Supporting Documentation · Dec 4, 2024
Filing Letter to Board in Response to M Bennett Email with Exhibits 12 02 2024
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CORPORATE CHAIN, ATTACH A DIAGRAM DEPICTING THE CORPORATE RELATIONSHIPS AND THE PERCENTAGE OF STOCK INTEREST, IN THE COMPANY TO BE LICENSED, OWNED BY OTHER CORPORATIONS OR OTHER NON-CORPORATE ENTITIES (INDIVIDUALS, PARTNERSHIPS, ASSOCIATIONS). SEE ATTACHED ORGANIZATION CHART
Page 10A PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER _1802__-_ 33 -_005 -_011 ALL APPLICANTS ANSWER THE FOLLOWING (ADD PAGES AS NECESSARY) SOLE OWNERS AND PARTNERSHIPS: Complete the page in full LIMITED PARTNERSHIP: Ail information about a general partner or partners of a limited partnership must be reported, whether the general partner is an individual or a corporation. A list of the names and addresses of all limited partners must be submitted as an attachment to this application with an identification of the percentage of each limited partner as it relates to total ownership of the business entity to be licensed CORPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interest in the corporation under license or to be licensed must have been reported on page 10. Information on this page, 10A, will identify all officers, directors, and stockholders holding one percent or more of the shares of the respective company. Club licenses must list names of officers and directors and attach a current membership list NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP) Steele HGC Investment, LLC Name of individual (last name first), stockholder, partner, officer or director: / Siegel Steven Ss. Home Street Address Number lame Zip Social Security numbel Date of birth Fl Home telephone number Area Exchange Number —a- = 8=— as CU Area Exchange Number % of business owned or controlled 0% Number of shares Check position that applies: Sole owner Partner Stockholder _v President ____ Vice-President _W_ Secretary Treasurer _¥_ Director Trustee Manager Agent Executor/Administrator _ Receiver Beneficiary Other (specify) ame of individual (last name first): ¥ Martin James ("Charlie") Charles Last Name Middle Initial Home Street Address Number jet Name P.O. Box # Municipality State | Zig = ea ae | Home telephone number Office telephone number Area Exchange Number % of business owned or controlled __ 0% Number of shares Check position that applies: Sole owner Partner Stockholder President __ Vice-President Secretary _W Treasurer Director Trustee Manager Agent Executor/Administrator _____ Receiver Beneficiary _¥ Other (specify) Chief Financial Officer and Assistant Secretary
Page 10A PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER 1802 __- 33 -_005 - 011 ALL APPLICANTS ANSWER THE FOLLOWING (ADD PAGES AS NECESSARY) SOLE OWNERS AND PARTNERSHIPS: Complete the page in full LIMITED PARTNERSHIP: All information about a general partner or partners of a limited partnership must be reported, whether the general partner is an individual or a corporation. A list of the names and addresses of all limited partners must be submitted as an attachment to this application with an identification of the percentage of each limited partner as it relates to total ownership of the business entity to be licensed. CORPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interest in the corporation under license or to be licensed must have been reported on page 10. Information on this page, 10A, will identify all officers, directors, and stockholders holding one percent or more of the shares of the respective company. Club licenses must list names of officers and directors and attach a current membership list. NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP) Steele HGC Investment, LLC Jame of individual (last name first), stockholder, partner, officer or director: Rohnstock Kevin R Last Name st Middle Initial Number t Name Zip Home telephone number Office telephone number P.O. Box # es Exchange Number % of business owned or controlled 0% Number of shares Check position that applies: Sole owner Partner Stockholder ____ President _¥ _ Vice-President Secretary Treasurer Director Trustee Manager Agent Executor/Administrator ____ Receiver Beneficiary _¥ Other (specify) Assistant Secretary Name of individual (last name first): Resnick Eric c Last Name =_—_ Middle Initial 7 Street Name oe Box# Municipality il sate im Home telephone number Area Exchange lumber Home Street Address % of business owned or controlled 0% Number of shares Check position that applies: Sole owner Partner Stockholder ___ President ____ Vice-President Secretary Treasurer _¥ Director Trustee Manager Agent Executor/Administrator ____ Receiver Beneficiary _W Other (specify)_ Chairman of the Board of Directors
Page 10A PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER _1802__-_ 33 -_005 -_011 ALL APPLICANTS ANSWER THE FOLLOWING (ADD PAGES AS NECESSARY) SOLE OWNERS AND PARTNERSHIPS: Complete the page in full. LIMITED PARTNERSHIP: All information about a general partner or partners of a limited partnership must be reported, whether ‘the general partner is an individual or a corporation. A list of the names and addresses of all limited partners must be submitted as an attachment to this application with an identification of the percentage of each limited partner as it relates to total ownership of the business entity to be licensed CORPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interest in the corporation under license or to be licensed must have been reported on page 10. Information on this page, 10A, will identify all officers, directors, and stockholders holding one percent or more of the shares of the respective company. Club licenses must list names of officers and directors and attach a current membership list NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP) Steele HGC Investment, LLC Name of incividual (last name first), stockholder, partner, officer or director ¥ McDermott Peter R First Middle Initial Last Name Home sree Aaeress Number e P.O. Box # Municipality Zip Social Security number Home telephone Ta Office telephone number Area Exchange Number % of business owned or controlled 0% Number of shares Check position that applies: Sole owner Partner Stockholder ____ President ____ Vice-President Secretary Treasurer _W_ Director Trustee Manager Agent Executor/Administrator ____ Receiver Beneficiary Other (specify) Name of individual (last name first VJ Steele HGC Investment II, LLC Last Name First Middle Initial Home Street Address __100 St. Paul Street, Suite 800 Number Street Name P.O. Box # Municipality _ Denver state _CO Zip 80206 “5 Social Security number _ Date of birth rt Home telephone number ( < Area Exchange Number Office telephone number (720_) 284 _ 6400 ‘Area Exchange Number 100% % of business owned or controlled Number of shares Check position that applies Sole owner Partner Stockholder President Vice-President Secretary Treasurer Director Trustee Manager Agent Executor/Administrator
iness owned or controlled Number of shares Check position that applies Sole owner Partner Stockholder President Vice-President Secretary Treasurer Director Trustee Manager Agent Executor/Administrator Receiver Beneficial ¥ _ Other (specify,)_Member ry
Page 10 PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER 1802 __- 33 - 005 -011 QUESTIONS TO BE ANSWERED BY CORPORATIONS ONLY. ANY CORPORATION THAT IS REPORTED TO HAVE AN INTEREST IN THE BUSINESS TO BE LICENSED, WHETHER THE LICNESEE COMPANY, THE PARENT CORPORATION OR THE LICENSED COMPANY, HOLDING COMPANY, OR OTHERWISE AFFILIATED IN THE CORPORATE CHAIN MUST ANSWER THE FOLLOWING USING SEPARATE PAGE 10 AND 10A FOR EACH CORPORATION. ANSWER QUESTIONS ON BOTH PAGE 10 AND 10A FOR EACH CORPORATION. 10.4 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 Name or corporation _Steele HGC Investment II, LLC Street address of home office _ 100 St. Paul Street, Suite 800 Number Street Name Municipality _Denver State __CO Zip 80206 . NJ Sales Tax Certificate of Authority Number _N/A IF CORPORATION ADDRESS IN NUMBER 10.2 ABOVE IS OUT OF STATE, REPORT BELOW THE ADDRESS OF ANY OFFICE LOCATION IN NEW JERSEY, INSERT N/A IF NONE. Street Address_N/A Number Street Name Municipality New Jersey Zip : IS THE CORPORATION NOW AN EXISTING, VALID CORPORATION? ¥_y DATE CHARTERED OR INCORPORATED CERTIFICATE OF INCORPORATION NUMBER | IF NOT INCORPORATED UNDER THE LAWS OF NEW JERSEY, HAS THE CORPORATION RECEIVED AN AUTHORIZATION TO CONDUCT BUSINESS IN NEW JERSEY FROM THE NEW JERSEY OFFICE OF THE SECRETARY OF STATE? ves _¥_No HAS THE CORPORATION CHARTER EVER BEEN REVOKED BY THE OFFICE OF THE SECRETARY OF STATE IN NEW JERSEY? Yes _¥_No IF THE ANSWER IS “YES”, INSERT THE DATE OF REVOCATION, OR IF SUSPENDED, THE BEGINNING AND ENDING DATE OF THE SUSPENSION Date or revocation ! 1 Beginning date yt Ending date Jt INSERT THE NAME AND ADDRESS OF REGISTERED OR AUTHORIZED AGENT IN NEW JERSEY UPON WHOM SERVICE OF PROCESS IN ANY PROCEEDINGS AGAINST THE APPLICANT, PURSUANT TO THE NEW JERSEY ALCOHOLIC BEVERAGE LAW, THE ALCOHOLIC BEVERAGE TAX LAW, OR PROCEEDINGS IN A STATE OF U.S. DISTRICT COURT, MAY BE MADE: Name _N/A (Last Name, First Name, Middle Initial or Corporate Name) Street Address Number Street Name Municipality New Jersey Zip __-____ Telephone Number ( ) . Area Exchange Number IF THE LICENSED COMPANY IS OWNED BY OTHER CORPORATION(S) OR IN A CORPORATE CHAIN, ATTACH A DIAGRAM DEPICTING THE CORPORATE RELATIONSHIPS AND THE PERCENTAGE OF STOCK INTEREST, IN THE COMPANY TO BE LICENSED, OWNED BY OTHER CORPORATIONS OR OTHER NON-CORPORATE ENTITIES
ORPORATE CHAIN, ATTACH A DIAGRAM DEPICTING THE CORPORATE RELATIONSHIPS AND THE PERCENTAGE OF STOCK INTEREST, IN THE COMPANY TO BE LICENSED, OWNED BY OTHER CORPORATIONS OR OTHER NON-CORPORATE ENTITIES (INDIVIDUALS, PARTNERSHIPS, ASSOCIATIONS). SEE ATTACHED ORGANIZATION CHART
Page 10A PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER _1802___-_ 33 -_005 -011 ALL APPLICANTS ANSWER THE FOLLOWING (ADD PAGES AS NECESSARY) SOLE OWNERS AND PARTNERSHIPS: Complete the page in full LIMITED PARTNERSHIP: All information about a general partner or partners of a limited partnership must be reported, whether the general partner is an individual or a corporation. A list of the names and addresses of all limited partners must be submitted as an attachment to this application with an identification of the percentage of each limited partner as it relates to total ownership of the business entity to be licensed. CORPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interest in the corporation under license or to be licensed must have been reported on page 10. Information on this page, 10A, will identify all officers, directors, and stockholders holding one percent or more of the shares of the respective company. Club licenses must list names of officers and directors and attach a current membership list. NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP) Steele HGC Investment II, LLC Name of individual (last name first), stockholder, partner, officer or director: v Siegel Steven Ss Last Name Middle Initial Home Street Address __| Number —— Name P.O. Box Municipality State Zz Zip Social Security number oosteorinn Home telephone number rea xchange jumber % of business owned or controlled 0% Number of shares Check position that applies: Sole owner Partner Stockholder _v President _ Vice-President _W Secretary Treasurer Director Trustee Manager Agent Executor/Administrator __ Receiver Beneficiary Other (specify) Name of individual (last name first) Vv Martin James ("Charlie") Charles Last Name Middle Initial Home Street Address | Number lame POBox Municipality coe i Social Security number Home telephone number % of business owned or controlled 0% Number of shares Check position that applies: Sole owner Partner Stockholder ____ President ____ Vice-President Secretary _W Treasurer Director Trustee Manager Agent Executor/Administrator ____ Receiver Beneficiary _W Other (specify) _Chief Financial Officer and Assistant Secretary
Page 10A PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER _1802__-_ 33 -_005 -011 ALL APPLICANTS ANSWER THE FOLLOWING (ADD PAGES AS NECESSARY) SOLE OWNERS AND PARTNERSHIPS: Complete the page in full LIMITED PARTNERSHIP: All information about a general partner or partners of a limited partnership must be reported, whether the general partner is an individual or a corporation. A list of the names and addresses of all limited partners must be submitted as an attachment to this application with an identification of the percentage of each limited partner as it relates to total ownership of the business entity to be licensed CORPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interest in the corporation under license or to be licensed must have been reported on page 10. Information on this page. 10A, will identify all officers, directors, and stockholders holding one percent or more of the shares of the respective company. Club licenses must list names of officers and directors and attach a current membership list. NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER ISA CORPORATION OR PARTNERSHIP) Steele HGC Investment Il, LLC ime of individual (last name first), stockholder, partner, officer or director: Rohnstock Kevin R Last Name First Middle Initial Home Street Adoress Number et Name P.O. Box # Municipality | State : | Zip Social Security numbe} Date of birth Home telephone number Office telephone number Aree exchange Number % of business owned or controlled 0% Number of shares Check position that applies Sole owner Partner Stockholder ____ President _¥ _ Vice-President Secretary Treasurer Director Trustee Manager Agent Executor/Administrator ____ Receiver Beneficiary _¥ Other (specify) Assistant Secretary sme of individual (last name first): Steele HGC Investment, LLC Last Name First Middle Initial Home Street Address __100 St. Paul Street, Suite 800 Number Street Name P.O. Box # Municipality _ Denver State _CO Zip 80206 - Social Security number — Date of birth /_ Home telephone number ( ) - Area Exchange Number Office telephone number (720 ) 284 _ 6400 ‘Area Exchange Number % of business owned or controlled 0% Number of shares Check position that applies: Sole owner Partner Stockholder President _ Vice-President Secretary Treasurer
(720 ) 284 _ 6400 ‘Area Exchange Number % of business owned or controlled 0% Number of shares Check position that applies: Sole owner Partner Stockholder President _ Vice-President Secretary Treasurer Director Trustee Manager Agent Executor/Administrator ____ Receiver Beneficiary _W Other (specify)_Managing Member
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- Sep 29, 2026
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