G-1139 - 11/27/2018 - LICENSE -ALCOHOL - Ordinances Supporting DocumentsBOT 112718 AGENDA
Breatrix Page 1
BOARD OF TRUSTEES MEETING
SAMUEL E. DEAN BOARD ROOM
BUTLER GOVERNMENT CENTER
1200 OAK BROOK ROAD
OAK BROOK, ILLINOIS
630-368-5000
AGENDA ITEM
Regular Board of Trustees Meeting
of
November 27, 2018
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
BUDGET SOURCE/BUDGET IMPACT: N/A
RECOMMENDED MOTION: I move to approve passage of Ordinance G-1139,
“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 Thirty-Five the Number of
Authorized Class A-1 Liquor Licenses
Background/History:
Beatrix Oak Brook LLC d/b/a Breatrix has made application to the Village of Oak Brook
for a Class A-1 Liquor License for their restaurant, Breatrix located at 272 Oakbrook
Center. The approval of this liquor license will increase the number of Class A-1 liquor
licenses in the Village of Oak Brook from 34 to 35. Background checks are being
processed at this time for the officers and manager.
The applicant has requested that this application be brought before you for your
consideration at the Village Board’s regular meeting of November 27, 2018. Enclosed for
the Village Board’s review is the Application for a Liquor License.
Recommendation:
The recommendation is for Passage of Ordinance G-1139, which increases the number of
Class 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
Breatrix located at 272 Oakbrook Center.
ITEM 6.C.1
Additions are bold and double-underlined; deletions are struck through.
ORDINANCE 2018-LC-AL-G-1139
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 THIRTY-FIVE
THE NUMBER OF AUTHORIZED CLASS A-1 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 Breatrix Oak Brook LLC, d/b/a
Beatrix, 272 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:
Class Of License Application Fee Annual License Fee Number Issued
A-1 $2,000.00 $2,750.00 34 35
A-2 2,000.00 2,750.00 0
A-3 2,000.00 2,750.00 1
B 2,000.00 2,750.00 15
C 2,000.00 2,200.00 1
D 2,000.00 2,200.00 2
E 2,000.00 4,950.00 7
F No Fee $50 per event Not Applicable
G No Fee No Fee 1
H No Fee No Fee 1
I 2,000.00 2,750.00 2
J 2,000.00 500.00 1
K 2,000.00 2,750.00 0
L 2,000.00 2,750.00 1
M ---- 500.00 3
N 2,000.00 2,750.00 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.
Ordinance 2018-LC-AL-G-1139
Amending Title 4, Chapter 1,
Section 8A Relative to Liquor
Licenses Page 2 of 2
APPROVED THIS 27th day of November, 2018.
Gopal G. Lalmalani
Village President
PASSED THIS 27th day of November, 2018.
Ayes:
Nays:
Absent:
ATTEST:
Charlotte K. Pruss
Village Clerk
FOR OF「ICE USE
Date Approved:
Liccnsc#Issucd:
ⅥLLAGE OF OAK BR00K
Charlotte K.Pruss,Village Clerk
12∞Oak Brook Road
Oak Brook,11linois 60523‐2255
(630)368‐5036 Fax(630)368‐ 5037
Application is hereby made to the Local Liquor Control Co―issioner ofthe Villagc of Oak BЮ ok for issllance
ofa Village ofOak Brook liquor license,pllrsuant to the ordinances ofthe Village and laws ofthe Statc of11linois.
In support ofsaid application,the following is subllllttcd:
CLASS:A-l FEE:
EXTENDED HOUR FOR CLASS A‐l LICENSE ONLY:Yes tt No[ヨ ADDIT10NAL FEE:500。00
Corporate Name:
Business Name:
Establishment Name:
Corporate Address:
Street Address
Beatrix Oak Brook LLC
Beatrlx
Beatrix
c/o Lettuce Entertaln You Enterprlses,
5419 N. Sherldan Road Sulte 116
Phone#: (773) 878-7340
Phone#: (773) 878-7340
Phone#: (773) 878…7340
City/State/Zip ChiCago,IL 60640
ContactName: Slssle Sappanos
Phone#: (773)878-7340
Establishment Address:
StreetAddress 272 oakbrook Center
City/State/Zip Oak BrOok, IL 60523
Contact Name: Mlchael Ostas
Phone#: (3120 597-3074
Inc。
FaxI:(773)878-7667
E―Mail Address: SSappanoseleyeocom
ContactTitle: Dlrector of Llcenslng
E-mailaddress: ssappanos@leye.com
FaxI:(773)878…7667
E-Mail Address: ssappanosGleye.corn
E‐mail address:
Contact Title: General Manager/Llquor Manager
mostasGleye. com
State of Illinois Liquor License Number :紗 饉On hα
List each specific location within this 1) Dining Room
establishment where alcoholic
liquor is being offered for retail sale:
2\ Barll,ounee Area
3) outdoor Dlnlns
4)
5)
6)
Ownershゎ ofPremises Owlled日
Lcased国
For initial application, provide proof of ownership (e.g. title policy)
If leased, provide copy of lease for full period of license and provide the
fol lowing information :
Name oflessor: Oakbrook Shopplng Center LLC
Addressoflessor: 110 I^I. tr'lacker Drlve
City,State&Zip: Chicago, IL 60606
nPE OF BUSINESS:□CorpOration ttlndividua1/SolePropridotthip tt LimitedLiabilityCo.日 Parmership
Length of time in fu5ing5s; Approxlmate Character of business: Restaurant
Opening Date ls
APPLiCAT:ON FOR LIQUOR L:CENSE
LIQUOR LICENSE APPLICATION 5‐12
昭 /19
Page I of9
Fee Received:Pf u.
VLLAGE OF OAK BR00K
Charlotte K Pmss,Village Clerk
12CX1 0ak Brook Road
Oak Brook,Ininois 60523‐2255
(630)368-5036 Fax(630)368-5037
INDIVIDUAUSOLE PROPRIETORSHIP : AreyouaresidentofOakBrook I Yes E No
kvonachen@oak-brook.org
N/A
Other than an IndividuaUSole Proprietorchip this section must be completed by an authorized agent of
the applicant
This applicant, other than an IndividuaVSole Proprietorship, was organized, formed, or incorporated under the laws of the
State of 11linois On the 3rd day of 」uly 2018 .
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 tllinois E yes E No Please check which one:
ffi nlinois Business Corporation Act
f[ tttinois Secretary of State
[Yes ENo
Eヨ 11linois Revised Unifoニ ュ1l Limited Partnership Act
□Ⅲhds Re宙 sed U」おm Patteshゎ Act
Other Jhan an lndividuaySolc PropHetorship is this business qualifled plllrsuant to one ofthe following to transact business
in 11linois ltt Yes□No Please check which one:
E lilinois Business Corporation Act Ellinois Revised Uniform Limited Partnership Act
f] tllinois Secretary of State I tllinois Revised Uniform Parrnership Act x ar"t_fJ"lriiLlmlted Liabllltv
Registered Agent:
Name: Mlchael Fox (Fox,Swlbel,Levln & Carroll)Telephone#: (312) 224-1211
StreetAddress 200 W. Madlson St. Suite 3000 FaxI: (312)224-1201
City/State/Zip chicago,IL 60606 E-Mail Address: mf ox@f slc. com
OUALIFICAT10NS:
回Yes□No Does the applicat the llllanager or any petton or entity lis“d as OIbet Shareholdet Member,
日Yes ttNo
Manager or Partrer possess a current Federal wagering and gaming device stamp?
(If yes, provide details on reverse side) (or on on addendum)
Has a federal wagering stamp been issued by the federal govemment for the current tax period
for the premises for which a license is sought?
(Ifyes,provide details on reverse side)
Has applicant, the manager or any person or entity listed as Officer, Shareholder, Member,
Manager or Parfrter 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?
(If yes, provide date, offense, jurisdiction and case number on reverse side)
Has applicant made application for similar or other liquor license on premises other than
described in this application?
□Yes ttNo
LIQUOR LICENSE APPLICATION 05‐12 Page 2 of 9
VILLAGE OF OAK BR00K
Charlotte K Pruss,Village Clerk
1200 0ak Brook Road
Oak Brook,Ininois 60523‐2255
(630)368‐5036 Fax(630)368-5037
kvonachen@。ak_brook org
0初 観ρリソj″diΨosJ′Jο ″0/S″θ力のノJε αria″ο″″rsθ sJ`り
□Yes ttNo Has anyliquorlicense issucdto the applicanteverbeenrevokedor suspended?
Jソ eS,′ЮソJ″あれrcasο ″αれdJ“7漁 影″εわ″ο″″θッθrSe S′`り
□Yes tt No Hasapplicant,the manager or any petton or en饉 サlisted as offlcer,Sharcholder,Member,
Manager or Partner ever been convicted ofa gambling offense in violation ofSectiOn 28-3 of
the Criminal Code ofthe State oflllinois(720 1LCS 5.28-1,ct seq。),as heretofore or hereafter
amended,or as prosc五 bed by a statute replaced by any ofthe aforesaid statutory pro宙 sions?
∬ド機、′raソjル ″1%改ぉαittdttθ ″ο″α“グε“ι″
"“
bθ ″Oκ 漁勢κrsc sJグリ
□Yes tt No Has applicant,the manager or any person or entity listed as Offlcer,Shareholder,Member,
Manager or Parbler ever been convicted ofa felony?
口Yes ttNo Hasapplicant,the manager or any person or entity listed as Offlcer,Sharcholder,Member,
Manager or Ptter everbeen convicted ofbeing the keeper ol oris keeping,a house ofill
fame?
回 Yes ttNo Has applicant,the manager or any petton or entity listed as Offlcer,Shareholder,Member,
Manager or Parmer ever been convicted ofpandc五 ng or other c五 rne or inisdemeanor opposcd
to public decency and lnorality?
INDⅣDUAL殷
For each Person,Owner,Partner9 0fFlcer,Director9 Member and Stockholder holding directly or beneicially
more than 50/O ofstock in the business please pro宙 de the fouo▼減ng infOrmation.
Name
Position Held Within Organization
i.e. Owner, Managing Partner, general partner, shareholder,
officer (name office held)
% of stock
owned or
membshp
interest
Richard Alan Melman LLC Manager
Kevin Justin Brown LLC Manager & Member 4%
Jay Lawrence Stleber LLC Manager
Marc Jacobs Member 12%
John Chlakulas Member 7.5Z
Lettuce Entertaln You
Enterprises, Inc.Member :58%
LIQUOR LICENSE APPLICA■ON 05‐12 Page 3 of9
VILLAGE OF OAK BR00K
Charlotte K ms,Village Cl薇
12∞ Oak Brook Road
Oak BrooL 11linois 60523‐2255
(630)368‐5036 Fax(630)368‐ 5037
Name:
Address:
Rlchard Alan Melman
City/State,Zip
Drivers License Number: #
Position held with above narned business: LLC Manager
Eコ Yes [コ No AreyouacitizcniI11:,l:∥
)ち ,I:]り::izα″ο廻f/yο ″are α″α″ralizedε Jtセ “
g7″dPhone number:#
Date of Birth:
Place of Birth:
日No Are you a Namlized citizen?
Court in which (or law under which) you were naturalized_N/A
FOR EACH OF THEINDIVIDUALS LISTED PLEASE PROVIDE THE FOLLOWING INFORMATION:
Name:Kevin Justln Brown Phone number:#
Address: Date ofBirth:
City/State,Zip Place ofI〕irth:
Drivers License Number: #
Position held with above named business:LLC Manager & Member
S Yes E No Are you a citizen of the United States?□Yes tt No AreyouaNamlizedcttizen?
If you are a naturalized citizen give date and city of naturalization: NIA
Court in which (or law under which) you were naturalized_N/A
Name:Jay Lawrence Stleber Phone numbcr:#
Address: Date ofBirth:
Place ofBirth:City/State,Zip ,
Drivers License NШ ber: #
Position held with above nalned business: LLC Manager
国 Yes□No Are you a citセ en ofthe United States? □Yes ttNo AreyouaNamlセ ed citizen?
If you are a naturalized citizen give date and city of naturalization: N/A
LIQUOR LICENSE APPLICATION 05‐12 Page 4 of9
VILLAGE OF OAK BROOK
Charlotte K. Pruss, Village Clerk
1200 Oak Brook Road
Oak Brook, Illinois 60523-2255
(630) 368-5036 Fax (630) 368-5037
kvonachen@oak-brook.org
Court inwhich (or law underwhich) youwere naturalized N/A
Name: Marc Jacobs Phone number:#
Address:Date ofBIぬ : 6
City/State,Zip Place ofI〕i血 :
Drivers Liccnsc Nmber: #
Position hcld with above narncd business: Member
国Yes□No Are you a cittzen of■e Unittd States? 国Yes□No AreyouaNamlセ ed citizen?
Ifyou are a naturalized citizen give date and city of naturalization: N/A
Court in which (or law under which) you were naturalized N / A
Nalne: Phone nmber:#
Address: Date ofBirth:
City/State,Zip Place of Birthi
Drivers License Number: #
Position held with above named business: Member
□Yes□No Are you a citレ en of■e Unitd States? □Yes ttNo AreyouaNamlizedcH“n?
If you are a naturalized citizen give date and city of naturalization: NIA
Court inwhich (or law underwhich) youwere naturalized__a115
Name: Lettuce Entertain you Enterprlses, Inc. Phonenumber:# (773) 878-7340
Address: 5419 N. Sherldan Road Sulte 116 Date ofBirth:
Place ofBirth:City/State,Zip Chicago, IL 60640
Drivers License Number: # FEIN:
Position held with above named business Member
□Yes tt No Areyou acidzen oftheUnitd States? 回 Ycs□No Are you a Naturalized CHzen?
Ifyou are a naturalized citben give date and city of naturalization:
Court in which (or law under which) you were naturalized.
LIQUOR LICENSE APPLICAT10N 05‐12 Page 5 of9
Name:
Address:
VILLAGE OF OAK BROOK
Charlotte K. Pruss, Village Cler*
1200 Oak Brook Road
Oak Brook, Illinois 60523-2255
(630) 368-5036 Fax (630) 368-5037
kvonachen@oak-brook.org
Phone number: #
Date ofBirth:
Place ofBiJ山:City/Statc,Zip
Drivers License Number: #
Position held with above named business:
EI yes E No Are you a citizen of the United States?国 Yes ttNo AreyouaNamlirdcitizen?
Ifyou are a naturalized citizen give date and city of naturalization:
Court in which (or law under which) you were naturalized_
Name:
Address:
Phone number: #
Date of Birth:
Place ofBirth:City/Statc,Zip
Drivers License Number: #
Position held with above named business:
I Yes E No Are you acittzenof the United States?□Yes tt No AreyouaNamlizedcitizen?
If you are o naturalbed citizen give date and city of naturalization:
Court in which (or low under which) you were naturalized_
Name:
Address:
Phone number: #
Date of Birth:
Place ofBirttr:City/State,Zip
Drivers License Number: #
Position held with above named business:
回Yes ttNo Areyouac五 zm ofthc Unitd States?□Yes ttNo AreyouaNamlizedcttm?
If you are a naturalized citizen give date and city of naturalization:
Court in which (or law under which) you were naturalized.
LIQUOR LICENSE APPLICAT10N 05‐12 Page 6 of9
VILLAGE OF OAK BROOK
Charlotte K. Pruss, Village Clerk
1200 Oak Brook Road
Oak Brook, Illinois 60523-2255
(630) 368-5036 Fax (630) 368-5037
kvonachen@oak-brook.org
Name of person operating as General Manager of the premises:Michael 0stas
Name of person operating as Liquor Manager of the premises: Mlchael ostas
A Manager Application Form must be submittedfor the individuals named above. An initial application must
also include completed lingerprint 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 S1,000,000 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
(s1,000,000).
SUBMITTALS:
In addition to this application form the following must be submitted:
[-l O*,ral Fee plus Extended Hour Fee if Applicable
l-l C".tifi cate of Insurance
Liquor License Manager Application Form
Lease-If premises not beneficially owned by Applicant
Proof of completion of the Illinois Department of Alcohol and Substance Program by all
facility managefii and employees as is necessary.
LIQUOR LICENSE APPLICATION O5-I2 Page 7 of9
VILLAGE OF OAK BROOK
Charlotte K. Pruss, Village Clerk
1200 Oak Brook Road
Oak Brook, Illinois 60523-2255
(630) 368-5036 Fax (630) 368-5037
kvonachen@oak-brook.org
l-loroof 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.
Initial Applicants must also provide:
l-lrroof of ownership of premises (e.g. title report)
l-lRoo, 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.)
l-tornpleted fingerprint cards for each Corporate Officer, General Manager and Liquor Manager
.l-l-rrnployee 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 notifu 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-I2 Page 8 of9
VILLAGE OF OAK BROOK
Charlotte IC Pruss, Village Clerk
1200 Oak Brook Road
Oak Brcolq Illinois 60523-2255
(630) 368-5036 Fax (630) 368-5037
kvonachen@oak-brook. org
ATTESTATIONS:
[, Jay L. Stleber , the LLC Manager of the above licensee, hereby certiry under oath,
that the foregoing application is true and correct and all information previously submiffed 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.
APPLICANT Beatrix oak Brook LLC
BY:
Signature
Print Name
Title LLC Manaser
tleber
LIQUOR LICENSE APPLICATION 05-I2 Page 9 of9
壽パcoR CERT!F:CATE OF L:AB!L:TY!NSURANCE DATE(MM′DDHYY)
■■/06/20■8THiS CERTiFiCATE iS:SSUED AS A MAttER OF:NFORMAT:ON ONLY AND CONFERS NO R:GHTS UPON THE CERT:FiCATE HOLDER.THiS
CERT:F:CATE DOES NOT AFFIRMATiVELY OR NECATiVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLiCiES
BELOW TH:S CERT!F:CATE OF iNSURANCE DOES NOT CONST:TUTE A CONTRACT BETWEEN THE ISSulNG:NSURER{S),AUTHOR:ZED
REPRESENTAT:VE OR PRODUCER,AND THE CERTIF:CATE HOLDER.
:MPORTANT: :f the certificate hoider is an ADD:TiONAL:NSURED,the poiicy(les)must have ADDiT:ONAL:NSURED provisiOns or be endorsed.
:f SUBROCAT:ONIS WA:VED,subieCttO the tems and conditions ofthe po∥cy,cenain po:icies may require an endo時 ement. A statement on
this certincate does not confer rights to the certificate hoider in∥eu of such endorsementls).
PRODuCER
」MB Insurance Age,cy′ Inc.900 N Michigan Ave′ ■5th Floor
Chicago 工L 606■■
NX∥どし[ Darla Kinkade
]田 LE薫 1(312)9■5-2200 1闘 さ.Nd:(3■2)577‐0725
iiffit.", dkinkade@iubins.co&
埜 υRERIS)AFFORDINC COVERAGE NA:C″
INSURERA: Federal Inaurance Compail,2028■
:NSURED
Lettuce Enterta■n You Enterprェ ges′ Inc.
54■9 N Sheridan Rd
Chicago ■L 60640
INSURERB: Great Northerrr Ins. Co.20303
INSURERC: Contsinental Inaurance Company 35289
INSURERD: Safety National Casualtv CorD ■5■05
INSURERE: Chubb Inde$nity Insurance Co.■2777
lNSuRER F:
CERT:FiCATE NUMBER:Cort 工D6■090 REViS:ON NUMBER:THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED NOn川 THSTANDING ANY REQUIREMENT,TERM OR CONDIT10N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 1/VHICH THIS
CERTIFICATE MAY BE ISSuED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB」ECT TO ALL THE TERMS,EXCLUS10NS AND CONDIT10NS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
TYPE OFINSURANCE POLiCY NUMBER POLiCY EXP(M MIE2D中 〕A X35339232 02/28/20■8EACH OCCURRENCE s ■′000′000
02/23/2019 O RENTED
(Ea o@ren@)S ■,000,000X
MED EXP (Anv one Derson)S ■,000X
Policx二 ■gg: S■5M PERSONAL&ADV IN」URY S ■,000,000
ヽ.L AGGRECATE LIMIT APPLIES PERI
I POttCY□盤□Loc
GENERAL AGGRECATE S 3′000′000
PRODuCTS―coMP/OP ACG S ■,000,000
Liquor Liabi■ity S ■,000′000
「OMOB:LE L:AB!L:TY
I ANYAUTO職器日i鼈
73234■■1 02/23/20■8JMtsINEU !JINGLE LIMII
a a@ident)$ r, ooo, oooX
02/23/20■BODlLY IN」URY(Per persOn)S80DILY INJURY(Per aCddent)$XPROPERTY DAMAGE
`Per accideniヽSSC
[I懲 1∬H闊 誕∥ЮE 5085962387 02/23/20■〔02/28/20■EACH OCCURRENCE S 25′000′000
ACGREGATE s 25,000,000
DED I x lnerrruTror'rs 10,oooD
WORKERS COMPENSAT:ON
AND EMPLOYERS'L:ABILllヽ
N′ASP 4057887 ■2/3■/20■■2/3■/20■8XI酢 肝UTE I I蹟 H‐
朧 醐 罰締
翻 U麗 5う
∝UT VE□
じと場 腎聞 さ￡♂ 訃 ERATЮ NS bd“
L EACH ACCIDENT S ■′000′000
E L DISEASE‐EA EMPLOYEE s ■′000,000
E L DISEASE‐POLICY LlMIT ■′000,000
Workers ccmp & Empo Liab.
Workers Comp & Emp. Liab.
7■7■8989
7■7■8988
06/0■/20■806/0■/20■806/0■/20■`06/0■/20■SSee WC LinitB Above
See WC Linits Aわove
$ See Above
$ See Above
DESCR!P■ON OF OPERA■ONS′LOCA■ONS′VEHICLES(ACORD 101,Addた :ona:Remarks Schedu:●,may be attached ir m。"space is required)RE: Beatrix Oak Brook, 272 0akbrook center′ oak Brook′ 工L 60523
Nalned lnsured ェncludes: Beatrix oak Brook LLC
Vi■lage of Oak Brook is inc■uded as Additional 工ngured with respect to Ceneral Liabi■ity Coverageif required by written cOntract.
village of Oak Brook
1200 Oak Brook Road
Oak Brook IL 50521
SHOULD ANY OF THE ABOVE DESCR:BED POLiC:ES BE CANCELLED BEFORE
THE EXPiRA■ON DATE THEREOF, NO■CE W:LL BE DEL:VERED lNACCORDANCEV∥TH THE POLiCY PROV:S10NS.
AUTHORIZED REPRESENTA￢VE
〆る.4_5The ACORD name and logo are registered marks of ACORDACORD 25(2016′03)
Page 1 of 1
CORPORATION.A∥rights reserved.
||
EH日 日日e Liability lnsurance
Endorsement
Poliey Pariod
Etractive Date
Policy Numbar
lnsurad
srare Or POlitica′
SybdiЙ srion―Perm∴is
Operations For State Or
Political Subdivision
FEBRUARY 23.2018 TO 「LttRUARY 28,2019
「LuRUARY 28)2018
3533‐92-32 Cm
膨ErrucE ENTERTAIN Y01J ENT馴 劇PruSES INC
Na″θ οr Cottary ttERALINSIJRANCE CoMPANY
DaFe rss」θσ 織 BRUARY 28,2018
総 蕩″羹爛^躍 鑢 爾総 膠
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瀬攣
Ihis EndorFttnt appltsto由 にfo∥o宙 ng fom:
GttNERAI,1′lABIILI「Yji\\\i/7/rr$l&,}.ijit&ilN\t?l.tNl4rt{Jl"{#t$f/,4t\lr#Z}y.Jri{e1J}1}r(r!4l.r1Y u$rrilEzx,iiilt*zr/,@rw
Under Who [s An Insured, the following provision is added:
Who ls An lnsured
f//rtNiiTratTrtr hit's/7*ti.\5$tiz,lltiftt[]:'adrrit\. tr.y/,ti$it zalN ?trsvrrff*
Under Bodily Injury/Property Damage Exclusions, the following exclusion is added:
Qo cl i ly I njg ry/Praperty
Oamage Exclusions
Any state or political subdivision designatcd below is an insured: but they arc insrreds only with
respect to liability arising out of operations performed by you or on your behalf for which the state
or political subdivision has issued a permit.
This insurance does not apply to bodily injury or property damage included withio the producb-
complettd operations hazard arising out of operations performed for any state or political
subdivision designarcd as an insured.
姜 鋤螂贈繭輔醐織綴ドな翔醐磁翻燃W郷 囲躍ゞη輔漱額彰ぃ囲臨締御翻機ヽ翅籠醐幽翻卿贈翻囲融吻醐熙軸漏卿彙
Liabitity lnsurance
aa‐02‐2306 rRe′4θ り
ハddfa●●ar rnstlred―Sraゎ orメ b″」
“
rsυ 走」略 bり ‐乃 爾 ぉ
Under Policy Exclusions the following exclusion is added:
Po″qy Exclusions
Operatilons For Sfare Or This insurancc docs not appけ to bOduy ittry,prOperty damage,adve曲 聰呻 ry Orpemmal
わ′たわar SIJbd′νぉjO月 歯oury ttsin3 0ut ofoperations perfonned for any state or politlcal subdivision dcsignatcd as an
2HDsured.
DcsignatiOn Of Statc Or Polidcal Subdivisbn
AS REQUIRED FOR PERMrr BY THE CrrY FOR THE
ASSOCIATED LOCAT10NS ON ttLE WrrH CoMPANY.
All other terms and conditions remain unchanged.
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Form aa‐o22306 rRe′4‐οり Frldorsemert Page 2
VILLAGE OF OAK BR00K
Charl●tc K,Pr“s,Villtt Clerk
12000よ Br●●kR●3d
Oak Book,11■ mis 60523 2255
“
3の 3`●5036F察
“
30)368・ 5億7
L:QUOR L:CENSE
LANAC=R APPLiCAT:ON
Corporate Nami::
Buslne$s Name:
Beatrix Oak Brook LLC
Beatrlx
Ettblishment■lame: Beatrix
Steet Address 272 oakbrook Center Phonc#: (773) 878-7340
Applicant
Name:
Home
Address:
Mlchael Ostag
Phone#:
e‐nlall(wkl
Date ofB趨 漁: 9
Place ofB缶 山:PosHon held wm above namedbusinesS Cenera■Ma
City/State,Zip
Drivers Licensc#
□Yesメ
Eコ Yes/No
□Yesメ
ΞI::餓
□γes/No
frvr" DNo Are you a citizen ofthe unitcd stahs?I Yes d*" Are you a Naturalized Citizen?/
- Ifyou are a naturalized citizen give date and city of naturalization:
働″″加磁励″ム赫盟ル″滋′
`〃″
“
wα
`″
″
`“
燿′姥4
Do you possess a current Federal wagering and gaming device shmp?
Qfyes, provide details on reverse side)
Have you everbeen convicted of a violation of any Federal or State law concerning the
manufactwe, possession or sale of alcoholic liguor, or forfeited their bond for failure to appear
in court to answer charges for any such violation?
(Ifyes, provide date, offense, jurisdiction and case namber on reverse side)
Have you ever been convicted of a garnbling 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 stafirte replaced by any ofthe aforesaid statutory provisions?
(Ifyes, pravide date, offenre,jurisdiction and case number on reverse side)
Have you ever bern convicted of a felony?
Have you ever been convicted of being tle keeper o{, or is keepirg a house of ill fame?
Have you ever been convicted ofpandering or other crime or misdemeanor opposed to public
decency and morality?
LIQUOR Lで ENSE MANAGER APPHCA■ON FORM∝-2t6 Prgc I of2
「
ffi} c,#Hffiffiffi
1200 Olk Brco& Road\;kv' - ,"o,Tuf$lt'i'llffiffiii::il;,/ kvonachcn@oak-brook.org
f] yes ZI No Have you ever been convicted of a dnrg-related offense?
' (tfyo, provide date, offense, jurisdiction wd case number on rarute side),/
ft Yes d*t ' Have you pled guilty to or werc you ever been convicted of &iving under the influencg Class
Amidemeanof?
If yes, indicate on r€terse side date of guilty plea or date of conviction and if suspension given,
date of completion of suipension. '-2
./
flves ENo Have you successfirlly completed a State-licensed alcohol seller/server education program?
Ifyes, please prwide a copy of the Cetificate of Completion. If no, please orrange to attend a
Village of Oak Brook B.4.SSET program.
Liquor Handling Experience - Please provide name and address of any other liquor establishmenl in which you
have been employed or owned an interest.
Mtchael Ostas has becu employed wlth Lettuce Eatertaln You s{ncc 616120L3
I m oath stte thatI輛 Hnd宙 dtt anyご 饉oo●nm∝s of鮨 Ⅵllage JOよ
慰驚蠅躍正ll淑 温nhds σ ttc unittd States ofAmerica h the opmtion oftt placc ofbusincss“sc
me and cOrrect.
LIQUOR LICENSE MANACER APPLICA70N FORM 01‐201`Page 2 of2
BASSET Card OF
December 16,2016
MiCHAEL OSTAS JR
850 N STATE ST 20C
CHiCACO IL 60610
n'Student lD number" directly above to ,re-prilt your card.
lMPORTANT:
To【卜print your card,visitthe lttnois Liquor Control Conlmission website at iLCC∥∥nOis=gov
くC"Ck On the RESOURCES tabto accessthe“BASSET Card Lookup"page).
P-000367
∥∥鵬硼Ⅲ∥側朧ⅢⅧ脚[∥Ⅲ]∥Ⅲ∥]Letter il):L1033027664
License No.: 5A‐0052103
Expiration Date: lo/17/2019
License Type: Basset Card
Your "Student lD numbed' is: 000054*--.._^
Your "Trainer's tD number" is: 5A-0052103
Your BASSET Card is located BELOW
DO NOT throw away this letter as you will need your
Date of
Traincr's IL
HCHAEL OSTAS,
LCC301(N‐01′15)
: ′′
L二
=f■
1■
=11聖
1空 雪le-OFF‐PREMISE ONLY■■
lCXI W.Randolph Street,Suite 7■801‐Chcago,L60601
BEVERACE ALCOHOL SELLERS AND SERVERS
EDUCAT10N CARD
10ノ 17/2019