January - June

Logbook

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LOGBOOK DATES: JANUARY - JUNE, 20

IMPORTANT CONTACT NUMBERS

Serving It Right 604-633-9798

3

Guidelines for using your Serving It Right Logbook

An Incident Logbook is your record of the details surrounding an incident involving a patron. It gives an accurate and measurable picture of what happened in the event that:

• A patron was denied entry, refused or cut off from service, or required transportation home;

• An injury or accident occurred on your premise;

• A minor was present on your premise;

• Emergency personnel were called (police, fire, or ambulance).

A detailed, accurate incident logbook is a strong element of any defense should an incident lead to legal action against your business. It will be used by police, lawyers, and the courts.

Records must be kept for at least six years. In most instances a person’s right to sue for an incident in an establishment ends after two years. However, there are various circumstances when a legal proceeding may be commenced against an establishment several years after the incident.

Completing the Daily Communications Log

The Daily Communications Log should be completed every day even if nothing happened. It is a method of due diligence to help you and your staff record and recall events that occur on your premise on a daily basis. Each day, the staff member who completed the daily entry should sign his or her name.

When a Yes is circled an Incident Report MUST be completed and the Incident Report # cross referenced in the Daily Entry. A separate Incident Report must be completed for every Yes that is circled, even if more than one is circled on the same day.

Completing an Incident Report

An accurate and complete log, together with sales slips, may form the backbone of your defense in civil litigation and in enforcement hearings before the liquor authority.

As soon as an incident has been taken care of a manager or licensee must:

• Complete an Incident Report from Section 2.

• Record the Incident Report # on the Daily Communications Entry (Section 1) for the date of the incident.

• Attach all sales records associated with the incident to the Incident Report.

If the incident may lead to legal action a manager should notify the insurer. Staff should always be debriefed after an incident. This is an opportunity to assess and improve procedures and house policies to avoid a repeat of the incident.

4

INCIDENT REPORT SAMPLE

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

April 3, 2016 11:29

Tina S October 15, 1963

5’ 7”

170 lbs.

None

Reddish Brown

2345

4

Pink top, black velvet jacket, black pants n/a

Alice T

Jennifer R and Robert B

Robert B Steve H

Jennifer R

5

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

Robert B. offered a free taxi home

Acme Cabs

Shane J

123 Main St., Vancouver, BC V0V 0V0

604-555-5555

At 10:30 pm Tina S and Alice T entered the establishment and ordered

appetizers and one bottle of wine with a 12% alcohol volume. At 11:20 Tina attempted

to order a second bottle of wine, but was refused service by Jennifer R . Tina

asked to speak with the manager and Jennifer asked Robert B to come to speak

with the ladies. Robert also refused service and offered Tina and Alice a free taxi ride

home. This offer was accepted and Tina and Alice left the establishment at 11:37 pmin an Acme taxi.

Robert B

Jennifer R

Robert B

Server

Manager

Maureen S

567 First St., Vancouver, BC V1V 1V1

778-555-5555

6

DAILY COMMUNICATION LOG ENTRY January 1

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 2

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 3

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 4

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

7

DAILY COMMUNICATION LOG ENTRY January 5

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 6

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 7

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 8

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

8

DAILY COMMUNICATION LOG ENTRY January 9

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 10

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 11

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 12

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

9

DAILY COMMUNICATION LOG ENTRY January 13

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 14

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 15

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 16

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

10

DAILY COMMUNICATION LOG ENTRY January 17

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 18

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 19

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 20

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

11

DAILY COMMUNICATION LOG ENTRY January 21

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 22

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 23

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 24

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

12

DAILY COMMUNICATION LOG ENTRY January 25

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 26

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 27

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 28

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

13

DAILY COMMUNICATION LOG ENTRY January 29

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 30

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY January 31

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 1

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

14

DAILY COMMUNICATION LOG ENTRY February 2

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 3

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 4

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 5

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

15

DAILY COMMUNICATION LOG ENTRY February 6

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 7

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 8

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 9

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

16

DAILY COMMUNICATION LOG ENTRY February 10

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 11

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 12

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 13

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

17

DAILY COMMUNICATION LOG ENTRY February 14

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 15

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 16

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 17

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

18

DAILY COMMUNICATION LOG ENTRY February 18

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 19

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 20

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 21

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

19

DAILY COMMUNICATION LOG ENTRY February 22

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 23

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 24

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 25

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

20

DAILY COMMUNICATION LOG ENTRY February 26

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 27

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY February 28

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 1

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

21

DAILY COMMUNICATION LOG ENTRY March 2

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 3

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 4

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 5

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

22

DAILY COMMUNICATION LOG ENTRY March 6

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 7

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 8

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 9

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

23

DAILY COMMUNICATION LOG ENTRY March 10

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 11

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 12

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 13

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

24

DAILY COMMUNICATION LOG ENTRY March 14

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 15

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 16

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 17

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

25

DAILY COMMUNICATION LOG ENTRY March 18

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 19

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 20

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 21

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

26

DAILY COMMUNICATION LOG ENTRY March 22

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 23

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 24

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 25

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

27

DAILY COMMUNICATION LOG ENTRY March 26

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 27

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 28

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 29

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

28

DAILY COMMUNICATION LOG ENTRY March 30

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY March 31

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 1

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 2

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

29

DAILY COMMUNICATION LOG ENTRY April 3

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 4

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 5

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 6

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

30

DAILY COMMUNICATION LOG ENTRY April 7

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 8

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 9

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 10

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

31

DAILY COMMUNICATION LOG ENTRY April 11

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 12

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 13

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 14

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

32

DAILY COMMUNICATION LOG ENTRY April 15

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 16

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 17

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 18

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

33

DAILY COMMUNICATION LOG ENTRY April 19

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 20

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 21

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 22

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

34

DAILY COMMUNICATION LOG ENTRY April 23

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 24

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 25

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 26

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

35

DAILY COMMUNICATION LOG ENTRY April 27

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 28

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 29

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY April 30

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

36

DAILY COMMUNICATION LOG ENTRY May 1

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 2

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 3

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 4

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

37

DAILY COMMUNICATION LOG ENTRY May 5

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 6

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 7

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 8

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

38

DAILY COMMUNICATION LOG ENTRY May 9

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 10

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 11

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 12

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

39

DAILY COMMUNICATION LOG ENTRY May 13

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 14

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 15

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 16

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

40

DAILY COMMUNICATION LOG ENTRY May 17

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 18

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 19

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 20

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

41

DAILY COMMUNICATION LOG ENTRY May 21

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 22

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 23

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 24

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

42

DAILY COMMUNICATION LOG ENTRY May 25

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 26

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 27

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 28

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

43

DAILY COMMUNICATION LOG ENTRY May 29

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 30

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY May 31

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 1

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

44

DAILY COMMUNICATION LOG ENTRY June 2

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 3

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 4

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 5

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

45

DAILY COMMUNICATION LOG ENTRY June 6

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 7

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 8

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 9

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

46

DAILY COMMUNICATION LOG ENTRY June 10

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 11

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 12

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 13

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

47

DAILY COMMUNICATION LOG ENTRY June 14

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 15

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 16

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 17

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

48

DAILY COMMUNICATION LOG ENTRY June 18

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 19

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 20

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 21

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

49

DAILY COMMUNICATION LOG ENTRY June 22

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 23

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 24

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 25

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

50

DAILY COMMUNICATION LOG ENTRY June 26

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 27

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 28

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

DAILY COMMUNICATION LOG ENTRY June 29

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

51

DAILY COMMUNICATION LOG ENTRY June 30

Completed by:

Did any staff member: Incident Report #

Deny entry: Yes / No

Refuse/cut off service: Yes / No Was there:

Remove an intoxicated patron: Yes / No An injury or accident: Yes / No

Arrange transportation for a patron: Yes / No A minor on premise: Yes / No

If Yes to any of the above an Incident Report

must be completed.

Were police, fire, or ambulance called? Yes / No

52

INCIDENT REPORT #01

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

53

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

54

INCIDENT REPORT #02

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

55

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

56

INCIDENT REPORT #03

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

57

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

58

INCIDENT REPORT #04

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

59

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

60

INCIDENT REPORT #05

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

61

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

62

INCIDENT REPORT #06

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

63

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

64

INCIDENT REPORT #07

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

65

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

66

INCIDENT REPORT #08

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

67

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

68

INCIDENT REPORT #09

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

69

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

70

INCIDENT REPORT #10

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

71

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

72

INCIDENT REPORT #11

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

73

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

74

INCIDENT REPORT #12

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

75

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

76

INCIDENT REPORT #13

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

77

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

78

INCIDENT REPORT #14

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

79

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

80

INCIDENT REPORT #15

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

81

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

82

INCIDENT REPORT #16

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

83

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

84

INCIDENT REPORT #17

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

85

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

86

INCIDENT REPORT #18

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

87

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

88

INCIDENT REPORT #19

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

89

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

90

INCIDENT REPORT #20

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

91

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

92

INCIDENT REPORT #21

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

93

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

94

INCIDENT REPORT #22

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

95

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

96

INCIDENT REPORT #23

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

97

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

98

INCIDENT REPORT #24

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

99

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

100

INCIDENT REPORT #25

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

101

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

102

INCIDENT REPORT #26

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

103

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

104

INCIDENT REPORT #27

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

105

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

106

INCIDENT REPORT #28

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

107

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

108

INCIDENT REPORT #29

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

109

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

110

INCIDENT REPORT #30

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

111

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

112

INCIDENT REPORT #31

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

113

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

114

INCIDENT REPORT #32

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

115

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

116

INCIDENT REPORT #33

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

117

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

118

INCIDENT REPORT #34

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

119

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

120

INCIDENT REPORT #35

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

121

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

122

INCIDENT REPORT #36

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

123

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

124

INCIDENT REPORT #37

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

125

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

126

INCIDENT REPORT #38

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

127

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

128

INCIDENT REPORT #39

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

129

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

130

INCIDENT REPORT #40

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

131

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

132

INCIDENT REPORT #41

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

133

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

134

INCIDENT REPORT #42

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

135

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

136

INCIDENT REPORT #43

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

137

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

138

INCIDENT REPORT #44

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

139

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

140

INCIDENT REPORT #45

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

141

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

142

INCIDENT REPORT #46

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

143

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

144

INCIDENT REPORT #47

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

145

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

146

INCIDENT REPORT #48

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

147

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

148

INCIDENT REPORT #49

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

149

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

150

INCIDENT REPORT #50

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

151

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

152

INCIDENT REPORT #51

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

153

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

154

INCIDENT REPORT #52

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

155

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

156

INCIDENT REPORT #53

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

157

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

158

INCIDENT REPORT #54

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

159

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

160

INCIDENT REPORT #55

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

161

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

162

INCIDENT REPORT #56

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

163

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

164

INCIDENT REPORT #57

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

165

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

166

INCIDENT REPORT #58

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

167

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

168

INCIDENT REPORT #59

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

169

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

170

INCIDENT REPORT #60

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

171

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

INCIDENT REPORT #

Date: Time incident occurred: am / pm

Weather: Sun / Clouds / Wet / Dry / Snow / Wind

Customer details

Name: Sex: Male / Female Birth date:

Age: 19-25 / 26-30 / 31-35 / 36-40 / 41-49 / 50-59 / 60-65 / 66+ Height:

Weight: Eye colour: Blue / Brown / Green / Grey / Unknown Glasses: Yes / No

Facial hair: Moustache / Beard / Goatee / Other:

Hair colour: Blonde / Brown / Black / Grey / Other:

Hair length: Short / Mid / Long Details:

Clothes: Other:

Was the person alone? Yes / No / Don’t know If no, name of person they were with?

Were staff familiar with the patron and/or accompanying patrons? Yes / No / Don’t know

Why/how were they familiar?

Denial of entry

Reason: Intoxicated / Minor / Troublesome / Dress code / No ID / False ID / Previously barred / Other:

Refusal of service / Removal from premises

Reason: Intoxicated / Troublesome / Minor / Other: Number of drinks consumed on premises:

What was the patron drinking? Beer / Wine / Spirits / Fortified wine / Other:

Were all of the patron’s receipts retained? Yes / No Receipt numbers:

Names of all staff who served patron:

Refusal by whom? Was the patron removed from the premises? Yes / No

Names of all staff involved in removal:

Did all staff removing the patron possess security certificates? Yes / No

Injury / accident

What part of the body was affected?

Was medical attention given? Yes / No If yes, by whom?

Was hospitalization required? Yes / No How did the patron contribute to their injury?

If trip or fall, condition of the floor and any foreign substances detected:

Are photos available of the area? Yes / No

Minor on premises

Was the minor caught drinking alcohol? Yes / No If yes, who gave the minor a drink?

Was ID checked? Yes / No If yes, by whom?

If yes, indicate type of ID: BC Services Card / Driver’s License / BCID / Passport / Military ID / Other:

Transportation

Were alternate methods of transportation offered? Yes / No If yes, specify:

How did the patron leave the premises? Taxi (company: ) / Friend on premises

Friend from home / Walking / Car / Motorcycle / Bicycle / Boat / Police / Other:

If the patron drove home in their own vehicle please specify: License plate number:

Province/State: Colour: Make:

Police

Time of call: am / pm

Time of patron’s departure: am / pm Time of officer’s arrival: am / pm

Name of officer(s): Badge number(s):

Witnesses (if possible obtain for at least 2 witnesses)

Witness #1 name: Witness #2 name:

Address: Address:

Telephone: Telephone:

Detailed description of incident (include documentation on how much alcohol was served; recommend attaching copy of staff schedule for that day)

All appropriate steps have been taken: Yes / No All evidence has been retained: Yes / No

Manager notified: Yes / No If yes, name of manager:

Video surveillance available? Yes / No Bar Watch / TreoScope information available? Yes / No

Insurance company / broker contacted? Yes / No Date contacted:

We, the undersigned affirm that all the information recorded herein is factual, accurate and complete regarding the circumstances surrounding the incident.

Print name: Signature: Position:

Print name: Signature: Position:

go2HR — The resource for people in Tourism

Suite 450, One Bentall Centre

505 Burrard Street

P.O. Box 59

Vancouver, BC V7X 1M3

Phone: 604-633-9798

Fax: 604-633-9796

Email: info@servingitright.com

Website: www.servingitright.com