The following documents are required to be on file and up to date at all times: 

A document detailing the Establishments where devices will be located. To be accepted, the document must include only the following:

• Legal Entity Name of the business;
• DBA/Assumed Name of the business, if applicable;
• Complete address of the business, including suite, unit, etc. numbers; and
• Total number of devices that will be at that specific location.

As a reminder, device details are not required. Please only submit the information requested above.

The following documents are required to be on file and up to date at all times:  

1. List of Owners, Partners, Officers, etc. and Managers of the Business. To be accepted, the list must include all of the following for each:
   • Full Legal Name (as it appears on their Government-Issued ID);
   • Title or Relation to Business;
   • Personal Email Address;
   • Date of Birth;
   • Personal Address (including City, State, and Zip Code); and
   •  Percentage of Ownership/Stock.
2. A clear photocopy of a Government Issued photo ID for each owner over 20% and Managers of the business. To be accepted, your ID copy must be completely shown in the picture and not be blurry.
3. Lease Agreement (if establishment is not owned). To be accepted, the Lease Agreement must include:
   • Name of Entity or Person(s) under Ownership;
   • Establishment Address (including applicable suite or unit #s); and Term Dates.
4. Certificate of Liability Insurance (Not Policy Declarations). To be accepted, your Certificate of Liability Insurance must include all of the following: 
   • Insured Name — The applicant’s name must be listed as the insured. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Business Address — The address of the business or entity. 
   • Coverage Dates & Limits— The certificate must show the start and end dates of coverage as well as coverage limits:
     • Must hold a minimum amount of $500,000 per person and $1,000,000 in the aggregate per occurrence and property damage in a minimum amount of $1,000,000
   • Additional Insured — The City of Bloomington must be listed as an Additional Insured (can be included in the “Description of Operations” box). 
     • Please ensure the phrase “only when required by written contract” or similar is not included as the license application is not considered a contract between the City and the applicant.
   • Certificate Holder — The following must be listed in the Certificate Holder section (bottom left of the form): 
     • City of Bloomington, 115 E. Washington St., Bloomington, IL 61701
5. $2,000 Surety/Penal Bond. To be accepted, your bond must include all of the following details: 
   • Entity Name — The applicant’s name must be listed. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Business Address — The address of the business or entity. 
   • License Type
   • Bond Amount 
   • Bond number
   • Term Dates — Start and end dates of the bond. 
   • Obligee (who the bond is for) — The following must be listed as the Obligee: 
     •  City of Bloomington, 115 E. Washington St., Bloomington, IL 61701 

The following documents are required to be on file and up to date at all times: 

1. List of Owners, Partners, Officers, etc. and Managers of the Business. To be accepted, the list must include all of the following for each:
   • Full Legal Name (as it appears on their Government-Issued ID);
   • Title or Relation to Busiuness;
   • Personal Email Address;
   • Date of Birth;
   • Personal Address (including City, State, and Zip Code); and
   • Percentage of Ownership/Stock.
2. A clear photocopy of a Government Issued photo ID for each owner over 20% and Managers of the business. To be accepted, your ID copy must be completely shown in the picture and not be blurry.
3. Lease Agreement (if establishment is not owned). To be accepted, the Lease Agreement must include:
   • Name of Entity or Person(s) under Ownership;
   • Establishment Address (including applicable suite or unit #s); and Term Dates.
4. Certificate of Liability Insurance (Not Policy Declarations). To be accepted, your Certificate of Liability Insurance must include all of the following: 
   • Insured Name — The applicant’s name must be listed as the insured. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Business Address — The address of the business or entity. 
   • Coverage Dates & Limits— The certificate must show the start and end dates of coverage as well as coverage limits:
     • Must hold a minimum amount of $500,000 per person and $1,000,000 in the aggregate per occurrence and property damage in a minimum amount of $1,000,000
   • Additional Insured — The City of Bloomington must be listed as an Additional Insured (can be included in the “Description of Operations” box). 
     • Please ensure the phrase “only when required by written contract” or similar is not included as the license application is not considered a contract between the City and the applicant.
   • Certificate Holder — The following must be listed in the Certificate Holder section (bottom left of the form): 
     • City of Bloomington, 115 E. Washington St., Bloomington, IL 61701
5. $2,000 Surety/Penal Bond. To be accepted, your bond must include all of the following details: 
   • Entity Name — The applicant’s name must be listed. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Business Address — The address of the business or entity. 
   • License Type
   • Bond Amount 
   • Bond number
   • Term Dates — Start and end dates of the bond. 
   • Obligee (who the bond is for) — The following must be listed as the Obligee: 
     •  City of Bloomington, 115 E. Washington St., Bloomington, IL 61701 

The following documents are required to be on file and up to date at all times: 

1. List of Owners, Partners, Officers, etc. and Managers of the Business. To be accepted, the list must include all of the following for each:
   • Full Legal Name (as it appears on their Government-Issued ID);
   • Title or Relation to Business;
   • Personal Email Address;
   • Date of Birth;
   • Personal Address (including City, State, and Zip Code); and
   •  Percentage of Ownership/Stock.
2. A clear photocopy of a Government Issued photo ID for each owner over 20% and Managers of the business. To be accepted, your ID copy must be completely shown in the picture and not be blurry.
3. McLean County Health Permit. To be accepted, the actual McLean County Health Permit for the Mobile vehicle must be submitted, not inspection reports.
4. Food & Beverage Tax Remittance Forms are used for businesses that are active and need to provide information about their taxable income.
   • These forms should be completed each month, even if the business is reporting $0.
   • Forms can be found at http://bloomingtonil.gov/departments/finance/local-tax-information/food-and-beverage-tax.
5. Certificate of Liability Insurance* (Not Policy Declarations). To be accepted, your Certificate of Liability Insurance must include all of the following: 
   • Insured Name — The applicant’s name must be listed as the insured. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Business Address — The address of the business or entity. 
   • Coverage Dates & Limits— The certificate must show the start and end dates of coverage as well as coverage limits.
   • *Vehicle Make, Model, and License Plate # (can be included in the “Description of Operations” box). 
   • Additional Insured — The City of Bloomington must be listed as an Additional Insured (can be included in the “Description of Operations” box). 
     • Please ensure the phrase “only when required by written contract” or similar is not included as the license application is not considered a contract between the City and the applicant.
   • Certificate Holder — The following must be listed in the Certificate Holder section (bottom left of the form): 
     • City of Bloomington, 115 E. Washington St., Bloomington, IL 61701

*Note that if the vehicle insurance and business insurance are separate, copies of the insurance cards for the vehicle must be provided in addition to the business insurance; however, the vehicle details are not required to be listed on the Certificate.

The following documents are required to be on file and up to date at all times: 

1. List of Owners, Partners, Officers, etc. and Managers of the Business. To be accepted, the list must include all of the following for each:
   •  Full Legal Name (as it appears on their Government-Issued ID);
   • Title or Relation to Business;
   • Personal Email Address;
   • Date of Birth;
   • Personal Address (including City, State, and Zip Code); and
   • Percentage of Ownership/Stock.
2. Copy of the Driver's License for all Owners, Partners, Officers, etc. with over 20% interest and any General Managers of the Business. To be accepted, your ID copy must be completely shown in the picture and not be blurry.
3. Lease Agreement (if establishment is not owned). To be accepted, the Lease Agreement must include:
   1. Name of Entity or Person(s) under Ownership;
   2. Establishment Address (including applicable suite or unit #s); and Term Dates.
4. Computer Generated Site./Floor Plan*. To be accepted the submitted plan must (1) show exits, entrances, restrooms, and any other identifying features of the premises; and (2) include the ENTIRE premises included in the Liquor License, including any outdoor areas. *If you would like to redefine the premises that was last approved by the Liquor Commission, please contact the City Clerk Department at cityclerk@cityblm.org to find out how to apply.
5. Certificate of Liquor Liability Insurance (Not Policy Declarations). To be accepted, your Certificate of Liability Insurance must include all of the following: 
   • Insured Name — The applicant’s name must be listed as the insured. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Establishment Address — The address of the location where business is operated.
   • Coverage Dates & Limits— The certificate must show the start and end dates of coverage as well as coverage limits (dictated by the State of IL Liquor Control Commission). 
   • Additional Insured — The City of Bloomington must be listed as an Additional Insured (can be included in the “Description of Operations” box).
     1. Please ensure the phrase “only when required by written contract” or similar is not included as the license application is not considered a contract between the City and the applicant.
   • Certificate Holder — The following must be listed in the Certificate Holder section (bottom left of the form): 
     • City of Bloomington, 115 E. Washington St., Bloomington, IL 61701
6. $2,000 Surety/Penal Bond. To be accepted, your bond must include all of the following details: 
   • Entity Name — The applicant’s name must be listed. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Establishment Address — The address of the location where business is operated.
   • License Type
   • Bond Amount 
   • Bond number
   • Term Dates — Start and end dates of the bond. 
   • Obligee (who the bond is for) — The following must be listed as the Obligee:
     • City of Bloomington, 115 E. Washington St., Bloomington, IL 61701
7. BASSET Certifications. A List of those who are BASSET Certified must be on file and must include the General Manager. To be accepted, the list must include all of the following for each person that holds a BASSET Card:
   • Name;
   • Title;
   • Certificate Number;
   • Date Certified; and
   • Expiration Date of Certification.

The following documents are required to be on file and up to date at all times: 

1. List of Employees, Massage Therapists, Managers, and Persons with Supervisory Authority. To be accepted, the following information must be provided for each person:
   • Full Legal Name (as it appears on their Government-Issued ID);
   • Title or Relation to Business;
   • Personal Email Address;
   • Date of Birth;
   • Personal Address (including City, State, and Zip Code); and
   • Percentage of Ownership/Stock. 
2. Copy of the Driver's License for all Owners, Partners, Officers, etc. with over 20% interest and any General Managers of the Business. To be accepted, your ID copy must be completely shown in the picture and not be blurry.
3. State of Illinois Massage Therapist License
   •  A copy for each massage therapist employed by the applicant to provide massage services must be submitted.
4. Lease Agreement (if establishment is not owned). To be accepted, the Lease Agreement must include:
   • Name of Entity or Person(s) under Ownership;
   • Establishment Address (including applicable suite or unit #s); and Term Dates.
5. Computer Generated Site./Floor Plan. To be accepted the submitted plan must (1) show exits, entrances, restrooms, and any other identifying features of the premises; and (2) Be labeled and designate each room by its purpose or the activity that will take place in each room.

The following documents are required to be on file and up to date at all times: 

1. Copy of Driver's License. To be accepted, your ID copy must be completely shown in the picture and not be blurry.
2. Copy of State of Illinois Massage Therapist License

The following documents are required to be on file and up to date at all times: 

1. List of Owners, Partners, Officers, etc. and Managers of the Business. To be accepted, the list must include all of the following for each:
   •  Full Legal Name (as it appears on their Government-Issued ID);
   • Title or Relation to Business;
   • Personal Email Address;
   • Date of Birth;
   • Personal Address (including City, State, and Zip Code); and
   •  Percentage of Ownership/Stock.
2. McLean County Food Permit – A Health Permit is required if the applicant's business intends to sell any food (includes the use of ice).
3. Food & Beverage Tax Remittance Forms are used for businesses that are active and need to provide information about their taxable income.
   •  These forms should be completed each month, even if the business is reporting $0.
   • Forms can be found at http://bloomingtonil.gov/departments/finance/local-tax-information/food-and-beverage-tax.

The following documents are required to be on file and up to date at all times: 

1. List of Owners, Partners, Officers, etc. and Managers of the Business. To be accepted, the list must include all of the following for each:
   •  Full Legal Name (as it appears on their Government-Issued ID);
   • Title or Relation to Business;
   • Personal Email Address;
   • Date of Birth;
   • Personal Address (including City, State, and Zip Code); and
   •  Percentage of Ownership/Stock.
2. A clear photocopy of two Government Issued photo IDs for each owner over 20% and Managers of the business. To be accepted, your ID copies must be completely shown in the picture and not be blurry.
3. Lease Agreement (if establishment is not owned). To be accepted, the Lease Agreement must include:
   • Name of Entity or Person(s) under Ownership;
   • Establishment Address (including applicable suite or unit #s); and Term Dates.
4. $5,000 Surety/Penal Bond. To be accepted, your bond must include all of the following details: 
   • Entity Name — The applicant’s name must be listed. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Business Address — The address of the business or entity. 
   • License Type
   • Bond Amount 
   • Bond number
   • Term Dates — Start and end dates of the bond. 
   • Obligee (who the bond is for) — The following must be listed as the Obligee: 
     •  City of Bloomington, 115 E. Washington St., Bloomington, IL 61701 

The following documents are required to be on file and up to date at all times: 

1. List of Owners, Partners, Officers, etc. and Managers of the Business. To be accepted, the list must include all of the following for each:
   •  Full Legal Name (as it appears on their Government-Issued ID);
   • Title or Relation to Business;
   • Personal Email Address;
   • Date of Birth;
   • Personal Address (including City, State, and Zip Code); and
   •  Percentage of Ownership/Stock.
2. A clear photocopy of a Government Issued photo ID for each owner over 20% and Managers of the business. To be accepted, your ID copy must be completely shown in the picture and not be blurry.
3. State of Illinois Tobacco License
4. Lease Agreement (if establishment is not owned). To be accepted, the Lease Agreement must include:
   • Name of Entity or Person(s) under Ownership;
   • Establishment Address (including applicable suite or unit #s); and Term Dates.
5. $2,000 Surety/Penal Bond. To be accepted, your bond must include all of the following details: 
   • Entity Name — The applicant’s name must be listed. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Business Address — The address of the business or entity. 
   • License Type
   • Bond Amount 
   • Bond number
   • Term Dates — Start and end dates of the bond. 
   • Obligee (who the bond is for) — The following must be listed as the Obligee: 
     •  City of Bloomington, 115 E. Washington St., Bloomington, IL 61701 

The following documents are required to be on file and up to date at all times: 

1. List of Owners, Partners, Officers, etc. and Managers of the Business. To be accepted, the list must include all of the following for each:
   •  Full Legal Name (as it appears on their Government-Issued ID);
   • Title or Relation to Business;
   • Personal Email Address;
   • Date of Birth;
   • Personal Address (including City, State, and Zip Code); and
   •  Percentage of Ownership/Stock.
2. A clear photocopy of two Government Issued photo IDs for each owner over 20% and Managers of the business. To be accepted, your ID copies must be completely shown in the picture and not be blurry.
3. Certificate of Liability Insurance (Not Policy Declarations). To be accepted, your Certificate of Liability Insurance must include all of the following: 
   • Insured Name — The applicant’s name must be listed as the insured. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Establishment Address — The address of the location where business is operated.
   • Vehicle Make, Model, and License Plate # listed for Each Vehicle;
   • Coverage Dates & Minimum Coverage Limits listed as required by (625 ILCS 57/10);
   • Additional Insured — The City of Bloomington must be listed as an Additional Insured (can be included in the “Description of Operations” box).
     • Please ensure the phrase “only when required by written contract” or similar is not included as the license application is not considered a contract between the City and the applicant.
   • Certificate Holder — The following must be listed in the Certificate Holder section (bottom left of the form): 
     •  City of Bloomington, 115 E. Washington St., Bloomington, IL 61701

The following documents are required to be on file and up to date at all times: 

DRIVERS

1. A clear photocopy of a Government Issued photo ID. To be accepted, your ID copy must be completely shown in the picture and not be blurry.

COMPANIES

1. List of Owners, Partners, Officers, etc. and Managers of the Business. To be accepted, the list must include all of the following for each:
   •  Full Legal Name (as it appears on their Government-Issued ID);
   • Title or Relation to Business;
   • Personal Email Address;
   • Date of Birth;
   • Personal Address (including City, State, and Zip Code); and
   •  Percentage of Ownership/Stock.
2. A clear photocopy of two Government Issued photo IDs for each owner over 20% and Managers of the business. To be accepted, your ID copies must be completely shown in the picture and not be blurry.
3. Copy of the Vehicle Registration for Each Vehicle
   1.  If multiple vehicles are being applied for, please combine all registrations into one file and attach to the application
4. Copy of the State of IL Certificate of Safety for Each Vehicle
   1.  If multiple vehicles are being applied for, please combine all certificates into one file and attach to the application
5. $2,000 Surety/Penal Bond. To be accepted, your bond must include all of the following details: 
   • Entity Name — The applicant’s name must be listed. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Business Address — The address of the business or entity. 
   • License Type
   • Bond Amount 
   • Bond number
   • Term Dates — Start and end dates of the bond. 
   • Obligee (who the bond is for) — The following must be listed as the Obligee: 
     •  City of Bloomington, 115 E. Washington St., Bloomington, IL 61701 
6. Certificate of Liability Insurance (Not Policy Declarations). To be accepted, your Certificate of Liability Insurance must include all of the following: 
   • Insured Name — The applicant’s name must be listed as the insured. If the applicant is a corporation, the corporation’s legal name must appear here.
   • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County. 
   • Establishment Address — The address of the location where business is operated.
   • Vehicle Make, Model, and License Plate # listed for Each Vehicle;
   • Coverage Dates & Minimum Coverage Limits* listed as required by § 40-205 (also provided below);
   • Additional Insured — The City of Bloomington must be listed as an Additional Insured (can be included in the “Description of Operations” box).
     • Please ensure the phrase “only when required by written contract” or similar is not included as the license application is not considered a contract between the City and the applicant.
   • Certificate Holder — The following must be listed in the Certificate Holder section (bottom left of the form): 
     • City of Bloomington, 115 E. Washington St., Bloomington, IL 61701

*Minimum Coverage Requirements for Liability Insurance

• For vehicles carrying eight or less passengers:
  • $500,000 for bodily injury or death per person;
  • $1,000,000 for bodily injury or death per accident; and
  • $100,000 for property damage per accident.
• For vehicles carrying nine or more passengers:
  • A combined single limit for each accident of $1,200,000
• For a vehicle for hire entity operating vehicle(s) for hire:
  • A combined single limit of $1,000,000