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Tobacco Compliance Settlement AgreementsCity of Dubuque City Council C,9191Z 9���i���►�i6'�9�iF� Copyrighted October 20, 2025 ITEM TITLE: Tobacco Compliance Settlement Agreements SUMMARY: City Manager recommending City Council approval of the following Tobacco Compliance Acknowledgment/Settlement Agreements and authorize the mayor to sign the agreements: Fas Mart #5159, 2175 Central Ave; Caseys, 4003 Peru Rd; EZ Stop I, 1101 Rhomberg Ave (two separate violations); BP Fuel, 1450 Loras Blvd; EZ Stop ll, 700 Rhomberg Ave. Establishments that choose to participate in the I -PLEDGE Retailer Training program are granted an affirmative defense, which may be exercised once within a four-year period. Kwik Stop has elected to invoke this defense in response to its three violations at the following locations: Kwik Stop, 4039 Pennsylvania Ave; Kwik Stop, 2320 Gateway Dr.; Kwik Stop, 3201 Central Ave. SUGGUESTED Receive and File; Approve DISPOSITION: ATTACHMENTS: 1. MVM Memo 2. Staff Memo 3. Tobacco Agreements 4. Kwik Stop Affirmative Defense Page 406 of 817 THE CITY DUOF B TEE Masterpiece on the Mississippi TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Tobacco Compliance Settlement Agreements DATE: October 15, 2025 Dubuque All -America City 'I I' �N 2007.2012.2013 2017*2019 Chief of Police Jeremy Jensen is recommending City Council approval and Mayor Cavanagh's signature on the attached Tobacco Compliance Acknowledgement/Settlement Agreements for the following: Retailer Fas Mart #5159 Caseys EZ Stop I EZ Stop BP Fuel EZ Stop II Address 2175 Central Ave 4003 Peru Rd 1101 Rhomberg Ave 1101 Rhomberg Ave 1450 Loras Blvd 700 Rhomberg Ave Violation Date 05/18/2025-1 st Violation 06/08/2025-3rd Violation 05/18/2025-3rd Violation 06/22/2025-4th Violation 06/22/25-1 st Violation 5/18/25-2nd Violation Establishments that choose to participate in the I -PLEDGE Retailer Training program are granted an affirmative defense, which may be exercised once within a four-year period. Kwik Stop has elected to invoke this defense in response for the following three violations: Retailer Address Violation Date Kwik Stop 4039 Pennsylvania Ave 06/08/2025-1 st Violation Kwik Stop 2320 Gateway Dr. 06/08/2025-1 st Violation Kwik Stop 3201 Central Ave 06/08/2025-1 st Violation I concur with the recommendation and respectfully request Mayor and City Council approval. Mic ael C. Van Milligen MCVM:sv Attachment Page 407 of 817 CC' Crenna Brumwell, City Attorney Cori Burbach, Assistant City Manager Jeremy Jensen, Chief of Police Page 408 of 817 THE CITY OF DU Police Department Dubuque Law Enforcement Center p®MeficaCRY DUB 770 Iowa Street P.O. Box 875 Dubuque,lA 52004-0875 Mastupiece on the MIssissippi I I Office (563) 589-4410 Fax (563) 589-4497 2007.7012 •2013 TTY (563) 583-1711 E-mail! police@cityofdubuque.org www.cityofdubuque.org September 25, 2025 To: Michael C Van Milligen City Manager Fr: Jeremy Jensen Chief of Police Re: Tobacco Compliance Settlement Agreements INTRODUCTION This memo will detail the Tobacco Compliance settlement between the City of Dubuque and the following retailers: Retailer Address Fas Mart #5159 2175 Central Ave Kwik Stop 4039Pennsylvania Ave Kwik Stop 2320 Gateway Dr. Kwik Stop 3201 Central Ave Caseys 4003 Peru Rd EZ Stop 1 1101 Rhomberg Ave EZ Stop 1 1101 Rhomberg Ave BP Fuel 1450 Loras Blvd EZ Stop II 700 Rhomberg Ave BACKGROUND Violation Date 05/18/2025-1It Violation 06/08/2025-1st Violation 06/08/2025-1" Violation 06/0812025-1It Violation 06/08/2025-3rd Violation 05/18/2025-311 Violation 06/22/2025-4th Violation 06/22/25-1 st Violation 5/18/25-2nd Violation The Retailers have a tobacco license for their establishment in the city of Dubuque. The Dubuque Police Department conducted a tobacco compliance check. An employee sold nicotine -based tobacco products, which is governed under Iowa's tobacco laws, to underage youth compliance monitors. The Retailers have elected to forego a public hearing and will instead submit to statutory penalties prescribed by law. Fas Mart and BP Fuel have agreed to a $300 fine for a first violation and have submitted payment to the Police Department. The three Kwik Stops have used their Affirmative Action with the employees IPledge certifications. Page 409 of 817 They will not be allowed to use the Affirmative Action now for four years. Caseys has agreed to the $1500 fine and will notify us when they will be suspending their sales for 30 days. They have submitted payment to the Police Department. EZ Stop I with both the 3rd and 41h Violation have agreed to and submitted the fine of $1500 for each violation and started their 30-day suspension on September 7, 2025 and continue with their 60-day suspension. EZ Stop ii has agreed to the $1500 fine and submitted payment to the Police Department. CONCLUSION & RECOMMENDATION The Police Department have reviewed the agreement and concur with the requirements. ACTION REQUESTED City Manager review, City Council approval, and Mayor Cavanagh signature of the attached Acknowledgment/Settlement Agreement. cc: Crenna Brumwell Page 410 of 817 ACKNOWLEDGMENT/SETTLEMENT AGREEMENT Tobacco Compliance — 1st Violation RE: BP Fuel 1450 Loras Blvd. Dubuque, IA 52001 on behalf of BP Fuel, hereby knowingly and voluntarily acknowledge that: a) BP Fuel received the notice regarding the above referenced case. b) BP Fuel admits that the facts and allegations are true and correct. c) BP Fuel waives a hearing and submits to the statutory penalties prescribed by law. d) BP Fuel understands that this violation will count as an official "First Violation — Tobacco Compliance" of City of Dubuque Code of Ordinances Section 7-5A-15, pursuant to Iowa Code §805.8C. BP Fuel has a tobacco permit for 1450 Loras Blvd. Violation of the tobacco permit occurred as follows: Violation Date June 22, 2025 Violation Type Violation Number Tobacco Violation 1 st Violation Under the foregoing Iowa Code provisions, BP Fuel is subject a three hundred dollar ($300.00) fine. In accordance with Iowa Code §805.8C, BP Fuel accepts the following penalty: • Three hundred dollar ($300.00) fine. BP Fuel Signature Name — Please Print Date Signature Name — Please Print Date NOTE: This must be signed by an individual tobacco permittee, or in the case of another business entity, by individual(s) who have authority to bind the entity. THEREFORE, in lieu of a hearing, the City of Dubuque City Council hereby orders that the foregoing civil penalty has been remitted by BP Fuel to the City of Dubuque — Police Department. PASSED AND APPROVED this oki 4 — day of �` ���� , 20 Q5. Bra M. Cavanagh, Mayor Attest: ,12 &41�9161 Adrienne Breitfelder, City Clerk ACKNOWLEDGMENT/SETTLEMENT AGREEMENT Tobacco Compliance — 3rd Violation RE: EZ Stop I 1101 Rhomberg Avenue Dubuque, IA 52001 I, on behalf of EZ Stop I, hereby knowingly and voluntarily acknowledge that: a) EZ Stop I received the notice regarding the above referenced case. b) EZ Stop I admits that the facts and allegations contained in the Complaint, which is attached hereto and incorporated herein by reference, are true and correct. c) EZ Stop I waives a hearing and submits to the statutory penalties prescribed by law. d) EZ Stop I understands that this violation will count as an official "Second Violation — Tobacco Compliance" of City of Dubuque Code of Ordinances Section 7-5A-15, pursuant to Iowa Code §805.8C. EZ Stop I has a tobacco permit for 1101 Rhomberg Avenue. Violation of the tobacco permit occurred as follows: Violation Date April 28, 2023 June 22, 2023 May 18, 2025 Violation Type Tobacco Violation Tobacco Violation Tobacco Violation Violation Number 1 st Violation 2nd Violation 3rd Violation Under the foregoing Iowa Code provisions, EZ Stop I is subject to the following: 1) A one thousand five hundred dollar ($1,500) fine AND 2) A thirty (30) day suspension of the tobacco permit. Please review the enclosed suspension guidelines and then contact my office at (563) 589-4410 by August 30, 2025 to arrange for payment of the fine and scheduling of the suspension. Please be advised that further violations of City of Dubuque Code of Ordinances Section 7-5A-15 will result in the following: • 4t' Violation within three (3) years: $1,500 fine and sixty (60) day suspension 5th Violation within four (4) years: Revocation of Permit If you, or the attorney representing you, have any questions regarding this notice, please feel free to contact my office. Thank you for your anticipated cooperation. EZ Stop I OP 1-.1 i< p J<cub Signature Name — Please Print T Signature Name — Please Print Sip L-1 I ) 05 Date Date NOTE: This must be signed by an individual tobacco permittee, or in the case of another business entity, by individual(s) who have authority to bind the entity. THEREFORE, in lieu of a hearing, the City of Dubuque City Council hereby orders that the foregoing civil penalty has been remitted by EZ Stop I to the City of Dubuque — Police Department. PASSED AND APPROVED this "rh day of C to) , , 20 a . Brad Cavanagh, Ma- r Attest: Adrienne Breitfelder, Ci y Clerk ACKNOWLEDGMENT/SETTLEMENT AGREEMENT Tobacco Compliance - 4th Violation RE: EZ Stop I 1101 Rhomberg Avenue Dubuque, IA 52001 I, on behalf of EZ Stop I, hereby knowingly and voluntarily acknowledge that: a) EZ Stop I received the notice regarding the above referenced case. b) EZ Stop 1 admits that the facts and allegations contained in the Complaint, which is attached hereto and incorporated herein by reference, are true and correct. c) EZ Stop I waives a hearing and submits to the statutory penalties prescribed by law. d) EZ Stop I understands that this violation will count as an official "Fourth Violation — Tobacco Compliance" of City of Dubuque Code of Ordinances Section 7-5A-15, pursuant to Iowa Code §805.8C. EZ Stop I has a tobacco permit for 1101 Rhomberg Avenue. Violation of the tobacco permit occurred as follows: Violation Date Violation Type Violation Number April 28, 2023 Tobacco Violation 1 St Violation June 22, 2023 Tobacco Violation 2nd Violation May 18, 2025 Tobacco Violation 3rd Violation June 22, 2025 Tobacco Violation 4tn Violation Under the foregoing Iowa Code provisions, EZ Stop 1 is subject to the following: 1) A one thousand five hundred dollar ($1,500) fine G►►Roj 2) A sixty (60) day suspension of the tobacco permit. Please review the enclosed suspension guidelines and then contact my office at (563) 589-4410 by September 30, 2025 to arrange for payment of the fine and scheduling of the suspension. Please be advised that further violations of City of Dubuque Code of Ordinances Section 7-5A-15 will result in the following: 0 5tn Violation within four (4) years: Revocation of Permit If you, or the attorney representing you, have any questions regarding this notice, please feel free to contact my office. Thank you for your anticipated cooperation. EZ Stop I Signature Name — Please Print UR C Date Signature Name — Please Print Date NOTE: This must be signed by an individual tobacco permittee, or in the case of another business entity, by individual(s) who have authority to bind the entity. THEREFORE, in lieu of a hearing, the City of Dubuque City Council hereby orders that the foregoing civil penalty has been remitted by EZ Stop I to the City of Dubuque — Police Department. PASSED AND APPROVED this aO" day of Odob--- , 20 mac', Bra avanagh, Mom, Attest: Adrienne Breitfelder, bty Clerk 4"' Violation within three (3) years: $1,500 fine and sixty (60) day suspension 5°i Violation within four (4) years: Revocation of Permit If you, or the attorney representing you, have any questions regarding this notice, please feel free to contact my office. Thank you for your anticipated cooperation. Casey's General Stores, Inc �f�X DocuSigned by: i� gptP593434 Siynahire tl 7f Kyle Paris Director Enterprise Risk & Comnliancp Name —Please Print9/10/2025 Name —Please Print Y Date Dom- _ ; T � ;_ NOTE This must be signed by an individual tobacco permittee, or in the case of another business entity. by Ord .vidual(s) who have authority to bind the entity. lieu of a hearing orders that the foregoing civil penalty Dubulque — Police Department. the City of Dubuque City Council hereby been remitted by fiZ x>bdsxthe City of Casey's General Stores, Inc. n'� PASSED AND APPROVED this day of C e Qr , 20 Brad Cavanagh, Ma Attest: , 1.j,-�_ Adrienne Brleitfelder, Clty Clerk Sender's Direct -Dial Telephone Number: 515.446.6196 Fax Number: 515.965.6i6o E-mail Address: patty.ewing@caseys.com September 11, 2025 City of Dubuque — Police Department 770 Iowa Street Dubuque, IA 52001 RE: Casey's Store #2421 4003 Peru Road Dubuque, IA 52001 Dear Chief Jensen, Enclosed is the signed Acknowledgment/Settlement Agreement, as well as Casey's check for payment of the fine in the amount of $1,500. Said amount was assessed as a penalty against the Dubuque, Iowa, store for an alleged sale of tobacco to a minor that reportedly occurred on or about June 8, 2025. I am working with the store to decide on suspension dates. Sincerely, Patty Compliance Analyst Enclosure cc: Lynn Cargin, Region Director (via Email) Amy Bellew, District Manager (via Email) One SE Convenience Blvd I Ankeny, Iowa' 50021-8045 I caseys.com 1515-965-6100 ACKNOWLEDGMENT/SETTLEMENT AGREEMENT Tobacco Compliance — 111 Violation RE: Fas Mart #5159 GPM Midwest, LLC 2175 Central Avenue 8565 Magellan Pkwy, Ste 400 Dubuque, IA 52001 Richmond, VA 23227 I, , on behalf of Fas Mart #5159, hereby knowingly and voluntarily acknowledge that: a) Fas Mart #5159 received the notice regarding the above referenced case. b) Fas Mart #5159 admits that the facts and allegations contained in the Complaint, which is attached hereto and incorporated herein by reference, are true and correct. c) Fas Mart #5159 waives a hearing and submits to the statutory penalties prescribed by law. d) Fas Mart #5159 understands that this violation will count as an official "First Violation — Tobacco Compliance" of City of Dubuque Code of Ordinances Section 7-5A-15, pursua tq ow Code §80 8C. Fas Mart #5159 has a tobacco permit fcUb liiammafr of Avenue. Violation of the tobacco permit occurred as follows: Violation Date Violation Type Violation Number May 18, 2025 Tobacco Violation 1 st Violation Under the foregoing Iowa Code provisions, Fas Mart #5159 is subject a three hundred dollar ($300.00) fine. In accordance with Iowa Code §805.8C, Fas Mart #5159 accepts the following penalty: • Three hundred dollar ($300.00) fine. Fas Mart #5159 Signature Name - Please Print Date Signature Robb Giammatteo Name - Please Print 8/19/2025 Date NOTE: This must be signed by an individual tobacco permittee, or in the case of another business entity, by individual(s) who have authority to bind the entity. THEREFORE, in lieu of a hearing, the City of Dubuque City Council hereby orders that the foregoing civil penalty has been remitted by Fas Mart #5159 to the City of Dubuque — Police Department. � PASSED AND APPROVED this 21_ �r h day of oc^I o r , 20 r6 Brad Cavan , Mayor Attest: Adrienne Breitfelder, City Clerk ACKNOWLEDGMENT/SETTLEMENT AGREEMENT Tobacco Compliance - 2nd Violation RE: EZ Stop II 700 Rhomberg Avenue Dubuque, IA 52001 1, i IC 'ld hl/ty , on behalf of EZ Stop II, hereby knowingly and voluntarily acknowledge that: a) EZ Stop II received the notice regarding the above -referenced case. b) EZ Stop it admits that the facts and allegations are true and correct. c) EZ Stop II waives a hearing and submits to the statutory penalties prescribed by law. d) EZ Stop II understands that this violation will count as an official "First Violation — Tobacco Compliance" of City of Dubuque Code of Ordinances Section 7-5A-15, pursuant to Iowa Code §805.8C. EZ Stop II has a tobacco permit for 700 Rhomberg Avenue. Violation of the tobacco permit occurred as follows: Violation Date February 9, 2024 May 18, 2025 Violation Type pe Tobacco Violation Tobacco Violation Violation Number 1 st Violation 2"d Violation Under the foregoing Iowa Code provisions, EZ Stop II is subject to the following:ln accordance with Iowa Code §805.8C, EZ Stop 11 accepts the following penalty: 1) Fifteen Hundred dollars ($1500.00) fine W4 2) A thirty (30) day suspension of the tobacco permit In accordance with Iowa Code §805.8C, EZ Stop 11 accepts the following penalty: o One thousand five hundred dollars ($1,500) fine o Thirty (30) day tobacco permit suspension EZ Stop II Signature Nk,e IKIRb,,vi O Name — Please Print q )-( PS Date Signature Name — Please Print Date NOTE: This must be signed by an individual tobacco permittee, or in the case of another business entity, by individual(s) who have authority to bind the entity. THEREFORE, in lieu of a hearing, the City of Dubuque City Council hereby orders that the foregoing civil penalty has been remitted by EZ Stop II to the City of Dubuque — Police Department. PASSED AND APPROVED this )fir„ day of C%cfo�er , 20 Brad M. Cava nag0�--- Attest: ,It,1�2 �g2� Adrienne Breitfelder, City Clerk PO BOX 768, Dubuque IA 52004.0768 • 15631582. 7291 • GoWkStop.com August 29, 2025 Dear Members of the City Council, I am writing to formally request approval to apply an affirmative defense in response to three violations issued against Kwik Stop on June 8, 2025. Each of these violations occurred at different stores operating under separate tobacco licenses. We respectfully assert that the violations occurred at the locations listed below and the employees had valid I -PLEDGE certifications at the time of citation. • Kwik Stop 4039 Pennsylvania Ave., Natalie Morel (I -PLEDGE certification expires 11/14/26) • Kwik Stop 2320 Gateway Dr., Dustin Soots (I -PLEDGE certification expires 5/23/26) • Kwik Stop 3201 Central Ave., Timothy Herber (I -PLEDGE certification expires 12/21 /26) It is our policy to terminate employment of anyone that sells age -restricted items to a minor. We have also taken proactive steps to address the issue, including adding additional mandatory training, and requiring customers provide a scannable ID for all age -restricted sales on our registers. Our intention has always been to remain in full compliance with regulations and to uphold the standards expected of responsible members of the community. We kindly ask the Council to consider our request under the affirmative defense framework. Thank you for your time and consideration. Sincerely, Melissa Lolwing Operations Excellence KWIK STOP LOCATIONS IN YOUR NEIGHBORHOOD 4039 PENNSYLVANIA AVE • 2335 UNIVERSITY AVE • 2320 GATEWAY DR • 2150 TWIN VALLEY DR • 3201 CENTRAL AVE 1210 E 16T" ST • 1215 E 161" ST • 2255 KERPER BLVD • 3340 JFK RD • 185 PEOSTA ST IN PEOSTA • 504 3R1 ST IN DELHI Page 424 of 817 Aft � M ACKNOWLEDGMENT/SETTLEMENT AGREEMENT Tobacco Compliance - 1$t Violation RE: Kwik atop : Riverdam Properties, LLC 2320 Gateway Dr. PO Box 768 Dubuque, IA 52001 Dubuque, to 52004-0768 1, , on behalf of Kwik Stop Gateway Dr., hereby knowingly and voluntarily acknowledge that: a) Kwik Stop received the notice regarding the above referenced case. b) Kwik Stop admits that the facts and allegations are true and correct. c) Kwlk Stop waives a hearing and submits to the statutory penalties prescribed by law. d) Kwik Stop understands that this violation will count as an official "First Violation -- Tobacco Compliance" of City of Dubuque Code of Ordinances Section 7-5A-15, pursuant to Iowa Code §805.8C. Kwlk Stop has a tobacco permit for 2320 Gateway Dr. Violation of the tobacco permit occurred as follows: Violation D@te Violation -Type Violation Number 06/08/2025 Tobacco Violation 1 St Violation Under the foregoing Iowa Code provisions, Kwik Stop is subject a three hundred dollar ($300.00) fine. In accordance with Iowa Code §805.8C, Kwik Stop Gateway accepts the following penalty: Three hundred dollar ($300.00) fine. Kwik Strap Gateway Signature Name — Please Print Date Signature Name — Please Print Date NOTE: This must be signed by an Individual tobacco permittee, or in the case of another business entity, by Individual(s) who have authority to bind the entity. Page 425 of 817 THEREFORE, In lieu of a hearing, the City of Dubuque City Council hereby orders that the foregoing civil penalty has been remitted by Kwlk Stop to the City of Dubuque -- Police Department, PASSED AND APPROVED this T day of , 20__ ----_. Brad M, Cavanagh, Mayor Attest; Adrienne Breitfelder, City Clerk Page 426 of 817 Page 427 of 817 ACKNOWLEDGMENTISETTLEMENT AGREEMENT Tobacco Compliance — .ilat Violation RE: Kwik Stop : Riverdam Properties, LLC 3201 Central Ave PO Box 768 Dubuque, IA 52001 : Dubuque, IA 52004.0768 : I, , on behalf of Kwik Stop Central Ave, hereby knowingly and voluntarily acknowledge that: a) Kwik Stop received the notice regarding the above referenced case, b) Kwik Stop admits that the facts and allegations are true and correct. c) Kwik Stop waives a hearing and submits to the statutory penalties prescribed by law. d) Kwik Stop understands that this violation will count as an official "First Violation — Tobacco Compliance" of City of Dubuque Code of Ordinances Section 7-5A-15, pursuant to Iowa Code §805.8C. Kwik Stop has a tobacco permit for 3201 Central Ave. Violation of the tobacco permit occurred as follows: Violation Date Violation.Tyoe Violation Number 06/08/2025 Tobacco Violation 1st Violation Under the foregoing Iowa Code provisions, Kwik Stop is subject a three hundred dollar ($300.00) fine. In accordance with Iowa Code §805.8C, Kwik Stop #72 accepts the following penalty: • Three hundred dollar ($300.00) fine, Kwik Stop Central Ave Signature Name --- Please Print Date Signature Name W Please Print Date NOTE: This must be signed by an Individual tobacco permittee, or In the case of another business entity, �)y indlvidual(s) who have authority to bind the entity. Page 428 of 817 THEREFORE, in lieu of a hearing, the City of Dubuque City Council hereby orders that the foregoing civil penalty has been remitted by Kwik Stop #72 to the City of Dubuque — Police Department. PASSED AND APPROVED this day of Brad M. Cavanagh, Mayor Attest; Adrienne Breltfelder, City Clerk Page 429 of 817 PLEDGE -A - l '_ M-re, Awarded to. - Timothy J Herber Sr For completion of. - Iowa Pledge Retailer Training Program Date of completion: Dec 21, 2024 Expires on: Dec 21, 2026 Certificate No: 202711 Thank you for participating in the Iowa Pledge Retailer Training Program and for partnering with the Iowa Alcoholic Beverages Division to not sell tobacco products to Iowa's kids. State of Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road, Stephen Larson Ankeny, IA 50021 Administrator Page 430 of 817 ACKNQWLEDGMENTISETTLEMENT AGREEMENT Tobacco Compliance — Pt Violation RE: Kwlk Stop Riverdam Properties, LLC 4039 Pennsylvanian Dr, PO Box 768 Dubuque, IA 52002 Dubuque, IA 52004.0768 1, , on behalf of Kwik Stop Pennsylvania, hereby knowingly and voluntarily acknowledge that: a) Kwlk Stop received the notice regarding the above referenced case. b) Kwlk Stop admits that the facts and allegations are true and correct. c) Kwik Stop waives a hearing and submits to the statutory penalties prescribed by law. d) Kwik Stop understands that this violation will count as an official "First Violation — Tobacco Compliance" of City of Dubuque Code of Otdinances Section 7-5A-15, pursuant to Iowa Code §805.8C. Kwik Stop has a tobacco permit for 4039 Pennsylvania Ave. Violation of the tobacco permit occurred as follows: Violation Date Violation Type Violation Number 06/08/2025 Tobacco Violation 13t Violation Under the foregoing Iowa Code provisions, Kwik Stop is subject a three hundred dollar ($300.00) fine. In accordance with Iowa Code §805,8C, Kwik Stop accepts the following penalty: • Three hundred dollar ($300,00) fine, Kwlk Stop PennsylvAn.11gj.Ave. Signature Name -- Please Print Date Signature Name — Please Print Date NOTE: This must be signed by an individual tobacco permitter, or In the case of another business entity, by individual(s) who have authority to bind the entity. Page 431 of 817 THEREFORE, in lieu of a hearing, the City of Dubuque City Council hereby orders that the foregoing civil penalty has been remitted by Kwik Stop #72 to the City of Dubuque — Police Department. PASSED AND APPROVED this day of 120 Brad M. Cavanagh, Mayor Attest: Adrienne Breitfelder, City Clerk Page 432 of 817 PLEDGE Awarded to. - Natalie Ann Morel For completion of. - Iowa Pledge Retailer Training Program Date of completion: Nov 14, 2024 Expires on: Nov 14, 2026 Certificate No: 201819 Thank you for participating in the Iowa Pledge Retailer Training Program andforpartnering with the Iowa Alcoholic Beverages Division to not sell tobacco products to Iowa's kids. State of Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road, Stephen Larson Ankeny, IA 50021 Administrator Page 433 of 817