HomeMy WebLinkAboutCSE-20-72 Emerald Lush RedactedApplication Type
Social Equity Criteria
Applicant (Entity) Information
Social Equity Cannabis Business
Permit Application
CSE-20-72
Submitted On: Nov 13, 2020
Applicant
Nicholas Johnson
In order to qualify as a social equity applicant, applicants must
satisfy at least one of the following criteria:
1. Low income household and either:
a. A past conviction for a cannabis crime, or
b. Immediate family member with a past conviction for a
cannabis crime.
2. Low income household in a zip code identified as at least
60% according to the CalEnviroScreen for five (5) consecutive
year period and either:
a. A past conviction for a cannabis crime, or
b. Immediate family member with a past conviction for a
cannabis crime.
3. Low income household and either:
a. Five (5) years cumulative residency in a zip code identified as
at least 70% according to the CalEnviroScreen, or
b. Ten (10) years cumulative residency in a zip code identified
by CalEnviroScreen.
4. Business with no less than fifty-one percent (51%) ownership
by individuals who meet Criteria 1 and 2 above.
5. Cannabis social enterprise with no less than fifty-one percent
(51%) ownership by individuals who meet Criteria 1 and 2
above.
6. An individual with a membership interest in a cannabis
business formed as a cooperative.
Do you meet the above criteria, and want to apply as a Social
Equity Applicant?
Yes
Please state your annual income:Do you have a past cannabis conviction?
No
Do you claim eligibility based on a family member past
cannabis conviction?
Yes
Do you represent a cannabis social enterprise?
No
Do you have a membership interest in a cannabis cooperative?
No
Application Type
Proposed Location
Applicant (Entity) Name:
Emerald Management Group LLC
DBA:
Emerald Lush
Physical Address:
323 W Cromwell #110
City:
Fresno
State:
CA
Zip Code:
93711
Primary Contact Same as Above?
No
Primary Contact Name:
Kristin Ivy
Primary Contact Title:
CEO
Primary Contact Address:
323 W Cromwell #110
Primary Contact City:
Fresno
Primary Contact State:
CA
Primary Contact Zip Code:
93711
Primary Contact Phone:
Primary Contact Email:HAS ANY INDIVIDUAL IN THIS APPLICATION APPLIED FOR
ANY OTHER CANNABIS PERMIT IN THE CITY OF FRESNO?:
No
Select one or more of the following categories. For each
category, indicate whether you are applying for Adult-Use (“A”)
or/and Medicinal (“M”) or both
Both
Please make one selection for permit type. If making multiple
applications, please submit a new application for each permit
type.
Permit Type
Retail (Storefront)
Business Formation Documentation:
Limited Liability Company
Property Owner Name:
--
Proposed Location Address:
--
City:
--
State:
--
Zip Code:
--
Property Owner Phone:
--
Property Owner Email:
--
Assessor's Parcel Number (APN):
--
Proposed Location Square Footage:
--
1 SECTION 1. BUSINESS PLAN (due on January 8, 2021 by 4pm)
❏ 1.1 Owner Qualifications
- Resume: NAJ
❏ 1.2 Proposed Budget (s)
- Spreadsheets with budget
- LivePlan budget statement
- Note: Budget details may include construction for build-out, operations,
maintenance, compensation of employees, equipment costs, utility costs,
and other operating costs.
❏ 1.3 Proof of Capitalization (matching your budget plus, 3 months of expenses)
- Bank statements
- Letter(s) of credit
- Evidence of other liquid assets
- Or plan demonstrating how you will secure funding. Private Financing
❏ 1.4 Pro Forma
- Profit & Loss statement, Cashflow statement, Balance Sheet
- LivePlan pro forma statements
❏ 1.5 Description of hours of operations and daily opening and closing procedures
M-Sat Storefront & Deliveries by APPOINTMENT ONLY. Delivery hours from
9am – 7pm.
- Narrative describing hours of operation and opening and closing procedures.
To add to allure and exclusivity of Emerald Lush, onsite sales are made by
appointment only with a product concierge.
- SOPs describing opening and closing procedures
Opening: Prior to opening, the manager on duty will prepare the day’s orders and
dispatch delivery routes and orders to the drivers. The drivers will verify that the
correct number of orders have been loaded for delivery. Both the driver and
manager sign the delivery manifest as correct and complete. The manager will
then review and confirm appointment requests.
❏ 1.6 Description of daily operations
- Narrative describing proposed daily operations for cannabis retail dispensary
Daily operations procedures of Emerald Lush are centered on providing a safe,
inviting environment to purchase cannabis and encouraging a positive work
environment. To achieve these goals, our day starts with brief meeting to review
delivery protocols and safety. We disperse the current day’s dispatch and
conclude. Once the drivers have left, the manager prepares for the day’s first
appointment. Based on information collected at the time of appointment booking,
the manager pulls the appropriate amounts of product for the sale. At the
conclusion of each appointment, the unsold product is returned to the safe. The
manager on duty also periodically monitors the drivers’ locations and completed
deliveries using proprietary technology developed to measure these metrics.
At the end of the day, the manager reconciles the day’s sales and inventory. As
the drivers return from their deliveries, the manager reconciles orders delivered
vs. not delivered and updates inventory management software. Each driver is
checked out by signing an end of day completed manifest.
❏ 1.6.1(a) Customer check-in procedures
- SOPs describing how customer age and ID validity will be determined.
Government issued ID information will be required to be entered at the time of
checkout or appointment booking on the website. At the time of delivery, the
driver will scan the customer Government issued ID barcode in a manner that
mirrors alcohol delivery services. The customer will be buzzed in after
confirmation of identity and age
For appointments, a barcode scanner will be installed at the customer entrance.
Customers must swipe the barcode on their driver’s license or ID. The manager
verifies the scanned information as correct prior to customer entry. All customer
information will be retained in compliance with any and all state and local
requirements.
❏ 1.6.1(b) Location & procedures for receiving deliveries during business hours
- Premises diagram indicating where deliveries will be received and SOP(s)
describing how deliveries will be received when open.
Deliveries will be scheduled when both managers are on duty. Product will arrive
through the back service entrance. A manager will buzz in the product supplier
after confirming his/her identity. Inventory will be counted and received in the
secure Inventory Control Room. New shipments will be logged and tracked via
inventory control software.
❏ 1.6.1(c) Identify POS system
- Description of proposed POS system
Blaze POS system will be utilized to manage orders and purchases.
❏ 1.6.1(d) - 1.6.1(e) Estimated number of customers daily & proposed product to be
sold
- Market research outlining proposed number of customers on a daily
basis, proposed products to be sold, and potential ratio at which they’ll be
sold.
A combined average of 50 sales per day are projected between the storefront
and mobile delivery service.
❏ 1.6.1(f) Describe delivery service procedures (required only if applicant intends to
have delivery operations)
- SOP(s) describing proposed delivery operations compliant to Fresno
regulations.
Emerald Lush will utilize the delivery function of the Blaze POS platform to
manage mobile deliveries. Drivers will be required to download the Blaze App to
track location and inventory while delivering. Implementing this technology will
insure regulatory compliance, employee safety and order visibility for consumers.
2 SECTION 2. SOCIAL POLICY & LOCAL ENTERPRISE PLAN (due on January 8, 2021
by 4pm)
❏ 2.1 - 2.3 Living Wage, Employee Benefits, Continuing Education
- Description of proposed salaries and employee benefits
per hour. One week paid vacation. Health Insurance benefits.
❏ 2.4 - 2.5 Recruitment of low-income and local employees; description of how business
will be locally managed.
- Outline of proposed hiring practices describing how business will obtain specified
employees and management structure that demonstrates local management.
To encourage local and low income employees, Emerald Lush give hiring
preference to local applicants. In addition, Emerald Lush will partner with
Workforce Connection to offer training and employment opportunities.
❏ 2.6 Description of number of employees, title/position, and responsibilities.
- List of employee positions, their title, and respective responsibilities for the
business.
Managers (2): Responsible for day to day operations including but not limited to,
inventory management, safety training, compliance certification, new employee
hiring and terminations, record keeping and dispute resolution.
Drivers (2): Responsible transport and delivery of product to customers. Accurate
age verification. Compliance with state and local delivery regulations while an
acting on behalf of Emerald Lush.
❏ 2.7 Labor Peace Agreement (if more than 5 employees are proposed)
- Letter from local union identifying intent to enter into a labor peace agreement.
N/A
❏ 2.8 (2.8.1 - 2.8.3) Workforce plan
- Outline describing commitment to local hiring, proposed compensation for
continuing education, commitment to paying living wage.
In addition to the starting hourly wage, Emerald Lush will provide additional
benefits as part of the employee benefits package. Employees will be receive a
3% raise for each year of service. All employees will receive one week of paid
vacation each year in addition to 5 paid sick days. Emerald Lush will offer tuition
reimbursement as well health insurance. Emerald Lush will offer quarterly
incentives to its drivers who have provided perfect service and/or delivery
accuracy.
3 SECTION 3. NEIGHBORHOOD COMPATIBILITY PLAN (due on January 8, 2021 by
4pm)
❏ 3.1 Plans to address potential complaints from neighboring businesses.
- Description of complaint mitigation plan.
Because the business model for the storefront is by appointment only, there
should not be much cause for complaints from neighboring businesses. Foot
traffic will be minimal. Each client will arrive at a scheduled time. State of the art
odor abatement will be used to eliminate the chance of the aroma circulating past
our facilities. In the event of a concern voiced by a neighboring business,
Emerald Lush will work diligently to mitigate any issues as soon as they arise.
❏ 3.2 Plans to avoid having a negative impact on surrounding businesses.
- Description of commitment to safe business practices and in what circumstances
law enforcement will be contacted.
The by appointment business model will eliminate any parking or loitering
concerns that neighboring businesses may have. In instances where a client is
exhibiting behavior that falls outside what is accepted by state and local
ordinances, Fresno PD will be called without hesitation. The safety of the
Emerald Lush Family and our community is of primary importance.
❏ 3.3 Odor mitigation practices
- Description of how business will mitigate issues with cannabis odor.
State of the art odor abatements will be installed prior to Opening Day.
❏ 3.4 Identifying potential odor sources
- Premises diagram indicating where cannabis odor may arise.
- Description of areas of premises that may be a source of cannabis odor.
Location TBD. Odor source would come from inside the locked,
fireproof/waterproof safe in the locked Inventory Control Room
❏ 3.5 Odor control techniques
- Description of how applicant will control odor including description of HVAC
system and filters used for odor mitigations
TBD
❏ 3.6 Staff odor training & system maintenance
- Description of how applicant will training staff in mitigating cannabis odor andregular
maintenance of HVAC system.
TBD
❏ 3.7 Waste Management Plan
- Description of applicants’ proposed waste management plan.
- SOPs describing waste management procedures.
TBD
SECTION 7. COMMUNITY BENEFITS & INVESTMENT PLAN (due on January 8, 2021
by
4pm)
❏ 7.1 (7.1.1 - 7.1.3) Social responsibility plan
- Description of how applicant will provide the requirement community investments
and documentation demonstrating proposed property as vacant
building/brownsfield land/blighted area of city.
- Letters from organizations with whom the applicant intends to work in this
respect.
Emerald Lush is committed to the Fresno Community. We will provide an annual
academic scholarship to socially disadvantaged high school seniors whose
immediate family member was impacted by the cannabis laws of that targeted so
many communities of color. Emerald Lush will host workshops on criminal
record expungement for cannabis related crimes. And lastly, Emerald Lush will
host voter registration drives to assist underrepresented communities make their
voices heard.
❏ 7.2 Public health outreach plan
- Description of how applicant intends to provide a youth-oriented outreach
program.
Emerald Lush will offer internships as a means of passing on industry knowledge
to the next generation of cannabis entrepreneurs. We will offer scholarships for students of
color in the STEM fields who are committed to innovate in the cannabis field.
Make Green Go is here to help you through this application process step-by-step. Keep in
mind
that we have a limited budget to provide guidance and assistance which consists of advising
applicants, rather than crafting the content for you.
1. For help login to the Fresno Guide at
https://makegreengo.thinkific.com/pages/fresno-guide
2. We strongly encourage you to use a business plan software to write you plan and
complete your pro forma statements and budgets https://www.liveplan.com/features
3. Need more support go to https://connect.zoho.com/portal/equityconnect/group/fresno
and post a question or schedule a 1:1 Consultation
EMERALD MANAGEMENT
GROUP LLC
DBA
EMERALD LUSH
JANUARY 8, 2021
323 W Cromwell #110 Fresno CA 93711
Proof of Capitalization (matching your budget plus, 3 months of expenses)
Capitalization requirements will be met in the form of a private lender.
Pro Forma
Profit & Loss Statement Attached.
Description of hours of operations and daily opening and closing procedures
Emerald Lush will operate Monday through Saturday for storefront sales and
mobile deliveries. Storefront sales take place by APPOINTMENT ONLY.
Delivery and store hours are from 9am – 7pm.
To add to allure and exclusivity of Emerald Lush, onsite sales are made by
appointment only with a product concierge.
Prior to opening, the manager on duty will prepare the day’s orders and dispatch
delivery routes and orders to the drivers. The drivers will verify that the correct
number of orders have been loaded for delivery. Both the driver and manager
sign the delivery manifest as correct and complete. The manager will then
review and confirm appointment requests.
Description of daily operations
Daily operations procedures of Emerald Lush are centered on providing a safe,
inviting environment to purchase cannabis and encouraging a positive work
environment. To achieve these goals, our day starts with brief meeting to review
delivery protocols and safety. We disperse the current day’s dispatch and
conclude. Once the drivers have left, the manager prepares for the day’s first
appointment. Based on information collected at the time of appointment booking,
the manager pulls the appropriate amounts of product for the sale. At the
conclusion of each appointment, the unsold product is returned to the safe. The
manager on duty also periodically monitors the drivers’ locations and completed
deliveries using proprietary technology developed to measure these metrics.
At the end of the day, the manager reconciles the day’s sales and inventory. As
the drivers return from their deliveries, the manager reconciles orders delivered
vs. not delivered and updates inventory management software. Each driver is
checked out by signing an end of day completed manifest.
Customer check-in procedures
Government issued ID information will be required to be entered at the time of
checkout or appointment booking on the website. At the time of delivery, the
driver will scan the customer Government issued ID barcode in a manner that
mirrors alcohol delivery services. The customer will be buzzed in after
confirmation of identity and age
For appointments, a barcode scanner will be installed at the customer entrance.
Customers must swipe the barcode on their driver’s license or ID. The manager
verifies the scanned information as correct prior to customer entry. All customer
information will be retained in compliance with any and all state and local
requirements.
Location & procedures for receiving deliveries during business hours
Deliveries will be scheduled when both managers are on duty. Product will arrive
through the back service entrance. A manager will buzz in the product supplier
after confirming his/her identity. Inventory will be counted and received in the
secure Inventory Control Room. New shipments will be logged and tracked via
inventory control software.
Identify POS system
Blaze POS system will be utilized to manage orders and purchases.
Estimated number of customers daily & proposed product to be sold
California is projected to generate $6 Billion in cannabis sales in 2021. Emerald
Lush projects a very conservative combined average of 50 sales per day
between the storefront and mobile delivery service.
Describe delivery service procedures (required only if applicant intends to have delivery
operations)
Emerald Lush will utilize the delivery function of the Blaze POS platform to
manage mobile deliveries. Drivers will be required to download the Blaze App to
track location and inventory while delivering. Implementing this technology will
insure regulatory compliance, employee safety and order visibility for consumers.
SECTION 2. SOCIAL POLICY & LOCAL ENTERPRISE PLAN (due on January 8, 2021 by
4pm)
Living Wage, Employee Benefits, Continuing Education
per hour. One week paid vacation. Health Insurance benefits.
Recruitment of low-income and local employees; description of how business will be locally
managed.
To encourage local and low income employees, Emerald Lush give hiring
preference to local applicants. In addition, Emerald Lush will partner with
Workforce Connection to offer training and employment opportunities.
Description of number of employees, title/position, and responsibilities.
Managers (2): Responsible for day to day operations including but not limited to,
inventory management, safety training, compliance certification, new employee
hiring and terminations, record keeping and dispute resolution.
Drivers (2): Responsible transport and delivery of product to customers. Accurate
age verification. Compliance with state and local delivery regulations while an
acting on behalf of Emerald Lush.
Peace Agreement (if more than 5 employees are proposed)
N/A
Workforce plan
In addition to the starting hourly wage, Emerald Lush will provide additional
benefits as part of the employee benefits package. Employees will be receive a
3% raise for each year of service. All employees will receive one week of paid
vacation each year in addition to 5 paid sick days. Emerald Lush will offer tuition
reimbursement as well health insurance. Emerald Lush will offer quarterly
incentives to its drivers who have provided perfect service and/or delivery
accuracy.
SECTION 3. NEIGHBORHOOD COMPATIBILITY PLAN (due on January 8, 2021 by
4pm)
Plans to address potential complaints from neighboring businesses.
Because the business model for the storefront is by appointment only, there
should not be much cause for complaints from neighboring businesses. Foot
traffic will be minimal. Each client will arrive at a scheduled time. State of the art
odor abatement will be used to eliminate the chance of the aroma circulating past
our facilities. In the event of a concern voiced by a neighboring business,
Emerald Lush will work diligently to mitigate any issues as soon as they arise.
Plans to avoid having a negative impact on surrounding businesses.
The by appointment business model will eliminate any parking or loitering
concerns that neighboring businesses may have. In instances where a client is
exhibiting behavior that falls outside what is accepted by state and local
ordinances, Fresno PD will be called without hesitation. The safety of the
Emerald Lush Family and our community is of primary importance.
Odor mitigation practices
State of the art odor abatements will be installed prior to Opening Day.
Identifying potential odor sources
Location TBD. Odor source would come from inside the locked,
fireproof/waterproof safe in the locked Inventory Control Room.
Odor control techniques
In compliance with industry standards and state/local regulations. System
manufacturer to be determined.
Staff odor training & system maintenance
In compliance with industry standards and state/local regulations. System to be
determined.
Waste Management Plan
In compliance with industry standards and state/local regulations. System to be
determined.
SECTION 7. COMMUNITY BENEFITS & INVESTMENT PLAN (due on January 8, 2021
by
4pm)
Social responsibility plan
Emerald Lush is committed to the Fresno Community. We will provide an annual
academic scholarship to socially disadvantaged high school seniors whose
immediate family member was impacted by the cannabis laws of that targeted so
many communities of color. Emerald Lush will host workshops on criminal
record expungement for cannabis related crimes. And lastly, Emerald Lush will
host voter registration drives to assist underrepresented communities make their
voices heard.
Public health outreach plan
Emerald Lush will offer internships as a means of passing on industry knowledge to the next
generation of cannabis entrepreneurs. We will offer scholarships for students of color in the
STEM fields who are committed to innovate in the cannabis field.
OWNERSHIP ACKNOWLEDGEMENT FORM
FOR COMMERCIAL CANNABIS BUSINESS PERMIT APPLICATION
It is the intent of the City of Fresno to promote equitable ownership and employment opportunities in the cannabis industry to
decrease the disparities in life outcomes for marginalized communities and to provide opportunities for local residents to
compete for cannabis business permits. Therefore, this notice is to clarify the eligibility requirements in order to receive
qualification as a Social Equity Applicant or points for Local Preference by establishing this acknowledgement to provide
additional protections to mitigate against potential predatory practices.
In order to qualify as a social equity applicant, or for the full points relating to the local preference criteria, the business entity
must have ownership that meets the respective eligibility factors and hold at least 51% ownership interest. The social equity
eligibility requirements are identified in FMC section 9-3316(b)(6), while the local preference criteria is identified in FMC 9-
3317(a) and the application evaluation criteria 2.5 (Appendix A). This majority interest can be made up of a single individual that
meets this criteria, or any combination of individuals that hold at least 20% interest individually and meet the definition of an
owner in FMC 9-3304(j). The cannabis social equity permits, and the local preference criteria are intended for the benefit of the
Social Equity or Local Preference Individual Applicants related to business profits, proceeds of the sale of business assets, voting
rights and additional protections. This also requires the Social Equity or Local Preference Owner to receive the Equity Share
percent of the retained earnings and 100 percent of the unencumbered value of each share of stock, member interest or
partnership interest owned in the event of the dissolution of the entity to their equity share, or 100 percent of the value of each
of stock, member interest or partnership interest in the event that the stock, member interest or partnership interest is sold.
Chief among the concepts of equity share, is unconditional ownership which means such individual(s) will receive equal profits,
and distributions or other payments proportionate to their ownership interests. This is intended to ensure true ownership by the
Social Equity or Local Preference Individual Applicant and as such, prohibits the divestment or relinquishment of any part of their
ownership under any circumstance. In addition, the Equity Share is also expanded to address voting rights on fundamental
decisions relating to the business and control of at least the equity share percent of the voting rights on all decisions involving
the operation of the business. Furthermore, it requires the Social Equity or Local Preference Individual owner be the highest
officer position of the business or that another individual is appointed to that position by mutual agreement of the parties. This
requirement is also subject to being audited to assess compliance and the Social Equity or Local Preference Owner can initiate
legal action due to a breach of contract agreement, and the City may suspend and/or revoke a license if any provision in an
operating agreement violates any of the Equity Share or Local Preference requirements. Lastly, all applicants will be required to
incorporate an addendum into their operating agreements that makes any provision ineffective, unenforceable, null and void, if
it is inconsistent with, or in violation of, the Equity Share requirements. As proposed, Social Equity Applicants or Local Preference
Applicants will be required to verify under Section 9-3316(b)(6), 9-3317(a), and Criteria 2.5 of appendix A that they meet the
definition of a Social Equity or Local Preference Owner at the time of applying for a permit or permit renewal. The City shall have
the sole and absolute discretion to determine whether the Applicant qualifies as a Social Equity Applicant and the number of
points for Local Preference.
The undersigned acknowledges that he/she has read and fully understands the content of this Agreement and is
the Applicant or his/her/its authorized signatory.
__________________________________________________ __________________________________________________
Applicant Signature Date Signed
__________________________________________________ __________________________________________________
Print Name Title
__________________________________________________ __________________________________________________
Company Name Address/Telephone
DocuSign Envelope ID: D25F2B3F-6984-4701-8FBF-A1171E012294
CEO
11/13/2020
Kristin Ivy
Emerald Management Group LLC
OWNERSHIP ACKNOWLEDGEMENT FORM
FOR COMMERCIAL CANNABIS BUSINESS PERMIT APPLICATION
It is the intent of the City of Fresno to promote equitable ownership and employment opportunities in the cannabis industry to
decrease the disparities in life outcomes for marginalized communities and to provide opportunities for local residents to
compete for cannabis business permits. Therefore, this notice is to clarify the eligibility requirements in order to receive
qualification as a Social Equity Applicant or points for Local Preference by establishing this acknowledgement to provide
additional protections to mitigate against potential predatory practices.
In order to qualify as a social equity applicant, or for the full points relating to the local preference criteria, the business entity
must have ownership that meets the respective eligibility factors and hold at least 51% ownership interest. The social equity
eligibility requirements are identified in FMC section 9-3316(b)(6), while the local preference criteria is identified in FMC 9-
3317(a) and the application evaluation criteria 2.5 (Appendix A). This majority interest can be made up of a single individual that
meets this criteria, or any combination of individuals that hold at least 20% interest individually and meet the definition of an
owner in FMC 9-3304(j). The cannabis social equity permits, and the local preference criteria are intended for the benefit of the
Social Equity or Local Preference Individual Applicants related to business profits, proceeds of the sale of business assets, voting
rights and additional protections. This also requires the Social Equity or Local Preference Owner to receive the Equity Share
percent of the retained earnings and 100 percent of the unencumbered value of each share of stock, member interest or
partnership interest owned in the event of the dissolution of the entity to their equity share, or 100 percent of the value of each
of stock, member interest or partnership interest in the event that the stock, member interest or partnership interest is sold.
Chief among the concepts of equity share, is unconditional ownership which means such individual(s) will receive equal profits,
and distributions or other payments proportionate to their ownership interests. This is intended to ensure true ownership by the
Social Equity or Local Preference Individual Applicant and as such, prohibits the divestment or relinquishment of any part of their
ownership under any circumstance. In addition, the Equity Share is also expanded to address voting rights on fundamental
decisions relating to the business and control of at least the equity share percent of the voting rights on all decisions involving
the operation of the business. Furthermore, it requires the Social Equity or Local Preference Individual owner be the highest
officer position of the business or that another individual is appointed to that position by mutual agreement of the parties. This
requirement is also subject to being audited to assess compliance and the Social Equity or Local Preference Owner can initiate
legal action due to a breach of contract agreement, and the City may suspend and/or revoke a license if any provision in an
operating agreement violates any of the Equity Share or Local Preference requirements. Lastly, all applicants will be required to
incorporate an addendum into their operating agreements that makes any provision ineffective, unenforceable, null and void, if
it is inconsistent with, or in violation of, the Equity Share requirements. As proposed, Social Equity Applicants or Local Preference
Applicants will be required to verify under Section 9-3316(b)(6), 9-3317(a), and Criteria 2.5 of appendix A that they meet the
definition of a Social Equity or Local Preference Owner at the time of applying for a permit or permit renewal. The City shall have
the sole and absolute discretion to determine whether the Applicant qualifies as a Social Equity Applicant and the number of
points for Local Preference.
The undersigned acknowledges that he/she has read and fully understands the content of this Agreement and is
the Applicant or his/her/its authorized signatory.
__________________________________________________ __________________________________________________
Applicant Signature Date Signed
__________________________________________________ __________________________________________________
Print Name Title
__________________________________________________ __________________________________________________
Company Name Address/Telephone
DocuSign Envelope ID: BB4A91B9-2ED5-4D02-8EF4-43FF272C19BF
Owner
Nicholas Johnson
Nicholas Johnson
11/13/2020
11/13/2020