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G-1183 - 04/13/2021 - LICENSE -ALCOHOL - Ordinances Supporting Documents ITEM 6.13.4 BOARD OF TRUSTEES MEETING VILLAGE or SAMUEL E. DEAN BOARD ROOM OAK BF 91 K BUTLER GOVERNMENT CENTER 1200 OAK BROOK ROAD OAK BROOK, ILLINOIS 630-368-5000 AGENDA ITEM Regular Board of Trustees Meeting of April 13, 2021 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 Kathy Vonachen, Deputy Village Clerk -t, BUDGET SOURCE/BUDGET IMPACT: N/A RECOMMENDED MOTION: I Move to Approve Passage of Ordinance G-1183, "An Ordinance Amending Title 4, Chapter 1, Section 8A of the Village Code of the Village of Oak Brook,Illinois by Increasing by One to One the Number of Authorized Class O Liquor Licenses." Backeround/History: BMSH II Oak Brook IL, LLC d/b/a The Sheridan at Oak Brook has made application to the Village of Oak Brook for a Class O Liquor License for their restaurant, The Sheridan at Oak Brook, 2055 Clearwater Drive. The approval of this liquor licenses will increase the number of Class O liquor licenses in the Village of Oak Brook from 0 to 1. The Village's liquor license ordinance requirements for a Class O liquor license has been submitted at this time. The applicant has requested that this application be brought before you for your consideration at the Village Board's regular meeting of April 13th. Enclosed for the Village Board's review is the Application for a Liquor License. BOT 041321AGENDA RU The Sheridan at Oak Brook Liquor License Page 1 i Recommendation: The recommendation is for Passage of Ordinance G-1183, which increases the number of Class O licenses by one. Provided that approval of all legal documentation and ordinance requirements are met,the Local Liquor Commissioner Gopal Lalmalani, will issue a Class O Liquor License to The Sheridan at Oak Brook, 2055 Clearwater Drive. BOT 041321AGENDA The Sheridan at Oak Brook Liquor License Page 2 FOR OFFICE USE Date Approved: " VILLAGE OF OAKBROOK License q Issued' ve Charlotte K.Press,Village Clerk Fee Received: 1200 Oak Brook Road Oak Brook,Illinois 60523.2255 (630)368-5036 I'm(630)368-5037 kvonachen(&oak-brook.or 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: FEE: $2,000.00 EXTENDED HOUR FOR CLASS A-1 LICENSE ONLY: Yes 8 No®ADDITIONAL FEE: 500.00 Corporate Name: BMSH II Oak Brook IL,LLC Phone#: Business Name: The Sheridan at Oak Brook Phone#: Establishment Name: Same Phone#: Corporate Address: Street Address 303 E.Wacker Drive,#2400 Fax#: City/State/Zip Chicago,IL 60601 E-Mail Address: dbriars@seniorlifestyle.% Contact Name: Deborah Briars Contact Title: Senior Paralegal Phone#: 312-673-4470 E-mail address: dbriarsinseniorlifestVle.com Establishment Address: Street Address 2055 Clearwater Drive Fax#: City/State/Zip Oak Brook,IL 60523 E-Mail Address: tobrien@seniorlifestyle.11 Contact Name: Ted O'Brien Contact Title: Executive Director Phone#: 630-394-5116 E-mail address: tobrien0seniorlifestvle.com State of Illinois Liquor License Number: TBD Expiration Date: TBD List each specific location within this 1) LOUNGE BAR establishment where alcoholic 2) Dining Rooms,Private Dining Room liquor is being offered for retail sale: 3) Theatre 4) Livina Room,Great Room See attached floor plan 5) Hospitality Suite for more details. 6) Game Room Ownership of Premises: Owned M 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: Name of Lessor: Address of Lessor: City,State&Zip: TYPE OF BUSINESS: El Corporation B Individual/Sole Proprietorship 0 Limited Liability Co.93 Partnership Length of time in business: New business Character of business:Senior Ilyina residential communitld LIQUOR LICENSE APPLICAMN 5-12 Page I d9 VILLAGE OF OAK BROOK Charlotte K.Prins,Village Clerk rs 1200 Oak Brook Rod e Oak Brook,Illinois 60523-2255 (630)368-5036 Fax(630)368-5037 k vonachen@oak-brook.org INDIVIDUAL/SOLE PROPRIETORSHIP: Are you a resident of Oak Brook 0 Yes ❑ No 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 Delaware on the 26th day of June,201A . 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 m+ Yes ❑No Please check which one: ® Illinois Business Corporation Act 8111inois Revised Uniform Limited Partnership Act ED 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 0 Yes❑No Please check which one: D 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 Company Telephone#: 866-403-5272 Street Address 801 Adlai Stevenson Drive Fax#: City/State/Zip Springfield,IL 62703 E-Mail Address: OUALIFICATIONS: ❑Yes E 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? Qf yes,provide details on reverse side)(or on an addendum) ❑Yes El 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? (lf yes,provide details on reverse side) ❑ Yes E)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 ❑� No Has applicant made application for similar or other liquor license on premises other than described in this application? LIQUOR LICENSE APPLICAItON 05.12 Page 2 of 9 VILLAGE OF OAK BROOK •, Chadoac K.Pr—,Village Clak �` 1200 Oak Brook Road Oak Brook,Illinois 60523-2255 (630)368-5036 Fax(630)368-5037 k—hen@oak-brook.org (Ifyes,provide disposition ofsuch application on reverse side) ❑Yes E]No Has any liquor license issued to the applicant ever been revoked or suspended? (If yes,provide date,reason and jurisdiction on reverse side) ❑Yes Q 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-I,et seq.),as heretofore or hereafter amended,or as proscribed by a statute replaced by any of the aforesaid statutory provisions? (If yes,provide date,offense,jurisdiction and case number 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 felony? ❑Yes ❑� 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. Position Held Within Organization %of stock i.e.Owner,Managing Partner,general partner,shareholder, owned or Name officer(name office held) membshp interest BMSH II Oak Brook ILJVComJ Sole Member 100% LIQUOR LICFNSE APPLICATION 05.12 Page 3 of 9 VILLAGE OF OAK BROOK 4#0 Charlotte K.Pr=,VillageClrk 1200 Oak Brook Road Oak Brook,Illinois 60523-2255 (630)368-5036 Fu(630)368.5037 k,,hett(aloek-brook.org Name of person operating as General Manager of the premises: Ted O'Brien Name of person operating as Liquor Manager of the premises: Ted O'Brien,Executive Director Roey Phillips,Director of Dining Services A Manager Application Form must be submitted for 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 a men 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: Annual Fee plus Extended Hour Fee if Applicable See attached(check#1186). =Certificate of Insurance Application submitted and under review by carrier.Will provide. ✓QLiquor License Manager Application Form Lease-If premises not beneficially owned by Applicant Not Applicable.See attached deed. ,Proof of completion of the Illinois Department of Alcohol and Substance Program by all facility managers and employees as is necessary. Basset training will be on site, LIQUOR LICENSE APPLICATION 05-I2 will provide date. Page 7of9 VILLAGE OF OAK BROOK ,�• •, Charlotte K Pnus,Villege Clerk a 1200 Oak Brook Ro f F Oak Brook,Illinoiad s 60523-2255 ,_0 .,,-� (630)76&5036 Fax(670)768-5(137 kvonachwQ)oak-brook org =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. OB training date pending. Initial Applicants must also provide: =Proof of ownership of premises(e.g.title report) See attached deed. 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.) �� f alompleted fingerprint cards for each Corporate Officer,General Manager and Liquor Manager Finger prints for both Ted O'Brien and Roey Phillips were taken by the Oak Brook police dept. =Employee liquor handling training manual describing the specific procedures of the applicant to monitor operations to insure no incidences of underage drinking. Liquor handling documents will be provided. 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 05-12 Page 8 of 9 VILI.AGF OF OAK BROOK Charloae lk Pans,V d1W Clerk 1200 Oak Brook Rad •••f Oak B-A,111-6 60523-2255 (630)36R-Sf136 Fax(Aif11368.5(137 kronschenZak4wook.org ATTESTATIONS: 1 Stephen J.Levy the Authorized Signatoo 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 ani 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. APPLIC;AN I BMSH II Oak Brook IL,LLC BY: Signature Print Name Stephen YLevy-� Title Authorized Signatory LIWOR LICENSE APPLICATION 05-12 Page 9 of 9 I a72/5/2021 E(MM/DD/YYYY) AR" CERTIFICATE OF LIABILITY INSURANCE 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 have ADDITIONAL INSURED provisions or 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 endorsement(s). CONTAPRODUCER NAME: Mark Kohrman __..- Assurance, a Marsh &McLennan Agency LLC company PHONE FAX 20 N Martingale Road -ESA Lo Et):(847)797-5700 (A/c No):(847)440-9116 Suite 100 ADDRESS: mkohrman@assuranceagency.com Schaumburg IL 60173 INSURERS AFFORDING COVERAGE NAICN INSURER A:Accident Fund National Insuran 12305 INSURED SENILIF-01 INSURERS:Philadelphia Indemnity Insuran 18058 Senior Lifestyle Holding Company, LLC INSURERC:National Fire&Marine Insuran 20079 303 East Wacker Drive Suite 2400 INSURERD:Illinois Union Insurance 27960 Chicago IL 60601 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1431501174 REVISION NUMBER: 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. INS RI ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD M/DD C X COMMERCIAL GENERAL LIABILITY NSCIO0560 9/1/2020 9/1/2021 EACH OCCURRENCE $1,000,000 X YDAMAGE TO RENT CLAIMS-MADE OCCUR PREMISES Ea occurrence $100,000 X Ded-$75,000 MED EXP(Any one person) $10,000 X Professional PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $15,000,000 X POLICY F-1LOC❑ LOC PRODUCTS-COMP/OP AGG $3,000,000 JECT OTHER: Per Location A $3,000,000 B AUTOMOBILE LIABILITY PHPK2161798 8/1/2020 8/1/2021 COMBINEDSINGLELIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PReOPPE�Ra DAMAGE $ AUTOS ONLY AUTOS ONLY Comp/Coll $1,000/$1,000 C UMBRELLA LIAB OCCUR ENSC100562 9/1/2020 9/1/2021 EACH OCCURRENCE $15,000,000 X EXCESS LIAB X CLAIMS-MADE AGGREGATE $15,000,000 DED X RETENTION$ $ q WORKERS COMPENSATION 1400016873 8/1/2020 8/1!2021 X STATUTE ER AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED7 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Liquor Liability Binder 4/8/2021 4/8/2022 Limit $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Location:The Sheridan at Oak Brook-22nd and York Road,Oak Brook, IL 60523 The following are included as additional insureds as their interest may appear: BMSH II Oak Brook IL, LLC; BMSH II Oak Brook IL JV Company,LLC; SLKJ Oak Brook Developer, LLC;SLH Oak Brook Manager, LLC;Senior Lifestyle Management Holdings, LLC;Senior Lifestyle Holding Company, LLC;and Village of Oak Brook,its officials,employees,volunteers,and agents,are listed as additional insureds as stated by ordinance. Coverage will commence upon the date the Named Insured begins management of the community scheduled for 3/1/2021. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ATE THEREOF, The Village of Oak Brook ACCORDANCE WITH THE POLICY PROVISIONS.E WILL BE DELIVERED IN 1200 Oak Brook Road Oak Brook, IL 60523 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Sheridan at Oak Brook Alcohol Serving Areas R 1, I i, a� lx I I l" Me i Serving Areas: —, .__ _Tp 1.AL Dining Room I ! 2.AL Great Room 3.AL Game Room 4.Private Dining Room 5. IL Dining — — 6.Bar 7.Social Area 8.Arts Room — I— I'. 9.Game Room _ 10.Theatre 11. MC Activities 12.MC Dining 13.MC Living Room VILIAGE OF OAK BROOK Kuhy V—hm.Admin Am 1200 Oak Brook Road Oek Brook,111—s 60523-2255 (6 a30)36&5037 ==-brook. LIQUOR LICENSE MANAGER APPLICATION Corporate Name: a.ey� Business Name: LASH Establishment Name: Street Address 0-1p5Z Ct.�rkrisrarr�� > a tc Phone#: kCaq'3-%A t5 Wt2 Applicant Phone Name: � j'�. e-mail(wk) mgr:st.ttels It,- Home CA Address: Date of Birth: City/State,Zip Place of Birth: Drivers License#: Position held with above named business: �CwT rJv "7vt.ata,Z (�Yes ❑No Are you a citizen of the United States? [l Yes []No Are you a Naturalized Citizen? If you are a naturalized citizen give date and city of naturalization: Court in which(or law under which)you were naturalized, ❑Yes ©No Do you possess a current Federal wagering and gaming device stamp? (If)es,provide details on reverse side) ❑Yes No [lave you ever been convicted ofa violation ofany 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? (1f)es,provide date,offense,jurisdiction and case number on reverse.side) ❑Yes ®No Have you ever been convicted ofa 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'? (If yes,provide date,offense,jurisdiction and case number on reverse side) ❑Yes 0 No Have you ever been convicted ofa felony? ❑Yes ®No Have you ever been convicted of being the keeper of.or is keeping,a house of ill fame? ❑Yes ©No Have you ever been convicted of pandering or other crime or misdemeanor opposed to public decency and morality? LIQUOR LICENSE MANAGER APPLICATION FORM 0111213 pare I o(2 . VILLAGE OF OAK BROOK Kady Vn,rehen,Admin AYt 1200 Oat Brook Rod Oak Boot,Ohms 60523-2255 (63D)368-5036 Fu(630)369-5037 kvonachen@oak-brook.org ElYes ®No Have you ever been convicted of a drug-related offense? (If yrs,provide date,offense,jurisdiction and case number on reverse side) ❑Yes ®No Have you pled guilty to or were you ever been convicted of driving under the influence,Class A misdemeanor? If yes,indicate on reverse side date of guilty plea or date of conviction and if suspension given, date ofcompletion ofsrupension. ❑Yes ®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 contact the Illinois Liquor Control Commission to inquire about training Liquor Handling Experience—Please provide name and address ofany other liquor establishment in which you have been employed or owned an interest. I on oath state that 1 will not violate any of the ordinances of the Village of Oak Brook or the laws of the State of I llinois 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 heroin arc true and correct. Signature LIOINIR IJCFNgE MANAGER APPLICA770N FORM 081213 Page 2 of 2 w, VILLAGE.OF OAK BROOK K..hy Vma th Admin A" 1200 oak Brook Rod Oak Book,Illinois 60523.2255 (630))68-5036 F.(630)369-5037 kvofuchcn k-brookor LIQUOR LICENSE F_ MANAGER APPLICATION Corporate Name: > n(9r U��s 11,t- nnnn J LL Business Name: $t f>b ��pvool`1 IL Lu, Establishment Name: 56'-'jg_A Q:� ()ab Rroo L Street Address 7p�Gt4rkk�fk�e�DcwL tlk&&iLRlaDSP3Phonc#: (ojU- t j�-tl2(o0 Applicant n Phone 11: Name: PtSv)f PHILUP� e-mail(wk)t f Sns�nrir___ r 5 Home Address: Date of Birth: _ City/State,Zip Place of Birth: Drivers License q: Position held with above named business: Dtttc}ar 0y D7IJ,Aj e-VVI Lef [ f Yes ❑No Are you a citizen of the United States? R Yes ❑Nu Are you a Naturalized Citizen? lj you area naturalize(citizen give dare and cip-ojrwluralizalion.r'J-k a�f(96 ,h1r-, Court in which(at-law under which)you were naturalized UPo kb5&4n D1 Cy-r} �,r s{e e^ � -r�O +A E]Yes N No Do you possess a current Federal wagering and gaming device stamp? M (/Dyes,provide details on reverse side) ❑Yes ®No 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 Rny such violation? (If yes,provide date•offense,jurisdiction and case number on reverse side) ❑Yes [4 No 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? (Ifpes,provide date,offense•jurisdiction and case number on reverse side) ❑ Yes No Have you ever been convicted of a felony? ❑Ycs No Have you ever been convicted of being the keeper of,or is keeping,a house of ill fame? ❑Yes 9No Have you ever been convicted of pandering or other crime or misdemeanor opposed to public decency and morality? LIQUOR LICENSE MANAGER APPLICATION FORM 091213 Pqc I of 2 VR.LAOE OF OAK BROOK Ka5►y V­km Admin A- 1200 Oak n,120004 Brook Road Oak Brvot.Hh",60523.2233 (630)3"4036 Fu(650)562-5031 kvonaehen@nak-brook.org ❑Yes No Have you ever been convicted of a drug-related offense? (If ws,provide date,offense,jurisdiction and case number on reverse side) ❑Yes '�No Have you pled guilty to or were you ever been convicted of driving under the influence,Class A misdemeanor? ?lyes,indicate on reverse side date ojguflty plea or•date p conviction and if suspension given, date of completion ojswpension. g(Yes ❑No Have you successfully completed a State-licensed alcohol selledserver education program? If yes,please provide a copy of the Certificate ojCompletion. If no,please contact the Illinois Liquor Control Commission to inquire about training. Liquor Handling Experience—Please provide name and address of any other liquor establishment in which you have been employed or owned an interest. t f u ion (L 15ne a�Ffs} tLl' 9LJ M.v�e ar r c n 4�E] 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 arc true and correct. Signature LIQUOR LKENSE MANAGER APPLICA71011 FORM 011213 Paye 2ur2 cat e of compfietionCe�rti f i American Safety Council T ROEY PHILLIPS Has diligently and with merit completed the On-Premise BASSET Alcohol Certification on 4/5/2021 from the American Safety Council. i-. Jeff" 1 Pairan i 8 0 1 0 8 5 6 9 7:::40058859 FRED BUCHOLZ, RECORDER DUPAGE COUNTY ILLINOIS PREPARED BY: 08/12/2019 11:23 AM RHSP COUNTY TAX STAMP FEE 2,760.00 Daniel J.Kopp,Esq. STATE TAX STAMP FEE 5,520.00 Daspin&Aument,LLP 300 South Wacker Drive,Suite 2200 DOCUMENT # R2019-068324 Chicago,Illinois 60606 WHEN RECORDED RETURN TO: DLA Piper LLP(US) 444 W.Lake Street,Suite 900 Chicago,Illinois 60606 (Above Space for Recorder's use only) Attn:Bradley Levy / SPECIAL WARRANTY DEED TIES SPECIAL WARRANTY DEED is made as of this�'�day of July,2019 between YORK ROAD ASSOCIATES LLC, an Illinois limited liability company ("Grantor"), and BMSA H OAK BROOK IL LLC,a Delaware limited liability company("Grantee"); THAT,for and in consideration of the sum of TEN AND NO/100 DOLLARS($10.00)in hand paid and other valuable consideration, the receipt and sufficiency of which are hereby acknowledged, Grantor has granted,bargained,sold,aliened,conveyed and confirmed and by these presents does hereby grant,bargain,sell,alien,convey and confirm unto Grantee all that tract or parcel of land described in Exhibit "A" attached hereto and made a part hereof, together with all buildings, structures and improvements located thereon, together with all rights, easements and appurtenances in any manner appertaining or belonging to said property(collectively the"Property"); Grantor shall warrant and forever defend the right,title and interest to the Property unto Grantee against the claims of all persons claiming by,through or under Grantor,except for claims arising under and by virtue of the matters set forth in Exhibit`B"attached hereto and made a part hereof. "Grantor" and"Grantee"shall include their respective heirs,successors and assigns; MAIL-To: CHICAGO LAND AGENY SERVICES) (Signatures begin on next page) 1620 W BELMONT AVE CHICAGO,IL 60657 400711.00012.23016440.2 6 N-0,d.Sea h Pape 1 of 6 Requested By Ind..keM.Panted&22/2019 8:40 AM D.DUPG2019 OW324 IN WITNESS WHEREOF,Grantor has executed this Special Warranty Deed as of the day of July,2019. GRANTOR YORK ROAD ASSOCIATES,LLC, an Illinois limited liability company By: LO York,LLC, a Delaware limited liability company,its Manager 14y:Non-Member Manager Inc., a Texas corporation,its Manager By: JkAn Grissim,Vice President STATE OF ILLINOIS ) )SS COUNTY OF COOK ) On the 1�day of July,2019 before me,a notary public in and for the State and County aforesaid,personally appeared John Grissim, Vice President of Non-Member Manager, Inc.,a Texas corporation,as Manager of LO York,LLC,a Delaware limited liability company,as Manager of York Road Associates LLC,an Illinois limited liability company("Seller"),who is known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity,and that by his signature on the instrument the person acted and executed the instrument on behalf of said corporation,in its capacity as Manager of the Manager of Seller. IN WITNESS WHEREOF,I have herenntn net my hand and nfficinl ural My Commission Expires: notary ruouc �___I_ Sit, OFFICIAL SEAL Send future real estate tax bills tol r 1 ddW Lj51 MARYBM PEHANICH NOTARY PUBLIC-STATE OF ILLINOIS Y COMMISSION EXPIRES.05@022 "1Jn r CJ -�2yaJ 2 400711.00012.23 0164 40.2 Non Order Search Pape 2016 Requested By find.k-t P,m a222018 8 40 AM D.DUPG'2019 066324 Exhibit A Legal Description PARCEL 1: LOT 6 IN THE FINAL PLAT OF RESUBDIVISION OF CLEARWATER, BEING A RESUBDIVISION IN PART OF THE SOUTHWEST 1/4 OF SECTION 24,TOWNSHIP 39 NORTH, RANGE 11,EAST OF THE THIRD PRINCIPAL MERIDIAN,1N DUPAGE COUNTY, ILLINOIS, ACCORDING TO THE PLAT THEREOF RECORDED SEPTEMBER 22, 2016 AS DOCUMENT R2016-102540. PARCEL 2: NON-EXCLUSIVE EASEMENT APPURTENANT TO AND FOR THE BENEFIT OF PARCEL 1 AS CREATED BY THIRD AMENDED AND RESTATED RECIPROCAL EASEMENT,MAINTENANCE AND USE DECLARATION DATED AUGUST 8,2018 AND RECORDED AUGUST 22,2018 AS DOCUMENT NUMBER R2018-078944, OF THE REAL PROPERTY RECORDS OF DUPAGE COUNTY, ILLINOIS, AS AMENDED BY FIRST AMENDMENT TO THIRD AMENDED AND RESTATED RECIPROCAL EASEMENT, MAINTENANCE AND USE DECLARATION, RECORDED JULY 10,2019 AS DOCUMENT R2019-056433. Address of the Real Estate: 2055 Clearwater Drive,Oak Brook,IL 60523 Parcel ID:06-24-308-019 A-1 Error!Unknown document property name. N—Ord.Search Pape 3 d 6 Roquesmtl By:i ndakeM.PriNed.8/2212019 8:40 AM Doo:DUPG2019088324 Exhibit B Permitted Encumbrances 1. TAXES FOR 2019 AND SUBSEQUENT YEARS 2. TERMS, PROVISIONS AND CONDITIONS OF ORDINANCE 2007-ZO-SU-S-1183, GRANTING A SPECIAL USE FOR A MIXED USE DEVELOPMENT IN THE 04 DISTRICT FOR CLEARWATER RECORDED FEBRUARY 27,2007 AS DOCUMENT NUMBER R2007- 035898,AND AS SHOWN ON THE FINAL PLAT OF RESUBDMSION CLEARWATER RECORDED SEPTEMBER 22,2016 AS DOCUMENT NUMBER R2016-102540. 3. ORDINANCE 2018-ZO-V-EX-S-1538 APPROVING AN AMENDMENT TO SPECIAL USE ORDINANCE S-1183 TO ALLOW THE CONSTRUCTION OF A SIX STORY SENIOR HOUSING DEVELOPMENT ON THE PROPERTY LOCATED AT 2055 CLEARWATER DRIVE IN THE VILLAGE OF OAK BROOK RECORDED NNE 22,2018 AS DOCUMENT NUMBER R2018-056813. 4. TERMS,PROVISIONS AND CONDITIONS OF NO FURTHER REMEDIATION LETTERS RECORDED AUGUST 31,2001 AS DOCUMENT NUMBER R2001-186284 AND RECORDED APRIL 7,2009 AS DOCUMENT NUMBER R2009-050300. 5. A 30 FOOT BUILDING SETBACK LINES AS DEPICTED ON PLATS OF CLEARWATER OAK BROOK ASSESSMENT PLAT, RECORDED AUGUST 28, 2008 AS DOCUMENT NUMBER R2008-133469, CLEARWATER OAK BROOK ASSESSMENT PLAT NO. 2, RECORDED MARCH 26, 2010 AS DOCUMENT NUMBER R2010-39896, CLEARWATER OAK BROOK ASSESSMENT PLAT NO 3,RECORDED MARCH 26,2010 AS DOCUMENT NUMBER R2010-39897,AND CLEARWATER OAK BROOK ASSESSMENT PLAT NO.4 RECORDED MARCH 13,2014 AS DOCUMENT NUMBER R2014-020867,AND AS SHOWN ON THE FINAL PLAT OF RESUBDIVISION CLEARWATER RECORDED SEPTEMBER 22, 2016 AS DOCUMENT NUMBER R2016-102540. 6. THIRD AMENDED AND RESTATED RECIPROCAL EASEMENT, MAINTENANCE AND USE DECLARATION WAS RECORDED AUGUST 22, 2018 AS DOCUMENT NUMBER 82018-078944. FIRST AMENDMENT TO THIRD AMENDED AND RESTATED RECIPROCAL EASEMENT,MAINTENANCE AND USE DECLARATION WAS RECORDED JULY 10,2019 AS DOCUMENT NUMBER R2019-056433. 7. TERMS,PROVISIONS AND CONDITIONS OF THE DECLARATION OF STORMWATER FACILITIES EASEMENT'S,COVENANTS,CONDITIONS AND RESTRICTIONS,MADE BY AND BETWEEN THE VILLAGE OF OAK BROOK, AN ILLINOIS MUNICIPAL CORPORATION AND YORK ROAD EW, LLC, A DELAWARE LIMITED LIABILITY COMPANY,WAS RECORDED DECEMBER 17,2008 AS DOCUMENT NUMBER 82008- 178190. 8. EASEMENT GRANT DATED MAY 27,2010 AND RECORDED SEPTEMBER 22,2010 AS DOCUMENT NUMBER R2010-126156 TO FLAGG CREEK WATER RECLAMATION DISTRICT, A MUNICIPAL CORPORATION, FOR THE PURPOSE OF, AMONG OTHER THINGS, SANITARY SEWER EASEMENT,AND AS SHOWN ON THE FINAL PLAT OF RESUBDIVISION CLEARWATER RECORDED SEPTEMBER 22, 2016 AS DOCUMENT NUMBER 82016-102540. 9. GRANT OF EASEMENT PLAT FOR WATERMAN,STORM SEWER AND SIDEWALK TO THE VILLAGE OF OAK BROOK AND PLAT OF VACATION OF STORM SEWER EASEMENT RECORDED FEBRUARY 22,2010 AS DOCUMENT NUMBER R2010-023909, B-1 400711.0 D D 12.23 0164402 Non-Order Search Pape 4 of 8 Requested By:BMake14,Pnnt d:812212019 8:40 AM Doc:DUPG:201 B 068324 AND AS SHOWN ON THE FINAL PLAT OF RESUBDIVISION CLEARWATER RECORDED SEPTEMBER 22,2016 AS DOCUMENT NUMBER R2016-102540- 10.THE LAND LIES WITHIN THE FLAGG CREEK WATER RECLAMATION DISTRICT WHICH HAS ACCEPTED FEDERAL GRANTS FOR TREATMENT WORKS PURSUANT TO PUBLIC LAW 92-500.FEDERAL LAW REQUIRES A USER CHARGE SYSTEM SEPARATE FROM GENERAL AD VALOREM PROPERTY TAXES. 11.AS DISCLOSED BY LETTER DATED JANUARY 6, 1998 FROM THE VILLAGE OF OAK BROOK,T 1E VILLAGE OPERATES AND MAINTAINS AN EXISTING 12 INCH WATER DISTRIBUTION MAIN (ALONG 22ND STREET) AND AN EXISTING 8 INCH WATER DISTRIBUTION MAIN(ALA)NG CLEARWATER DRIVE)BOTH OF WHICH CUT ACROSS A PORTION OF THE LAND.ALSO,THE VILLAGE OPERATES AND MAINTAINS AN EXISTING 10 INCH WATER DISTRIBUTION MAIN ALONG CLEARWATER DRIVE WHICH CUTS ACROSS A PORTION OF THE NORTHEAST CORNER OF UNDERLYING LOTS 1 AND 2 IN CLEARWATER OAK BROOK ASSESSMENT PLAT NO.3,RECORDED MARCH 26,2010 AS DOCUMENT NUMBER R2010-39897- 12.A 10 FOOT PUBLIC UTILITIES EASEMENT AS DEPICTED ON FINAL PLAT OF RESUBDIVISION CLEARWATER RECORDED SEPTEMBER 22, 2016 AS DOCUMENT NUMBER R2016-102540. 13.EASEMENT IN FAVOR OF VILLAGE OF OAK BROOK,AND FLAGG CREEK WATER RECLAMATION DISTRICT,AND 1TSfrHEM RESPECTIVE SUCCESSORS AND ASSIGNS, TO INSTALL„ OPERATE AND MAINTAIN ALL EQUIPMENT NECESSARY FOR THE PURPOSE OF SERVING THE LAND AND OTHER PROPERTY,TOGETHER WITH THE RIGHT OF ACCESS TO SAID EQUIPMENT,AND THE PROVISIONS RELATING THERETO CONTAINED IN THE PLAT RECORDED SEPTEMBER 22,2016 AS DOCUMENT NUMBER 82016.102540. 14.TERMS, PROVISIONS AND CONDITIONS OF ORDINANCE 2016-7O-V-EX-S-1474 AN ORDINANCE APPROVING AN AMENDMENT TO A SPECIAL USE FOR THE CLEARWATER DEVELOPMENT IN THE VILLAGE OF OAK BROOK, ILLINOIS 60523 RECORDED NOVEMBER 1, 2016 AS DOCUMENT AS DOCUMENT NUMBER 82016 120341. 15.SUBJECT TO THE PLAT OF SUBDIVISION RECORDED AS DOCUMENT NUMBER R2016- 102540 16.CONSENT DECREE FILED JUNE 18, 2018 IN CASE 18CH000224 APPROVING AND INCORPORATING THE SETTLEMENT AGREEMENT APPROVED JUNE 12, 2018 AND RECORDED JUNE 20,2018 AS DOCUMENT NUMBER R2018-055826- 17.TERMS AND PROVISION OF ORDINANCE 2018-ZO-V-EX-S-1537 GRANTING VARIATIONS FROM SEVERAL PROVISIONS OF TITLE 13('ZONING REGULATTONSe) OF THE VILLAGE CODE OF THE VILLAGE OF OAK BROOK TO ALLOW FOR THE CONSTRUCTION OF A SIX STORY SENIOR HOUSING DEVELOPMENT ON THE PROPERTY LOCATED AT 2055 CLEARWATER DRIVE IN THE VILLAGE OF OAK BROOK RECORDED JUNE 22,2018 AS DOCUMENT NUMBER R2018-056812. 18.TERMS AND PROVISIONS OF MEMORANDUM OF SETTLEMENT AGREEMENT AND RELEASE RECORDED JULY 10,2018 AS DOCUMENT NUMBER R2018-062881. 19.AMENDMENT TO AMENDED ORDINANCE 756 BY FLAGG CREEK WATER RECLAMATION DISTRICT WAS RECORDED APRIL 23,2019 AS DOCUMENT NUMBER R2019-030006,AND THE TERMS AND CONDITIONS CONTAINED THEREIN. 2 400711.00012.23016440.2 Non-0rder Search Pae 5 ol6 Requested By:lindo.kern,Printed:8r2711019 8:40 AM Doc:DUPG:201906=4 20.DECLARATION RECORDED JULY 10,2019 AS DOCUMENT NUMBER R2019-056434. 21.ACTS OF GRANTEE. 3 40071 1.00012.23016440.2 Non-Order S—h Pape 6 of 6 Requested By:finds keit,Pnrded:8222019 8:40 AM Doc:DUPG2019088924