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, e e . 04/28/05 02:42 FAX 6514150082 MJDAIDlAN 14103 Minnesota Lawful Gambling LG215 lease for lawful Gambling Activity City Ifle 6/03 Page 1 of2 Daytime phone >SV;;. t9t3J 77] DayUrre prone NamBi_ of legal owner of premises J Nameofl8aslXl promises Stmeladdress City Zip Daytime phone F(....I..~..."r. S A 1'....... "!;!l>1oo)1 1~7?1 \II.t.T'~ /l.l ~ ,.d&. Urll' S'SIl:J. '-611&."-(71 Name of lessee (organization leasing1he pramises) Organlzallon Iiceru;e number Daytime phone lady Slipper Chapter ABWA # 03162 651/481-0672 Rent Information (for activily involving pulHabs, dpboards, padllle_ls, and puJl.- dispensing dBVlces) Boom operallon - sales 01 gombJ;ag oquipmei1t by .n employee (or Bor DperilUon - sales of g....-"'!l "",wpment wt1h.<1a'''''''''' YOlunteer) of a licenst.-d organization within ~ ~te ~re Ulat i5 pren1ses by an empJoyee of rn~ ~ from:li CDrm10n iUfi. wl1ere dlstlna from ...... where food and bevorGges are sold, _ and bev_ .... .... _, .-------~~~~~an~Il;ORan~~~~~~Dn~~~9a~I~-------, from il boo~ operation at thi. lor.ation7 X Veo NO l_____________________~_~==__~______~ If you answered yes to lIle question above, rent limits a... basel! on lIle I'llllowing wmbinalicns 01 oper;ltion: . Booth ope<ation _Operationanll pulHabdiSpenSingdevice EIoolh operotioo and bar operolion Booth ope<ation, bilf operation, and pull-tab dispensing devlm The maximum rent allowed may not exceed $1,750 in total per month for aU OI1lanlzlltlons at this p"'mIses. Complete one option: Option A: 0 to 10% of the gross prolitsper month, Percentage to be paid % If you allSWeroO no to the questlon above, rent limits are based on the following DlmbinatJons of operation: - Bar operation Bar operation with pull-tab dispensing dBllice PulHab dispensing device only The maximum rent allowed may not exceed $2,000 in total per month for all org.nil:ations ot this premiSeS. ComplBte one option. Option A: 0 to 20% of the gross profits per month. Per1:enlage to be paid % Option B: When ~ross prollts are $4,000 Or less per month, $0 to Option B: When gross profits are $1,000 or less per month, $0 to $400 per month may be paid. Amount to be paid $ $200 per month may be paid, AmoWl[ to be paid $ . . Option C: $0 to $400 per monltl may be paid on the first $4,000 of gross profit. Amount to be paid $ 'iDe> , PJusO%lD 10% of the gross profits may be paid per monltl on gross profits over $4,000. Percentage to be paid (0 % Option c. $0 to $200 per month may be paid on the first $1,000 of gross profits, Amount to be pald,$ _ Plus 0% to 20% of ltIe gross profits may be paid per month on gross profits over $1,000, P<;rcentage to be paid 'Yo NOTE. If lIlere are MY other terms or condltlons ror rent-related expense:;, they must be identified on page 2 Wlder Acknowledgment of Lease Terms, Pingo and/or Bar Pingo Ootasions Rent Information: Bingo , Rent for bingo anll all other gambling activities conducted during a bingo occasion may not exJ:eed: . $200 per oa:asioll for up to 6,000 square feet . $:300 per occasion fO( up to 12,000 square feet . $400 per OCGiSion for mo", than 11,000 square feet . $25 per occasion for bar blngo conducted at any time In a bar (regardless of square tcotage). Your organization must conduct another form of lawful gambling, and the premises must serve intoxkating liquor or :3.2 percent malt beverages. Rent to be paid per bingo occasion $ If ltIis is an amended lease showing chango:s occurring during ltIe IimI afthe C1lrrent premise; perrnlt, both parties thai: SIgned the lease must initial and date all dlanges, Changes must be submitted to the Gamilllng ControIlloilrd at least ~O da", prior to lIle change. Write in the date Il1attl1e dlanges will be effedJve ----'---1_, Lessor Dab! Organization Dare Noon HOllr Bingo Occasions Rent may not exreed $25 per day for noon hour bingo conducted between 11 a.m, and 2 p.m, at a premises with a license for the sale of inlolOcating beverages on the premises. Rent to be paId per bingo occasJon $ Amended Lea$e Only