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HomeMy WebLinkAboutWines & More (GT Retail, Inc.) - 12/31/2021JzS�xo -[5 .. 0 Town of Mansfield - Board of Health PERMIT NUMBER: 00 f(d Nov (I l'V Yo of Mansfield 6 Park Mansfield, MA 0 Application for the Sale of Tobacco Products I hereby make application for a permit to sell tobacco products in compliance with the Board of Health Regulation Affecting Smoking and the Sale, Vending and Distribution of Tobacco. By signing this application, I declare that I have read the regulation and am responsible for tobacco product sales regarding federal, state and local laws. This permit expires on December 31st of each year. Violation of this Regulation may result in Flnes, suspension or revocation of this permit. NAME OF BUSINESS: Wines & More - Mansfield LOCATION OF SALE OF TOBACCO PRODUCTS: 280 School Street, Suite 140, Mansfield, MA 02048 TELEPHONE AT LOCATION: 508-339-6900 OWNER OF BUSINESS: Kathleen Haronian ADDRESS OF OWNER: 98 A Nipmuc Trail, No, Providence, RI 02904 TELEPHONE OF OWNER: 401-353-4400 FAX NUMBER: 401-353-4469 If a corporation or partnership, give name, title, and home address of officers or partner Kathleen Haronian, President 98 A Nipmuc Trail, No, Providence, RI 02904 Briefly describe your tobacco and nicotine delivery product sales training. Attach employee training documentation * Provide a copy of current Department of Revenue CT-3T Retail Excise Unit License, FEE:$160.00 CT-3T NUMBER: 1871013888 FEDERAL ID/SS NUMBER: 27-2176426 SIGNATURE: DATE: 10/15/2020 4�4 ' A check mark signifies your understanding and agreement. I understand and agree that: 41 It is against the law to sell any tobacco product and/or nicotine delivery product (e,g, e-cigarettes) to anyone less than 21 years of age, regardless of how old the person looks. IX/ Anyone selling tobacco products and/or nicotine delivery products must conclusively establish the customer's / age as over 21 years old, by means of government -issued photographic ID. N Anyone selling tobacco products and/or nicotine delivery products must check and verify official government photo ID for anyone less than 27 years of age. I/ I must consent to unannounced, periodic inspections and compliance checks of the permitted retail , establishment. GY/Flavored tobacco products and vape products (including mint, menthol and wintergreen) can only be sold In / licensed smoking bars, for onsite consumption only. 19 Unflavored E-cigarettes with nicotine content over 35 mg/per ml can only be sold In adult -only retail tobacco stores and licensed smoking bars. 15/ Flavored e-cigarettes with any strength of nicotine content can only be sold in licensed smoking bars, for onsite consumption only. Self-service tobacco product and/or nicotine delivery product displays from which the customer may select products are prohibited. U/, The sale of single or loose cigarettes or cigarettes in packages of fewer than 20 cigarettes is prohibited. [U I may not distribute any free samples of tobacco products or nicotine delivery products (e.g. e-cigarettes) and I may not accept any means, instruments or devices that allow for the redemption of tobacco products for free or // cigarettes at a price below the minimum retail price determined by the Massachusetts Department of Revenue. Tobacco vending machines are prohibited. �y Non-residential Roll -Your -Own machines are prohibited. /Blunt wraps are prohibited. iy Penaltles for violation of the regulation include monetary fines and/or suspension of this permit for seven or thirty days. VI may not allow any employee to sell tobacco products or nicotine delivery products (e.g. e-cigarettes) until such employee reads this regulation, state and federal laws regarding the sale of tobacco and signs a statement, a / copy of which will be placed on file, that he/she has read the regulation and applicable state laws. q/ I must prominently display a copy of the "Permit to Sell Tobacco and Nicotine Delivery Devices". C� I must provide the Board of Health with proof of a current "Cigarette Retailers License" from the Massachusetts /Department of Revenue (DOR) and my DOR business permit (Attach a copy of each permit/license). �/I must display Department of Public Health signs stating, "Sale of tobacco to Minors is prohibited". LR"/I must display signs provided by the Board of Health that discloses referral information about cessation. L�' If I sell nicotine delivery devices (e.g. e-cigarettes) I must display signs stating that sale of nicotine delivery devices to anyone below the minimum legal sales age is prohibited and that the used of e-cigarettes at Indoor establishments is prohibited by local law. I have received, read and understand the Board of Health regulation "Regulation Affecting Smoking and the Sale, Vending, and Distribution of Tobacco and Nicotine Delivery Products" and agree to abide by it. Signature' y x94 Date 10/15/2020 Print Name Kathleen Haronian Commonwealth of Massachusetts Lotter to: L0930260544 ,iPS�n2�Ur6�. O 6Y Department of Revenue Notice Date: September 2, 2020 Geoffrey E. Snyder, Commissioner Account to: COL-1 1451273-008 !'Evrow� mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARETTES �9"�'d��PrIIInII�l�9rt��IrlvdPdl��iilllud���'hlll�i OT RETAIL INC WINES & MORE - MANSFIELD 1405 DOUGLAS AVE NORTH PROVIDENCE RI 02904-4052 Attached below is your Retailer License for Sale of Cigarettes (Form CT-3). Cut along the dotted line and display at your business location. At any time, you can log into your MassTaxConnect account at .mass.gov/masstaxconnect to view and re -print a copy of this license. If you have any questions about your license, call us at (617) 887-6367 or toll -free in Massachusetts at (800) 392-6089, Monday through Friday, 8:30 a.m, to 4:30 p.m. DETACH HERE MASSACI USETTS DEPARTMENT OF REVIENUE � F T 0i'nl CT-3 b jA Retailer License for Sale of Cigarettes 'FNr oe ``w This license must be posted and visible at all times. The sale of tobacco products to anyone under 18 years of age is prohibited. GT RETAIL INC WINES & MORE - MANSFIELD 280 SCHOOL ST MANSFIELD MA 02048-1840 Account ED: CGL-11451273-008 License Number: 1871013888 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non -transferable and may be suspended or revolted for failure to comply with state laws and regulations. o�o Effective Date: October 1, 2020 Expiration Date: September 30, 2022 Insurer ID No (a): 34355 MA Retail Merchants WC Group Inc. PO Box 859222.9222 Braintree, MA 02186.0000 Workers Compensation and Employers Liability . Insurance Policy Carrier Polic #: Policy Period 014006032982120 01/01/2020 to 01/01/2021 Information Page FEIN: 272176426 Renewal Policy Carrier Prior Polley #: 014005032982119 Item 1: Named.insured and Address Agency GT Retail Inc Hays Insurance Brokerage of New England Wines And More Mansfield 133 Federal St, 4th Floor 1406 Douglas Ave Boston, MA 02110 N Providence, RI 02004 Schedule of Covered Workplaces Other Workplace OT Retail Inc Effective Date: 01/01/2020 Wines And More Mansfield NAICS Code; 445310 280 School St Ste 140 Division #: 0 Mansfield, MA 02048 Workplace #: 0000000001 State Risk ID #; 000859879 Mailing: 1406 Douglas Ave N Providence, RI 02904 Form # WC 00 00 01 C (Ed, ) 0 Copyright 2013 National Connell on Compensation Insurance, Inc, All Rights Reserved, Page 1 of 1 `,t'CJ+U56 MASSACHUSETTS DEPARTMENT OP REVENUE Letter ID: LI 130678272 PO BOX 7044 Notice Date: February 8, 2016 ((y I BOSTON, MA 02204 Account ID: SLS-11451273-007 CONTACT CENTER ynroea (617)887-6367 SALES AND USE TAX REGISTRATION CERTIFICATE tIu11PPIII�uti11PIu1m11i��1��11i11dI�I�n111161P11i1h a® GT RETAIL INC WINES AND MORE O1� 1405 DOUGLAS AVE NORTH PROVIDENCE RI 02904-4052 Attached below is your Sales and Use Tax Registration Certificate (Form ST-1). Cut along the dotted line and display at your place of business. You must report any change of name or address to us so that a revised ST-1 can be issued. At any time, you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re- print a copy of this certificate. DETACH HERE MASSACHUSETTS DEPARTMENT OF REVENUE Form ST-1 M F6 Sales and Use Tax Registration Certificate This registration must be posted and visible at all times. M o� GT RETAIL INC Account ID: SLS-11451273-007 WINES AND MORE Certificate Number: 1450762240 280 SCHOOL ST MANSFIELD MA 02048-1840 This certifies that the taxpayer named above is registered under Chapters 62C, 64H and 64I of the Massachusetts General Laws to sell tangible personal property at retail or for resale at the address shown above. This registration is non -transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: June 1, 2010 Via Commonwealth ofMassachusetfs Department offndustriatAccidents 1 Congress Street, Suite 100 r Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavits General Businesses, TO B)l FILED WITH TBEP);RM1TTING ADTIfORITV. ]lean Infotrual-If P10asgR)AntLe heir riskiness/Organization Name; GT Retail, Inc, d/b/a Wines & More Mansfield Address; . 280 School Street Suite 140 City/State/Zip;, Mansfield,.MA 02048 Phone #: 508-339-6900 Are you an employer? Chock the appropriate box: L M I am a employe' with_21 employees (ibll and/ orpart-time).* 2, ® 1 am a sole proprietor or partnership and have no employeos working for me In any capacity, [No workers' comp. Insurance required] 3, ® We are a corporation and its officers have exercised their right of exemption per a. 152, §1(4), and we have no employees. [No workers' camp, insurance required 4, ❑ We are a non-profit organization, staffed by volunteers with no omnlovees, [No workers' comp, insurance tea, Dosimss Type (required); 5, [@ Retail 6, QRestaurant/Bar/EatingEstabllsbment 7, ❑ Office, and/or Sales (inel, real estate, auto, eta) 8, ❑ Non-profit 9. ❑ Entertainment 10,❑ Ivfanufaohu'ing 11,❑ Health Cara 12,[] Other **If tho corporaro o8laers bave exempted themselves, but tho oorporatiunhes otheremployoes, aworkers' compensation polloy is required and such an organization should oheok box R. lain an employer dial is provldingworkem' compensation lnsarance for my employees. Below is iho policy information. Insm'anco Company Name; MA RETAIL MERCHANTS WC GROUP, INC. insurer's Address; P.0,BOX859222-922 City/Stato/zip. BRAINTREE, MA 02185 Poiloy4orSelf-ins,L)o,# 014005032982120 _Expiration Date; 1/1/2021 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MOT, e.152 can lead to the Imposition of criminal penalties ofit fine up to $1,500,00 and/or oneyear imprisonment, as well as civil penalties in the form of a STOP WORK OFDBR and a line of up to M,00 a day against the violator. Be advised that a copy of this statement may he forwarded to Pita Office of Investigations of the DIA for Insurance coverage verification, 1'do hereby der lWl, Ckeinformadonproplded above Is true 10/30/2020 Offlelal use only. Do not write in lhts area, to be completed by ally or town offlciad correct, City or .Town: Permit/License # Issuing Authority (circle oue)t 1. Board of Healtli 2. Building Department 3. City/Town Clerk 4, Licensing Bonrd 5, Selectmen's Office 6.Other_ ContactPersont • Phone TOWN OF MANSFIELD LOCAL BYLAWS The following bylaws apply to all food establishments permitted by the Mansfield Health Department: Plastic Waste Reduction; Polystyrene Container Reduction; and Plastic Straw/Stirrer Reduction. A copy of each bylaw is included. It is the responsibility of the applicant to read and understand all bylaws. Please Indicate by initialing the following statements that the permitted food establishment will adhere to all applicable bylaws. The applicant and associate corporation are subject to fines associated with violations. Plastic Waste Reduction No retail establishment In the Town of Mansfield shall provide thin-film, single -use plastic check-out bags to customers. it have received a copy of the Plastic Waste Reduction bylaw. I understand my responsibility to ensure that this bylaw is adhered to at the permitted food establishment. I understand violations of this bylaw will result in fines. Polystyrene Container Reduction (effective January 1,2021) Food establishments are prohibited from dispensing prepared food and drink in disposable food service containers made from expanded polystyrene. All food establishments are strongly encouraged to use reusable food service containers and cutlery, and when possible biodegradable, compostable alternatives. Compostable materials must meet ASTM (American Society of the International Association for Testing and Materials) Standards for compostability. �I have received a copy of the Polystyrene Container Reduction bylaw. I understand my responsibility to ensure that this bylaw is adhered to at the permitted food establishment. I understand violations of this bylaw will result In fines. Plastic Straw/Stirrer Reduction (effective January 1, 2021) Plastic beverage straws and plastic stirrers shall not be used or dispensed or sold except upon request in conjunction with the serving by business establishments or at any town -sponsored event of liquid, slurry, frozen, semi -frozen, or other forms of beverages to the public for consumption. 1 have received a copy of the Plastic Straw/Stirrer Reduction bylaw. I understand my responsibility to ensure that this bylaw Is adhered to at the permitted food establishment. I understand violations of this bylaw will result In fines. Applicant Applicant Name (please print V bD TAX CERTIFICATION FORM I certify under the penalties of perjury that 1, to my best lmowledge and belief, have filed all state flax returns and paid all state taxes required under law. Signa ire of Individual or Corporate Name 27-2176426 "Social Security No. (Voluntary) or Federal Identification Number Kathy Haronian By; Corporate Officer (Mandatory, if Applicable) *This license will not be issued unless this certification clause is signed by the applicant. ** Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Licensees who fail to correct their non -filing or delinquency will be subject to license suspension or revocation. This request is made under the authority of Massachusetts General Law Chapter 62C, section 49A. CAUsers\sleite\Desktop\ScoWs Documents\Food Establishments- Temp\TAX CERTIFICATION FORM.doc Age -Restricted Products Policy & Procedures: Tobacco LOCATION Every Employee at this location has the legal and moral responsibility to control the sale and distribution of age -restricted Items to ensure these Items do not get sold to minorsl I TOBACCO PRODUCT SALES POLICY Objective: That all store Employees follow all laws and procedu'res of thl$.pollcy related to the sale of 'tobacco products including, cigarettes, smokeless tobacco, loose tobacco, pipe tobacco, rolling papers, cigars, e-clgar6ttes, vape and lighters, The minimum age to purchase tobacc-P.Products Is twenty one ,:(21) years of age, It Is our responsibility as a retailer and members o e community to prevent the sale of tobacco to anyone und ei.1f t t 0. nq�.(21). ,,,e�theagP. PROCEDURES: 1. This policy will be,revlewed with,all new Employees before they can operate a cash reglst&'and sell tobacco products. 2. All store Em Vloyees10 take cbmpui& based training and successfully pass with .100% p 'i rior to starting on a register. This certification to be updated QWan anhdalbasis prior to previous year expiration, 3. A valid form o6dentification will be required for all tobacco purchases regardless of age or frequency of customer visits, Acceptable forms of Id are as follows: Valid Massachusetts License Valid Massachusetts state id Valid US passport Valid Out of State License No expired Identification will be accepted. Photos must be visually matched to the customer purchasing and licenses scanned into the register, Driver's License is to be scanned Into the register system. All other Identification from the acceptable list will require manual entry of the date of birth listed on the documentation, d, If It is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required fro ...all members of the party. I have read and understand the Mansfield Board of Health Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twontyone (21) years, I also understand that If I fall to follow store policy and local and state laws about the solo of tobacco or nicotine delivery products to any person under the legal age, I could lose myJob or be fined, I agree to the following rules about the sale of tobacco products; I will not sell any tobacco products, Including cigarettes, cigars, chewing tobacco, bidls, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21. If anyporson regardless of ago;attampts to make a tobacco purchase without an acceptable, I will not make the sale, •t will not accept a note from an adult glying pornilsslon to a parson under the age of 21 to buy tobacco products. In turn, management agrees to support my Judgment not to make the sale ki any of the cases lescribed. above, Failure to follow this policy may rest.11t in disciplinary action up to and including termination, Employee Slgrlature Date Store Operator Signature Date (This form will be maintained in your personnel file as a part of your permanent employee record) Joi rq 1, Age -Restricted products policy & procedures: Tobacco LOCATION Every Employee at this location has the I71 and moral responsibility to control the sale and distribution of age -restricted Items to ensure these items do not get sold to minorsl I 'f"Uli/1CCO PI'tOOUC'f' SALt:s POLICY Objective: That all store Employees follow all laws and proced&s,of this,;policy related to the sale of tobacco products including: cigarettes, smokeless tobacco, loose tobacco, pipe tobacco, rolling papers, cigars,'e-cigarettes, vape and lighters. The minimum age to purchase tobacco products Is twenty One (21) years of age, It is our responsibility as a retailer and members of the community to prevent the sale of tobacco to anyone under the age of twenty one; (21). PROCEDURES: 1. This policy will be.reviewed with all now Employees before they can operate a cash register and sell tobacco products. 2. All store Er ployees to take..corpputer based training and successfully pass with 100% prlor to starting on a'register. This certification to be updated on an annual basis prior to previous year expiration, 3. A valid form of Identification will be required for all tobacco purchases regardless of age or frequency of custorrier visits, Acceptable forms of Id are as follows: Valid Massachusetts License Valid Massachusetts stake id Valid US passport Valid Out of State License No expired identification will be accepted, Photos must be visually matched to the customer purchasing and licenses scanned into the register, Driver's License Is to be scanned Into the register system. All other Identification from the acceptable list will require manual entry of the date of birth listed on the documentation, d, if It Is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from.all members of the party, I have read and understand the Mansfield Board of Hoalth Regulations which prohibits the sale of tobacco and nicotino delivery products to anyone under the age of twenty-one (21) yeas. I also understand that If I fall to follow store policy and local and state.laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my job or be fined. I agree to the following rules about the sale of tobacco products: I will not sell any tobacco products, Including cigarettes, clgars, chowing tobacco, bidls, or any other form of tobacco, or any nicotino delivory product to any person under the age of 21, If any person regardloss of ago attempts to rapke a tobacco purchase without an acceptable, I will not make tho sale., I will not accept a note from an adult giving pormisslon to a person uhder the age of z1 to buy tobacco products. In turn, management agraes to support my judgment not to snake the sale In any of the rases. descrjbed above, Failure to follow this policy may result in disciplinary action up to and Including tC, r linati r1 VIA 20 �"rryyfoyce Si lnttl� Demo 1912 G--- Store Operator Signature Date (This form will be maintained in your personnel file as a part of your permanent employee record) y4ge_lie,stricted Products E'nlic i —' ---- t yt LOcArtniu Procedures: Tobacc� I Every Employee at this location has the I moral responsibility to control the sale and distribution of age -restricted items to ensure these Items do not get sold to irtinorsil TOBACCO PRODUCT SALES POLICY Objective: That all store rmployees follow all laws and procedures of this policy related to the sale of tobacco products including: cigarettes, smokeless. tobacco, loose tobacco, pipe tobacco, rolling papers, cigars, e-cigarettes, vape and lighters. The minimum age to purchase tobacco products Is twenty one (21) years of age, It is our responsibility as a retailer and members of the community to prevent the sale of tobacco to anyone tmraer the age of twenty ohe, PROCEDURES: 1, This policy will be,revlewed with.all new Employees before they can operate a cash register"and sell Tobacco products, 2. All store Erriployees`to take computer based training and successfully pass with i00% prfar to starling on a register, This certification to be updated on an annuai,uasis prior to previous year expiration, 3. A valid form of identification will be required for all tobacco purchases regardless of age,or frequency of customer visits, Acceptable forms of id are as follows: Valid Massachusetts License Valid Massachusetts state id Valid US passport Valid Out of State License No expired identification will be accepted, Photos must be visually matched to the customer purchasing and licenses scanned Into the register, Driver's License Is to be scanned into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation, 4If It Is suspected that someone is purchasing tobacco -for anyone under the age of twenty-one (?.:I.) a valid Id will be required frorn all members of the party, I have read and understand the Mansfield Board of Health Begula. tlons which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty -ono (21) years. I also understand that If I fill to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my. Job or be fined, I agree to the following rules about the sale of tobacco products: I will not sell any tobacco products, including cigarettes, cigars, chewing tobacco, bidis, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21, If any person regardless of agu attempts to make a tobacco purchase without an acceptable, I will not make the sale, .J will not accept a note from an adult giving jjermisslon to a person under the.age of 21 to buy tobacco products. . In turn, managoment agrees to support my Judgment not to'malw the sale In any of the cases lgscilbed above, rallui-e to follow this policy may result In dlsriplinary action up to and including termination. 7cehn o5ignaturc-, Store Operator Signature Date/ Date LLL (This form will be maintained In your personnel file as a part of your permanent employee record) 3 Gvi r— Age-Restricted Products Policy & Procedures: Tobacco LOCATION Every Employee at this location has the legal and moral responsibility to control the sale and distribution of age -restricted Items to ensure these Items do not get sold to minors II TOBACCO PRODUCTSALES POLICY Objective: That all store Employees follow all laws and procedures.:of this policy related to the sale of tobacco products Including cigarettes, smokelesstobacco, loose tobacco, pipe tobacco, rolling papers,';clgars, e=cigarettes, vape and lighters, The minimum age to purchase tobacco products is twenty one (21) years of age, It is our responsibility as a retailer and .members of the community to prevent the sale of tobacco to anyone under the age of twenty one (21). PROCEDURES: I. This policy will be.reviewed with all 11ew:{mpioyees before they can Operate a cash register and sell tobacco products, 2. All store Employees'to take computer based training and successfully pass with lop/ prior to starting on a register, This certification to be updated on an aririval basis prior to previous year expiration. 3. -A valid form of ldentificatIcn will be required for all tobacco purchases regardless of age or frequency of c;ustorner visits, Acceptable forms of Id are as follows; Valid Massachusetts Licerise Valid Massachusetts state id Valid Us passport' Valicl Out o(State License No expired Identification will be accepted, Photos must be visually matched to the customer purchasing and licenses scanned Into the register. Driver's License is to be scanned Into the register system, All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation, 4, I f it is suspected that someone is purchasing, tobacco for anyone under the age of twenty-one (21.) a valid Id will be required from ail members of the party, I have read and understand the Mansfield [)card of Health Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (21) years, I also understand that If I fall to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal ago, I could lose my Job or be fined, I agree to the following rules about the sale of tobacco products: I will not sell any tobacco products, including cigarettes, cigars, chewing tobacco, bldls, or any other form Of tobacco, or any nlcotino delivery product to any.person under the age of 21, If any parson regardless of age, attempts to make a tobacco purchase without an acceptable, I will not make the Salo. I will not accept I note from an adult giving parmission to a person under the age of 21 to buy tobacco products, In tta'n,planagemelit agrees to support my judgment not to make the solo In any of the cases doscrlbed above, Failure.to follow this pbllcy may result in disciplinary action up to and including termination, 3'�Vw Ali Employee Signature Date Store OJ.rerator Signature Date (This form will be malntalnerl in your personnel file as a part of your perirlanent employee record) Age -Restricted Products Policy ttt Procedures: Tobacco LOCATIOIU Every Employee at this location has the sale file Iega-'- andandMoral responsibility to control and distribution of age -restricted items to ensure these items do not get sold to Minersil TOBACCO PRODUCT SALES POLICY Objective: That all store related to the sale of tobEmployees follow all laws and procedures, of this acco products including: cigarett(policy es, smokeless tobacco, loose tobacco, pipe tobacco, rolling papers, cigars,e-cigarettes, vape and The minimum age to purchase tobacco.products lighters, Is twenty one.p years lighters, age, It is our responsibility as a retailer and members of the community to prevent the sale of tobacco to anyone under the age of twenty one (21). PROCEDURES: 1, This policy will be reviewed with all new: Employees before they can operate a cash register and,sell to products, 2. All store Employees to take computer based training and successfully pass with 100% pl:(or to starting on a register. This certification to be updated on an annual basis prior to previous year expiration. 3. A valid form of Identification will be required for all tobacco purchases regardless of age or frequency of customer visits, Acceptable forms of Id are as follows: Valid Massachusetts License Valid Massachusetts state id Valid US passport Valid Out of State License No expired identification will be accepted. Photos most be visually matched to the customer purchasing and licenses scanned Into the register, Driver's license is to be scanned Into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation, h. 'fit is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from all members of the party, I have read and understand the Mansfield Board of flealth Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (4) years. I also understand that if I fail to follow store policy and local and state laws about the silo of tobacco or nlcotlno delivery products to any person under the legal age, I could lose rnyiob or be fined. I agree to the following rules about the sale of tobacco products: I will not sell any, tobacco products, Including cigarettes, cigars, chewing tobacco, bldls, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21. If any person regardless of ago attempts to make a tobacco purchase without an,acceptabis, I will not make the sale. I will not accept a note from all adult giving permission to a person undor,the age of 21 to buy tohacco products, In turh,.monagement agrees to support my Judgment not to'inakc the Sala In any of the cases, described above, 1=allure to follow tills policy may result: in disciplinary actlon up to and including terrnhlatiorl, q 2rnere I I (t 1 2Ci Grnployee °,igr Jldlr< Date, Store Operator Signature bate (This form will be maintained In your personnel file as a part of your permanent employee record) Age -Restricted products Policy & Procedures: Tobacco LOCATION L'very Employee at th(s location has the Icy �� the sale and dito stribution of age -restricted Items to ensure these It ims do not gent sold to minors!! TOBACCO PRODUCT SALES poLlCy Objective: That ail store Employees follow all laws and procedures of this policy related to the sale of tobacco products including cigarettes, smokeless. tobacco loose tobacco, pipe tobacco, rolling paperscigars, e=cigarettes, vape and lighters, The minimum age to purchase tobacc, o products is twenty one (21) years of age, It is our responsibility as a retailer and members ofahe community to prevent the sale of tobacco to anyone under the age of twenty one (21). PROCEDURES: 1. This policy will be,:reviewed With all'new Employees before they can operate a cash ragister and sell tobacco products. 2. All store Cin'ployees to take computer based training and successfully pass with 100%prior to starting on a register. This certification to be updated on an annual basis prior to previous year expiration, 3. A valid form oNdentification will be required for all tobacco purchases regardless of age or frequency of customer visits, Acceptable forms of Id are as follows: Valid MassaChusetts License Valid Massachusetts state Id Valid US passport Valid out of State License No expired identiflcation will be accepted, Photos must be visually matched to the customer purchasing and licenses scanned Into tl7e register, Driver's License is to be scanned into the register system, All other Identification from the acceptable list will require manual entry of the date of birth listed on the documentation, 4, If It Is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from, 611 members of the party, I have road and understand the Mansfield Board of noalth)tegulatlons which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty -ono (21) years. I also understand that if I fall to follow store policy and local -and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my)ob or be fined, I agree to the following rules about the sale of tobacco products: I will pot sell any tobacco products, Including cigarettes, cigars, chewing tobacco, bidls, or any other Farm of tobacco, or any nicotine d.a l ry product to 0nyperson under the age of 21. If any'pprson regardless of age attempts to malco a tohacco purchase without an agcoptable, I will not mak the sale, I w111 not accept a note front an adult Plying permission to a person undoY tia age of 21 to buy tobacco proilgct;. In t(irn,'managoment agrees to support My)udgment not to final«, the sale in any of the cases described above, Failure to follow this policy rrlay result In disciplinary action up to and including terirlination. Frrlployee ;ignal:ure 17:Ii:c QtArt26 Store Operator Signature Date (This form will be rnalntalned In your personnel file as a part of your permanent employee record) Age -Restricted Products Policy & Procedures: Tobacco LOCATION Every Employee at this location has the legal and moral responsibility to control the sale and distribution of age-Testricted Items to ensure these items do not get sold to minors I rO13ACCO PRODUCT SALES POLICY Objective: That all store Employees follow all laws and procedures of this policy related to the sale of tobacco products Including: cigarettes, smokeless tobacco, loose tobacco, pipe tobacco, rolling papers, cigars, e-cigarettes, vape and lighters. The minimum age to purchase tobacco products Is twenty of e.(21) years of age, It is our responsibility as a retailer and members of the community to prevent the sale of tobacco to anyone under the age of twenty one (21). PROCEDURES: 1. This policy will be,reviewed with,all new. Employees before they can operate a cash register' and,sell'tobacco products. 2. All store Employeesfo tal<e`co_mputer based training and successfully pass with 100% prior to starting on a register. This certification to be updated on an annual basis prior to previous year expiration, 3. A valid form of Identification will be required for all tobacco purchases regardless of age or frequericy of custorner visits. Acceptable forms of id are as follows: Valid IVlassachuseia:s License Valid Massachusetts state id Valid US passport Valid Out of State License No expired Identification will be accepted. Photos must be visually matched to the customer purchasing and licenses scanned Into the register, Driver's License is to be scanned Into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the CIOClimentation. 4. If it is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from- all members of the party, I have road and understand the Mansfield Board of Health Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (21) years. I also understand that If I fall to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any poison tinder the legal age, I could lose myiob or be fined. I agree to the following rules about the sale of tobacco products: i will not sell any tobacco products, including cigarettes, cigars, chowing tobacco, bidis, or any other forin of tobacco, or any nIcotina doIIvory product to any person under the age of 21. If any person regardless of age attempts to ntalco a tobacco purchase without an acceptable, I will not make the sale, i will not accept a note from an adult giving pormisslon to a person Lindar,tlte age of 21 to buy tobacco products. In turn,'tnanagement agrees fp support myiudgment dot to make the sale In any of the cases, described above. _ Falh.ue to follow 1:1-ils policy may result In disciplinary action uh to and including 'I:ei'Irlil'IatlUl'1, ` Pn'iployee Signal G/ Deft: Store Operator Signature Date (This form will be maintained In your personnel file as a part of your permanent employee record) _ J"'/ Age -Restricted products Policy Rr Procedures: Tobacco LOCATION Every Employee at this location has the )er'al and moral responsibility to control the sale and distribution of age -restricted Items to ensure these Items do not get sold to minorslI TOBACCO PRODUCT SALES Pol lCy objective; That all store Employees follow all laws and procedures of this policy related to the sale of tobacco products including: cigarettes, smokeless', tobacco, loose tobacco, pipe tobacco, rolling papers, clgars,'e.-cigarettes, vape and lighters, The mininum age to purchase tobacco products Is twenty one (21) years of age, It is our responsibility as a retailer and members of the community to prevent the sale of tobacco to anyone under the age of twenty one.. (21). PROCEDURES: 1. This policy will boxevlewed with all new Employees before they can operate a cash register and sell tobacco products. 2. All store Employees to take computer based training and successfully pass with.100% prior to starting on a register, This certification to be updated on an annual basis prior to previous year expiration. 3. A valid form oflldentiflcation will be required for all tobacco purchases regardless of age or frequency of customer visits. Acceptable forms of id are as follows: Valid Massachusetts License Valid Massachusetts state Id Valid US passport Valid Out of State License No expired Identification will be accepted, Photos must be visually matched to the customer purchasing and licenses scanned into the register, Driver's License Is to be scanned Into the register system, All other Identification from the acceptable list will require manual entry of the date of birth listed on the documentation, 4, If It is suspected that someone Is purchasing tobacco for anyone tinder the age of twenty-one (21.) a valid Id will be required frcrrl all members of the party, I have road and understand the Mansfield Board of I lea Ith Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (21) years. I also understand that If I fall to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my job or be fined, I agree to the following rules about the sale of tobacco products: I will not sell any tobacco products, Including cigarettes, cigars, chewing tobacco, bldis, or any other form of tobacco, or any nicotlno delivery product to any person under the age of 21, If any person regardless of aga,attempts to make a tobacco purchase without an accepteble, I will not matte the. sale, [.Will not accept a note from an adult giving partnlsslon to a parson under tho uge of 21 to buy tobacco products. In turn, management agrees to support my judgment riot to make the sale In any of the cases desrrlbed above, Failure to follow (:his policy may result in disciplinary action up to and Including t rminatiorl, Jj�I�I�W�I_�! hnnployeeS >ratul'c, G���--- Store Operator Signature Da/te` Date (]'his form will be maintained In your personnel file as a part of your permanent employee record) Age-R"r trtcted products policy tic procedures: Tobacco LOCATION Every Employee at this location has the I,et al and moral responsibility to control the sale and distribution of age -restricted Items to ensure these items do not get sold to minors I tO131 CCO PRO DUCrMILES P'ULICY Objective: That all store Employees follow all laws and procedures of this policy related to the sale of tobacco products Including: cigarettes, smokeless tobacco, loose tobacco, pipe tobacco, rolling papers, cigars, e-cigarettes, vape and lighters, The minimum age to purchase tobacco products Is twenty one (21) years of age, It is our responsibility as a retailer and members of the community to prevent the sale of tobacco to anyone under the age of twenty one (21). PROCEDURES: 1. This policy will be.reviewed with all new Employees before they can operate a cash register and sell tobacco products. 2. All store Employees to take computer based training and successfully pass with 100% prior to starting on a register, This certification to be updated on an annual basis prior to previous year expiration, 3. A valid form of identification will be required for all tobacco purchases regardless of age or frequency of custorner visits. Acceptable forms of id are as follows: Valid Massachusetts License Valid Massachusetts state id Valid US passport Valid Out of Stato License No expired identification will he accepted. Photos must be visually matched to the customer purchasing and licenses scanned into the register. Driver's License Is to be scanned into the register system. All other Identification from the acceptable list will require manual entry of the date of birth listed on the documentation. 4. If it is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21.) a valid Id will be required froln all members of the party, I have read and understand the Mansfield Board of Health Regulatlons which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (21) years. I also understand that If I fall to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my Job or be, fined. I agree to the following rul.os about the sale of tobacco products; I will not sell any tobacco products, Including cigarettes, cigars, chewing tobacco, bldis, or any other form of tobacco, or any nicotine delivery product to any person under the ago of 21, if any person regardless of age attempts to make a tobacco purchase without an acceptable, I will not make the sale, I will not accept a note from an adult giving pertnlsslon to a person under hie age of 21 to buy tobacco products. In turn, management agrees to support my judgment not to make the sale In any of the cases described above. Failure -to follow this policy may result III d15ciplinary action III.) to and Including 't-' I Ill'l iltr i> i rnplo �51J;nature Store Operator Signature D�att(.1% — 6 ) -- Date (This form will be maintained in your personnel file as a part of your permanent employee record) Age -Restricted products policy tip procedures: Tobacco LOCATION Every Employee at this location has the le al and moral responsibility to control the sale and distrlbutlon of age -restricted Items to ensure these items do not get sold to minorsl I ---- Objective: That all store Employees follow all laws and procedure s.of this policy related to the sale of tobacco products Including: cigarettes, smokeless'tobacco, loose tobacco,. pipe tobacco, rolling papers; cigars, e-cigarettes, vape and lighters. The minimum age to purchase tobacco.products is twenty one (21.) years of age. It is our responsibility as a retailer and members of the community to prevent the sale of tobacco to anyone under the age of twenty one, (21). PROCEDURES: 1. This policy will be reviewed with all new Employees before they can operate a cash register and sell tobacco products. 2, All store Employees to take cornputer based training and successfully pass with 100% pHor to starting on a register, This certification to be updated on. an annual basis prior to previous year expiration, 3. A valid form of Identification will be required for all tobacco purchases regardless of age or frequency of customer visits, Acceptable forms of id are as follows: Valid Massachusetts License Valid Massachusetts state id Valid US passport Valid Out of State License No expired identiflcation will be accepted, Photos must be visually matched to the customer purchasing and licenses scanned Into the register. Driver's License is to be scanned Into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation. 4. If it is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21r ) a valid Id will be required fr�n all members of the party. I have read and understand the Mansfield Hoard of Health Iegulatlons whlch prohibits the sale of. tobacco and nicotine delivery products to anyone tinder the age of twenty-one. (21.) years. I also understand that If I fall to follow store policy and local and state laws about the sale of tobacco or nlcotlne delivery products to any person under the legal age, I could lose my)ob orb a fined. I agree to the following rules about the sale of tobacco products; I will not sell any tobacco products, Including cigarettes, cigars, chewing tobacco, bldls, or any other form of tobacco, or any nicotlno delivery product to any person under the age of 21. if any person regardless of age attempts to mako a tobacco purchase without an acceptable, I will not make tine sale. I will not accept a note from an adult giving permission to a person undor the age of 21 to buy tobacco products. In turn, management agrees to support my)udgment not to Make the sale In any of the cases described above. Failure'i:o follow this policy may result In disciplinary action up 'to and includlnt; 'CN.I'li'llnatlUf inq'� IoU�ign a1:u rc------ -- Store Operator Signature 17ate� Date (Tills form will be maintained in your personnel file as a part of your permanent employee record) Age -Restricted products policy tat procedures: Tobacco LOCATION Every Employee at this location has the le al and moral responsibility to control the sale and distribution of age -restricted Items to ensure these items do not get sold to minorsl I ----'i'CtiBACCo pRot7UC'1"SALES POLICY -- —� objective: That all store Employees follow all laws and procedures of this policy related to the sale of tobacco products Including: clgarettes, smokeless tobacco, loose tobacco, pipe tobacco, rolling papers, cigars, e-cigarettes, vnpe and lighters, The minimum age to purchase tobacco products Is twenty one (21) years of age, It is our responsibility as a retailer and members of the community to prevent the sale of tobacco to anyone under the age of twenty one (21). PROCEDURES: 1. This policy will be; e.viewed with all new,Employees before they can operate a cash register and sell tobacco products. 2. All store Em'ployees'to take computer based training and successfully pass with 100% prior to starting on a register, This certification to be updated on an annu'a(bas,is prior to previous year expiration. 3,. A valid form of,identificatlon will be required for all tobacco purchases regardless of age or frequency of customer visits. Acceptable forms of id are as follows: Valid Massachusetts License Valid MaMChuSettS state id Valid US passport Valid Out of State License No expired identlficatlon will be accepted. Photos must be visually matched to the customer purchasing and licenses scanned into the register. Driver's license is to be scanned Into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation. 4, PP it is suspected that someone is purchasing tobacco for artyorte raider the age of twenty-one (21.) a valid Id will be required from all members of the party, I have read and understand the Mansfield Board of Health Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (21) years, I also understand that If I fall to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person unifier the legal age, I could 105e my Job or be fined, I agree to the following rules about the. sale of tobacco products: I will not sell any tobacco products, Including cigarettes, cigars, chewing tobacco, bldis, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21, If any person regardless of add, attempts to snake a tobacco purchase without an acceptable, I will not make the sale. I will not accept a note from an adult giving permission to a parsori under the age of 4 to buy tobacco products, In turn, management agrees to support my Judgment not to make the sale In any of the cases ¢oscrlbed. above. Failure to follow this policy may result in disciplinary action up to and including term Inatioi Frrihloyet. 5 �. �tire _ Daic� Store Operator Signature Date (This form will be maintained In your personnel file as a part of your permanent employee record) Memorandum from: Sal Rao, GT Retail, Inc. dba Wines & More To: Chris George, Administrative Assistant, Public Health Department, Town of Mansfield Date:11/23/2020 Subject: Tobacco Sales Training Our training consists of two tiers of layered training, with the first being CBT (computer based training) and the second being small group seminar training. New employees working in retail sales are directed to watch two instructional videos on their own. Upon completion, supervisors discuss the content of the videos and answer questions. The videos are webinars distributed by 1) the Food and Drug Administration, and 2) Massachusetts Health Officers Association. The training can be viewed at the following links: httos://www.voutube.com/watch?v=LFx-tX Uei httos: //m hoa. com/oro iect/to bacco-reta i le r-tra i n ine-for-store-i)erso n ne I New employees working in retail sales attend a live training seminar with a commercial enterprise named Server Training On Premises (STOP), where they receive training on topics that are relevant to sales of alcoholic beverages and tobacco products. Specific to tobacco, STOP training on techniques of ID/age verification is especially useful. Note that our ID scanning technology training is conducted as part of our cash register and peripheral hardware training and may be conducted before or after the STOP training seminar, depending of dates of hire versus STOP training availability. I trust that you'll find this useful in meeting the requirement for issuance of our renewed tobacco products permit. I can be reached at 401-353-4400 or at srao@wsretailers.com if you wish to discuss this.