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RES 2012-0104 - Appoint Edward J Lube manager of Kiewit Fitness Center/Student Center `s w y- STATE OF NEBRASKA %I;W:',.✓+--��' ` I% Dave Heineman G ��it/g 1, NEBRASKA LIQUOR CONTROL COMMISSION 41�� ;,,,, • r... '_/- Governor f/i f 'c �7 Hobert B. Rupe ''- '-"'6� _/ / Executive Director • t "9R`x'�'a`� AI '�� 301 Centennial Mall South,5th Floor • Cr j<, Cie P.O. Box 95046 K Lincoln,Nebraska 68509-5046 am « December 23, 2011 �f >7t• Phone(402)471-2571 i �• Fax(402)471-2814 or(402)471-2374 �'U� �1�' TRS USER 800 833-7352(TTY) web address: http://www.lcc.ne.gov/ OMAHA CITY CLERK 1819 FARNAM STREET LC-1 OMAHA NE 68183 RE: Ciewit Fitness Center nd Alumni Sports Cafe LICENSE(#IK-46506 nd IK-79390 Dear Clerk: Enclosed is a copy of a manager application for Edward J. Lube in connection with the Kiewit Fitness Center and the.Alumni Sports Café both located in Omaha. Please present this application for manager to your City/Village Council or County Commissioners and send us the results of their action. . Sincerely, (16e, ; i •�/Ll;? '1�C�'i <-!i Jacqueline Rodriguez Licensing Division NEBRASKA LIQUOR CONTROL COMMISSION 402-471-2572 encl. Janice M.Wiebusch Robert Batt William F.Austin Commissioner Chairman Commissioner An Equal Opportunity/Affirmative Action Employer Printed with soy ink on recycled paper R CONTROL COMMISSION CONTROL COMMISSION lkfuot. .• ' .. •• •. . . .• - :. •a_Z/77- •e--07 • eZtie- -;-'41, Zii _IZ___ Signature of wills s f o . -, name of applying inilividord (Spouse of individual listed above) State of , .--- County of..-Deu vox The-fob instrument was acknowledged before me this 146s ..�%0 -v- 10 20 E l by 544,9c 3' c . cname of pesionim �� at t1w B�AtiIOTARY-1�aI • Aiataly ' < 1{p Ili'L t3 in compliancewimnmeADA,mr:spousal alrelawitoffionpatidpathth ilISINdfable Mother Somme far mama Itl,}Fig rk Atm maenad to plane the alternate tbs� � �G•C Lp FORM 3514176 DEC 2 8 2011 1' NEBRASKA LIQUOR CONTROL COMMISSION Forth 103 DEC 23 2011 Rev 1/2011 DEC 14 2011 NOV 2 9 2011 Page 5 of 5 NEBRASKA LIQUOR NEBRASKA LIQUOR NEBRASKA LIQUORCONTROL COMMISSION CONTROL COMMISSION CONTROL COMMISSION eherVAAI, 1.:q,N A .4 ] g t, . atillieogirilbeelrilog'iRigiN:vgiaqvu0;:=;t-..;== 1:',C / —4111411r ofl 5 re itt Co,A ,-i...4.,...___ , - Signature o' ,'• vidual involved with application Printed name of applying individual ._. (Spouse o I: ••ividual listed above) State of iliebraz Vsi County of The foregoing instrument was acknowledged before me this i 1 [0101 1date bY ' EI-ema V Kilo i clq rovoi name of person acknowledged Affix Seal cEezi NotaiyPublic signature . 1 GENERAL NOTARY-State ofNebtralta .. , I, ELENA U ICAHAIDAROVA _ ,_ ,- MY m.Gom MO.Yetaant 10.2014 • —• - • t-- II/ In compliance with the ADA;this spousal affidavit of n ' Ill ..:‘i 4 .L.i -formes for Persons with disabilities. A ten day advance period Is requested in writing to produce the alternate format. DEC 23 2011 FORM 35-4 1.713 Revised 1/2008 NEBRASKA LIQUOR . CONTROL COhAMISSPON CONTROL COMMISSION Page 3 of 5 ..t. e - MANAGER APPLICATION orree use INSERT-FORM3c RECEIVED NEBRASKA LIQUOR CONTROL COMMISSION 301 CENTENNIAL MALL SOUTH N 0 V 2 9 2011 PO BOX 95046 NEBRASKA LIQUOR LINCOLN,NE 68509-5046 PHONE: (402)471-2571 CONTROL COMMISSION FAX: (402)471-2814 Website: www.lcc.ne.gov Corporate manager,including their spouse,are required to adhere to the following requirements 1) Must be a citizen of the United States 2) Must be a Nebraska resident(Chapter 2—006)and must provide proof of voter registration in the State of Nebraska 3) Must provide a copy of one of the following: state issued US birth certificate, naturalization paper or US passport 4) Must submit their fingerprints (2 cards per person)and fees of$38 per person, made payable to the Nebraska State Patrol 5) Must be 21 years of age or older gg- 6) Applicant may be required to take a training course ^•,dN� , v'+e• `r'' fii l •..._>t �\4 a: s�". �� aff ��. W- '• . ?Y '�c $� aw'":. #L$r � � 4 �; r �;. .: a 93 . Sa 1 d"zj ¢ ' �1'7-4 � .•,a ..a! r Tv Name of Corporation/LLC: Sock es o man m Pam►+ .. y-.7 1�`• a. Jr'cr i.1.- ac<�2 ` +.y T� nAn't.� ti W� r ; 7 Ie hf r y • ittil r.e 1 Premise License Number: O(0. (if w application leave blank)/, Premise Trade Name/DBA: Jieiuif 1 i h' C Premise Street Address: ?L100 C it SS 31 City: 0 h t/1 6" State: Zip Code: 6,8` 78' Premise Phone Number: L40 Z. ' 260— 17 7 The individual whose name is listed as a corporate officer or managing member as reported on insert form 3a or 3b must sign their name below 46411"1-'4" y� _-- CORPORATE OFFICER/MANAGING MEMBER SIGNATURE (Faxed signatures are acceptable) RECEIVED RECEIVED Form 103 Rev 1/2011 DEC 14 2011 Page 2 of DEC 23 2011 NEBRASKA LIQUOR 1100020967 IEERASKA LIQUOR CONTROL COMMISSION SONTROL COMfv;a; SION DEC 2 8 2011 1' NEBRASKA LIQUOR CONTROL COMMISSION Forth 103 DEC 23 2011 Rev 1/2011 DEC 14 2011 NOV 2 9 2011 Page 5 of 5 NEBRASKA LIQUOR NEBRASKA LIQUOR NEBRASKA LIQUORCONTROL COMMISSION CONTROL COMMISSION CONTROL COMMISSION eherVAAI, 1.:q,N A .4 ] g t, . atillieogirilbeelrilog'iRigiN:vgiaqvu0;:=;t-..;== 1:',C / —4111411r ofl 5 re itt Co,A ,-i...4.,...___ , - Signature o' ,'• vidual involved with application Printed name of applying individual ._. (Spouse o I: ••ividual listed above) State of iliebraz Vsi County of The foregoing instrument was acknowledged before me this i 1 [0101 1date bY ' EI-ema V Kilo i clq rovoi name of person acknowledged Affix Seal cEezi NotaiyPublic signature . 1 GENERAL NOTARY-State ofNebtralta .. , I, ELENA U ICAHAIDAROVA _ ,_ ,- MY m.Gom MO.Yetaant 10.2014 • —• - • t-- II/ In compliance with the ADA;this spousal affidavit of n ' Ill ..:‘i 4 .L.i -formes for Persons with disabilities. A ten day advance period Is requested in writing to produce the alternate format. DEC 23 2011 FORM 35-4 1.713 Revised 1/2008 NEBRASKA LIQUOR . CONTROL COhAMISSPON CONTROL COMMISSION Page 3 of 5 r Manager's infotmation must be completed bolo* PLEASE PRINT CLEARLY *.-.rie. .646:C:miL.;1;q4. `'?`i r. _,, .. : r g4"..lo.:::iy 44-6..b-, 1 hti+.:, � r,w.,; ., .,..,:,.:,,.;..A....:: -r'. , .4 ii, . ,,,,, n:s.;:= Gender: [MALE 0 FEMALE Last Name: Z.v6,e— First Name: t IsJ eel MI:� Home Address(include PO Box if applicable): 3/17 4,4u1,44e %/,2 // l`-L7 City: /'ikitie County: S;./7 Zip Code: `r/o2s Home Phone Number: r03 3. -'?i,_D Business Phone Number:, feZ--- b'"/7 71 Social Security Number:` Drivers License Number& State:, _ - ) �, Date Of Birth: _ c • Place Of Birth: er�� 4k i a y�,� , i. , (tip! r�F i , ,3 � t� 3 a:iin 4 R i,'VOq�F �� kw.r ��a� '�+ �+• �':?-��ti�r�`.F 1"I.�r�I*Jl. �i r r'.,d, �i�n��x�,+�� r �, 9 ,F ` A` ,' '-`st. , k.F�' ,.y„41�i�'S 4ui. yf` ..,L`? •-4r �. 4� t ,FUtr t ti 1.k}'a, zrrvw•� rF';�' ,' +h�"t:' Mrtat'!: .,vaik :r ! P v.�-cr.t .:1,7 u ,L r. ,� F e.t.; .. .t_t: +u2 ,-4.. •in#.-s .., ._... ... .ti mt.. uA .... tp.‘ ❑NO " ��)�l r. � : 's "4 � 7� 3 Ai�i� { � � ii h a }e . ; y i . n i � �S } �yt j,. h , + . ,.; .c,,r. ,..>.�• �:.. `..-�3.Yi'�It73c._w_.tr•�.1; .r..�b,.. ">+L xvx„ R..>: ea,.ra.sSt�}::: raa!�t,i�.,. 4�':�zU ...1.:,1 .. ,. .._Yc3 c. `2.V . t _., Spouses Last Name: L v Lj C First Name: "--,747,A.A., MI: Social Security Number:,__i fivers License Number&State: '1. 5 Date Of Birth: _ i �- _ _ _ Place Of Birth: A fro ( f� VA r �0 y T Ir'Ikg ' •" 1 TC `�Sj FOR'ik6;PAS' U �o s % u �aX^;`."�' r '�a h » �S � r ti:ti a'k- -"k,��„,�� ,`k .f - r�. � -:�,t�S``a,r4•. �e <c 1 r n hr . ;� F; .1a 4 a r z l r E' s 3 f ' w ..1 !�tf� €��., .e 9 r:... �'. �a s ,.10,7 F.4k � r_ ,� .' ft1 'kt 3 40.. 4 Or � i r5r� � 1 i•J. 4 `t {s� x} v t• ,lA vC " � ^f '�',t;" p�d t i � ,�. s 77.. -�; I S Jra".lKr�4�sA4cr��r,.,�K c, 4 d9 ,2r e ^t i);: 7 tH▪ ,I .r� 56 �.<`J'vxd h p { Yt.p 1.� . -.t.k�.:3.�__.. . _N. � .�_.,. ��f�. ..,� =��> .,�v•... < ?� ... ►7i"- 1J.�71 :s:t"r T .� .,. ..}�,,. ...��. . . CITY& STATE YEAR YEAR CITY& STATE YEAR YEAR FROM TO FROM TO Col deAt.4 9q .5'C. 2007 frt , ;ECE11 �19,, , I - ''rt L/ 1"0 7 /o o3 o7 Nov 2 9 201 ‘lieVett) --e-• /9�9/ A005 NEBRASKA LIQUOR "+HOL COiViiWISSION RECEIVED RECEIVED Form103 Rev 1/2011 DEC 2 3 2011 DEC 14 2011 Page 3ofS NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION d Affix Seal cEezi NotaiyPublic signature . 1 GENERAL NOTARY-State ofNebtralta .. , I, ELENA U ICAHAIDAROVA _ ,_ ,- MY m.Gom MO.Yetaant 10.2014 • —• - • t-- II/ In compliance with the ADA;this spousal affidavit of n ' Ill ..:‘i 4 .L.i -formes for Persons with disabilities. A ten day advance period Is requested in writing to produce the alternate format. DEC 23 2011 FORM 35-4 1.713 Revised 1/2008 NEBRASKA LIQUOR . CONTROL COhAMISSPON CONTROL COMMISSION Page 3 of 5 ql '7'ie R:fS1 ''T{s :4 {+� t y t t' '-�'�j1y�r"�` i ,�`R ti n N s ^Y e 5, ' n t ,, ��j�^��h !vt F rcI r'i-a �{ �� lE�t7 J�iJ�Q� ,4:!111�1r��-------_. _��. � ,,'( h� 7! .._�_ YER� ..• ..._ YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE FROM TO NUMBER 1931 tt �l Gee Pc--Fig—S"510 M$AdEk ►sPOUst sT .0 W. ►' t tno BELoW= -I.,)- Please printclearly` 1. READ CAREFULLY. ANSWER COMPLETELY AND ACCURATELY. Has anyone who is a party to this application,or their spouse,EVER been convicted of or plead guilty to any charge. Charge means any charge alleging a felony,misdemeanor,violation of a federal or state law;a violation of a local law, ordinance or resolution. List the nature of the charge,where the charge occurred and the year and month of the conviction or plea. Also list an harges pending at the time of this application. If more than one party,please list charges by each individual's e. ❑ YES NO If yes, please explain below or attach a separate page. Name of Applicant Date of Where Description of Charge Disposition Conviction Convicted (mm/yyyy) (city&state) RECEIVED RECEWED DEC 14 2011 NOV B 9 2011 VESRASI LIQUOR NEB ASt,A LIQUOR CONIROL COMMISSION CONTROL COMMISSION 2. Have you or your spouse ever be approved or made application for a liquor license in Nebraska or any other state? YES ONO . IF , list then a of the J e. /� 7ir#17T LISP (-Apr rA- ef.r ee r�/ -7;-‘4, 3. Do you,as a manager,qualify under Nebraska Liquor Control (§53-131.01)and do you intend to supervise, in person,the management of the business? [ ''ES ENO 4. Have u enclosed the required fingerprint cards and PROPER FEES with this application? (C or money order made payable to the Nebraska State Patrol for$38.00 per person) ES ENO RECEIVED C : 2 3 2011 Form 103 Rev 1/2011 ICE RA3KA LIQUOR Page4of5 CONT OL COMMISSION d t i � ,�. s 77.. -�; I S Jra".lKr�4�sA4cr��r,.,�K c, 4 d9 ,2r e ^t i);: 7 tH▪ ,I .r� 56 �.<`J'vxd h p { Yt.p 1.� . -.t.k�.:3.�__.. . _N. � .�_.,. ��f�. ..,� =��> .,�v•... < ?� ... ►7i"- 1J.�71 :s:t"r T .� .,. ..}�,,. ...��. . . CITY& STATE YEAR YEAR CITY& STATE YEAR YEAR FROM TO FROM TO Col deAt.4 9q .5'C. 2007 frt , ;ECE11 �19,, , I - ''rt L/ 1"0 7 /o o3 o7 Nov 2 9 201 ‘lieVett) --e-• /9�9/ A005 NEBRASKA LIQUOR "+HOL COiViiWISSION RECEIVED RECEIVED Form103 Rev 1/2011 DEC 2 3 2011 DEC 14 2011 Page 3ofS NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION d Affix Seal cEezi NotaiyPublic signature . 1 GENERAL NOTARY-State ofNebtralta .. , I, ELENA U ICAHAIDAROVA _ ,_ ,- MY m.Gom MO.Yetaant 10.2014 • —• - • t-- II/ In compliance with the ADA;this spousal affidavit of n ' Ill ..:‘i 4 .L.i -formes for Persons with disabilities. A ten day advance period Is requested in writing to produce the alternate format. DEC 23 2011 FORM 35-4 1.713 Revised 1/2008 NEBRASKA LIQUOR . CONTROL COhAMISSPON CONTROL COMMISSION Page 3 of 5 .y i� 1i:i1 < ;;# ,,,,� -. , 1S` PI-,i�_ it,@:''' :,tfS .�1 .� t t:.' S 4_'',' n.. $ ` :: 'hi � �� f .� 4 r� �..-�ai 0 �j... '1 '�,^':a ' ,.. �g.re� - ,9.r.yk.:i •�{ t� �!- 14: IF '.-0, .0 rr r� "4'�, 1 '' r: ri <'i'•.`9 x,•;,,J�( c,Y,,,, .,�{{++a.��4��x... i, .4.." 4:::, t!_ro 4 t...��+.... Y--_. ,�C�:.s-,.;V �' �}��'?:—. .a.�'v'�;`.( >!�t7•�. a." .1:�`L '- . Yti':�7'.i.al�rt •i:., :�x•3•a,%:' The above individual(s), being first duly sworn upon oath, deposes and states that the undersigned is the applicant and/or spouse of applicant who makes the above and foregoing application that said application has been read and that the contents thereof and all statements contained therein are true. If any false statement is made in any part of this application, the applicant(s) shall be deemed guilty of perjury and subject to penalties provided by law. (Sec§53-131.01)Nebraska Liquor Control Act. The undersigned applicant hereby consents to an investigation of his/her background including all records of every kind and description including police records, tax records (State and Federal), and bank or lending institution records, and said applicant and spouse waive any rights or causes of action that said applicant or spouse may have against the Nebraska Liquor Control Commission and any other individual disclosing or releasing said information to the Nebraska Liquor Control Commission. If spouse has NO interest directly or indirectly,a spousal affidavit of non participation may be attached. The undersigned understand and acknowledge that any license issued,based on the information submitted in this application, is subject to cancellation if the information contained herein is incomplete, inaccurate, or fraudulent .40 4K. 44 PN S 16;;AL„ )Signature of t:141,,""Applicant Signature of Spouse ACKNOWLEDGEMENT State of Nebriska County of ` O t{.Q/.el4X The foregoing instrument was acknowledged before me this 100t (g/ �/I by E�,tt. �• /1GLAa name of person acknowledged ledged f jc_der .ft,(411-K /.bf Affix Seal Notary Public si•k1 1DeaGENERALNDR14-liateof tank ROBERTMICHMIDT *Ikon Mbt! In compliance with the ADA,this application is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. RECEIVED RECEIVED RECEIVED Form,03 DEC 23 2011 Rev inol l DEC 14 2011 NOV 2 9 2011 Page eof5 NEBRASKA LIQUOR NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION CONTROL COMMISSION NEBRASKA LIQUOR "+HOL COiViiWISSION RECEIVED RECEIVED Form103 Rev 1/2011 DEC 2 3 2011 DEC 14 2011 Page 3ofS NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION d Affix Seal cEezi NotaiyPublic signature . 1 GENERAL NOTARY-State ofNebtralta .. , I, ELENA U ICAHAIDAROVA _ ,_ ,- MY m.Gom MO.Yetaant 10.2014 • —• - • t-- II/ In compliance with the ADA;this spousal affidavit of n ' Ill ..:‘i 4 .L.i -formes for Persons with disabilities. A ten day advance period Is requested in writing to produce the alternate format. DEC 23 2011 FORM 35-4 1.713 Revised 1/2008 NEBRASKA LIQUOR . CONTROL COhAMISSPON CONTROL COMMISSION Page 3 of 5 I. gip , .: 'i ,ao> RECEIvEe,� •NON 1 �N , RECE'vE® M __ DEC 14 2011 301 C3114110111/AL MALL SO PO BOUM NEBRASKA LIQ �R NOV 2 9 2011 Fwwxn CONTROL COMMI SIOIJEBRASKA LIQUOR ONTROL COMMISSION • :4ikaitedPlid Ibint1re eofsl I * _ ::., I that Ivtffi�w. tha+. : b!. ►Ni.go at Oft ,.: .. :(;s3-1 oto t 4►i I will nOt lend 4 advi;:scne a twit Vie_or s E elves• e"gwamrc�t : ► iet e t eq ►: fir' ': 1112' . . 1. I .r‘ Sr'SA1/4— [ %kw, s. Wat- - Si of sfonsB aslchigfor waiver Printedof sponse=icing for waiver .abulivIdual` bled below) 1 Sate of 1��h VGCO`IY�A Calmly of V jbeAwgick‘ The finegolog bostruntent was acknowledged before me tbis eal • � t by ff Lug IVO 2.$ i I L it .1��(er `� • 1 eijmnieheige that Ina the l et`te downsteguinvittad.ivithirktmadthatmypriuseomIna 111011001ble far withiThe een,didats sit aetainme: 'fit 4 •mat i v cd( 53425(I3))tlm COnindadon m otr' liico�e. .• • ' .. .• . . . ' • . ; ...---.: , i of w Paidteap3ig®edna ha o .41. Zd2-Q.,___ (Spouse of individual listed above) Stabs of i N morns Countyof T zoksjk The foregobe Instrument was acknowledged before me ibis `%l/ or-en 10 :: 20 r l b, 1At.sera Lube.._ 1►c...) 1(41._. t •ffiSm Nada Nosy pr MAIL% l ♦ ::Jit:illl 11 2112 !"!. .. . Qaa� Jsa/ in°Milan with �ADA.�ba�afe oleare , � E1V5D Atmdegr ;obib to tupoem es imam tads DEC 2 8 2011 Rsrioed' NEBRASKA LIQUOR CONTROL COMMISSION NOWLEDGEMENT State of Nebriska County of ` O t{.Q/.el4X The foregoing instrument was acknowledged before me this 100t (g/ �/I by E�,tt. �• /1GLAa name of person acknowledged ledged f jc_der .ft,(411-K /.bf Affix Seal Notary Public si•k1 1DeaGENERALNDR14-liateof tank ROBERTMICHMIDT *Ikon Mbt! In compliance with the ADA,this application is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. RECEIVED RECEIVED RECEIVED Form,03 DEC 23 2011 Rev inol l DEC 14 2011 NOV 2 9 2011 Page eof5 NEBRASKA LIQUOR NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION CONTROL COMMISSION NEBRASKA LIQUOR "+HOL COiViiWISSION RECEIVED RECEIVED Form103 Rev 1/2011 DEC 2 3 2011 DEC 14 2011 Page 3ofS NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION d Affix Seal cEezi NotaiyPublic signature . 1 GENERAL NOTARY-State ofNebtralta .. , I, ELENA U ICAHAIDAROVA _ ,_ ,- MY m.Gom MO.Yetaant 10.2014 • —• - • t-- II/ In compliance with the ADA;this spousal affidavit of n ' Ill ..:‘i 4 .L.i -formes for Persons with disabilities. A ten day advance period Is requested in writing to produce the alternate format. DEC 23 2011 FORM 35-4 1.713 Revised 1/2008 NEBRASKA LIQUOR . CONTROL COhAMISSPON CONTROL COMMISSION Page 3 of 5 INSTRUMENT OF DELEGATION The undersigned,holding the office of Senior Vice President and General Counsel of SODEXO INC,appoints and delegates to the employee of the Company named below,holding the position described below,the authority to execute the documents specifically described below in connection to the below described transaction(s). This delegation is made pursuant to the authority contained in certain resolutions adopted by the Board of Directors of Sodexo, Inc., which resolutions remain in full force and effect. Transaction: Transactions related to liquor licensing and day-to-day on-site management. Documents: Documents related to liquor licensing and on-site management. Term: This delegation shall commence on the Effective Date of Delegation indication below and shall automatically terminate at the election of the Company. Employee: Edward J. Lube General Manager Creighton University Cindy Adair, Catering Manager(catering authorizations only) Effective Date of Delegation: November 28,2011 SODEXO, INC. By: / .0 -- g/(71----- Robert A. Stem Senior Vice President and General Counsel Attest: Scott Robins, Vice President,Associate General Counsel RECEIVED and Corporate Secretary NOV 2 9 2011 Signature Date: November 28, 2011 NEBRASKA LIQUOR RECEIVED CONTROL COMMISSION DEC 23 2011 RECEIVED NEBRASKA LIQUOR DEC 14 2011 CONTROL COMMISSION NEBRASKA LIQUOR CONTROL COMMISSION Nosy pr MAIL% l ♦ ::Jit:illl 11 2112 !"!. .. . Qaa� Jsa/ in°Milan with �ADA.�ba�afe oleare , � E1V5D Atmdegr ;obib to tupoem es imam tads DEC 2 8 2011 Rsrioed' NEBRASKA LIQUOR CONTROL COMMISSION NOWLEDGEMENT State of Nebriska County of ` O t{.Q/.el4X The foregoing instrument was acknowledged before me this 100t (g/ �/I by E�,tt. �• /1GLAa name of person acknowledged ledged f jc_der .ft,(411-K /.bf Affix Seal Notary Public si•k1 1DeaGENERALNDR14-liateof tank ROBERTMICHMIDT *Ikon Mbt! In compliance with the ADA,this application is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. RECEIVED RECEIVED RECEIVED Form,03 DEC 23 2011 Rev inol l DEC 14 2011 NOV 2 9 2011 Page eof5 NEBRASKA LIQUOR NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION CONTROL COMMISSION NEBRASKA LIQUOR "+HOL COiViiWISSION RECEIVED RECEIVED Form103 Rev 1/2011 DEC 2 3 2011 DEC 14 2011 Page 3ofS NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION d Affix Seal cEezi NotaiyPublic signature . 1 GENERAL NOTARY-State ofNebtralta .. , I, ELENA U ICAHAIDAROVA _ ,_ ,- MY m.Gom MO.Yetaant 10.2014 • —• - • t-- II/ In compliance with the ADA;this spousal affidavit of n ' Ill ..:‘i 4 .L.i -formes for Persons with disabilities. A ten day advance period Is requested in writing to produce the alternate format. DEC 23 2011 FORM 35-4 1.713 Revised 1/2008 NEBRASKA LIQUOR . CONTROL COhAMISSPON CONTROL COMMISSION Page 3 of 5 - - - ®MF►HA, Art . City of Omaha, Nebraska cp_ 1819 Farnam—Suite LC 1 z® `�� it Omaha, Nebraska 68183-0112 0 ' Buster Brown (402) 444-5550 A City Clerk FAX (402) 444-5263 o�9TED FEBRut+�� January 10, 2012 Sodexo Management, Inc. Application to appoint Edward J. Lube Dba"Kiewit Fitness Center/Student Center" manager of your present Class "I" and 2400 Cass Street Catering Liquor License location Omaha, NE 68178 Dear Liquor License Applicant: This letter is notification that a hearing before the Omaha City Council on your application to appoint a manager to the liquor license has been set for January 24, 2012 . The City Council Meeting begins at 2:00 P.M. in the Legislative Chamber, (LC-4), Omaha/Douglas Civic Center, 1819 Farnam Street, Omaha, Nebraska. City Council. Liquor Rule No. 6 states, "Each applicant for any type of license shall be personally present in the Council Chambers, in order that the Council may make inquiries, on the date of public hearing of the application for said license". Failure to be present at this Council Meeting is grounds to recommend denial of your application to the Nebraska Liquor Control Commission. Sincere y yours, Buster Brown . City Clerk • BJB:clj NEBRASKA LIQUOR RECEIVED CONTROL COMMISSION DEC 23 2011 RECEIVED NEBRASKA LIQUOR DEC 14 2011 CONTROL COMMISSION NEBRASKA LIQUOR CONTROL COMMISSION Nosy pr MAIL% l ♦ ::Jit:illl 11 2112 !"!. .. . Qaa� Jsa/ in°Milan with �ADA.�ba�afe oleare , � E1V5D Atmdegr ;obib to tupoem es imam tads DEC 2 8 2011 Rsrioed' NEBRASKA LIQUOR CONTROL COMMISSION NOWLEDGEMENT State of Nebriska County of ` O t{.Q/.el4X The foregoing instrument was acknowledged before me this 100t (g/ �/I by E�,tt. �• /1GLAa name of person acknowledged ledged f jc_der .ft,(411-K /.bf Affix Seal Notary Public si•k1 1DeaGENERALNDR14-liateof tank ROBERTMICHMIDT *Ikon Mbt! In compliance with the ADA,this application is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. RECEIVED RECEIVED RECEIVED Form,03 DEC 23 2011 Rev inol l DEC 14 2011 NOV 2 9 2011 Page eof5 NEBRASKA LIQUOR NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION CONTROL COMMISSION NEBRASKA LIQUOR "+HOL COiViiWISSION RECEIVED RECEIVED Form103 Rev 1/2011 DEC 2 3 2011 DEC 14 2011 Page 3ofS NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION d Affix Seal cEezi NotaiyPublic signature . 1 GENERAL NOTARY-State ofNebtralta .. , I, ELENA U ICAHAIDAROVA _ ,_ ,- MY m.Gom MO.Yetaant 10.2014 • —• - • t-- II/ In compliance with the ADA;this spousal affidavit of n ' Ill ..:‘i 4 .L.i -formes for Persons with disabilities. A ten day advance period Is requested in writing to produce the alternate format. DEC 23 2011 FORM 35-4 1.713 Revised 1/2008 NEBRASKA LIQUOR . CONTROL COhAMISSPON CONTROL COMMISSION Page 3 of 5 city of• Onalza, Webraskg `1 ' C sviordrvilikroz- 1819 Farnam—Suite LC 1 ® �� y �, 0� Omaha, Nebraska 68183-0112 �° Buster Brown (402) 444-5550 City Clerk FAX (402) 444-5263 O4, .13 F BR5t'I- January 10, 2012 Edward J. Lube Applications to be appoint manager of the Class "I" 3117 Comstock Avenue, Apt #7 and Catering Liquor License locations for Sodexo Belleuvue, NE 68123 Management, Inc., and Sodexo America, LLC (See Attached) Dear Liquor License Manager Applicant: This letter is notification that a hearing before the Omaha City Council on your application to be appointed manager of the liquor license has been set for January 24, 2012 . The City Council Meeting begins at 2:00 P.M. in the Legislative Chamber, (LC-4), Omaha/Douglas Civic Center, .1819 Farnam Street, Omaha, Nebraska. City Council Liquor Rule No. 6 states, "Each applicant for any type of license shall be personally present in the Council Chambers, in order that the Council may make inquiries, on the date of public hearing of the application for said license". Failure to be present at this Council Meeting is grounds to recommend denial of your application to the Nebraska Liquor Control Commission. Sincerely yours, .e5rtoz ,Szsi. Buster Brown City Clerk BJB:clj ECEIVED CONTROL COMMISSION DEC 23 2011 RECEIVED NEBRASKA LIQUOR DEC 14 2011 CONTROL COMMISSION NEBRASKA LIQUOR CONTROL COMMISSION Nosy pr MAIL% l ♦ ::Jit:illl 11 2112 !"!. .. . Qaa� Jsa/ in°Milan with �ADA.�ba�afe oleare , � E1V5D Atmdegr ;obib to tupoem es imam tads DEC 2 8 2011 Rsrioed' NEBRASKA LIQUOR CONTROL COMMISSION NOWLEDGEMENT State of Nebriska County of ` O t{.Q/.el4X The foregoing instrument was acknowledged before me this 100t (g/ �/I by E�,tt. �• /1GLAa name of person acknowledged ledged f jc_der .ft,(411-K /.bf Affix Seal Notary Public si•k1 1DeaGENERALNDR14-liateof tank ROBERTMICHMIDT *Ikon Mbt! In compliance with the ADA,this application is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. RECEIVED RECEIVED RECEIVED Form,03 DEC 23 2011 Rev inol l DEC 14 2011 NOV 2 9 2011 Page eof5 NEBRASKA LIQUOR NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION CONTROL COMMISSION NEBRASKA LIQUOR "+HOL COiViiWISSION RECEIVED RECEIVED Form103 Rev 1/2011 DEC 2 3 2011 DEC 14 2011 Page 3ofS NEBRASKA LIQUOR NEBRASKA LIQUOR CONTROL COMMISSION CONTROL COMMISSION d Affix Seal cEezi NotaiyPublic signature . 1 GENERAL NOTARY-State ofNebtralta .. , I, ELENA U ICAHAIDAROVA _ ,_ ,- MY m.Gom MO.Yetaant 10.2014 • —• - • t-- II/ In compliance with the ADA;this spousal affidavit of n ' Ill ..:‘i 4 .L.i -formes for Persons with disabilities. A ten day advance period Is requested in writing to produce the alternate format. DEC 23 2011 FORM 35-4 1.713 Revised 1/2008 NEBRASKA LIQUOR . CONTROL COhAMISSPON CONTROL COMMISSION Page 3 of 5 c 4. % 4� A 2 jfl ril . a it o n CD 2' � k % ° o ^ '• § II !; 6 kt . q J § ¢ \ c, 7 E , - - U 6 \ q q r , k 7 § ? % 1 q . 2 I r ri # 7 \ k F \ � C-