SPECIAL EVENT LIQUOR LICENSE APPLICATION – For Profit

Pursuant to the provisions of Chapter 13 of the Municipal Code of Arlington Heights, as now or hereafter amended, the Local Liquor Commissioner may grant a daily permit which shall authorize the retail sale of alcoholic liquors for consumption on the premises where sold, to any organization or group at any function given by that organization.

The fee for a Daily Permit – For Profit shall be $65.00/day. To pay by credit card call 847-368-5500 or mail payment to Village Manager’s Office: 33 S. Arlington Heights Rd., Village of Arlington Heights, IL 60005

In order to be eligible, applicant must already hold a State of Illinois Retail Liquor License.

The undersigned hereby submits the following information and states that the answers to the following questions are true and correct in every detail.

Name of Event

Brief Description of Event:

Date(s) of Event

Hours of Event

Company Name

Phone Number

Name and phone number of individual(s) who will be responsible for overseeing the serving of alcoholic liquors

Confirm that you understand that a valid Basset Certified person must be on premise during all hours liquor is served.

Yes

What controls will be instituted to ensure that the legal age requirements are met?

Please provide proof of Dram Shop insurance, in the form of a Certificate of Liquor Liability insurance. The Village of Arlington Heights must be listed as Certificate Holder and the event name, dates and location must be listed on the Dram Shop.

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All liquor sales must be concluded no less than 30 minutes prior to the end of the event for the day.

After receiving local approval, applicants must apply for a state license. Visit www2.illinois.gov/ilcc

By signing this Application, the undersigned acknowledges that s/he is familiar with the laws of the Village and the State related to the serving and sale of liquor. It is understood that the acceptance of payment of the fee does not constitute approval of the request for a Daily Special Event Liquor License- For Profit. If this Application is not approved, the Village will refund the entire fee paid.

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

For more information or questions, please contact the Village Managers Office at 847-368-5100 or Administration@vah.com

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Application Approved: ____________________________ (Local Liquor Control Commissioner)

Date Approved: ______________