Nationality Act (INA)

D 2. An allen who Is granted asylum under Section 208 of the INA

0 3. A refugee admitted to the United States under Section 207 of the INA

D 4. An allen paroled Into the United States for at least one year under Section 212(d)(5) of the INA

0 5. An allen whose deportation Is being wUhheld under Section 243(h) of the INA

0 6. An alien granted conditional entry under Section 203(a)(7) of the INA as In effect prior to Aprll1, 1980.

0 7. An alien who Is a Cuban/Haitian entrant.

Os. An allen who has, or whose child or child's parent Is a "battered alien" or an allen subjectto extreme cruelty In the United states.

Nonimmigrant Status (8 U.S.C. § 1621 (a)(2))

0 9, A nonimmigrant under the Immigration and Nationality Act [8 U.S.C § 1101 et seq.] Non Immigrants are persons who have temporary status for a specific purpose. See 8 U.S.C § 1101 (a)(15).

Allen Paroled Into the United States for Less Than One Year(8 u.s. c. § 1621 (a)(3))

0 10. An allen paroled Into the United States for less than one year under Section 212(d)(5) of the INA

Other Persons (8 U.S.C § 1621 (c)(2)(A) and (C)

0 11. A nonimmigrant whose visa for entry Is related to employment In the United States, or

0 12. A citizen of a freely associated state, If section 141 of the applicable compact of free association approved In Public Law 99-239 or 99-658 (or a successor provision) Is In effect [Freely Associated States Include the Republic of the Marshall islands, Republic of Palau and the Federate States of Micronesia, 48 U.S. C.§ 1901 et seq.];

013. A foreign national not physically present in the United States.

Otherwise Lawfully Present

D 14. A person not described in categories 1-13 who Is otherwise lawfully present in the United States.

12/9/2015

PLEASE NOTE: The federal Personal Responsibility and Work Opportunity Reconciliation Act may make persons who fall into this category Ineligible for licensure. See 8 U.S.C, § 1621(a).

Page 2 of3 Individuals requbing ADA accommodations please call (602}542~9027

SECTION IV - DECLARATION

All applicants must complete this section. I declare under penalty of peljury under the laws of the state of Artzona that the answers and evidence 1 have given are true and correct to the best of my knowledge.

Agent Signature

EVIDENCE OF U.S. CITIZENSHIP. U.S. NATIONAL STATUS. OR ALIEN STATUS

You must submit supporting legal documentation (I.e. marriage certificate) If the name on your evidence is not the same as your current legal name.

Evidence showing authorized presence In the United State includes the following:

1. An Artzona driver license Issued after 1996 or an Arizona non·operatlng Identification card.

2. A driver license Issued by a state that vertfies lawful presence In the United States.

3. A birth certificate or delayed birth certificate showing birth In one of the 50 states, the District of Columbia,

Puerto Rico (on or after January 13, 1941), Guam, the ll.s. Virgin Islands (on or after January 17, 1917),

American Samoa, or the Northern Mariana Islands (on or after November 4, 1986, Northern Mariana Islands

local time)

4. A United States certificate of birth abroad.

5. A United States passport. ... Passport must be signed .. *.

6. A foreign passport with a United States visa.

7. An 1-94 form with a photograph.

B. A United States citizenship and Immigration services employment authorization document or refugee travel

document.

9. A United States certificate of naturalization.

10. A United States certificate of citizenship.

11. A tribal certificate of Indian blood.

12. A tribal or bureau of Indian affairs affidavit of birth.

13. Any other license that Is Issued by the federal government. any other state government, an agency of this

state or a political subdivision of this state that requires proof of citizenship or lawful allen status before Issuing

the license.

12/9/Z015 Page 3 of3 lndlvlduals requlr1ng ADA accommodations please call (602)542~9027

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Tille 4 BASIC Troiring in occadance wifh A.R.S. §4-1 i 2(GI(2) and Arizona Admirislrafive Cede iAAC.jRI9-l-103 using I raining course ccntenl and moteriats approved by the Arizcna Deporlrrent of uquor Licenses ond Centro!. I vnderslond ll<at nisvs<;> of lt'is Ceilificole of Corrplefkn c:an result inlhe revocolionof Slole-opprovol fr)l the Tille 4 lroirlr>;.J Provrcler nom:;d in 11-isseclicn as provided by A.A.C. R19-I-103{Ei ard (F).

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Uq.1or lic&i:S~ opplicatiOf"l'> fB\ifid end le!1e\'o'dl crG no1 ccmPete l..!f)lil vdid Cerfiflcot'\?.s of Co-.'Tlr:leion ford[ reqJfred poootJS hove boon wtmitled lo !he f.>SQotlmenl of tiq.>or. 'fha tf ... ~lil)nno'!e (which desi¢.1"1Qfe$ 0 Jl'l:O')Qg6-f fo OloColiOn) md ft·~~ Qd'\9nl c:.hcng.:;, form {whic.;h o:;sigrn on~'>'-.' O;J$OI!o octive liqJOt !iCEf'G-8-$) ae not con~le lJ(l!il vd.id O¥.fika~ of ccmpe~on lot ofi f(•QJired persom have been s:ulxnittec:f 1o t11e D8pof~IIE>nl of tiqJot.

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DATE:

TO:

FROM:

CITY OF BULLHEAD CITY Interoffice Memorandum

SEPTEMBER 17,2018

SUE STEIN, CITY CLERK

JOHNNY LOERA, PLANNING MANAGER

SUBJECT: INTERIM TRANSFER & NEW SERIES 12 LIQUOR LICENSE FOR FIREHOUSE COFFEE COMPANY JOB #29853

The Planning and Zoning Division has reviewed the attached Interim Transfer and New Series 12 Liquor License application for a business that is located within a C2 zoning district at 23 50 Miracle Mile, Ste. 306. in Bullhead City, and does not have any objections.

Bullhead City Police Department . • . - ~ ~-! :' :-;•-; \' :·. \- "\ l - . · .. '

SUBJECT:

TO:

FROM:

REFERENCE:

' :;•;··- •-!

MEMORANDUM September 25,2018

APPLICATION FOR INTERIM SERlES 12 LIQUOR LICENSE

SUE STEIN, CITY CLERK

BRlAN K. WILLIAMSON, CHIEF OF POLICEY

(a) Application for an Interim Series 12 Liquor License submitted by Mr. Jolm PaUl Hassett/KevCo Group LLC on behalf of the Firehouse Coffee Company

ENCLOSURE: (1) Memorandum from Lieutenant Nick Sessions concerning Subject, dated· September25, 2018

\aa

1. This memorandum is forwarded pursuant to Reference (a).

2. I did not find anything in Enclosure (1) that would prevent Mr, H:!ls~ett's request for an Interim Series 12 Liquor License.

3. Enclosure (1) is provided for your review and evaluation.

., "::' .

,. '.!·

SUBJECT:

TO:

FROM:

REFERNCE:

ENCLOSURES:

OFFICE OF THE COMMANDER BUREAU OF CRIMINAL INVESTIGATIONS

/LIQUOR LICENSE APPLICATION

---· BRIAN K. WilliAMSON, CHIEF OF POLICE

liEUTENANT NICK SESSIONS

(a) license No. 29853

{1) None

MEMORANDUM iB-21BCI

September 25, 2018 .

1. I have reviewed the application for the Interim transfer and New license application for a Series 12 liquor license submitted by John Hassett/KevCo Group LLC. The license is for Firehouse Coffee Company, located at 2350 Miracle Mile, Suite #306, in Bullhead City.

2. I have found no reasons to delay the approval of this application.

Arizona Department of Liquor Licenses and Control 800 W Washington 5th Floor

Phoenix, AZ 85007-2934 www.azliquor.gov

(602) 542-5141

AFFIDAVIT OF POSTING

Date of Posting Removal: __,f,'-0"'-----'g""-·~--'/__,Jf='------

Applicant's Name: ---:-"I/-'CL'A-L..-:SS.~edz-L-T ______ ---'\..t72-':;'-;Lii"-';Lf"="-------~/3-'?J-'-'-~{)-"L.=:---Last First Middle

I hereby certify that pursuant to A.R.S. 4-201, I posted notice in a conspicuous place on the premises proposed to be licensed by the above applicant and said notice was posted for at least twenty {20) days.

Print Name of City/County Official Title Phone Number

;o-C/-!J Signature Dote Signed

Return this affidavit with your recommendations {i.e., Minutes of Meeting, Verbatim, etc.) or any other related documents. If you have any questions please call { 602) 542-5141 and ask for the Licensing Division.

8/21/2015 Page I of! Individuals requiring ADA accommodations please call (602)542-9027