RES 2002-2330 - Appoint Mehron Maleki manager of Crowne Plaza Omaha Old Mill 1
•
STATE OF NEBRASKAFC ElvEt)
• -;t¢E HTq�, NEBRASKA LIQUOR CONTROL COMMISSION
02 SEP 25 fi ti 8: 46 Forrest D.Chapman
Executive Director
.cnS
:� �, 301 Centennial Mall South,5th Floor
CITY C
swj• `'f � L E R K P.O.Box 95046
Lincoln,Nebraska 68509-5046 O lt A H/. N L R 4 S / Phone(402)471-2571
yea:.. �:
RQ.'a,- Fax(402)471-2814
TRS USER 800 833-7352(TTY)
Mike Johanns web address:http://www.nol.org/home/NLCC/
Governor
September 23, 2002
Omaha City Clerk
Omaha/Douglas Civic Center
1819 Farnam Street
Omaha NE 68183
RE: Bristol Hospitality Beverage Company
dba Crowne Plaza Omaha- Old Mill
License#C-42186
Clerk:
Enclosed is a copy of the manager application for Mehran Maleki, being filed in
connection with the Class C liquor licensee, Bristol Hospitality Beverage Company dba Crowne
Plaza Omaha - Old Mill, 655 North 108th Ave, Omaha, NE 68154.
Please present this application to your City Council and send us the results of that action.
NEBRASKA LIQUOR CONTROL COMMISSION
•
� 1
Mary ess n
•
Licensing Division
nun
encl.
cc: File •
•
•
Rhonda R. Flower Bob Logsdon R.L. (Dick) Coyne
Commissioner Chairman Commissioner •
An Equal Opportunity/Affirmative Action Employer
Printed with soy ink on recycled paper
Application for Corporate Manager
• *Must Be A Nebraska Resident* RECEIVED
IV
Please submit in Triplicate
Return to: Nebraska Liquor Control Commission,PO Box 95046
301 Centennial Mall So.,Lincoln NE 68509 SEP 11 2002
Phone: (402)471-2571 Fax: (402)471-2814 Web address: http://www.nol.org/home/NLCC/
' s ,� ;LIQUOR LICENSE INFORbION
IVYATION3,, •�� � � zx. "
NAME OF LICENSED CORPORATION CLASS&LICENSE NUMBER
Bristol Hospitality Beverage Company Class C - 42186
TRADE NAME OF LICENSED PREMISE
Crowne Plaza - Old Mill
STREET ADDRESS OF LICENSED PREMISE CITY COUNTY ZIP CODE
655 North 108th Avenue Omaha Douglas 68154
On behalf of the corporation,I designate this individual as corporate manager
Signature of Corporate President/CEO:
. . 1..... `". z -ate`:. �`� y.K ..c a: .g
'�`APPLICANT`INFORMATION (MUST BE 2I OR OVER `
i
NAME(LAST,FIRST,MIDDLE,MAIDEN) SEX SOCIAL SECURITY NUMBER DATE OF BIRTH PLACE OF BIRTH
_
Maleki, Mehran F ,� - - ' - - N
HOME STREET ADDRESS CITY COUNTY STATE ZIP CODE
UCOM 3 2 )\n,et, S -• 3414 k S�eQ4 I3C
HOME TELEPHONE NUMBER BUSINESS TELEPHONE NUMBER DRIVERS LICENSE NUMBER&STATE
(I162) ' II - 6'2-`b ( 404 496-0850 H 1.2% 3 3 y 2 2—
_ ..: - • �� r "tEr C
SPOUSE'S INFORMATION(IF NOT MARRIED INDICATE : om va� - , k
FULL NAMEr (LAST,FIRST,MIDDLE,MAIDEN) SOCIAL SECURITY NUMBER DRIVERS LICENSE NUMBER
STATE
I ''FU AL --1 l`(L EE "P 1/<}l�(1JiSG)
/fJe-I4 �O .. — &
_ - - —
DATE OF BIRTH: / - PLACE OF BIRTH cy ktgcu - N I.(
I. READ CAREFULLY. Answer completely and accurately.
Has anyone who is a party io this application,or their spouse,ever been convicted of or plead guilty to any criminal charge. Criminal
charge means any charge alleging a felony or misdemeanor violation of a federal or state law;or 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 any
charges pending at the time of this application. If more than one party,please list charges by each individual's name.
❑Yes NI No
2. Have you or your spouse ever made application for any liquor license or manager for any liquor license? IF YES,for what premise give
license number and date.
DYES MONO
•
FORM 35-4013
REV 2/01
• PAGE 1
3. Have you or your spouse ever made a compromise settlement for violation of such laws? -,
OYES • a]NO
4. Do you,as a manager,have all the qualifications required by any person entitled to hold a Nebraska Liquor License?
Nebraska Liquor Control.Act(§53-131.01)
•
®YES ONO . , .
5. Have you filed fmgerprint cards and PROPER FEES(if check,make out to the NE State Patrol),with this application?
jgIYES ONO
v im ..,' .- r",a. ,' +a .r t'*:! f:7vaz,+z."'i0K-- ,,.:.rt--?:,:4-.N`...r s ai-. -„,.'!-.`-" or 9'Sy--.a `S .� s_h...-., .w: r. ,.:q y, .
.t�.` `,.L 4'`. ' f,4,,_RESIDENCES SINCE AGE 18 'PPLICANT-AND SPOUSE}MUST COMPLETEx} , ; , .4 ;t
APPLICANT:CITY&STATE YEAR SPOUSE:CITY&STATE YEAR •
FROM TO FROM TO
1 r ma�c//
e1n/Ac o ((tSWI.kg l/4....- \\`i -1 1 $2 S‘1ri.Cvse , N`\ iq 7el VI 1 o
o (c i 0, FL.- kt\t2 keWL1 .C 1 *WSbU'O , 9 A . k S $o V 1
QICcy, i) aii, FC \s$r tear\ CrAe. ar,avecti l, Ft ►(ols 15 5 to
w.F' '��� y KZ 1..Y� a?"Y�4 �.'x 1 T S �:nY�t- i 1.� _-IT, -'F�..1 '".yT" ;,�Vf"?iN "7' :1:".z _'^S "� r�i x�.�`�E.� x4 g `°''
` �-.,. i, ,4' , .µ t 4 r°I* EMPLOYERS 1-LIST LAST:TWO EMPLOYERS ' ` -*` . �,,,7 �"` T �
YEARO NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM TO ,.ten*- t .3 c 1 _ ► 1 t� r'
"tt L 204 k{c\� -rm W vr•,Ln c., ..SC t\j I' .{-,.AI 514,)1 ti.°3 --I el 4 -14`t o
\°\cit'( \e c\C 1.\01,' --01 >1li Qbcoc.Q2AGI\ `Fl-. 30N'Y'r\_ WA (c�S $u3 —577 —�1-`iv°
,i PER ONAL OATH"AND CONSENT'.OF INVESTIGATION; MUST BE SIGNED BY APPLICANT&SPOUS E.
STATE OF NEBRASKA ) Cclkwtkl'S SC I`1�1 G — 2c 1
SS • 11,s •
COUNTY OF ). °�Fi-
. BSc.
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,an affidavit may be attached,however,fingerprint cards are still required to be filed.
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 and inaccurate.
Signature of Applicant /CC. Signature of Spouse( applicable)
Subscribed in presence and sworn to before me this pci Subscribed i my present and sworn to before me this
day of N J Z.- t-7- . day of p744,N SJ- odd z .
•
9(...--Z
9_,...:g, d
Not gnature&SeaT Notary Signature& eal
GENERAL NOTARY-State of Nebraska GENERAL NOTARY State of Nebraska
KIMBERLY BOND KIMBERLY BOND FORM 35-4013
My Comm. Exp. Sept.25,2004 .::n + '- My Comm.Exp.Sept.25,2004 REV.2/01
GIvt'� 1'ti C. ICl iCt I9cj4 PAGE 2
Co�n41'� , Sc 1tS 1b —`20 14
-
''. :� i = e __- .4f` .-_ _ _ - f .kr:4;- " .i-1= :.--ram ,1 . rr
O _ /�R� - :',.��..f�t,�...'i--t 0�� ,7�T��F k.,.� .�ti�'r�sT�`-..�� �_. ]�� �'y {� -
o° / e ` ti Cl a . s
< q,.-."4...
q5,-'
s asp
• ip
ell.o
a
c-ri 'I
�-. 1-1
O ` ••i6'... - a m .
N n 1
x
r, DmY--//'..:
{'
le4L7/ - '''- I
et
�04,44#�Q, O T to .� I
. , .-, ,, )
k
107
It 9 1 N O C`\� \ tV
1-CFI G • % \
2
.- r
,. ,<,,
,. •
0 ,,, . .
t._, z, s ,,,, , ,..,,s,
, , ....,1 1E?
.., , , , r .1
........
,:_o ,, ...,
I.
N m \� (1\1I'Zf r, r \ '- O
gy„ L? ^ csi
,a,
fi
e�rjf� 0 gyp,, N \� ` 41 ,.,
n
r
•' _ _. ,
a
``,y m - = Y J---'t-1--,.,e -= rtV ," --F".m' �-_.:. -. . a
r J
RECEIVED
EXHIBIT A SEP 11 2002
BRISTOL HOSPITALITY BEVERAGE COMPANY NEBRASCK LIQUOR
LICENSED PREMISES IN STATE OF NEBRASII�NTROL COMMISSION
1. d/b/a Holiday Inn—Omaha Central I-80
3321 South 72nd Street
Omaha,NE 68124
Alcoholic Liquor Class C No. 42188
2. d/b/a Homewood Suites Hotel-Omaha
7010 Hascall Street
Omaha,NE 68106
Alcoholic Liquor Class C No. 42187
3. d/b/a Crowne Plaza—Old Mill
655 North 108th Street •
Omaha,NE 68154
Alcoholic Liquor Class C No. 42186
•
• RECEIVED
SEP 1 12002
NEBRASMUOR
SPOUSAL AFFIDAVIT OF NON PARTICIPATIOl
ONTRO COMMISSION
IN A LIQUOR LICENSE
The spouse, dal , acknowledges that he or she will have no interest, directly
or indirectly, in any part of the daily operations or profit of the business listed on the attached
Exhibit "A" as prescribed in Sec. 53-125(13) of the Nebraska Liquor Control Act. Such
individual shall not tend bar, stock shelves, write checks, sign invoices, represent themselves as
an owner or in any other way participate in any part of the operation of the licensed business.
The licensee/applicant understands that he or she is responsible for compliance with the
conditions set out above, and if such terms are violated the Commission may cancel or revoke
the license.
*** Please waive the fingerprint requirements.
nature of non participating spouse Signature o licensee applicant
OMAHA, NF
City of Omaha, Wec5ras&a : •Er
- „ .
1819 Farnam— Suite LC 1 tir- -+t a
ir
Omaha, Nebraska 68183-0112 0�.� �� ro
Buster Brown (402) 444-5550 .o
City Clerk FAX (402) 444-5263 o 'TED FE131°.��
September 25,2002
Bristol Hospitality Beverage Company Application to appoint Mehran Maleki
ATTN: Mehran Maleki manager of your present Class"C" Liquor
3321 South 72' Street Licenses for Crown Plaza Omaha Old Mill,
Omaha,NE 68124 655 No 108th Ave, Holiday Inn Omaha
Central I-80, 3321 So 72' Str., &
Homewood Suites Hotel Omaha, 7010
Hascall Str.
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 October 8, 2002.
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.
City Council Rule No. 14, requests each applicant to submit a signed statement
representing that a sign indicating the birth date for buyers of alcohol will be prominently
displayed on the licensed premises and that approved training in the proper procedures
for checking buyers' identification will be provided to employees. Attached is the
statement to be signed and returned (hand deliver, mail or fax) to the City Clerk's Office
before your public hearing. FOR YOUR FILE,ATTACHED SENT TO MANGER.
Since ly yours,
Buster Brown
City Clerk
BJB:clj
OMAHA. NF8
City o f Omaha, Weôras&aI l•
ffiritirl)W
1819 Farnam—Suite LC 1 ri � V
ttr
Omaha, Nebraska 68183-0112 0 �� m
Buster Brown (402) 444-5550 .e �
City Clerk FAX (402) 444-5263 O�,'rED FEBR�r4�
September 25, 2002
Mehran Maleki Application to be appointed manager of the
16604 Josephine Street Class "C"Liquor Licenses for Bristol
Omaha,NE 68136 Hospitality Beverage Company, dba
Crowne Plaza Omaha Old Mill, 655 No
108th Ave., Holiday Inn Central I-80, 3321
So. 72nd Str., &Homewood Suites Hotel
Omaha, 7010 Hascall Str.
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 October 8,
2002. 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.
City Council. Rule No. 14, requests each applicant to submit a signed statement
representing that a sign indicating the birth date for buyers of alcohol will be prominently
displayed on the licensed premises and that approv,ed training in the proper procedures
for checking buyers' identification will be provided to employees. Attached is the
statement to be signed and returned (hand deliver, mail or fax) to the City Clerk's •
Office before your public hearing.
Sincerely yours,
44e1
Buster Brown
City Clerk
BJB:clj
' , ,
ooa � ° .faDbo
b 0 -i •-
w•a•,. (-)) P P 'it: s-C
CD DCIQ COO ° C CD
, a s
vo
nod R �. � .
,y 4• = `1 no o
a