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G-1189 - 06/22/2021 - LICENSE -ALCOHOL - Ordinances Supporting Documents ITEM 6.C.3 BOARD OF TRUSTEES MEETING vii 1^(,l OI SAMUEL E. DEAN BOARD ROOM OAK B R , K BUTLER GOVERNMENT CENTER �� 1200 OAK BROOK ROAD OAK BROOK, ILLINOIS 630-368-5000 AGENDA ITEM Special Meeting of the Board of Trustees of June 22, 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 tV BUDGET SOURCE/BUDGET IMPACT: N/A RECOMMENDED MOTION: I Move to Approve Passage of Ordinance G-1189, "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: Blanco Oak Brook d/b/a Blanco Tacos + Tequila has made application to the Village of Oak Brook for a Class A-1 Liquor License for their restaurant. Blanco Cocina+ Cantina is located at 2022 Spring Road. The approval of this liquor licenses will increase the number of Class A-1 liquor licenses in the Village of Oak Brook from 34 to 35. All Village's liquor license ordinance requirements for a Class A-1 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 special meeting of June 22, 2021. Enclosed for the Village Board's review is the Application for a Liquor License. BOT 062221 AGENDA Blanco Cocina+Cantina Liquor License Page 1 Recommendation: The recommendation is for Passage of Ordinance G-1189, which increases the number of Class A-1 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 A-I Liquor License to Blanco Oak Brook LLC d/b/a Blanco Cocina+ Cantina, 2022 Spring Road, Oak Brook, IL. BOT 062221AGENDA Blanco Cocina+Cantina Liquor License Page 2 FOR OFFICE USE Date ApprovedVILLAGE OF OAK BROOK License#Issued: 8' Charlone K Pruss,Village Clerk ` =��" 1200 Oak Brook Road Fee Received-, Oak Brook,Illinois 60523-2255 raewT. 1630)368-5036 Fax(630)368-5037 kvonachen a�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: EXTENDED HOUR FOR CLASS A-I LICENSE ONLY: Yes 8 No ® ADDITIONAL FEE: 500.00 Corporate Name: Blanco Oak Brook LLC Phone#: 480-905-6920 Business Name: Blanco Cocina + Cantina Phone#: 480-905-6920 Establishment Name: Blanco Cocina + Cantina Phone#: 480-905-6920 Corporate Address: Street Address 4455 East Camelbaek Rd. Ste B100 Fax#: 877-817-8662 City/State/Zip Phoenix, AZ 85018 E-Mail Address: Ikim@foxrc.com Contact Name: Leezie Kim Contact Title: Legal Phone#: 480-751-2161 E-mail address: Ikim(Wfoxrc.eom Establishment Address: Street Address 2022 Spring Road Fax#: N/A City/State/Zip Oakbrook, IL 60523 E-Mail Address: Ikim@foxrc.eom Contact Name: Leezie Kim Contact Title: Legal Phone#: 480-751-2161 E-mail address: Ikim(Mure.com State of Illinois Liquor License Number : UPON VILLAGE ISSUANfi Expiration Date: TBD List each specific location within this 1) BAR AREA establishment where alcoholic 2) Outdoor Patio liquor is being offered for retail sale: 3) Dining Room 4) 5) 6) Ownership of Premises: Owned For initial application, provide proof of ownership(e.g.title policy) Leased Q✓ If leased, provide copy of lease for full period of license and provide the following information: Name of Lessor: Oakbrook Shopping Center, LLC Address of lessor: 1005 Oakbrook Center City, State& Zip: Oakbrgok. IL 60523 TYPE OF BUSINESS: El Corporation Ej Individual/Sole Proprietorship 0 Limited liability Co. 93 Partnership Length of time in business: 15 Years Character of business: Blanco is a restaurant serving Southwestern and Mexican cuisine. The brand has been in business for over 15 years and was started in Tucson Arizona. I,IQ1JORLICI:NSFAPPLICA IION 5-12 Page 1o!'4 VILLAGE OF OAK BROOK Charlotte K !'toss,Village Cleric rr 1200 Oak Brook Road t, Oak Brook,Illinois 60523-2255 ;v.,, .. (630)368.5036 Fax(630)368-5037 kvonachenCwoak-brook org INDIVIDUAL/SOLE. PROPRIETORSHIP : Are you a resident of Oak Brook ® Ye ® No Other than an Individual/Sole Proprietorship this section must be completed bN 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 Arizona on the 11 th day of Decembee . 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 0 Yes 13No Please check which one: ® Illinois Business Corporation Act 8111inois Revised Uniform Limited Partnership Act EE 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[a Yes❑No Please check which one: El Illinois Business Corporation Act ®Illinois Revised Uniform Limited Partnership Act Q Illinois Secretary of State E3 Illinois Revised Uniform Partnership Act Registered Agent: Nance: Corporation Service Company Telephone#: 800-927-9800 Street Address 801 Adlai Stevenson Drive Fax#: N/A City/State/Zip Springfield, IL 62703 F-Mail Address: Southwestern and Mexico 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? (If yes,provide details on reverse side)(or on an addendum) ❑ Yes ❑✓ 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? (If yes,provide details 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 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? Qfyes,provide date, offense,.jurisdiction and case number on reverse side) ❑ Yes Ej No Has applicant made application for similar or ether liquor license on premises other than described in this application? LIQUOR LICENSE APPLICATION 05-12 Page 2 of 9 ` r s VILLAGE OF OAK BROOK Charlotte K Pruss.Village Clerk 6 1200 Oak Brook Road Oak Brook.Illinois 60523-2255 (630)368-5036 Fax(630)368-5037 kvonachen�g?oak-brookorg Qf.yes,provide disposition ofsuch application oil reverse side) ❑ Yes M 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(724 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 ✓❑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 ❑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 Blanco Holding Company LLC Sole Owner of Blanco Oak Brook LLC 100% FRC Management LLC Manager of Blanco Oak Brook LLC 0% Samuel Fox Manager of FRC Management, LLC 0% LIQUOR LICENSE APPLICATION 05-12 Page 3 of 9 I 4`` r 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 _ kvonachenYboak-brook.ar FOR EACH OF THE INDIVIDUALS LISTED PLEASE PROVIDE THE FOLLOWING INFORMATION: Name: Samuel Fox Phone number: # Address: Date of Birth: City/State, Zip Place of Birth: Drivers License Number: # Position held with above named business: Manager of FRC Management, LLC o Q Yes ®No Are you a citizen of the United States? 0 Yes Q No Are you a Naturalized Citizen? If you are a naturalized citizen give date and cihVf naturalization: N/A Court in which (or law under which)you were naturalized N/A Name: N/A Phone number: # Address: Date ot'Birth: City/State,Zip Place of Birth: Drivers License Number: # Position held with above named business: ❑ 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 or naturalization: t'run-r in which (or law under which)you were naturalized Name: N/A Phone number: # Address: Date of Birth: City/State, Zip -------- —-- _ Place of Birth: Drivers License Number: Position held with above named business: ❑ 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: LIQUOR LICENSE APPLICATION 05-12 Page 4 of 9 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 kvonacherKivoak-brook org Court in which (or law under which)you were naturalized Name: NIA Phone number: # Address: Date of Birth: City/State, Zip Place of Birth: Drivers License Number: # Position held with above named business: ❑ 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: Court in i vhick (or law under which)you were naturalized Name: N/A Phone number: # Address: Date of Birth: City/State, Zip Place of Birth: Drivers License Number: # Position held with above named business: ❑ Yes ❑ No Are you a citizen of the United States? [] 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 Name: N/A Phone number: # Address: Date of Birth: City/State, Zip Place of Birth: Drivers License Number: # Position held with above named business ❑ Yes ® No Are you a citizen of the United States? [] Yes ❑No Are you a Naturalized Citizen? If you arra naturalized citizen give date and cin,of naturalization: Court in which (or law raider which)you were naturalized LIQUOR LICENSE APPLICATION 05-12 Page 5 of ' VILLAGE OF OAK BROOK ` Charlotte K.Pruss,Village Clerk 1200 Oak Brook Road Oak Brook,Illinois 60523-2255 t h (630)368-5036 Fax(630)368-5037 kvonachen@oak-brook org Name: N/A Phone number: # Address: Date of Birth: City/State,Zip Place of Birth: Drivers License Number: # Position held with above named business: ❑ Yes Q] 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; Cow-t in which (or law under which)you were naturalized Name: N/A Phone number: # Address: Date of Birth: City/State, Zip Place of Birth: Drivers License Number: # Position held with above named business: ❑ 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: Court in which (or law under which)you were naturalized _ Name: N/A Phone number: # Address: Date of Birth: City/State, Zip Place of Birth: Drivers License Number: # Position held with above named business: ® Yes ❑ No Are you a citizen of the United States? ❑ Yes ❑ No Are you a Naturalized Citizen? Ifyou are a naturalized citizen gime date and city of naturalization: Court in which (or law under which)you were naturalized LIQUOR LICENSE APPLICATION 05-12 Page 6 of 9 i VILLAGE OF OAK BROOK _ F s Charlotte K.Pruss,Village Clerk ®' 1200 Oak Brook Road Oak Brook,Illinois 60523-2255 -. (630)368-5036 Fax(630)368-5037 kvonachen+a^,�oak-brook org Name of person operating as General Manager of the premises: Stephanie Blakeslee Name of person operating as Liquor Manager of the premises: A Manager Application Form must be submitted fir the individuals framed 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 __Certificate 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 managers and employees as is necessary. ___ Forthcoming LIQUOR LICENSE APPLICATION 05-12 Page 7 of 4 VILLAGE OF OAK BROOK y Charlotte K.Pruss.Village Clerk 1200 Oak Brook Road Oak Brook.Illinois 60523-2255 (630)368-5036 Fax(630)368-5037 kvonachen(a)oak-brook org Proof of completion of attendance by all facility managers and employees as is necessary of Alcohol Awareness Training Program conducted by the Oak Brook Police Department. --PLEASE CONFIRM Initial Applicants must also provide: �✓ Proof 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 ��j��Plan and Menu.) I • IC:'ompleted 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 05-12 Page 8 of 9 VILLAGE OF OAK BROOK y Charlotte K.Pruss,Village Clerk ® t► 1200 Oak Brook Road Oak Brook,Illinois 60523-2255 (630)368-5036 Fax(630)368-5037 kvonachen@oak-brook.org ATTESTATIONS: SAMUEL FOX tthhee�Managgeof Fm Bla ok Brook LLC eM LLC, I, , the 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. APPLICANT Blanco Oak Brook LLC BY: Signature Print Name Samuel Fox Title Manager of FRC Management; LLC, the Manager of the Applicant LIQUOR LICENSE APPLICATION 05-12 I'uar c t J l ® DATE(MMIDDrYYYY, AC40R" 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). PRODUCER CONTACT -- --- --_-- marsh Risk b Insurance sen^Ces NAME' PHONE CA License 00437153 FJW -- ___ __ Not: _ 633 Y4 HRh Si(eal.Suite 12& EMAIL Lns Angeles CA 9D076 o INSURER(6)AFFORDING COVERAGE NAIL k ('141028023fI2-UakBr-GI(2)21-22 FRC It 1NsuRER A:ACE American Inurance Company 22661 INSURED INSURER a:NIA WA The Cheesecake Factory Inco poraled — --- - Inciudes Fax Restaurant Concepts LLCa wbldity of INSURER e-N)� K% The Cheesecake Factory Incorporated INSURER D:NA WA 26901 Matw Hil!sRd _.. -- -_. Calabasas CA 91311 I"VAER E INSURER r: COVERAGES CERTIFICATE NUMBER: LOSM254341207 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 REOUIREMENT,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 TILE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITICTNS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. aJTfR M TYPE OF INSURANCE _ - POLICY NUMBER LICY EFF POLICY EXP - Ute$ — —� A X COMMERCIAL GENERAL LIABILITY XSLG72486389 04,09=1 04/092022 EACH OCCURRENCE S 1.+5wwo A D HDOG77489SM 04A M21 04,OM27 )�DAMAAGETORENT E� _ _ _._ _--- LLAMAS-MADE OCCUR 1,50DA00 QQ�MISE$L�iomrtarol MEDEXP ore a_)_ 5 NM PERSONAL a ADV INJURY S1000 0 GEN'L AGGREGATE LIMIT APPUES PER GENERAL AGGREGATE S 3—000w0 POLICr �T LOC PRODUCTS-COMPIOPAGG f 3ADDA00 OTHER I AUTOMOBILE LIABILITY COMBINE MGL L I S ANY AUTO BODILY INJURY(Par person) S OWNED SCHEMILEO BODILY 04JURY(PIN Kddwu) a AUTOS ONt Y AUTOS HIRED NON-OWNED PROPERWDAMAO S -- AUTOS OWY ;AUTOS ONLY fPM>toa0w ]_-__ S UMBRELLAL.IAO OCCLIR EACHOCCU1W"_C_E_ t EXCESS LIAR __. CLAIMS-MADE AGGREGATE S - OED ' RE TE HTIONf - WORKERS COMPENSATION F AND EMPLOYERS'UASILITY STATUTE __ Ya A, YIN NIA ELL-EACH ACCIDENT S OFFICEFUME-MBEREXCLUDED'r i - - - --- (Mandatory in NH) E.L.DISEASE-EA EMPLOYE S aPidescribe ter --.— DESCat RIPTION OF OPERATIONS babe E.L.DISEASE-POUCY LIMIT I S A Liquor Liability Coverage (XSLG72496389 fHDOG72489585) D4iU972071 04*M22 Each ComiKin Cauae'. 1,500,000 Poky Aggregate 3.000, —1� DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddRlwlal Rwnwks iekMuk,mil he atted"N mora space Is requnvd) Re Blarm Tacos+Tequila at 2022 Spine Road.Oak Brook,It IiW3(at Gakbmoh Cerow) Named Insured includes for Restaurant Concepts LLC,a subsidiasry of The Cheewcake FaMry klmrporabd Inuired kldudes BW=Oak Brook LLC dba Blanco Tams+Tequila(an FRC managed efi ft as roQOW by w itlen contract and in eccoroance w4h 9*temp and eoriam of the Generol tla ft policy The VllIaga of Oak Brook its officials employees,volunteers and agents as stated by Ortlowee,are Included as additional foamed*Tien required Oy wntlen owrtraa and In accordance*0 ale twirls aW conditions of the General Lathy policy CERTIFICATE HOLDER CANCELLATION Village of Oak Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1400 Oak Brook Row THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Oak Brook,It 50573 ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE of Marsh Rink a Insurance Services rr if'1988-2016 ACORD CORPORATION All rights reserved ACORD 25(2016)03) The ACORD name and logo are registered marks of ACORD t 1:0 _. i o o 1 .1 .1 00 00 00 o h0 00 00 r � as ao as 00 j Vt,. 11m � I - og 02 � o a c o •1 f T-7 r 0,6 00 cc . i 0 :Tp - p 'C qq qq pp t STARTERS 71 CHICKEN TORTILLA SOUP avocado,Sour cream,pico de gallo,queso blanco 8 ` WARM QUESO guacamole,sour cream,pico de gallo 10 ADD:GROUND BEEF .2 THE MARGARITA 11 GUACAMOLE,roasted poblano&anaheim chiles,caramelized onion, Jose cuervo especial,patron citronge cotija cheese 10 SKINNY 12 'ESQUITES'MEXICAN STREET CORN mayo,cilantro,lime,cotua cheese 9 ana maria rosado,smasbed orange, SHRIMP&CRAB COCKTAIL avocado, celery leaf,cilantro,radish 15 rose petal,agave NACHOS CON QUESO BLANCO avocado,creme freaca,black been,pico de gallo 30 SMASHED WATERMELON 12 ADD:SHORT RIB MACHACA+5 or RED CHILE CHICKEN+4 white tequila&chile line salt H U E N-SA L A DA BLUEBERRY& & LOWER 12 house infused fiorents rente&white tequila ADD GRD.LF,PCHICKEN.S! _ ; _ _ STRAWBERRY&HABANERO 12 + SIF LITTLE GEM CAESAR 12 sliced strawberry,arbol,habanero, CHEESE 9 t.. I P ,; chili line salt �_� � avocado,parmesan,bread crumb SHORT RIB MACHACA,`'` CRUNCHY TACO SALAD 13 JALAPEAO&PINEAPPLE 12 GUACAMOLE,CHARRED 0 ION 23 ground beef,black beans,avocado, chile verde liqueur&babanero bitters BBQ PORK&ROASTED CORN 12 tomato,roasted corn,cheddar cheese, THE SPICY SKINNY 12 pasilla ranch dressing Serrano chile,cuervo silver, RED CHILE CHICKEN 12 SEASONAL CHOPPED CHICKEN 15 agave,line ROASTED POBLANO CHILE apple,date,quinas,kale, DODGE'S CADILLAC 17 crispy sweet potato,pomegranate, &TOMATO 11 goat cheese,chili walnut vinaigrette don Julio&grand marnier ACES&EIGHTS 125oz1 21 I'll E 'I� U C S ON C111 M I C 11 A NU A white tequila,patron citronge, red sangria float SHORT RIB MACHACA 17.5 BRAISED CHICKEN 15 1, GROUND BEEF 15 BEAN&CHEESE 14 cheese, guacamole,sour cream,pico de gallo,rice&beans r UUMIk1iANGAS.'THt SOULF000O1111l SOUtHwLS1. ANr)VROOI COLD AS 1Cf THAT YOU C AN ALVVAYSMAKi A(:000THING8LTIIR AMFN + SINGIF $1 . THRFF WAY$?l T WO TACOS ON HANDMADE CORN TORTILLAS FROZEN PALOMAS f. ii Ti} SERVED WITH RICES,CHOICE OF BLACK OR CHARRCI RF ANS Classic grapefruit GRILLED MARI'avocado,cabbage,baja sauce,pico de gallo 16 guava 8 passionfruit spicy Y CARNE ASADA'charred scallion relish,crushed avocado,s garlic butter 16 raspberry&Chambord GRILLED AVOCADO spicy yogurt,cabbage,pickled onion,cotUe cheese 12.5 FROZEN MARGARITAS TRADITIONAL CARNITAS orange,chile,salsa verde,onion,cilantro 13.5 'lassie Cadillac BRAISED SHORT RIB'MACHACA'roasted poblano&onions,cotUa cheese 15 blood orange 8 pomegranate RED CHILE CHICKEN cabbage,shredded cheese,pico de gallo 13 TWO CRISPY SHELL GROUND BEEF shredded lettuce,tomato,yellow cheese 13 SLOW COOKED BBQ PORK roasted corn slaw,pickled onion, creme freaca 13 COMBO PLATTER 14 GROUND BEEF TACO, CHEESE ENCHILADA,BEAN TOSTADA F� t T r i) S s-f W y C ARAA!£t#tft?PEP9FRS L ONIONS.SLOT£,GUACAMOLE. J 1 j ,[1 L QLtz 'C£Or BLACK OR CHA0140 BEANS TIGER SHRIMP' GRILLED CHICKEN CARNE ASADA' spicy garlic butter 20 achiote citrus sauce 19 tomatillo soy marinade 22 SERVED WITH SOUR CREAM,GUACAMOLE,PICO DE GALLO 6 RicF CHOICE C'1F BLACK OR CHARRO BEANS BRAISED CHICKEN charred onion,cilantro,Jack cheese,red chile,warm queso sauce 14 SHORT RIB MACHACA caramelized peppers&onions,yellow cheese,ancho chile sauce,cilantro 16.5 CARAMELIZED SWEET POTATO grilled portobello,kale,zucchini,manchego cheese,ancho chile sauce 19 PORK CHILE VERDE charred onion,roasted pasilla,tomatillo,cilantro,cotija 14.5 CARNE ASADA'caramelized onion,charred scallion relish,Jack cheese,ancho chile sauce 17.5 CHEESE BROWN SUGAR CARAMEL FLAN 6 ENCHILADA 12 MEXICAN CHOCOLATE TIRAMISU maria's cookies, grilled onion, ancho chile sauce chocolate mousse,dulce de lecbe,candied walnuts 8 I ` 'THESE ITEMS HAT BE SERVED RAW OR UXDElCOOKl0.COXSOHDLRl1V OR XXD£lCOOKED HEWS.FOUtriY,SlAF000,SH£LLF:SH OR FOGS MAY INCREASE TOUR RISK OF FOODBORNE ILLNESS,ESPECIALLT IF TOO HAVE CERTAIN MEDICAL CONDITIONS TI'LM L00 A C 0 am N WINE BLUE SKY WHISKEY GINGER 13 GLASS / BOTTLE jack daniels tennessee whiskey, angostura, ginger beer BATANQA 12 SPARKLING CAVA OAXACAN SHANDY 12 jaume serra'cristalino'brut, pineapple, mexican beer, blance tequila, clove bitters, penedts, spain 10/ 36 blood orange liqueur, mexican coca-cola, cinnamon ane maria tequila, cilantro BLACKBERRY SANQRIA 11 / 31 SAUVIGNON BLANC LONG RIDE SOUTH 14 (stirred) blackberry, brandy, elderflover, villa maria, marlborough, maker's mark bourbon, lime, red wine new zealand 11 / 40 clove and orange bitters, MY BLUE BURRO 12 CHARDONNAY luxy cherry basic vodka, blueberry newton'skyside', LITTLE WHISKEY RITA 13 elderflover, lime, ginger beer Sonoma county, ca 12 / 46 old forester bourbon, STRAWBERRY SHANDY 12 ROSE signature sour, basic vodka, strawberry& torres 'de caste', catelunya, Johnnie walker float lime,mamitas agave seltzer spain 10 / 36 C P(NOT NOIR LAS C E R VE 'Z A S 7 pavette, ca 11 / 42 CORONA CORONA LIGHT • MODELO ESPECIAL P1NOT NOIR PACIFICO TECATE NEQRA MODELO valravn'fox block XIV', !6!� russien river valley, ce 15 / 56 COORS LIGHT BUD LIGHT . MICHELOB ULTRA MALBEC MAMITAS PINEAPPLE SELTZER terrazas'altos del plata', 1 ( mendoza, argentine 11 / 40 YAZOO BREWING'hopry hazy ipa' JACKALOPE BREWING 'thunder ann pale ale' CABERNET SAUVIGNON TENNESSEE BREW WORKS'hippies and cowboys ipa' guenoc, ca 10 / 36 YAZOO BREWING'nomad wheat ale' (RN�(tIrl FLIGHTS RIwnsw eRr I(1 MEZCAL FLIGHT 22 THE ULTRA FLIGHT 53 banhez'joven', milagro'single barrel', AZURIA 20 MILAQRO 20 FORTALEZA 23 creyente, don Julio'1942', PATRON 21 CASAMIGOS 21 EL TESORO 23 del maguey'vida' reserve de le familia TEQUILASERVED NEAT OR ON TME ROCKS, MAKE I 1 r rr,r R(:ARITA+ 11 ADO ANEJC, r ULTRA 1800 9.5 1800 10 MILAHRO 12 DEL MAQUEY'VIDA' 9 ANA MARIA'ROSADO'10.5 MILAQRO 10.5 GRAN CENTENARIO 12 MONTELOBOS EL TESORO 10.5 EL TESORO 11.5 EL TESORO 12.5 'MEZCAL JOVEN' 11 MILAQRO 11 PATRON 115 DULCE VIDA 13 CREYENTE 11 TEQUILA OCHO 11 TEQUILA OCHO 12 DOBEL DIAMANTE 14 CLASE AZUL 44 CASA NOBLE CRYSTAL 11.5 CASAMIQOS 12 DON JULIO 14 BANHEZ,JOVEN 10 DULCE VIDA 11.5 DULCE VIDA 12.5 PATRON 14 ILEQAL,REPOSADO 19 CASAMIQOS 11 SIETE LEQUAS 12 AZURIA 16 CASAMIQOS 14 PATRON 11 DON JULIO 12.5 CASAMIQOS 15 SIETE LEQUAS 11 FORTALEZA 12.5 FORTALEZA 17 DON JULIO 11.5 AZUAIA 13 MILAQRO'SINGLE BARREL' 23 FORTALEZA 11.5 CLASE AZUL 19 PATRON PLATINUM 24 AZURIA 12 DON JULIO'1942' 25 TAPATIO 110 12 RESERVA DE LA FAMILIA 25 CLASE AZUL 16 PATRON GRAN BURDEOS 72 CLASE AZUL 75 VR.LAGE OF OAK BROOK r Kathy Vonachen,Admin Asst 1200 Oak Brook Road Oak Prook,Illinois 60523-2255 (630)368-5036 Fax(630)368-5031 kvonachcn oak-brook.o LIQUOR LICENSE MANAGER APPLICATION Corporate Name: Blanco Oak Brook LLC Business Name: Blanco Cocina+ Cantina Establishment Name: Blanco Cocina+Cantina Street Address 2022 Spring Road,Oakbrook, IL 60523 phone#: TSA Applicant Phone#: Name: Stephanie Blakeslee e-mail (wk) I Ionic Address: Date of Birth: City/State, Zip Place of Birth: Drivers License#: Position held with above named business: General Manager ® Yes [_]No Are you a citizen of the United States? ❑ Yes ®No Are you a Naturalized Citizen? If you are a naturalized citizen gine date and cit),ref naturalization: N/A Court in K,hich (or Imsr under which)You were naturalized N/A ❑ Yes FKj No Do you possess a current Federal wagering and gaming device stamp? (IJyes,provide details on reverse side) F] Yes [Z 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 any such violation? (If yes,provide date, offense.jurisdiction and case number on reverse side) ❑ Yes ®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,ct seq.),as heretofore or hereafter amended,or as proscribed by a statute replaced by any of the aforesaid statutory provisions? (IJ yes,provide date, offense,jurisdiction and case number on reverse side) ❑ Yes ❑X No Have you ever been convicted of a felony? ❑Yes ®No I lave you ever been convicted of being the keeper of,or is keeping,a house of ill fame? i ❑ Yes CX]No I lave you ever been convicted of pandering or other crime or misdemeanor opposed to public decency and morality`? I-IQUOR LICENSE MANAGER APPLICATION FORM 081211 Page I of 2 a , VILLAGE OF AK BROOK t••, Kathy Vonachc i,Admin Asst 1200 Oi k Brook Road Oak Brook,111inc s 60523-2255 ' (630)368-5036 Fax( 30)368-5037 kvonachen@oa brook.org ❑ Yes ❑X No Have you ever been convicted of a drug-related offense? Qf yes,provide date, offense,jurisdiction and case number on reverse side) ❑ Yes ❑X 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 suspensi gn given, date of completion of suspension. ® Yes ❑No Have you successfully completed a State-licensed alcohol seller/server education pro am? If yes,please provide a copy of the Certificate of Completion. If no,please contact th 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. I have been employed as the assistant general manager of Olive&Ivy, a sister restaurant to the applican located in Scottsdale,Arizona. I worked in this position for the last_L_years. 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 4ave read and understand the Oak Brook liquor control ordinances and that the statements herein are true and correct. _ Signature f I i ! LIQUOR LICENSE MANAGER APPLICATION FORM 081213 Page 2 ort BASSET Stephanie Blakeslee Illinois BASSET Responsible Beverage Server Training t ti,"Armw Ytw: ►fly_°* n~, f4na &A, wnnx cc*r V A"n,wVd t,i Nbc u1mmRLIPOW the i#1 ees tage�e i i"a s*t thu n; *W 4 srmdt�trl� a btk�` ' . •* . rdYi faXi �.'tis�" BASSET I , x tt�f eftik-W of C iltt Irktim t#W%#'m&ttt Stephanie Blakeslee �%4?'�tt';=:` °.,it t„�#33,d7. :ief"Eti'l2T:'Yte�u'nt'++.t•.<_ afar`; �-,"I:�`#"^'j r'".r�.{.�Yt,._' .,,gr„�e�t,.j,:f ..'ti3111 Illinois BASSET Responsible Beverage Server Training i I t�f�t�cw,Z RF•Y>i.+fit•.t f ,:i. ..� �1:•_a z�3v'4'x