HomeMy WebLinkAbout[04c] Gambling
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Council Agenda Item ] C
MEETING DATE:
March 6, 2008
AGENDA ITEM:
Premise Permit - St. Joseph Lions Club
SUBMITTED BY:
Administration
BOARD/COMMISSION/COMMITTEE RECOMMENDATION: N/ A
PREVIOUS COUNCIL ACTION:
BACKGROUND INFORMATION: Annually the Council must approve all Premise Permits for
Lawful Gambling. As part of the renewal process each organization is required to submit a financial
summary illustrating that at least 10% of the gambling proceeds have been expended in the defined trade
area. Based on the submitted information the Ordinance requirement has been satisfied.
BUDGETIFISCAL IMPACT:
ATTACHMENTS: 1) Minnesota Lawful Gambling License Renewal Application;
2) Summary Financial Statement.
REQUESTED COUNCIL ACTION: Accept the Premise Permit application for the St. Joseph
Lions Club to operate lawful gambling at the following two sites: 1) El Paso Bar & Grill, 200 2nd A venue
NW; 2)La Playette Bar, 20 College Avenue N.
f:znu
G Conbvl
Minnesota Lawful Gambling
(LG200R) Lawful Gambling License Renewal Application
Corrections should be made directly on this application
Submit one check for the combined total of renewal fees, payable to State. of Minnesota
Organization requirements:
1. An organization license fee of $350 paid annually.
Authorization #: 2021
Organization: St. Joseph Lions Club
12870 287th St, St. Joseph, MN 56374
CEO: Joseph Aloys Bechtold
28263 Jade Rd,. St. Cloud, MN 56301
Treasurer: Lyle Kruse
10528 295th St, St. Joseph, MN 56374
(320)363-1262
Gambling Manager Requirements:
1. A gambling manager license fee of $100 paid annually.
Gambling Manager Authorization: GM-02021-002
Current license term: 6/1/2006 to 5/31/2008
Renewing license term: 6/1/2008 to 5/31/2010
(320)363-4298
County: Steams
[j) r Check this box If your l
lorganizatlon qualifies for I
I the waiver of the $350 I
I organization license fee I
defined In MN Statute
L _ 349.16 Subd~ _ J
(320)363-4483
Annual Goal for
Charitable
Contributions I~- ZS'" %
Current License Term: 6/1/2006 to 5/31/2008
Renewing license term: 6/1/2008 to 5/31/2010
[j) The individual listed is not renewing their license; We have enClosed a LG212
Avon, MN 56310 application for the new applicant.
Note: The gambling manager duties may not be assumed by an
Beoond: # 6~8W637st54 S ty in. dividual until they are licensed by the Minnesota
mpany. e em ure Gambling Control Board.
Gambling Manager Affidavit and Consent Statement
Scott David Bloch
17975 St Anna Dr,
(320)845-7843
1. I have never been convicted of a felony or a crime
involving gambling.
2. I have never committed. a violation of law or Board rule
that resulted in the revocation of a license issued by the
Board within five years before the date of the license
application.
3. I have never been convicted of a criminal violation
involving fraud, theft, tax evasion, misrepresentation, or
gambling.
4. I have never been convicted of (i) assault, (ii) a criminal
violation involving the use of a firearm, or (Hi) making
terroristic threats.
5. I have never been, or am I now, connected with or
engaged in an illegal business.
6. I have never had a sales and use tax permit revoked by
the commissioner of revenue within the past two years.
7. I have never, after demand, failed to file tax returns
required by the commissioner of revenue.
8. I do not owe $500 or more in delinquent taxes as defined
in section 270.72.
9. I have been an active member of the organization for at
least two years at the time of our organization's initial license
application, or have been an active member for at least the
most recent six months prior to the effective date of our
organization's license renewal.
10. I am not a gambling manager or an assistant gambling
manager for another organization. -
11. I am not a lessor, a member of the lessor's immediate
family ora person residing in the same household as the
lessor, or an employee of a lessor of a premises where this
organization has a permit issued from the Board to conduct
lawful gambling.
12. I am not involved directly or indirectly as a bingo hall owner,
manufacturer. or distributor.
13. I am not the chief executive officer of this organization.
14. I am not the treasurer of this organization.
. 15. I was not an officer of an organization at a time when an
offense occurred which caused that organization's license to be
revoked.
Background Check. By signature of this document, the
undersigned authorizes the Departments of Public Safety and
Revenue to conduct a criminal and tax background check or review
and to share the results with the Gambling Control Board. Further,
I understand, agree, and hereby irrevocably consent that suits and
actions relating to the subject matter of this gambling manager
license application, or acts or omissions arising from such
application, may be commenced against me or my organization and
I will accept the service of process in any court of competent
jurisdiction in Minnesota by service on the Minnesota Secretary of
State of any summons, process, or pleading authorized by the laws
of Minnesota.
Failure to provide required information or providing false or
misleading information may result in the denial or revocation of the
license.
Changes in the information submitted in this application will be
submitted in writing no later than 10 days after the change has
taken effect.
I have read this application and declare that all information
sUbmitte~J} a~:::;dcgna
Signature, in ink, of gambling manager applicant
Date: ~ ts3 /~
License Number: 2021
. License Expiration: 5/31/2008
Premises permit requirements:
1. An premises permit fee of $150 paid annually, 2. A separate resolution of approval including the site address from
the local unit of government, (The local unit of government does not sign this renewal application) and 3. A LG215
lease agreement for each site your organization does not own is required.
Stearns County
Gambling account # 1066706
.. .. 1st State Bank of St. Joseph
Organization owns this site: N .' 25 N College Ave, St. Joseph;
?oes your organization conduct bingo at this site Y!~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , _M~ _ ~~~~4_ _ _ _ _ _ _ _ _ _ _ _ _ _ " _
Is the local resolution of approv,al attached?@ N: If yes, the attach a list of the days and beginning times of your bingo activities.:
Site number 001
EI Paso Bar & Grill
200 2nd Ave NW, St. Joseph, MN 56374
~TownshiP of (if applicable)
[i]
Check this box if this site has been discontinued or will not be renewed.
Site number 003
La Playette Bar
20 College Ave N, St. Joseph, MN 56374
~TownshiP of (if applicable)
[i]!
i
Check this box if this site has been discontinued or will not be renewed.
Stearns County
Gambling account # 108911506
First State Bank of St. Joseph
Organization owns this site: N . 400 4th Ave NE, St. Joseph,
?oes your organization conduct bingo at this site Y /~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _~~ _ 5~374_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Is the local resolution of approval attached?@' N : If yes, the attach a list of the days and beginning times of your bingo activities.:
License Number:. 2021
License Expiration: 5/31/2008
Chief Executive Officer's ACknowledgement and Oath
I declare that:
I have read this application and all information submitted to the Board. All information is true, accurate and complete.
All other required information has been fully disclosed. I am the chief executive officer of the organization.
I assume full responsibility for the fair and lawful operation of all gambling activities to be conducted. I will familiarize myself
with the laws of Minnesota governing lawful gambling and rules of the Board and agree, if licensed, to abide by those laws and
rules, including amendments to them.
I certify that the gambling manager is bonded and licensed as
required per Minnesota Statutes.
I understand that failure to provide required information or providing
false or misleading information may result in denial or revocation of
the license.
A termination plan will be submitted to the Board within 30 days of
termination of our gambling operation.
I have read this application and declare that all
information submitted is true,. accurate, and.
complete.
Date: ----LJ~-OZ.
."'.................. .. .. .. ...................... ............................ .........................................................."'................ .. .....................
Mail complete renewal application (all pages), and
one check made payable to the State of Minnesota
for all renewal fees by: 4/1/2008
to: . Gambling Control Board
1711 W Co Rd B #300 S
.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .~~s.ey!I!~,. r':1~. .~~1.1.3. . . . . . . . . . . . . . . . . . . . .
Licensing Contact:
Email :
Phone:
Fax #:
Deb Lewis
deb.lewis@gcb.state.mn.us
(651)639-4077
(651) 639-4032
The information requested on this form (and any attachments) will be used by the Gambling Control Board (Board) to determine your
qualifications to be involved in lawful gambling activities in Minnesota, and to assist the Board in conducting a background investigation of you.
You have the right to refuse to supply the information requested; however, if you refuse to supply this information, the Board may not be able to
determine your qualifications and, as a consequence, may refuse to issue you a license. If you supply the information requested, the Board will
be able to process your application. .
Your name and address will be public information when received by the Board. All the other information that you provide will be private data
about you until the Board issues your license. When the Board issues your license, all of the information that you have provided to the Board in
the process of applying for your license will become public except for your Social Security number, which remains private. If the Board does not
issue you a license, all information you have provided in the process of applying for a license remains private, with the exception of your name
and address which will remain public.
Private data about you are available only to the fol/owing: Board members, Board staff whose work assignment requires that they have access
to the information; the Minnesota Department of Public Safety; the Minnesota AttomeyGeneral; the Minnesota Commissioners of Administration,
Finance, and Revenue; the Minnesota Legislative Auditor, national and intemational gambling regulatory agencies; anyone pursuant to court
order; other individuals and agencies that are specifically authorized by state or federal law to have access to the information; individuals and
agencies for which law or legal order authorizes a new use or sharing of information after this Notice was given; and anyone with your written
consent.
Organization Renewal App: Report
Minnesota Lawful Gambling
lG215 Lease fo.r Lawful Gam]).lin
Checkapplicableltem: .
____1. LJ-.for ne~appllcati()O.Submit with new ~iS8$pEm1litapplication.;
~2.Rltnewedfell$8.SUbmltwilhPremisespennit'renewa'. '" ,. ..... , , ." "
_3. New owner. EffectiYedate.. .., '.' 1..f..--1-..:::... Submit new or amended lease within 10 days aflernew lessor assumes ownership.
_4. Amended le.ase..: . . ..' .' . . ."':;':;"',,,, ,.
· Ch$Ck1hechar1ge(s)inthelease: ,_Rent ~Premisesname ----"Boolhlbar _Activltydla~ ----,Other
· Date lhat cl'lar!gesWIII beeffective.......::J-'~
"Both partiesmust initial and date all changes.
· Submitchan es at'least10 dabefore'1he effedIve date of the cha
Organization name Ucensenumber
'6/07
Pagelof2
02 oz.,
aty
State [Zip
MN
CAtlaL.E.TI9J?/d1
Name of lessor (if SSrlle as IegaJ
owner;WJitetn.~SAMe'~ .,,'
.. ....._,._ ,."C'..,
" ,:.SA#lE..
Buslnesslstreetaddress
aty
Check C-.J).u aCtivIties that will beconclUdBd
J::.-Pull-tclbs ~-tabs with dispensing device .0p/)oards4add'ewheel ___Pack:lleWlleelWith table :.Blngo'
"PUII-!tati,Tiptioard, ,andPaddlewheel.Rent ." {NO:'easetRlgtiired for Taffle.$S"
Booth operation -salesol'gambling equipmentbY'anemPloyee BIIr Gpenltion - sales rA gambling equipment wIt:t1inll teasecL
(or volunteer) llf a licensedcorganlzatioilwlthln a SllPiH'Cll2 endosull! . premises Qy anemployee of the lessor from a mmmClll a~ wllere:
that Is dlsl:lnct: from areas where food and beverages are sold. foOCl"andbeveragesareatsosold;' "., " ,. ','..' ,.', ...... '.' \
r----- - --~- - ~~~:~.~~.~------_--__;_--._.___,
,. .... .. ....... '" .,o::n,:;:o::=:.;'.:~~=~;.;..; .
L_________________ ________________
IfYouan~y.i~thequestion ~~t~mitS~_... if you a~nOtothe9ueSfj'?"aoo~,-r~~fili~are
basedonthefollowingmmtlinationsofoperatlon: . based onthdoll~,~nations,Of,Operaliof}:,
- . Booth operation - . Bar ~!:IC)(l,: .'",,;" ..; ;', ..' '. ;. . "". ...
- Booth operation and pulHab dispensing device - Bar OpeJ"!:ltl9fl1t,\'ith w.11-tablfl~sing ~ce;
-Booth operation and bar..operation - Pull-t3b~ispeosingcl~yice only;
- Boothop~ratiQrl,.bar operatlon,and pull-tab dispensing devite
':",.,',-'.:.\
00MPI.EI'E0NE0PIl0N: . ~'c ·
OptlonA:..otolO% of the gross profits per,month.
Percentage to be paid %
Option B: When .gross profits are,$4,OOO orless per month, $0. to Qption B: When gross profits are $1,000. or less per month, $0.
$400 per month ~ be paid. Amountto be pajd$ ,to $200. per month ImlYbe.paid.~ul1t IDbe pak!..$. .
-. ......... '",,' ,'- . "C',' ,-- _ -, 1
TI1e mcDd~umrerit alloWed InaYno~~c~ $2,~OOin IDtal
per month. for,al' organizatiOl15 at this Premises. .
""
Option C: $0 to $400 per month on the first $4,000 of gross
profit. Amount ID be paid $ .
PlUS, 0% to.10% of the gross profits may be.paid per month on
gross profits over $4,000. Percentage to be paid %
Bing()~el1t'
OptionD: 0 to 10% Ofthe!;/~proijtS~ ~onth frorrjalllav.tfiJ1
gambling activities held during bingo occasions, ~dudin9bar bingO.
Percentageto~~id % (",,";:;...;:;.;, ~\t'"
>.'Co '1;;.",\. .'," ":',", - t,O....i' ~",'>' 'e,.,., . .,
Option c: $0 to$2l)D-permontllonthefirst$1,Oo.o. of9ross' .
profits. Amount to be paid $
Plus, 0% to 20% of the gross profits maybe paid per month.on
gross profits over $1,000.. Percentage to be paid %
Bar Bin 0 Rent
.--:...- Option F: No rentmay be paid for bingo
conducted in a bar. '
Option E: A rate based on a cost per square fOot, not to exceed
11.9% of a CO.fllPi3~b,leco~t pelrsqIJarefoqt.to,rleased space,. as ;
approved by me director of the Garnblingcqn~l8Clard. No rent may be
paid for bar binQO.. ,Rate to. be paicl $ . . 'persquare fool:. .
The lessor must attath dOOJrnentation, verified by the organization, to
confirm the comparable rate and all applicable coststO be paid by the
organization to the lessor.
~.EtYl( BingQA~tivity
For any new bingo activity not previously
included in a Premises Permit Application,
attach a separate sheet of paper listing the
. days and hours that bingo Will be conductecl.
LG215 Lease for Lawful Gambling .Activity
6/07
~20f2
Iri eldditiQR,'tfIElBoard maY~the organization to
withhold rent for a periocI of up to 9D days if the Board
determines that Illegal gambling occurred on the premises and
that ~ lessor or Its employees partic:lpated in the illegal
gamIiIng aJenew ofJhe garnbling.and did not take prompt
action to stop theganibling. Continued tenancy of the
organization is alJ!:hQri~ 'JVithoIJtPllyment elf rent dUJiOg the
time period deten'ninect by the Boan:lforViolationsof,i:I)is ; i
provisIonrasauthorizedbyMinnesota Statutes 349.18,
~l(Cl).\ ..,... ....... '... ..>..... . '.'
. To the best elf the lessor's knoWledge, the lesspraffirmsthat
any_all games,ordeYic:2sJocab!dontile premises are not.. Rentall-indusive
being used, and are not .capab1e:ofbelngused, loa ~ner ...... . ~urlt!Spaidasrentbythe'OrganilatiO!lto the lessor are all-indusive.
that violates the prohibitions agatnstlllegCllganibllng 10 ''NO'QtnerservlceS oreicpensesprovidedor conbacted by the lessor may
Minnesota Statutes 609.75.. .' .. .' ...... '. '1 bepaidbytheorgani%ation,indudingbutnotlirnitedtotrashremoval,
. NotwithStandif19,'~.'n~ .RuI.... . ~ 7865:.022. 0,5l!b.Pa. ......rt 3,. .an....... .... )an... Itorial. a~ deaning ~, snow removal. . ~1aWn.servtd!s. ,eIectridty,
organization muSt COrItinue mal<ing rent paymenlSunder'" .... .... . heat, secunty, security monItoring, storage, other utilities or services,
the terms of this lea~' if theo~an~ation or its agents a~' .! and In the case of bar operations, cash shortages.
found to be solely respohsfbIefoianyIllegal g"mbllng), ........ i...... . .'. ..L<
conducted at this site, that is prohibited by Minnesota Rules. : Any other expenditures made by an organization that is related to a
7861.0260, Subpart 1, Item H or Minnesota Statutes 609. ~5, , leased premises must be 'approved by the director of the Gambling
unless the()rQani~tion's agents responsible .for the illegal .. Control Board. Rent payments may not be made to an individual.
gamblingactlvityarea1SoageotsOremploy~ofthelessor. ; . .
. The lessor must nOt mociifv Or terminate the lease In whole or Changes ~n lease. . . . ." .
in part because the organization reporteq, tl) a ~te.Prlocal..; . If.the I~ IS amended WIth no change in ownership, the organization .
law enforcement authorityor1he .Board,the cOndu(:fClf:D1~l twill ~bmit the amended lease to the Board at teast l~days bef'on! the
gambling actiVitY i!Jtl:h!s Site ii'l wiiidtthe organizationtlia nof1 'eff~ ~ate ?f the~nge..lf.achangeln ownershlP~1'$1 the
partidpate. . 'orgarnzation will submit an amended lease to the,Boardwlthin.10 days
, alter the new lessor has assumed ownership.
Lease Tenn
The tenn of this lease agreement will be concurrent with the '.'
premises permit I$Ued by the Gambling Control Board (Board).
ManBgement of Gambling ProbibitBcl
Th(:! owner of the premisesorthe IessorWillnotmanage the
conduct: of gambling at the premises.
Partic:iplllion. _ Players Prohibited
Thelessor, the lessor's immediate family, and any agents or
gambling employees of the lessor wiD not partidpate as p1"yers
in tilecDl'lducl:oflawful gambling on the premises.
II.IGa.nbli"fl .1'/'':'',' " '" .,'
. ~ ~ is a1fiare of tI1eprghibitionagainst illegal gambling
in Minnesota Statutes 609.is, and the penalties for illegal
gambling Violations In Minnesota Rules 7865.0220, Subpart 3.
other PrOhibitions
· Theles$orwill not impose restrictionS on the organization With respect
to providers (distrlbutors)ofgamblJn9--relatedequipmentand serviC2S
or in the use.ofnet: profits for lawful purposes.
· Thele$Or, any. person residiflQ in the same househOJdasthe lessor, .
tile lessor'simmecliate familY, and any agents or emplQyees of the
lessor wlIln()t: reguiretheorganiZation 1nperform anyac:tlon that
WQljldViolatest:citutel)l" rlJIe..:Thelessormustnotmodify or tennlnate
this lease In'wiiO\e or 1n part due to thelessor'sviolation elf.thIs . '
provision. If there is a dispute as to whether a violatiOn OCCl.II'1'ed,tile
lease will remain in effect pending a final determlnationbYthe .
Compliance ReylevI~J),(qRG) of the GamblingControl,Board..'1Jle
lessor agrees to al'bitratlOn w.Jlen a violation of this provision 1$ .
all~e~. Thearb!tratotshall be the Qt<;.
,.~ to permitted premises ...'
"V1eBoclrd and its agents, tI1ec:ornmissloners of revenue andPublit:. !, ."
safety and their agents,.ancl~aw enforcement personnel haveacassto
the permitted premises at any reasonable time durlngthe businesS'
of tile lessor. The organization has aa:ess t().lhe.permlttecl premises
during any tlme reasonable and when necessary forthemnduct elf
lawful gamblingonthepremlses.
Lessorrec:ords
The lessor must maintain a record ofalllT1Ol'ltW recelvedi'rom1he
organization, and make the record available to the Board ancllts agents,
and tilecommlssloners of revenue and public safety and .tbelragents .
upon demand.Therecnrd musl:bemaintalnedfor 3~1/2:years.., ;',
..."'~
Acknowledgment of Lease Terms t alftnnthatthis lease is the total and only agreement between the Iessoranclthe
organization, and that all obligations and agreements are contained in or attached to this lease and are subject to the approval Df
the 'director of the Gambling Control BiHlnL
Other terms
G.m.
o ~.
QuestIons? Contact the Ucensing Section, Gamblin,Q Control Board, at 651-639-4000. This publication will be made available in
alternative format (i.e. large print, Braille) upon request. The information requested on this form will become public iriformation When
received by the Board, and used to detennine your compliance with Minnesota statutes and rules governing lawful gambling activities.
Minnesota Lawful Gambling
LG215 Lease for LawfuJ Gamblin
Check applicable item:
---.'1. Lease fornew application. Submit with new premises permit application. .
X2, Renewed,ease. Submit wit!1premlses permit renewal. .,' .,
_3. NeY/owner. Effective date 0' l~., i'Submitnewor amended lease within 10 days after new lessor assumes ownership.
_4.Atmt.ndedlease . ...... . ...... .... .' ......../ ;,.'",.,'
e Ched<thecha'1ge(s}in.lheJease: ~Rent __Premises name ---..;8ooti1lbar ----.;..AcIlvil:ydlallge _Other
eDatethatd'laogeswlllbe effeCtive-----1--.J~
e 'Bothpartles mustinlllal anddate all chaJ'l98S. . . . .
e Submltd'la esatJeast10da before the effedlve date of.lhe cha e.
Orgardzationname I Ucenseoili I
City
'C,O' . E 'Av~ tJ.
Businesslstreet address City
6/07
Page1of2
!SIate
MN
pa~~
=:.~s~r.~,:~aSlegat ,J;:~~~,
'~
Check (~) all activities that will be'COnducted
~II-tabs _Pull-tabs with dispensing device l~rds.~lewheE!I ---..:PattdIeWheeI with ta~e---"Bingo~bingo
pun-tab,. Tipboan:l~andPactdleWheeIRent. (No ~reqliiredforra_j;ic .
BldboperationfSaies of gambllrlg l!qulpmentby an employee; Bar operation - sales of gambllOg equipment wlthln,aleese<l
(or volunteer) Of a Uteilsed organization WIthin asepara~ endosure Premises by an employee of the lessor from a common area Where
that Is distinct from areas where food and beverages are sold. food 'and bewrages arealsosOlit. ,;. , .... '0
r- --- - - --~:...... -.......'---!',~'~.~~'~......;._'~,.-~_.,...._~__~.~~.:_~,~~~,~..."
Doe.sY-' ........DD...,:ftth.r,~c:onduct.....
"". . from'aboo.-u,aeratiOnllt>""'.IGcId:ian? ____yes <..Jt...;i.' I"~,
L__~~~___~________ _______________~~
Ifyoua~'eStothe~on~:~tliml~_ifyou an5wEiedDO to the queStiona~,"rentlimitSare
based on 'the fuIIowingmmblnatlon$ofoperation:,.. based Ollttle fdIlowingccmblnationsqfOpel'al:ion:
- BoothoperatiOll i(;'" , .~ . Bar~!i.9fl,'i '",...,,,,,',,. ;.;.; . ,'<..< ,:,
- Booth operation and pull-tab dispensing device - Bar operyitiQ9 Wi,t;hJ?!JII..,t;:lRdl~ngd~.'
- BootliOperatiol'landbarope~tiono" .. ' .. Pulhmh.9i~n9~c;egnly, '
- Booth o~ratlon, bar operation, and. pull-tab dispensing device ' ,.
",::', ' ",';,:-.",,', i:.~'('i<f
COMPLEIE.ONEOPI':ION:.....r
OptiOn A: 'Ota 10%Ofltlegrossproflts per month.
Percentagetobepald %
, ,. " " ,...,....,. .....
TheJjiaJd{ll~mreniallOwed rnaYOot~ $~SOO in ~I.
pei inonl:l1 for ai' organizations attttis premises. "
",,::i'~', i,' ". ~> ~::',;, ',-: ,0,,:",' >}" -;",
~ONEOPtIoN::..,.
~CII'IA:f)tQ~Q% c)f1hegross profits per mCJl'itK
Percentage to be paid 20 '.. %, ' ..'
Option&: When gross profitsare.$4,OOO or Jess per monttl, $0 to Option B: When,gross profits are $1,000 or less per month, $0
$400 per month may be paid. Amount to be paid.$. to $200permqntli lTllly~paid. ~unt to~,PCIid.$
OptIon C: $0 to $400 per month OIl the first $4,000 of gross
profit. Amount to be paid $ .
PJus, 0% to 10% of the gross profits mC!}' be paid per month on
gross profits over $4,000. Percentage to be paid %
. ,Bi,ngo Re.nt\
Optfon D: ota 10% of the' groSspiJlfitsper rnorrto frOm aU 1~lfJft,d
gambling actlvitiesheldduring biilgoOCcaslons, excluding barbfilgo.
Percentage to be paid % .
option C: $0 to,$2oo permonth.onth~firSt.$l,OOO of gross
profits. Amount to be paid $ . . .
Plus, 0% to 20% of the gross profits may be paid per month on
gross profits over $1,000. Percentage to be paid %
BarBiri"odRent
~ Option F: No renflTlaybe paid fO,r~ingo
~~,c:ted in a bar. ' .,
<' ~,~ ~, '\..'" ,j~"~:\\\~~-4;
,'- "; '~' .:'; ::l,. ";__'
Option E: A rate based on a cost per square foot, notto exceed
;;00(0 of a c9mRa~bl~cost~r.square foptf9r I~.ased~ace,as.
aPProved by the dii"ectorofthe GamblingCOntr91 ~r!i~ tJd rent.l)1Ciy be
pi:\id for bar bingo. Rate t() be paiq $ .. per SQuare foot. . ...
' The lesSOr must attaCh dOOJmentation, verified by the orgimizatiorl, to
confirm the comparable rate.and all applicable costs to bepald.by the
organization tottle lessor.
New Bingo Activity
For any new bingo activity not previously
indueled in a Premises PermitApplication,
attaCh a separate sheet of paper Jisting the
days and hoursthatblngo will be conducted.
LG215 Lease for Lawful Ga.mbling.,Activ.it,y
6/07
~2of2
DlegaIGambling\"..'\,.'/( .. . "''' ......."
· The ~r is.~re Of the PfQhibitiO!l~~inst jIIegalgalnbling
in MinneSota Stafutes 6O~.75, and the penalties for illegal
gambling violations In Minnesota Rules 7865.0220, Subpart 3.
In~,fiBoard ma'f'~iheorganlzation to
withhold rent for a period of upto 90 days if the Board
del:ermines that Illegal gambling oa:urred on the premises and
that the lessOr or Its empIovees partidpated in the Illegal
gambling a knew ofthe.gambling .anddld not take pmmpt
actiootostoptheigambllng. Qlntlnued~ oftl1e
organizal:iOn is. authorized without: payment of rent during the
time period determined byti1eBoaft;! for violations of this
, provision; asaut:horlzed by Minnesota Stafutes349.18,
~onl(a)., ..,' ...., ..... .,
. To the beSt of the lessor's knowleclge, the lessoraffinris that
anyandall games<< devla!Slocated on the premises are not Rentall...indusive .'
being used, and are not capableofbeingusecl, Inamanner: . Amoums'paidaS,.,tbYtheorgariizationto the lessor are a1I-1ndusive.
that violates the prohibitions against Hlegaigambling in I 'NO other-serviceS Or expenSes provided or contracted by the lessor may
Minnesota Statutes 609.75. ...... ....... .... . I be paid by the organlzation, induding but noI: limited to trash removal,
. ==1t~~~~~.=~~an....,I~~~~~~==~utH~:V'
the terms of this I~, Ifthl!org~nizati()l'\ Of. Its agen,tsare'.: 1 and in the case of bar operations, cash shortages.
foundtobesolelyrespOnslblefbranyillegalg~mbIlng,:. . ......! .... .,', " ....... . ,,' ...... .......
conducted at this site, that is prohibited by Minnesota Rules" ! Any other expenditures made by an, organization that is related to a
7861.0260, Subpart 1, Item H or Minnesota Statutes 609.75, , leased premises must beapprovect by the director of the Gambling
unl~ thE!organization's~~ts ~ponsi!:lle.foI" the iIIe~a1. ". " Control Board. Rent payments may not be made to an individual.
gambling activity a~ ~Iso aQents orE!m~l~ of thE! 1~r: ... ...' .
.~~~~::=~~~,e;:~~~t~:'=~~WlthnochangeinOWll~iP' theorgarUzation
law enforcement authority or the Board, thecorii:JUctofm~l'rWlII ~bmlt the amended lease to the Boa~ atleastl~daysbefon!: the
. gambling activity at this site .in whiCh the Ot;gaOlzation did not1~ ~ate ~ the change. Jfachange 10 OwnershlpOCCUl$ithe
partidpate. . ,. 'organization WIll submit an amended lease to the Board within 10 days
. after the new lessor has assumed ownership.
Lease Tenn
The tenn of this lease agreement Will be concurrent With the
premises permit issued by the Gambling Control Board (Board).
Management of Gambling Prohibited
The owner of the premisesorthelessorWlH Jl()l:manage the
conduct of gambling at the premises.
Participation _ .Players Prohibited
The II!!SS()r,' thetessor's immediate family, and anyagel1l5or
gambling .empIoyees of the lessor will not partidpate as players
in the conductd'JawfuI gambling on the.premises. ' .
Other Prohibitions .
'.The1essol'W111 Jl()l:lmposerestrlctionsontheorganizatlon with'respect
to providers (dIstrIbutors):of gambling-reiated equIpment.andSelvices
or in the use of net profits for lawful purposes; .
· The lessor, anyperson residir19 in the same househoIdasttle lessor,
the Iessor'simmedlate family, and any agents or employees of the
lessor Will notrequiretheOmanizettion to perform any action that
WClUidvioiate statute or rule. The lessor must not modify or terminate
this lease in whole or In part due to the lessor's violation of this . .'
provision. If there is a dispute as to whether a violatlonoa:urred, the
lease Will remain in effed pending a finaldel:erminationby the
. COmpliance Revif!wGroup(CRG) Of the Gambling ControlBoar'd. The
lessor agrees to arbltration whefl a violation of this provision is
aneg~;.!M CJ~~tor shall be the CRG., I;, ., :;", " ..\'('c:. ",
Accessto(,erm~premises . .' ."
The Boar9i;lnd!t? agents, the coffil'llissionersofieVenue ~ndpubllc \\\
'. safety andthelragents,and law enforcEmentpersoMel haVe acx:essto
the permitted premises at any reasonable time dllringthe'business
Of the lessor. The organization has access to the perm~ premises
during anytime reasonable and when necessary for tile condud:of
lawful garnbling.on.thepren1ises. .' ,
'Lessor reCords
The lessor must maintain a record of all money received from the
organlzatlon, and make the rec:oni availableto'theBoard and its agents,
and themrnmissionersofrevenue and publiC safety .an(lt.l:lJr:~'
upon demanc:L 1herecord must be maintained for 3-~12year$. " . .
'j'.,
Acknowledgment of Lease Terms I affinn that this lease is the total and onlyilgreement between the lessor and the
organization, and that an obligations and . ~reements are contained in or attadled to this lease and are subject to the approval of
the director of the Gambling ContrOl Board. . "
Other terms
Sf. 3"05~" 1.1005 >, seoff BLoeH
. Lessee's business address
P.O. 51':
QuestionS? Contact the Ucensing Section, Gambling Control Board, at 651-639-4000. This publication wilt bernacle available in
alternative format (i.e. large print, Braille) upon 'request. The infonnation requested on this form will become publiC information when
received by the Board, and used to determine your compliance with Minnesota statutes and rules goveming lawful gambling activities.
"wrJ
C. ~-.: J) ~ .'
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Print nam~ and title of lessee
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