Document reference ID : 409

Renewal Application Summary

Application ID: 409
License No: 3074
License Type applied for Renewal: Beverage Dispensary Tourism License (BDTL)
Licensee Name: Fountainhead Development, Inc.
Application Status: Approved
Application Submited On: 08/19/2024 11:22 AM AKDT
 

Entity Information

Business Structure: Corporation
FEIN/SSN Number:
Alaska Entity number (CBPL): 36844D
Alaska Entity Formed Date:
Home State:
 

Entity Contact Information

Entity Address: 1501 Queens Way, Fairbanks, AK, 99709

Renewal Information

Are there any changes to your ownership structure that have not been reported to AMCO prior to this application?:
No
Please select the seasonality:
Year-round
Has any person or entity in this application been convicted or disciplined for a violation of Title 04, 3 AAC 304 or 305, or a local ordinance adopted under AS 04.21.010 in the preceding two calendar years?:
No
Have any notices of violation or citations been issued for this license during the preceding two years?:
No

Endorsements

License #​ License Type Trade Name License Status City
3616 Multiple Fixed Counter Endorsement (MFCE) Wedgewood Resort Active Fairbanks

Attestations

As an applicant for a liquor license renewal, I declare under penalty of perjury that I have read and am familiar with AS 04 and 3 AAC 305, and that this application, including all accompanying schedules and statements, are true, correct, and complete.
I agree to provide all information required by the Alcoholic Beverage Control Board or requested by AMCO staff in support of this application and understand that failure to do so by any deadline given to me by AMCO staff will result in this application being returned and the license being potentially expired if I do not comply with statutory or regulatory requirements.
I certify that in accordance with AS 04.11.450, no one other than the licensee(s), as defined in AS 04.11.260, has a direct or indirect financial interest in the licensed business.
I certify that this entity is in good standing with Corporations, Business and Professional Licensing (CBPL) and that all entity officials and stakeholders are current and I have provided AMCO with all required changes of the ownership structure of the business license and have provided all required documents for any new or changes of officers.
I certify that all licensees, agents, and employees who sell or serve alcoholic beverages or check identification of patrons have completed an alcohol server education course approved by the ABC Board and keep current, valid copies of their course completion cards on the licensed premises during all working hours, if applicable for this license type as set forth in AS 04.21.025 and 3 AAC 305.700.
I hereby certify that I am the person herein named and subscribing to this application and that I have read the complete application, and I know the full content thereof. I declare that all of the information contained herein, and evidence or other documents submitted are true and correct. I understand that any falsification or misrepresentation of any item or response in this application, or any attachment, or documents to support this application, is sufficient grounds for denying or revoking a license/permit. I further understand that it is a Class A misdemeanor under Alaska Statute 11.56.210 to falsify an application and commit the crime of unsworn falsification.

Signature

Electronic Signature not collected; application submitted based on paper form.

Payment Info

Payment Type : Check
Check Number: 39622
Payment Date: 11/06/2023 01:49 PM AKST