3.7. SR 10-17-2005
*Item 3.7.~
MEMORANDUM
TO: Mayor and City Council
FROM: Joan Schmidt, City Clerk
DATE: October 17,2005
SUBJECT: Acknowledge Wal-Mart Stores Currency Exchange License
Backiround
Wal- Mart Stores, Inc. has applied to the Minnesota Department of Commerce to renew its
currency exchange license to operate at 18185 Zane Street. Minnesota Statues requires the
governing body of a municipality to render a decision in regards to this type of license
whenever a licensee wishes to renew their license.
Action Requested
Cooocil motion approving a Currency Exchange License Renewal for 2006 for Wal- Mart
Stores, Inc. operating at 18185 Zane Street.
S:\Council~oan\Currency Exchange\Wal-Mart.doc
OCT 0 5 2005
85 7th Place East, Suite 500
St. Paul, Minnesota 55101-2198
651.296.4026 FAX 651.297.1959 TTY 651.297.3067
October 3, 2005
City Clerk
City of Elk River
13065 Orono Rd.
Elk River, MN 55330
CERTIFIED MAIL
RE: Wal-Mart Stores, Inc. - License #20431046
Currency Exchange License Renewal for 2006
Dear City Clerk:
The above-named currency exchange licensee has made application to renew its currency
exchange license to operate at:
18185 Zane St.
Elk River, MN 55330
Pursuant to Minnesota Statutes Chapter 53A.04, we are forwarding a copy of the complete
renewal application to the City of Elk River care of your office for you to review.
Minnesota Statutes Chapter 53A.04 requires the Department of Commerce to submit any
application for licensure as a currency exchange to the governing body of the municipality in
which the currency exchange conducts business. The law further requires the governing
body of the municipality to render a decision regarding the renewal of the license within 60
days. Your cooperation in forwarding this information to the proper unit within your
organization is appreciated.
Your reply must be received within 60 days of receipt of this letter. If you have any
questions, please contact me at the telephone number listed below.
#~YYO:S'
~ Brown
Financial Examinations Division
651-282-9855
651-296-9851 (Fax)
Enclosure
Market Assurance: 1.800.657.3602
Energy Information: 1.800.657.3710
www.commerce.state.mn.us
Licensing: 1.800.657.3978
Unclaimed Property: 1.800.925.5668
An Equal Opportunity Employer
r
j{tJl5
MINNESOTA 2006 LICENSE RENEWAL NOTICE
CURRENCY EXCHANGE
WAL-MART STORES INC. dba \~~~~ercenter License Type: CURRENCY EXCHANGE
dba: WAL-MART ""-1#3209 OEl\*. License Number: 20431046
18185 ZANE ST SClp 01 200S C St ct CORPORATION
ELK RIVER, MN 55330 (;...&. J::.J'{....~.. . ompany ru ure:
w~ Renewal Fee: $500
Phone Number: (763) 441-3461 ~ [ ] Check this box if you will not be renewing the license for the year 2006.
Returning the form will serve as a SURRENDER of the license.
AFFIRMATION:
I hereby certify that the information and responses contained in this renewal application are true and correct to the best of my knowledge and belief.
Rick tv. Brazile
~eZ
. . ~~! tf,r
Signature
VP of Finance
Title
8/17/05
Date
NOTARY SEAL
Subscribed and :;worn to, before me, a Notary Public, this17 day of
a~OJ r; ~~ Smtem
.. Count of
Notary Public Signature \ y
My commission expires
Augus t , 2005.
Arkansas
Benton
6/22/13
You must return this entire 2-page form with attachments, signed, along with your renewal payment, to:
Minnesota Department of Commerce
Financial Examinations Division
85 - 7th Place East, Suite 500
S1. Paul, MN 55101-2198
CORRECTIONS/AMENDMENTS: Make name, address or telephone number corrections directly on the form above.
. For a name change, attach a copy of the amended name filed and stamped by the Minnesota Secretary of State.
. If the company uses an assumed name in Minnesota and the name is not included in the above information, attach a copy of the
Assumed Name Certificate from the Minnesota Secretary of State.
. P.O. Box addresses are not acceptable. Renewals without a street address will be returned.
TIMELY RENEWAL: The renewal form must be signed, notarized, and dated and returned with the correct renewal fee by Sept. 2, 2005.
. Pursuant to Minnesota Statutes, Chapter 53A.04(a), regarding the licensing of currency exchanges, both state and local approval
of the issuance and renewal of a currency exchange license is required. This process may take up to 120 days; therefore, you
should return the required forms immediately to ensure a timely renewal.
. If all required forms are not fully completed and returned to our office with payment by September 2, 2005, your license will lapse
effective December 31,2005. If your license does lapse, you must reapply for a license using the license application form and
paying the new license fees.
. A properly renewed license will be valid through December 31,2006.
RENEWAL FEE:
. NO CASH ACCEPTED. Please make check or money order payable to MN. DEPT. OF COMMERCE.
. NOTICE: Dishonored checks will be assessed a $30 service fee by law and may result in failure to renew license.
. Renewal fees are non-refundable except that an overpayment of a fee will be refundable upon proper application.
If you have questions, please contact the Financial Examinations Division bye-mail at
robin.brown@state.mn.us or by telephone at (651) 282.9855.
WAL-MART STORE #3209
18185 ZANE ST
ELK RIVER, MN 55330
Page 1 of 2
.
MINNESOTA 2005 LICENSE RENEWAL NOTICE
CURRENCY EXCHANGE
The following information must be completed as part of the renewal application:
1. Attach to this form a list of the name(s), business and residence address, and official title of each director, officer,
limited or general partner, manager, shareholder holding more than ten percent of the outstanding stock of the
corporation, and employees with authority to exercise management or policy control over the company or member of
the licensee. The list should contain the equity ownership of each person.
2. Each person listed in item 1 must request the Bureau of Criminal Apprehension conduct a background Investigation on
the form provided. Completed forms must be submitted with your renewal application.
3. Attach a current fee schedule of all fees charged by the currency exchange office for cashing checks, money orders
or travelers checks. The list must include the type of checks cashed, the fees charged, and whether or not the fees
vary depending on the amount of the check.
4. Attach the $10,000 Surety Bond (on the forms provided) with a power of attorney form. The bond must be effective
January 1, 2006, until December 31, 2006.
5. Does the licensee have employees at the currency exchange location?
[ X ] Yes [ ] No If yes, you must provide evidence of current workers' compensation insurance. Attach a copy
of the certificate of insurance.
6. Does the licensee operate any other currency exchange locations?
[ X] Yes [ ] No If yes, attach to this form the name of the location, the street address, city, state, zip code, and
county.
7. ~s~~
Name Pauline Lasister
Firm Name Wal-MartStores Inc.
Street Address 702 S. W. 8th Street
Ci Bentonville
StatelZi Code ~ 72716-0500
Tele hone Number 479-204-2055
Fax Number 479-204-9864
Pauline.Lasister@wal-mart.com
E-mail address
8.
to consumer com laints:
Name Cindy H. Yang-McPike
Title
Firm Name Wal-MartStores Inc.
Street Address 702 S. W. 8th Street
Ci Bentonville
State/Zi Code AR 72716-0500
Tele hone Number 479-204-0788
Fax Number 479-204-3004
chyang@Wal-martcom
E-mail address
9. Contact erson at the curren
e location:
Name Peter Reiner
Title Store Manager
Wal-M art Supercenter #3209
Street Address 18185 Z ane Street
Ci Elk River
StatelZi Code MN 55330
763441 3461
Tele hone Number
Fax Number nla
E-mail address nla
Page 2 of 2
OFFICERS AND DIRECTORS
NAME AND TITLE
RESIDENCE
SSN AND DATE
OF BIRTH
H. Lee Scott, Jr.
President & CEO
Director
61 Champions Boulevard
Rogers, AR 72758
~'
<""
.. - 4 - 4 9- .... .
Robin E. Forbis
Sr. V.P. of Finance
5103 South 44th Street
Rogers, AR 72758
Thomas C. Gean
Assistant Secretary
18 Copperfield ...............
Bentonville, AR 72712 ~.
Rick W. Brazile
Vice President of
Finance
25 Stonehenge Drive
Bentonville, AR 72712
The above officers/directors own less than 1% stock of Wal-Mart
Stores, Inc., a public corporation.
The above officers/directors are those designated authority for all
licensing matters and serve in the capacity as listed above for
Wal-Mart Stores, Inc., Wal-Mart Stores East, Inc., Wal-Mart Stores
East, LP, Wal-Mart Louisiana, LLC, Sam's East, Inc. and Sam's West,
Inc.
WSE Management, LLC and WSE Investment, LLC own the limited and
general partnership interest in Wal-Mart Stores East, LP.
WSE Management, LLC
WSE Investment, LLC
- General Partner - 1%
- Limited Partner - 99%
; .
Minnesota Department of Public Safety
Bureau of Criminal Apprehension
Criminal Justice Information Systems Section
1430 Maryland Avenue East
St Paul, MN 55106-2802
(651) 793-2400 TTY: (651) 282-6555
www.bca.state.mn.us
Date: 2005/09/20
Name: SCOTT, H LEE
DOB: 1949/03/14
SEQ #: 286
This letter certifies that a search has been made of the criminal
history files maintained in Minnesota by the Department of Public
Safety, Bureau of Criminal Apprehension.
The search was performed by Name and Date of Birth.
The result of this search indicates that no record was found based
on the above search criteria.
This does not preclude the possible existence of additional
information located at county or city levels.
If you have questions about this record please contact the
telephone number above.
Minnesota Department of Public Safety
Bureau of Criminal Apprehension
Criminal Justice Information Systems Section
1430 Maryland Avenue East
St Paul, MN 55106-2802
(651) 793-2400 TTY: (651) 282-6555
www.bca.state.mn.us
Date: 2005/09/20
Name: FORBIS, ROBIN E
DaB: 1968/04/04
SEQ #: 287
This letter certifies that'a search has been made of the criminal
history files maintained in Minnesota by the Department of Public
Safety, Bureau of Criminal Apprehension.
The search was performed by Name and Date of Birth.
The result of this search indicates that no record was found based
on the above search criteria.
This does not preclude the possible existence of additional
information located at county or city levels.
If you have questions about this record please contact the
telephone number above.
Minnesota Department of Public Safety
Bureau of Criminal Apprehension
Criminal Justice Information Systems Section
1430 Maryland Avenue East
St Paul, MN 55106-2802
(651) 793-2400 . TTY: (651) 282-6555
www.bca.state.rnn.us
Date: 2005/09/20
Name: GEAN, THOMAS C
DOB: 1962/10/28
SEQ #: 288
This letter certifies that a search has been made of the criminal
history files maintained in Minnesota by the Department of Public
Safety, Bureau of Criminal Apprehension.
The search was performed by Name and Date of Birth.
The result of this search indicates that no record was found based
on the above search criteria.
This does not preclude the possible existence of additional
information located at county or city levels.
If you have questions about this record please contact the
telephone number above.
Minnesota Department of Public Safety
Bureau of Criminal Apprehension
Criminal Justice Information Systems Section
1430 Maryland Avenue East
St Paul, MN 55106-2802
(651) 793-2400 TTY: (651) 282-6555
www.bca.state.mn.us
Date: 2005/09/20
Name: BRAZILE., RICl<: W
DOB: 1956/04/29
SEQ #: 289
This letter certifies that a search has been made of the criminal
history files maintained in Minnesota by the Department of Public
Safety, Bureau of Criminal Apprehension.
The search was performed by Name and Date of Birth.
The result of this search indicates that no record was found based
on the above search criteria.
This does not preclude the possible existence of additional
information located at county or city levels.
If you have questions about this record please contact the
telephone number above.
.-. -- ..-.,,-...__.... .w.'
Addendum 9
Wal-Mart Stores, Inc. is beginning a payroll check cashing service for our customers from its
cash registers only. Customers will be able to cash a payroll check for a small fee. The fee will
either be 1 % ofthe check or $3.00 for each transaction, with a maximum rate being $3.00 being
charged. Below is a list of all states where Wal-Mart Stores, Inc. has check cashing services for
our Customers.
Minnesota
South Carolina
California
Pennsylvania
Maryland
Utah
Louisiana
Virginia
Georgia
Nevada
Indiana
North Carolina
Washington
Delaware
Vermont
~';11Th:-.,
....
~"
---~..;;'.-
BOND NUMBER: 104137362
STATE OF MINNESOTA 'IR# 5780
DEPARTMENT OF COMMERCE
CURRENCY EXCHANGE SURETY BOND
KNOW ALL PERSONS BYlHESEPRESENTS: That tolal-Mart Stores. Inc. dba Store #3209
(Name ofCmrency Excbange)
a DisCOtmt Retailer. Delaware
(Desaiption or fo1m ofbusiness org;mi'7Jlfi~ inclndiog slate of incoIpom1ion)
with business office at . 18185 Zane Street Elk River MN 55330
(Street Address, City, Stare, Zip)
as PRlNCIP AL and Travelers Casualty & Surety Company of America
(Name of Surety)
a cozporation duly OI'!?'nw,ed under the laws of the State of Connecticut which is authorized to
engage in the business of insmance in the State of Minnesota, as SURETY, are hereby held and firmly bound to the
Department of Commerce of the State of Minnesota in the sum ofTEN mouSAND DOlLARS ($10,000). Principal
and Sure1;y hereby bind 1hemselves, their IepreSeIltatives, SUCCCSSOIS and ~~.jointfy and severally by 1hese presents.
The parties further agree that:
1. The purpose of tis obligmion, which is required by Minnesota S1a1ntes, Section S3AOS, is to secure die compliance
by Prlnclpa1 with the bms of Minnesota Statutes, Section S3A02 to S3A13, and any other legal obI~ arising
out of the Principal's conduct as a cmrency exchange.
2. This bond is for the benefit of the State ofM"11111f'.Snta and all persons suffering damages by reason of the Principal's
fililureto comply with MtnnP$J1:a ~ Section S3A02 10 S3A08, or other legal obligations arising out of
Principal's conduct as a Cl1l1"eIlCY exchange.
3. If1he Prlncipal shall violate Minnesota ~ Section 53A02to S3A08, or other Jegal obl~ arising out of
i1s conduct as a amency exchange, the CommiSsioner of Cnmtt-ce, as well as any petDl damaged as a result of
such violation shall have, in addition 10 all other legal remedies, a rlgbt of action on this bond in the name of the
iqjured party for loss sustained by the iqjured party.
4. This bond shall be effective from J an u a r y 1
2006 until~31,
200p
(Year)
Signed and Sealed this 1 s t day of SePtember
Travelers Casualty & Surety
By: Company of America
(Name ofSmety)
By: Wal-Mart Stores, Inc. dba Store
(Name ofCmrency Exchange) #3209
2005
. .
By:~/~ IIazel L. Pmsser
(Signature of Aumney in Fact of Surety Comp9ny)
~~~
By: ~~..
(SigJ1111:tlle of Sole Proprietor, Partner,or President)
H. Iaa Scott, Jr.
.. ........... ...........
FOR DEPARTMENT USE ONLY
Approved as to form and execotion by Department of Commerce.
Date
1
MNIDOC CE BOND 7/1999
1. This page is to be completed by a notIIypublic for bo1h the Principal and the Surety.
2. Please attach the Power of Attorney and Certified Copy of the CoIporate Resolution for the Smety listed herein.
ACKNOWLEDGMENT OF PRINCIPAL
STATE O~" Arkansas
COUNTY OF Benton
)
) 55.
(SOLE PROPRIETORSHIP) N/ A
The foregoing instrument was acknowledged before me this day of
by
(Name ofperson acknowledged)
NOTARY SEAL
NotaIy Public
.........................................................*..
(pARTNERSBIP/LIMITED LlABll.JTY COMPANY) N/ A--
The foregoing instrument was acknowledged before me this
by
day of
t a partner on behalf of
(Name of acknowledging partner)
t a partnership.
(Name ofpartnembiplJimited liabili1y company)
NOTARY SEAL
NotaIy Public
..*...*......*............... ...............***............*..
(CORPORATION)
The foregoing instrmnent was acknowledged before me this 1 s t
by H. Lee Scott, Jr.
(Name of cmporate president)
Wal-Mart Stores. Inc.
(Name of corporation acknowledging)
behalf of1he corporation.
day of September
. President of
t 2005 t
ta
Delaware cmpmation. on
(~~ h [f\~
otary Pobli
NOTARY SEAL
........*...................................................
ACKNOWLEDGMENT OF SURETY
STATE OF Arkansas
COUNTY OF Benton
)
) SS.
The foregoing instrument was acknowledged before me this. 1 s t day of September
by Hazel L. Prosser
(Name and title of officer or agent)
of Traveler Casualty & Surety Company of America
(Name of corporation acknowledging)
a Connecticut corporation, on bebalfofthe
(state of incorporation)
NOTARY SEAL
t 2005 t
2