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G-993 - 03/26/2013 - LICENSE-ALCOHOL - Ordinances Supporting DocumentsITEM O.F.1) OF OAf {{ M..t +tii11. '• Y � 1 4 AGENDA ITEM Regular Board of Trustees Meeting of March 26, 2013 SUBJECT: An Amendment to Title 4, Chapter 1, Section 8A of the Village Code of the Village of Oak Brook, Illinois Relative to the Number of Authorized Liquor Licenses FROM: Charlotte K. Pruss, Village Clerk BUDGET SOURCE/BUDGET IMPACT: N/A RECOMMENDED MOTION: I move to approve passage of Ordinance G -993, "An Ordinance Amending Title 4, Chapter 1, Section 8A of the Village Code of the Village of Oak Brook, Illinois Relative to the Number of Authorized Liquor Licenses" Background/History: Red Robin International, LLC has made application to the Village of Oak Brook for a Class A -1 Liquor License for their new restaurant, Red Robin Gourmet Burgers located at 552 Oakbrook Center. The approval of this liquor license will increase the number of A -1 liquor licenses in the Village of Oak Brook from 23 to 24. Background checks are being processed at this time for the the general manager. The applicant has requested that this application be brought before you for your consideration at the Village Board's regular meeting of March 26, 2013. Enclosed for the Village Board's review is the Application for a Liquor License. All ordinance submittal requirements have been met. Recommendation: The recommendation is for Passage of Ordinance G -993, which increases the number of A -1 liquor licenses by one. Provided that all ordinance requirements are met, the Local Liquor Commissioner Gopal Lalmalani, will issue a Class A -1 Liquor License to Red Robin International, LLC d/b /a Red Robin Gourmet Burgers when a stocking and training permit is issued. Last saved by DEFAULT J:IAgenda Memos\New LL RED ROWN.doc V Last printed 03113/2013 ORDINANCE 2013- LC -AL -G -993 AN ORDINANCE AMENDING TITLE 4, CHAPTER 1, SECTION 8A OF THE VILLAGE CODE OF THE VILLAGE OF OAK BROOK, ILLINOIS RELATIVE TO THE NUMBER OF AUTHORIZED LIQUOR LICENSES WHEREAS, Title 4, Chapter 1, Section 8A (4 -1 -8A) of the Village Code of the Village of Oak Brook authorizes certain numbers of liquor licenses and the number of such licenses issued for each class of license may be increased or decreased from time to time by ordinance approved by the President and Village Board due to changes in ownership of licensed premises, the creation of a new and deserving business enterprise, or the abandonment, revocation, surrender or other termination of an existing license; and WHEREAS, the President and Board of Trustees of the Village deem it advisable and in the best interest and in furtherance of the general welfare of the citizens of the Village that the Village Code of the Village of Oak Brook be amended to increase the number of Class A -1 liquor licenses and to enable the Local Liquor Control Commissioner to issue a new Class A -1 license to Red Robin International, LLC, dfbla Red Robin Gourmet Burgers, 552 Oakbrook Center, Oak Brook, Illinois. NOW, THEREFORE, BE IT ORDAINED BY THE PRESIDENT AND BOARD OF TRUSTEES OF THE VILLAGE OF OAK BROOK, DU PAGE AND COOK COUNTIES, ILLINOIS as follows: Section 1: That Section 8A of Chapter 1 (Liquor Control) of Title 4 (Business and License Regulations) (4 -1 -8A) of the Village Code of the Village of Oak Brook, Illinois be amended by deleting the table of licenses in its entirety and replacing it with the following table: ',Licensef� � y i,'., �'Applicatwn Fee , u �'s Annual UdOhse 17ee y I311 jll! u0iber'Isq di A -1 $2,000.00 $2,750.00 24 A -2 2,000.00 2,750.00 1 A -3 2,000.00 2,750.00 1 B 2,000.00 2,750.00 12 C 2,000.00 2,200.00 1 D 2,000.00 2,200.00 2 E 2,000.00 4,950.00 4 F No Fee $50 per event up to $500 Not Applicable G No Fee No Fee 0 H No Fee No Fee 1 Section 2: That this ordinance shall be in full force and effect from and after its passage, approval and publication as required by law. Section 3: That all ordinances or parts thereof in conflict with the provisions of this ordinance are hereby repealed to the extent of such conflict. APPROVED THIS 26th day of March, 2013. PASSED THIS 26th day of March, 2013. Ayes: Nays: Absent: Gopal G. Lalmalani Village President ATTEST: Charlotte K. Pruss Village Clerk Ordinance 2013- LC -AL -G -993 Amending Title 4, Chapter 1, Section aA Relative to Liquor Licenses Page 2 of 2 toe arts VILLAGE OF OAK BROOK A 0 1200 Oak Brook Road ` Oak Brook, Illinois 60523 -2255 s *ate (630) 368 -5036 - fax:(630) 368 -5037 APPLICATION FOR LIQUOR LICENSE Application is hereby made to the Local Liquor Control Commissioner of the Village of Oak Brook for issuance of a Village of Oak Brook liquor license, pursuant to the ordinances of the Village and laws of the State of Illinois. In support of said application, the following is submitted: CLASS: A -1 FEE: EXTENDED HOUR FOR CLASS A -1 LICENSE ONLY: Yes ❑ No ® FEE: $500.00 Corporate Name: Red Robin International Inc Phone #: 3 03 84 6 -6113 Business Name: Red Robin Gourmet Burgers Phone #: TED Establishment Name: Red Robin Gourmet Burgers Phone #: TED Corporate Address: Street Address 6312 S Fiddler's Green Circle, Ste 200 North Fax #: City /State /Zip Greenwood village, CO 80111 E -Mail Address: Jschlueter @redrobin.com Contact Name: Irene F Bahr Contact Title: Attorney Phone #: 630 - 462 -1113 E -mail address: irene.bahr @cxmail.com Establishment Address: Street Address 552 Oak Brook Center City /State /Zip Oak Brook, IL 60523 Fax #: E -Mail Address: Contact Name: James Shaw Contact Title: Phone 9: 708 - 937 -5029 E -mail address: State of Illinois Liquor License Number: List each specific location within this establishment where alcoholic liquor is being offered for retail sale: NA Manager Expiration Date: Il Ground Floor Restaurant NA Ownership of Premises: Owned ❑ For initial application, provide proof of ownership (e.g. title policy) Leased ® If leased, provide copy of lease for full period of license and provide the following information: NameofLessor. Oakbrook Shopping Center LLC C/O Oakbrook Center Address of Lessor: 100 Oakbrook Center City, State &Zip: _pakbrnnk TT 60523Attn• renA,-Al Manager TYPE OF BUSINESS: ® Corporation ❑ individual/Sole Proprietorship ❑ Limited Liability Co. ❑ Partnership Length of time in business: Since 2000 Character of business: Restaurant INDIVIDUAL /SOLE PROPRIETORSHIP: Are you a resident of Oak Brook ❑ Yes ® No LIQUOR LICENSE APPLICATION 7212011 Page I of 9 ya.. pe VILLAGE OF OAK BROOK 'e 1200 Oak Brook Road e Oak Brook, Illinois 60523 -2255 (630) 368 -5036 Fax(630)368 -5037 Kathy Vonachen-kvonnhen@oak- brook.org Other than an Individual/Sole Proprietorship this section must be completed by an authorized agent of the applicant This applicant, other than an Individual/Sole Proprietorship, was organized, formed, or incorporated under the laws of the State of NV on the 7th dayof July, 2000 If applicant was not organized, formed or incorporated in the State of Illinois, is applicant a foreign business qualified under one of the following to transact business in Illinois ® Yes ❑ No Please check which one: © Illinois Business Corporation Act ❑Illinois Revised Uniform Limited Partnership Act ❑ Illinois Secretary of State ❑ Illinois Revised Uniform Partnership Act Other than an Individual/Sole Proprietorship is this business qualified pursuant to one of the following to transact business in Illinois ® Yes ❑ No Please check which one: ® Illinois Business Corporation Act ❑Illinois Revised Uniform Limited Partnership Act ❑ Illinois Secretary of State ❑ Illinois Revised Uniform Partnership Act Registered Agent: Name: ILLINOIS CORPORATION SERVICE Cc Street Address 801 Adlai Stevenson Drive Telephone #: Fax #: City /State /Zip Springfield, IL 62703 E -Mail Address: QUALIFICATIONS: 217- 492 -2700 ❑ Yes ® No Does the applicant, the manager or any person or entity listed as Officer, Shareholder, Member, Manager or Partner possess a current Federal wagering and gaming device stamp? (Ifyes, provide details on reverse side) (or on an addendum) ❑ Yes F No Has a federal wagering stamp been issued by the federal government for the current tax period for the premises for which a license is sought? (Ifyes, provide details on reverse side) ❑ Yes ® No Has applicant, the manager or any person or entity listed as Officer, Shareholder, Member, Manager or Partner ever been convicted of a violation of any Federal or State law concerning the manufacture, possession or sale of alcoholic liquor, or forfeited their bond for failure to appear in court to answer charges for any such violation? (Ifyes, provide date, offense, jurisdiction and case number on reverse side) ❑ Yes ❑x No Has applicant made application for similar or other liquor license on premises other than described in this application? See Illinois Licenses held Ex. A (Ifyes, provide disposition of such application on reverse side) LIQUOR LICENSE APPLICATION 072111 Page 2 of 9 VILLAGE OF OAK BROOK 'g 1200 Oak Brook Road Oak Brook, Illinois 60523 -2255 (630) 368 -5036 Fax (630) 368 -5037 Kathy Vonachen - kvonachen@oak- brook.org ❑ Yes ® No Has any liquor license issued to the applicant ever been revoked or suspended? (Ifyes, provide date, reason andjurisdiction on reverse side) ❑ Yes ❑% No Has applicant, the manager or any person or entity listed as Officer, Shareholder, Member, Manager or Partner ever been convicted of a gambling offense in violation of Section 28 -3 of the Criminal Code of the State of Illinois (720 ILCS 5.28 -1, et seq.), as heretofore or hereafter amended, or as proscribed by a statute replaced by any of the aforesaid statutory provisions? (Ifyes, provide date, offense, jurisdiction and case number on reverse side) ❑ Yes M No Has applicant, the manager or any person or entity listed as Officer, Shareholder, Member, Manager or Partner ever been convicted of a felony? ❑ Yes Q No Has applicant, the manager or any person or entity listed as Officer, Shareholder, Member, Manager or Partner ever been convicted of being the keeper of, or is keeping, a house of ill fame? ❑ Yes Q No Has applicant, the manager or any person or entity listed as Officer, Shareholder, Member, Manager or Partner ever been convicted of pandering or other crime or misdemeanor opposed to public decency and morality? INDIVIDUALS: For each Person, Owner, Partner, Officer, Director, Member and Stockholder holding directly or beneficially more than 5% of stock in the business please provide the following information. Name Position Held Within Organization i.e. Owner, Managing Partner, general partner, shareholder, officer (name office held) % of stock owned or membshp interest Eric C Houseman President 0 Stuart B Brown Treasurer /Asst Secy 0 John W Grant Vice President /Asst Secy 0 Douglas L Christman Vice Presddent/ASSt Secy 0 Red Robin Gourmet Burgers Inc. Shareholder 100% FOR EACH OF THE INDIVIDUALS LISTED PLEASE PROVIDE THE FOLLOWING INFORMAr!ON: LIQUOR LICENSE APPLICATION 072111 Page 3 of 9 o, exrree Name: Eric C Houseman Address: 11591 Bent Oaks St. Parker, CO 80134 City /State, Zip Social Security Number: 156 -58 -7891 VILLAGE OF OAK BROOK 1200 Oak Brook Road Oak Brook, Illinois 60523 -2255 (630) 368 -5036 Fax(630)368 -5037 Kathy Vonachen - konachen @oak - brook.org Phonenumber:# 303 - 846 -6000 Date of Birth: 2/9/1968 Neptune NJ Place of Birth: Drivers License Number: # 00- 290 -0768 CO Position held with above named business: President /Sole Director ® Yes ❑ No Are you a citizen of the United States? ❑ Yes ® No If you are a naturalized citizen give date and city of naturalization: NA Court in which (or law under which) you were naturalized Are you a Naturalized Citizen? Name: Stuart B Brown Phone number: # 303 - 846 -6082 Address: 145 Fairfax Street City /State, Zip Denver, CO 80220 Social Security Number: 257-29-1756 Date of Birth: 2/11/1966 PlaceofBirth: Louisville KY Drivers License Number: # 07- 080 -0247 CO Position held with above named business: Trpaallrer /Asa Recy Q Yes ❑ No Are you a citizen of the United States? ❑ Yes ®No Are you a Naturalized Citizen? If you are a naturalized citizen give date and city of naturalization: NA Court in which (or law under which) you were naturalized Name: Douglas L Christman Phone number:# 303- 604 -1480 Address: 2319 High Lonesome Trail Date of Birth: 5/13/1953 City /State, Zip Lafayette, CO 80026 Place of Birth: Kansas City MO Social Security Number: 523-80-0615 Drivers License Number: # 95-129-0768 CO Position held with above named business: V.P./Asst Secy ® Yes ❑ No Are you a citizen of the United States? ❑ Yes ONO Are you a Naturalized Citizen? If you are a naturalized citizen give date and city of naturalization: NA NA Court in which (or law under which) you were naturalized Name: John W Grant Phone number:# 303 - 846 -6000 LIQUOR LICENSE APPLICATION 072111 Page 4 of 9 VILLAGE OF OAK BROOK de 1200 Oak Brook Road @' Oak Brook, Illinois 60523 -2255 (630) 368 -5036 Fax (630) 368 -5037 Kathy Vonachen - kvonuhen @oak- brook.org Address: 8376 Green Island Circle Date of Birth: 3/21/1947 City /State, Zip Lone Tree, CO 80124 Social Security Number: 315-50-5404 Evansville IN Place of Birth: Drivers License Number: # 96-319-0631 Position held with above named business: Vice President /Asst Secy ® Yes ❑ No Are you a citizen of the United States? ❑ Yes DNo Are you a Naturalized Citizen? If you are a naturalized citizen give date and city of naturalization: NA NA Court in which (or law under which) you were naturalized Name: Red Robin Gourmet Burgers, Inc. Phonenumber:# 303- 846 -6000 Address: 6312 S Fiddler's Green Circle #200 North DateofBirth: Greenwood Village, CO 80111 City /State, Zip Place of Birth: :FEIN: 52- 3800615 Position held with above named Drivers License Number: # NA Shareholder - 100% ❑ Yes ❑ No Are you a citizen of the United States? ❑ Yes ❑ No If you are a naturalized citizen give date and city of naturalization: NA Are you a Naturalized Citizen? Court in which (or law under which) you were naturalized Name: Phone number: # Address: City /State, Zip Social Security Number: Position held with above named business: ❑ Yes ❑ No Are you a citizen of the United If you are a naturalized citizen give date and city> Court in which (or law under which) Name: Date of Birth: Place of Birth: Drivers Licens umber: # ❑ Yes ❑ No Are you a Naturalized Citizen? Phone number: LIQUOR L10!nSE. APPLICATION 072111 Pag ,5 of 9 sr aye Name of person operating as General Manager of the premises: Name of person operating as Liquor Manager of the premises: VILLAGE OF OAK BROOK 1200 Oak Brook Road Oak Brook, Illinois 60523 -2255 (630) 368 -5036 Fax (630) 368 -5037 Kathy Vonachen - kvo=hm@oak-brook.org A Manager Application Form must be submittedfor the individuals named above An initial application must also include completed fingerprint card RESTRICTIONS: a. No liquor license shall be issued to any person for premises upon which theatrical or other live performances, which include the types of conduct enumerated in Sections 3 -55 of Chapter, 3 shall constitute the entertainment offered to the patrons thereof. This prohibition includes, but is not limited to, any entertainment, fashion show or other presentation which may include any person in a nude or semi -nude state, including, but not limited to, servers, hosts, hostesses, dancers, singers, models or other performance artists, or role playing interactions. b. No liquor license shall be issued to any person for premises upon which amen or women's club is located. INSURANCE REQUIREMENTS: a. Certificate of general liability insurance with limits of not less than $1,000,000 combined single limit or $1,000,000 per occurrence and per aggregate naming the Village of Oak Brook as a party insured issued by an insurance company licensed to do business in the State of Illinois having a `Best" rating acceptable to the Village. The effective period of such insurance coverage shall coincide with the period the liquor license is in effect. b. Policy of liquor liability insurance by a responsible insurance company authorized and licensed to do business in the state insuring such applicant in the amount of not less than one million dollars ($1,000,000). SUBMITTALS: In addition to this application form the following must be submitted: ual Fee plus Extended Hour Fee if Applicable O�L�' C�ficate of Insurance liquor License Manager Application Form ease -If premises not beneficially owned by Applicant Proof of completion of the Illinois Department of Alcohol and Substance Program by all facility managers and employees as is necessary. Proof of completion of attendance by all facility managers and employees as is necessary of a Alcohol Awareness Training Program conducted by the Oak Brook Police Department. LIQUOR LICENSE APPLICATION 072111 Page 7 of 9 as 4t� VILLAGE OF OAK BROOK 1200 Oak Brook Road Oak Brook, Illinois 60523 -2255 (630) 368 -5036 Fax (630) 368 -5037 Kathy Vonachen- kvonachen ®oak- brookorg Initial Applicants must also provide: P" P Of of ownership of premises (e.g. title report) Floor Plan, as required for any premises to be licensed for sale of alcoholic liquor for consumption on the premises, drawn to scale, and with sufficient detail to depict types of seating, location of bars and other design features. (Submit twelve (12) copies of Floor Plan and Menu.) LCompleted fingerprint cards for each Corporate Officer, General Manager and Liquor Manager �// Employee liquor handling training manual describing the specific procedures of the applicant to monitor operations to insure no incidences of underage drinking. Applicant understands and agrees that additional information and material may be required during the processing of this application related to applicant's qualifications, the information provided herein, including attachments, and the class of license involved. Applicant agrees to provide such additional information and material and that failure to do so may delay the processing of this application or result in its denial. Applicant understands that no liquor license shall be issued to any person: (a) for premises upon which theatrical or other live performances which include the types of conduct enumerated in Section 3 -55 of Chapter 3 of The Oak Brook Village Code. This prohibition includes, but is not limited to, any entertainment, fashion show or other presentation which may include any person in a nude or semi -nude state, including, but not limited to, servers, hosts, hostesses, dancers, singers, models or other performance artists, or role playing interactions. (b) for the sale at retail of any alcoholic liquor within one hundred (100) feet of any church, school, hospital, home for the aged or indigent persons or for veterans, their spouses or children or any military or naval stations. (c) for premises upon which a men's or women's club is located. In the event Applicant is made aware that any information or document submitted, as part of this application process is inaccurate or incomplete, Applicant agrees to immediately notify the Village and provide appropriate corrections. Applicant understands and agrees to provide such additional information and material, and that failure to do so may delay the processing of this application or result in its denial. LIQUOR LICENSE APPLICATION 072111 Page 8 of 9 ATTESTATIONS: I, _ Eric C Houseman aye VILLAGE OF OAK BROOK y 1200 Oak Brook Road Oak Brook, Illinois 60523 -2255 (630) 368-5036 F= (630) 368 -5037 < Kathy Vonachen- kvonachm@ oak -bro k.org the President of the above licensee, hereby certify under oath, that the foregoing application is true and correct and all information previously submitted on the original application, including the floor plan, has not changed. I further understand that any incorrect or fraudulent statement made in this application constitutes grounds for immediate suspension and/or revocation of the liquor license herein sought. The undersigned, does further state as follows: That the undersigned is empowered to prepare and sign this application on behalf of the applicant. That the undersigned has reviewed this application, and all attachments and submittals, and that the information contained herein is true and accurate. That the undersigned, on behalf of the Applicant, acknowledges and agrees that a false statement knowingly made in this application shall bar the Applicant from further consideration and the application shall be denied. That the undersigned is not disqualified to receive a liquor license by reason of any matter or thing contained in the laws of this state, or the ordinances of the Village. That the undersigned will not violate any of the laws of the State of Illinois, or of the United States, including but not limited to the Americans With Disabilities Act, or any ordinances of the Village in the conduct of the applicant's place of business. APPLICAI BY: Signature Print Name Title President LIQUOR LICENSE APPLICATION 072111 Page 9 of 9 i vesno :sa-0vodn -0e avuiwensaa d NS d `JNIHSNIHSMd NVI O YJ � H INII a 31m .....5.........a ,....,_«: _ _ ...... gy33P$PP ➢IIM a $ i��{��4$° ' @e'e a •..a - � a aap a $ �13�. 3--{{ jjaa �� iy$pp8$aflS' H -9 5y4y�s$ qq 3 a3 � 8g Y89eg w 8i a �'gagy9 �� @tlF'Pbbbb! iaifie "nioi ff PBPBPPP -0b -099_ d $xp�e2l�ppbs §}.� $ §�ea$8a�v'S��J de5g�- #92e13 $ 9p ge €$ � 3 ? eti �� �edei i ?�Y e49 Pa 9P94 �?i?iY3 E4 �3 �5��3➢��5 a5gg� 3 Y 9.0$ 9.a 959YvYy5 @:S�aSQY?F �YYECEE000 ?S i� €�i� YJ � H INII a 31m ° 4 VILLAGE OF OAK BROOK + Kathy VcWtW , Admin Asa 1200 Oak Brook Road 4�y Oak Brook 111ims 60523 -2255 (630) 368 -5036 Fax (630) 368 -5037 APPLICA Corporate Name: Red Robin International Inc. Business Name: Red Robin International Inc. Establishment Name: Red Robin Gourmet Burgers Street Address 552 Oak Brook Center, Oak Brook IL Phone #: TBD Applicant Phone #: 7P& Name: ,a�,y� e-mail (wk) Home Address: -�Z J 4-2 Date of Birth: City /State, Zip /��G:x� /f �r�fl✓i/' Place of Birth: Social Security Number. ,3to/- 7e %2Z0 ]rivers License #: - Sj7 o2SI Position held with above named business: Manager I�Yes ❑ No Are you a citizen of the United States? F1 Yes P1 'No ❑ Yes ✓ No �. Yes 9Io ❑ Yes Eiorbk ❑ Yes r1ja ❑ Yes No ❑ Yes ❑ No Are you a Naturalized Citizen? Ifyou are a naturalized citizen give date and city of naturalization: Court in which (or law under which) you were naturalized Do you possess a current Federal wagering and gaming device stamp? (If yes, provide details on reverse side) Have you ever been convicted of a violation of any Federal or State law concerning the manufacture, possession or sale of alcoholic liquor, or forfeited their bond for failure to appear in court to answer charges for any such violation? (Ifyes, provide date, offense, jurisdiction and case number on reverse side) Have you ever been convicted of a gambling offense in violation of Section 28 -3 of the Criminal Code of the State of Illinois (720 ILCS 5.28 -1, et seq.), as heretofore or hereafter amended, or as proscribed by a statute replaced by any of the aforesaid statutory provisions? (Ifyes pro vide date, offense, jurisdiction and case number on reverse side) Have you ever been convicted of a felony? Have you ever been convicted of being the keeper of, or is keeping, a house of ill fame? Have you ever been convicted of pandering or other crime or misdemeanor opposed to public decency and morality? LIQUOR LICENSE MANAGER APPi. CAT10N FORM 072111 Page I of 2 Liquor Handling Experience — Please provide name and address of any other liquor establishment in which you have been employed or owned an interest. I on oath state that I will not violate any of the ordinances of the Village of Oak Brook or the laws of the State of Illinois or the United States of America in the operation of the place of business described herein, that I have read and understand the Oak Brook liquor control ordinances and that the statements herein are true and correct, Signature ILis is to certify that !� JAMES SHAW 361 -74 -7220 0ecw&r 5, 2000 has succa3sfully completed a semmu in SERVING .@ SELLING ALCOHOL RESPONSIBLY Stagof11hn=Ce,dfwd aASW popes-MCC Liam a A- 0041637 F J ritz . ! M Goag® A: �QUOR L.C! NSE MANAGER APPLICATION FORM 07211: Page: o: 2 r VILLAGE OF OAK BROOK Kalhy Vomchen, Admin Assl ea o� 1200 oak amok Rood Oak Brook, 1111nms 60523-2255 (630) 368 -5036 Faa(530)369 -5037 ❑ Yes ZINIO Have you ever been convicted of adrug- related offense? kvonachen@oak- brook.org Wyes, provide date, offense, jurisdiction and case number on reverse side) ❑ Yes to Have you pled guilty to or were you ever been convicted of driving under the influence, Class A misdemeanor? Ifyes, indicate on reverse side date ofguilty plea or date of conviction and tfsuspension given, date of completion ofsuspension. es ❑ No Have you successfully completed a State - licensed alcohol seller /server education program? If yes, please provide a copy of the Certificate of Completion. If no, please arrange to attend a Village of Oak Brook BASSET program. Liquor Handling Experience — Please provide name and address of any other liquor establishment in which you have been employed or owned an interest. I on oath state that I will not violate any of the ordinances of the Village of Oak Brook or the laws of the State of Illinois or the United States of America in the operation of the place of business described herein, that I have read and understand the Oak Brook liquor control ordinances and that the statements herein are true and correct, Signature ILis is to certify that !� JAMES SHAW 361 -74 -7220 0ecw&r 5, 2000 has succa3sfully completed a semmu in SERVING .@ SELLING ALCOHOL RESPONSIBLY Stagof11hn=Ce,dfwd aASW popes-MCC Liam a A- 0041637 F J ritz . ! M Goag® A: �QUOR L.C! NSE MANAGER APPLICATION FORM 07211: Page: o: 2 LAW OFFICE OF IRENE F. BAHR J.D. concen&aaon: Liquor Licensing, Regulation and Related Litigation 1751 S. Naperville Road, Suite 209 Wheaton, Illinois 60189 -5896 630 -462 -1113, FAX 630 -462 -1273 E -Mail: irene.bahKiigmaileom Website: www.irenebahri".com President Gopal G Lalmalani Village of Oak Brook 1200 Oak Brook Road Oak Brook, IL 60523 -2255 February 27, 2013 RE: Red Robin International Inc, dba Red Robin Gourmet Burgers 552 Oak Brook Center, Oak Brook IL Application for Liquor License Dear President Lalmalani: Enclosed please find the following in support of my above client's application for a liquor license for its new restaurant in Oak Brook Center: 1. Application for liquor license and check for the application fee in the amount of $500. 2. Certificate of General and Liquor Liability Insurance. 3. Liquor Manager Application form and BASSET certificate. We understand that the manager must also complete Oak Brook's own BASSE "r training and are hereby requesting the contact information for our manager to register for that class. When we have hired other employees who will be serving/selling alcohol, we understand that they must also attend this class and we will make sure that they are, but right now we just have the manager. 4. Copy of the executed lease, with site plan. 5. Copy of the floor plan for this location. 6. Please send me the contact information for the manager to arrange for fingerprinting. 7. Do the officers also need to be fingerprinted, or just the manager? If the officers (who are not GWeersVranckQfiyq!951RPd RcbinlOakbrmk let,"d owners) do have to be fingerprinted, please send me the fingerprint cards that you need and I will see that it is done. The 100% shareholder of the applicant entity is Red Robin Gourmet Burgers, Inc., and it is traded publicly on the NASDQ under the symbol RRGB. 8. Liquor Handling policies and pledge signed by employees. 9. Menu. 10. List of current Illinois licenses held by Red Robin International, Inc. We have a target date of receiving our liquor license right now of June 1, 2013. Once you have had a chance to review these materials, please let me know the answers to my above questions and what else that you may need. I will look forward to completing the application requirements and to appearing before the Village Board. Best Regards, Irene F. Bahr cc. Jake Schlueter C lUSerP.lrann \MM; Fi!errRaA Robin \Oakbr.klW wpd TEAM MEMBER PLEDGE FOR THE RESPONSIBLE SERVICE OF ALCOHOL Red Robin expects all Team Members to comply with state and federal laws pertaining to alcohol service. Never Serve Alcohol to a Minor • No one under 21 years of age may order or consumer alcohol. • Red Robin's policy is to check the ID of every Guest who orders alcohol and appears to be under the age of 39%. • Serving a minor is against the law. Serving a minor will result in immediate Termination and possible personal liability for the Server /Mixologist and the Manager on duty, including fines and incarceration. Proper Identification Required • It is against the law to serve alcohol to anyone without proper ID. 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TappedaMab9pedaw WAedamah adsdpry.ITSlbeydedV smdmdaaY Ammm pa tm:m,bmrm Es4smmamN Wamo aa9 'dbpid4ambaarte RbASAssSral HOTFUOGESUHDAE I,Irsdamtmabbwma badamhlebaystappedyahrdPprdpmn dmmgesrnAl¢md,dep 11 FIlge2d2 iY.v se � ACORD® CERTIFICATE OF LIABILITY INSURANCE L..i 10/1/2013 DA`E(MM/DDMM 2/12/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER Lockton Companies, LLC Denver 8110 E Union Avenue Suite TOO Denver CO 80237 cgMEACT PHONE AK No: EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAICR (303) 414-6000 INSURER A: gin ton Insurance Connnny 19437 10/12012 INSURED Red Robin Gourmet Burgers, Inc. INSURER B S 1-000-000 INSURER c , Great American Insurance Company 16691 1057900 Red Robin International, Inc. IxsuRER D :Allied World Assurance Company, Ltd MMERCIAL GENERtfILITY ILA_ 6312 S. Fiddlers Green Circle, Suite 20ON Greenwood Village, CO 80111 INSURER E: INSURER F: MED EXP (Any one moo COVERAGES REDR001 CERTIFICATE NUMBER: 12187087 REVISION NUMBER: XX)O(XXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. S al3R TYPE OF INSURANCE 12187087 SUER POLICY NUMBER POLICY EFF MM/DO POLICY EXP MMIDD LIMITS A GENERAL IJABILITY N N 016199389 10/12012 10/112013 EACH OCCURRENCE S 1-000-000 DAMAGE TO RENTED PREMISES (Ea aavrtence) E 100,000 MMERCIAL GENERtfILITY ILA_ MED EXP (Any one moo CLAIMS-MADE OCCUR X PERSONALSADV INJURY $ 1,000,000 SIR $200,000 GENERAL AGGREGATE $ GENL AGGREGATE LIMB APPLIES PER PRODUCTS - COMP/OP AGG s 2-000,000 $ POLICY PRO- JECT X LOC B B AUTOMOBILE LIABILITY ANY AUTO N N 71CAB4980301 AOS) 71CA849RD4D1 ) 10/12012 10/12012 10/12013 10/1/2013 LE LIMIT (Ea ecddenq E 0 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per ecdtlant $ X PROPERTY DAMAGE $ i HIRED AUTOS X ANON-OWNED $XXXXXXX C UMBRELLA LUU3 }{ OCCUR N N TLTUO19532502 10/12012 10/12013 EACH OCCURRENCE $ 3,000,000 EXCESS UAS CLAIMS-MADE AGGREGATE $ DED I X I RETENTION$ 10,000 $ B WORKERS COMPENSATION ANDEMPLOYERS'WBILnY YIN N 71WC14980501 10/12012 10/12013 W A - X TORY LIMIT ER E.L. EACH ACCIDENT E ANY PROPRIETORIPARTNEPoEXECUTNE OFFICERMEMBER EXCLUDED] MIA E.L. DISEASE - EA EMPLOYEE $ 1000000 (Mandatory In NH) N dI=I0N under D SGRIPTIOOF OPERATIONS below E.L. DISEASE -POLICY LIMIT E 1 000(m D Property Special Form, RC N N 030597401A 1011/2012 10/12013 S5M Limit/$50K Ded. A Liquor Liability 016199389 10112012 10/120/3 $lm/Occ.;$2m Gen. Agg. DESCRIPTMN OF OPERAnONS / LOCATIONS / VEHICLES (AI h ACORD 101, Addtional Remmxs Schedule, N mon aWce is nqulnd) RE: Store #521, 552 Oak Brook Center, Oak Brook, IL 60523. The Village of Oak Brook is named as additional insured as respects General Liability per written contract CERTIFICATE HOLDER CANCELLATION See Attachment AUUKIJ Z5(ZUTWU5) The ACORD name and logo me registand msxn of ACORO (011953 -2070 ACORD CORPORATION. All rights roseNetl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12187087 AUTNORVFD REPRESENTATIVE Village of Oak Brook 1200 Oak Brook Road Oak Brook, IL 60523 AUUKIJ Z5(ZUTWU5) The ACORD name and logo me registand msxn of ACORO (011953 -2070 ACORD CORPORATION. All rights roseNetl Coverage applies only to properties Red Robin International, Inc. and Red Robin Gourmet Burgers, Inc is responsible for insuring. Special Causes of Loss Form; Replacement Cost Coverage; Building Ordinance or Law; No Coinsurance $5,000,000 primary limit: Allied World Assurance Company; Policy #030597401A $45,000,000 excess $5,000,000: RSUI; Policy #NHD378526 $20,000,000 excess $5,000,000 CA EQ: Endurance American Specialty Insurance Company Policy #CPN 10003773200 $20,000,000 excess $5,000,000 AOS ED (except CA): RSUI; Policy #NHD378526 $20,000,000 excess $5,000,000 Flood (excluding zones A and V): RSUI; Policy #NHD378526 Sublimits Fine Arts Accounts Receivables Valuable Papers and Records Building Ordinance or Law (A, B, C) EDP Equipment, Data, Media Extra Expense Off Premises Power Transit Newly Acquired Unscheduled Contractor's Equip Ingress/ Egress $50,000 per occurrence deductible except, $2,500,000 per occurrence $2,500,000 per occurrence $2,500,000 per occurrence Included $2,500,000 per occurrence $2,500,000 per occurrence $1,000,000 per occurrence $1,000,000 per occurrence 120 Days $1,000,000 per occurrence $2,500,000 per occurrence Special Flood Deductible (1) With respect to locations wholly or partially within Special Flood Hazard Areas (SFHA), the deductible shall be 5% of the total values at the time of loss at each location involved in the loss, subject to a minimum of $500,000 for any one occurrence; (2) With respect to Named Storms the deductible shall be 5% of the total values at the time of loss at each location involved in the loss, subject to a minimum of $100,000 for any one occurrence. (3) With respect to any other flood loss, the deductible shall be $50,000 any one occurrence. Special Wind Deductible (1) With respect to locations within Tier I wind zones the deductible shall be 5% of the total values at the time of loss or damage at each location involved in the loss or damage, subject to a minimum of $100,000 for any one occurrence; _ (2) With respect to any other Named Storm wind loss, the deductible shall be $50,000 any one occurrence Special Earthquake Deductible (1) With respect to locations wholly or partially within the states of California, Hawaii and Alaska the deductible shall be 5% of the total values at the time of loss or damage at each location involved in the loss or damage, subject to a minimum of $100,000 for any one occurrence; (2) With respect to locations wholly or partially Pacific Northwest or New Madrid Earthquake Areas, the deductible shall be 2% of the total values at the time of loss or damage at each location involved in the loss or damage, subject to a minimum of $100,000 for any one occurrence; (3) With respect to any other earthquake the deductible shall be $100,000 any one occurrence. Terrorism is not covered. Mlsmilaneous AOachm ft M4502r6 Mas SID: 106]900, Cer09eala ID: 1218"87