Santa Cruz — Daily_License_Application_Authorization

Source: https://shf.santacruzcountyca.gov/Portals/1/County/sheriff/formsdocs/ABC-221.pdf

State of California Department of Alcoholic Beverage Control DAILY LICENSE APPLICATION ABC USE ONLY License # Receipt # Fee Complete all applicable items. Submit this application to your local ABC district office with $ the required fee (cashier’s check or money order) payable to ABC. Once the daily license Conditions Requested Diagram Requestedis issued, fees cannot be refunded. Listing of ABC district office is available at ☐Yes ☐No ☐Yes ☐Nohttps://www.abc.ca.gov/contact/district-offices/. Please visit https://www.abc.ca.gov/abc- License Type221-instructions/ for further instructions. ☐B & W ☐General ☐Special SECTION 1. ORGANIZATION AND LICENSE TYPE INFORMATION Organization Name Tax ID

Organization Mailing Address

LICENSE TYPE ☐ Special Daily Beer and Wine ($50.00) ☐ Daily General ($75.00) ☐ Special Temporary License ($100.00) ☐ Amateur Sports Organization ☐ Political Party/Affiliate Supporting ☐ Television Station per Section 24045.2 ☐ Charitable Candidate for Public Office or Ballot or 24045.9 B&P ☐ Civic Measure ☐ Non-profit Corporation per Section ☐ Cultural ☐ Organization Formed for Specific 24045.4 and 24045.6 B&P Charitable or Civic Purpose ☐ Person Conducting Estate Wine ☐ Fraternal ☐ Political ☐ Fraternal Organization in Existence over Sale per Section 24045.8 B&P Five Years with Regular Membership ☐ Women’s Educational and Charitable ☐ Religious ☐ Religious Organization Organization per Section 24045.3 B&P ☐ Social ☐ Vessel per Section 24045.10 B&P ☐ Other Special Temporary License ☐ Other: ($50.00) Per Section: License #: Amount: SECTION 2. EVENT DETAILS Event Dates Total # of Days Hours of Alcoholic Beverage Sales, Service and/or Consumption Virtual Event Mark Yes, if the event is 100% To ☐ Yes ☐ No virtual Event Address (Street #, Name, and City) Event Location Description (Jones Park, Pavilion A, etc.) Location Within the City Limit ☐ Yes ☐ No Event Type Type of Entertainment Event Open to Public ☐B arbeque ☐Dinner ☐Sporting Event ☐ Yes ☐ No ☐Birthday ☐Festival ☐Social Gathering Estimated Attendance Security Guard If Yes, How Many Outdoor Event ☐ Concert ☐Lunch ☐Wedding ☐Carnival ☐Mixer ☐Other: ☐Yes ☐No ☐ Yes* *If Yes, a diagram of the ☐Dance ☐ Picnic ☐ No event area is required REQUIRED ☐ By checking this box, you are certifying that you understand the requirements detailed in Business and Professions (B&P) Code Section 25682(c) which state that a nonprofit organization that has obtained a temporary daily license from the department must designate a person(s) to receive RBS training certification prior to the event, and that designated person(s) shall remain onsite for the duration of the event. SECTION 3. CONTACT INFORMATION Contact Person Phone Number Email Address

SECTION 4. SIGNATURES AND APPROVALS I attest that I am authorized by the organization named above to make this application on its behalf. Organization’s Authorized Representative Name Phone Number Signature Date Signed

Property Owner Approval By (Name) Required Phone Number Signature Date Signed

Law Enforcement Approval By (Name), If applicable Phone Number Signature Date Signed

District Office Approval By (Name) Phone Number ABC Employee Signature Issuance Date

The above named organization is hereby licensed, pursuant to the California B&P Code Division 9 and California Code of Regulations, to engage in the temporary sale of alcoholic beverages for consumption at the abovenamed location for the period authorized above. B&P Code Section 25682(c) requires that a designated RBS-trained person(s) shall remain on site for the duration of the event. Failure to comply with this requirement will result in immediate cancellation of the permit. This license may be revoked summarily by the department if, in the opinion of the department and/or the local law enforcement agency, it is necessary to protect the safety, welfare, health, peace and morals of the people of the State. ABC-221 (Rev.11/2023)