9a. Hilton Garden Inn ABCCity Hall
10300 Torre Avenue
Cupertino, CA 95014
(408)777-3212
Fax: (408) 777-3366
OFFICE OF THE CITY MANAGER
SUMMARY
AGENDA ITEM NUMBER J a"
SUBJECT AND ISSUE
Application for Alcoholic Beverage License.
BACKGROUND
AGENDA DATE April 15, 2008
1. Name of Business: BSL Family, LLC (Hilton Garden Inn Cupertino)
Location: 10741 N. Wolfe Road
Type of Business: Hotel/Restaurant
Type of License: On-Sale General -Eating Place (47)
Reason for Application: Person-to-Person Transfer and Annual Fee
RECOMMENDATION
Thexe are no use permit restrictions or zoning restrictions which would prohibit this use and staff
has no objection to the issuance of the license,
Prepared by:
Ciddy Word 11, City Planner
Submitted by:
David W. Knapp, City Manager
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Printed on Recvcied Paper
Department of Alcoholic Beverage Control State of California
APPLICATION FOR ALCOHOLIC BEVERAGE ~.ICENSE(S)
AAC 211 (Gl99)
TO: Department of Alcoholic Beverage Control File Number: 465315
100 Paseo de San Antonio Receipt Number: 165b385
Rm. I19 Geographical Code: 4303
San Jose, CA 95113 Copies Mailed Date: March 26, 2008
(408)277-1200 Issued Date:
DISTRICT SERVING LOCATION: SAN JOSE
First Owner: BSLFAMILYLLC
Name of Business: HILTON GARDEN INN CUPERTINO
Location of Business: 10741 N WOLFS RD
CUPERTINO, CA 95014-0613
County: ~ SANTA CLARA
Is premise inside city limits? Yes Census Tract 5081 .01
Mailing Address: 160 W SANTA CLARA ST .
(If different from # 9 0 0
premises address} ~ SAN JOSE, CA 95113
Type of licenses}: 47
Transferor's license/name: 451338 /SAND HILL HOTF Dropping Partner: Yes No
License Tvne Transaction Type Fe Master Dun Date Fee
47 ON-SALE GENERAL ] PER50N TO PERSON TRANSF P40 Y 0 0 3 / 2 0 / 0 8 $ I ,250.00
47 ON-SALE GENERAL I ANNUAL FEE P40 Y 0 0 3/ 2 0/ 0 8 $758.00
47 ON-SALE GENERAL 1 FEDERAL FINGERPRINTS NA N 4 0 3/ 2 0/ 0 8 $96.00
47 ON-SALE GENERAL ] STATE FINGERPRINTS NA N 4 0 3 / 2 0 / 0 8 $156.00
30 TEMPORARY PERMi' DUPLICATE NA Y 1 0 3/ 2 0/ 0 8 $100.00
Total $2,360.00
Have you ever been convicted of a felony? N o
Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the
Department pertaining to the Act? No
Expluin any "Yes" answer to the above questions on an attachment which shall be deemed part of this application.
Applicant agrees (a) that any manager employed in an on-sale licensed premise will have al l the
qualifications of a licensee, and (b) that he will not violate or cause or permit to be violated any of the
provisions of the Alcoholic Beverage Control Act.
STATE OF CALIFORNIA County of SANTA CLARA Date: March 25, 2008
Under penalty of perjury, each person whose signature appears below, certifies and says: (!) He is an applicant, or one of the applicanls, or an
executive ofricer of the applicant corporation, named in the Foregoing application, duly authorized to make this upplication on its behalf; (2) that
he hus read the foregoing and knows the contents thereof and that each of the above statements therein mude are ttue; (3) that no person other
than the applicant or applicants has any direct or indirect interest in the applicant or applicant's business to be conducted under the license(s) for
which this application is nmde; (4} that the transfer application or proposed transfer is not made to satisfy the paytnent of a loan or to fulfill att
agreetnent entered into morc than ninety (90) Jays preceding the day oa which the transfer application is filed with the Depnriment or to gain or
establish a preference to or for any creditor or transferor or to defraud or injure any creditor of transferor; (5) thnl the transfer application may
be withdrawn by either the npplicant or the licensee with no resulting liability to the Department.
Applicant Names} Applicant Signature(s)
BSLFAMII.YLLC 4PP 211 SignafLre Page
PMD LLC ~ It ~ t ~ ~- - 1 `
F~J9J»iCwvRSS DSiPAxi7i4Si~ii~
! ~
State of California Department of Alcoholic Beverage Cantroi
APPLICATION SIGNATURE SHEET ("SIGN ON")
• This form Is to be used as the signature page for 1. OWNERSHIP TYPE(Cfreckona)
applications not signed in the District Office. ^ Sole OWtler ^ Corporation
• Read instructions on reverse before completing. ^ Partnership ^/ Limited Liability Company
• Al! signafures musf be notarized in accordance wffh ^ Husband & Wife ^ Other
laws of the State where signed. ^ Partnership-Ltd
2. FILE NUMBER (if any) 3. LICENSE TYPE 4. TRANSACTION TYPE
^ Original [/` Person to Person Transfer
~ ^ Exchange ^ Premiss to Premise Transfer
451338 Type 47 ^ Other
5. APPLICANT(S) NAME(Lasl. first, middle)
PMD, LLC
6. APPLICANT'S MAILING ADDRESS (Slreel address/P.O. hox, dh~, stale, zIp coda)
160 West Santa Clara Street, Suite 900, San Jose, CA 951 ] 3
7. PREAMSES ADDRESS (Skeet address, dly, zip code)
10741 N. Wolfe Road, Cupertino, CA 95014-0613
APPLICANT'S CERTIFICATION
Under penalty of perjury, each person whose signature appears
below, certifies and says: (1) I-te/She is an applicant, or one of payment of a loan or to fu1811 art agreement entered into more than
ninety (90) days precedingg the day on which the transfer
the applicants, or an executive officer of the applicant
corporation, named in the foregoing ap tication, duly authorized
to make the application on its behalf; ~2) that helshe has read application is filed with fire Department, (b) to ain or establish a
preference to or for any creditor or transferor, or~c) to defraud or
injure any, creditor or transferor; (5) that the transfer application
the, foregoing and knows the contents thereof and that each of the
above statements therein made are true; (3) that no person other
t
direct interest
li
h
an
di
t
i
ti
th
li
t maybe withdrawn by either the applicant or the licensee with no
resulting liability to the Department.
ualif
I understand that if I fail to
for the license or witlidraw thi
can
s
y
rec
or
n
tan
e appp
can
or app
as
in the a licant or appPcani's business to be conducted under the
fer
e f
hi
h thi
(4
th
t th
t
li
li
ti
i
d y
q
s
application there will be a service charge ofone-fourth of the
Itcense fee
aid
u
to $iQO
or w
a
e
rans
cense
c
s app
ca
on
s ma
e;
)
ann)icatlott or nronosed transfer is not made to (al satisfv the p
,
p
.
SOLE OWNER
8. PW NTED NAME (Last, first, rNddle} SIGNATURE DATE SIGNED
X
PARTNERSHIPILIMITED PARTNERSHIP (Signatures of general partners only)
8. PARTNER'S PRINTED NAME (last, frs4 middle} SIGNATURE GATE SIGNED
X
PARTNER'S PRINTED NAME (Last, tksl, midde) SIGNATt11tE DATE SIGNED
X
PARTNER'S PRINTED MAME (Last. first, midde) SIGNATURE DATE SIGNED
X
CORPORATION
1D. PRINTED NAIL {last, frsl, middle) SIGNATIAiE DATE SIGNED
X
TITLE
^ President ^ Vice President ^ Chairman of the Board
PRINTED NANtE (Last, fast, midde) I SIGNATURE DATE SIGNED
X
TITLE ----. _.- --. _ -.
^ Secretary ^ Asst. Secretary ^ Chief Financial Officer ^ Asst. Treasurer
LIMITED LIABILITY COMPANY
11. The limited liability company is member-run ^ Yes ^/ No (If no, complete Item #12 below)
12. NAME OF DESIGNATED MANAGER, MANAGING MEMBER OR DESIGNATED OFFICER (last, firSL middle) ABC INITIALS/DATE (ABC use aYyJ
Donna, Peter Daniel
13 btEMBEfrS PRINTED NAME (Last. lira; ) SIGNATURE DATE SIGNED
Peter D. Donna and Marion M. Donna Trust 10/10/a X
MEMBER'S PRINTED NAME (Last, ixet, rtddde) SIGMA DATE SI b
By: Peter D. Donna, Trustee X ~ /
ABC-211-SIG (2103) "SIGN O ',
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of ?~~~~ ~~~-~-
r ~ S~1ar~hsr~
pn o7 r/~ ~ ~ before me, ~~ana
Date ,Q Here Insert Name and TIUe ai the Officer ~
personally appeared / ef~~ '~' ~~Q~~
Name(s) of Signer(s)
DItMMJ. SFIAI~MION
CcrrwNrNtm~ 1S6S10!
3arMo Clo~ro CaNtwrNa
Nlll-Ccntrn, b~
Place Notary Seal Above
who proved to me on the basis of satisfactory ev'sdence to
be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signature(s) on the
instrument the persons}, or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is
true and correct.
WITNESS my_hand and official seal.
Signatur ~ ~~~'~~''
tree of Nafary Publ~
~PTI~NAL
Though the information below is not required by few, !t may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number ofi Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer{s)
Signer's Name:
^ Individual
^
Corporate Officer-Title(s): -
Partner - ^ Limited ^ General
Attorney in Fac#
Trustee
^ Guardian or Conservator
^ Other:
Signer Is Representing:
Top of thumb here
Signer's Name:
^ individual
^ Corporate Officer -Title(s):
^ Partner - ^ Limited ^ General
^ Attorney In Fact
^ Trustee
^ Guardian or Conservator
^ Other:
Signer is Representing:
Top of Thumb here
®2007 National Notary Assoc~Uon •9350 De Sob Ave., P.Q. Box 2402 • Chatsworth, C.4 91313-2402 • wx~w.NeUonalNotaryorg flem A5907 Reorder. Cap Toq-Free 1-800-876.6627
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L
State of California Department of Alcoholic Beverage Control
APPLICATION SIGNATURE SHEET ("SIGN ON")
• This form is to be used as the signature page for
applications not signed in the District Office.
• Read instructions on reverse before completing.
• Al! signatures must be notarhed In accordance with
laws of the State where signed
Sole Owner ^ Corporation
Partnership~]/ Limited Liability Company
^ Husband & Wife ^ Other
^ Partnership-Ltd
2. FlLE NUMBER (f any) 3. LICENSE TYPE 4. TRANSACTION TYPE
^ Original ^/ Person to Person Transfer
451338 Type 47 ^ Exchange ^ Premise to Premise Transfer
^ Other
5. APPLJCAtVT(S) NAME (Last, first, middle)
BSL Family, LLC
5. APPLICANT'S MAILING ADDRESS (Sheet eddressJP.O. box, dty, slate, zip code)
160 West Santa Clara Street, Suite 900, San Jose, CA 95113
7. PREMISES ADDRESS (Sheet address, cky. zip code)
10741 N. Wolfe Road, Cupertino, CA 95014-0613
APPLICANT'S CERTIFlCATlON
Under penalty of perjury, each ppeerson whose signature appears payment of a loan or to fulfill an agreement entered into more than
below, certifies and says: (I} He/She is an applicant, or one of ninety (90) days preceding the day ott which the transfer
the applicants, or an executive officer of the applicant application is filed with t e Department {b) to ain or establish a
corporatloti, named in the foregoing ap lication, duly authorized preference to or for any creditor or transferor, or~c)) to defraud or
to make thes application on its behalf; ~2) that he/she has read injure any creditor or transferor; (5) that the transfer application
the foregoing and knows the contents thereof and that each of fire maybe withdrawn by either the applicant or the licensee with no
above statements therein made are true; (3) that no person other resulting liability to the Department.
than the appplicant or ap~plicants has any direct or indirect interest I understand that if i fail to qualify for the license or withdraw this
in the a licant or applicant's business W be conducted under the application there will be a service charge ofone-fourth of the
licensee for which this application is made; (4 that the transfer license fee paid, up to $100.
application or proposed transfer is not made to ~a) satisfy the
SOLE OWNER
8. PRINTED NAME (Last, 6ret, mldde) f SIGNATURE DA7E SIGNED
x ~
PARTNERSHIP/LIMITED PARTNERSHIP (Signatures of general partners only)
9. PARTNERS PRINrEU NAME (Last, flrs4 middle) SIGNATURE DATE SIGNED
X
PARTNER'S PPoNTED NAME (Leal, tka4 midde} SIGNATURE DATE SIGNED
X
PARTNER'S PRINTED NAME (Last, fist, rrdddle) SIGNATURE DATE SIGNED
X
CORPORATION
1n. PPoNTED NAME (Last, fM1St, rnidtNe). SIGNATURE DATE SIGNFJ]
X
71TLE
^ President ^ Vice President ^ Chairman of the Board
PPoNTED NAME (Last, lust, mWc4e)
SIGNATURE DATE SIGNED
~
X
TITLE
^ Secretary ^ Asst. Secretary ^ Chief Financial Officer ^ Asst. Treasurer
LIMITED LIABILITY COMPANY
11. The limited liability company is member-run ^ Yes Q No (If no, complete Item #12 below)
72. NAAt£ OF DESIGNATED MANAGER, MANAGING h~N~ER OR DESIGNATED OFFlCFJt {Last, fast, midtlte) ABC IMTIALS/DATE (A8C use ady}
Longinetti, Robert Louis
13. MEMBERS PRINTED NAME (Last, first, midde) SIGNA DATE SIGNF~
The Lvnginetti 1996 Revocable Trust ~~, -~ ~. - O~
MEMBERS PPoNTED NAME (Last, fast mime) DATE SIGNED
By: Robert Louis Longinetti, Trustee --- _ , ~
ABC-211-SIG (2/03) ~~ N"
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of ~-~~7 ~ (~~ ~~--
On ~'f~ ~ ~ ~ before me, ~iahef. J• khan hoh
Date ! Flare lr~rt Name and Tflle of the Oflicer
personally appeared ~ob~~ ~- ' LOh ~ ~ ~ '~ ~ ~ ('
Names f Signer(s)
DIANA J. SHANNON
Comml~aion ~ i 565109
~ Notartr [9ubiic - Coll(omla
Sara Gkrra County
My Comm. Eupireft Apr 25, 2009
Platte Notary Seal Ahave
wha proved to me on the basis of satisfactory evidence to
be the persons} whose name(s) is/are subscribed to the
within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signature(s) on the
instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand and official seal.
Signature ~~
Slgnatu Notary c
OPTIONAL
Though the information below is not required by taw, it may prove valuable to persons retying on the document
and could prevent fraudulent removal and reattachment of this loan to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
^ Individual
^ Corporate Officer - Tdle(s): -
C] Partner - ^ Limited ^ General
~ Attorney in Fact
^ Trustee
D Guardian or Conservator
O Other:
Signer is Representing
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Number of Pages:
Signer's Name:
D Individual
D Corporate Officer -Title(s):
^ Partner - D Limited D General
^ Attorney in Fact
^ Trustee
^ Guardian or Conservator
^ Other:
Signer Is Representing:
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X2007 NaBonal Notary Association •8350 De Sdo Ave., P.O. Box 2402 • Chatsworth, CA 9 1 31 3-2402 • www.NationelNotarytug Item 85907 Aeartfer. Ceq Tot-f-rea 1-8tX1.878~8827
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