Ohio Medical Marijuana Dispensary Application HANGING GARDENS OH LLC Application ID 432
Demographic Information(Business Contact)
A-1.1 Business Name, as it appears on the Applicant’s certificate of incorporation, charter, bylaws, partnership agreement or other legal business formation documents
Hanging Gardens OH LLC
A-1.2 Other trade names and DBA (doing business as) names
No response provided by applicant
A-1.3 Business Street Address
50 West Broad Street, Suite 1330
A-1.4 City
Columbus
A-1.5 State
OH
A-1.6 Zip Code
43215
A-1.7 Phone
7745516875
A-1.8 Email [email protected] Demographic Information(Primary Contact/Registered Agent)
A-2.1 Please select: Primary Contact, or Registered Agent for this Application
PRIMARY CONTACT
A-2.2 First Name
Ethan
A-2.3 Middle Name
No response provided by applicant
A-2.4 Last Name
Moon
A-2.5 Street Address
9 Strathmore Rd., Unit 1
A-2.6 City
Brookline
A-2.7 State
OH
A-2.8 Zip Code
02445
A-2.9 Phone
7745516875
A-2.10 Email [email protected] Demographic Information(Applicant Organization and Tax Status)
A-3.1 Select One
Limited Liability Company
A-3.1A If other, explain
No response provided by applicant
A-3.2 State of Incorporation or Registration
OH
A-3.3 Date of Formation
05/23/2017
A-3.4 Business Name on Formation Documents
Hanging Gardens OH LLC
A-3.5 Federal Employer ID number
This response has been entirely redacted
A-3.6 Ohio Unemployment Compensation Account Number
No response provided by applicant
A-3.7 Ohio Department of Taxation Number (if Applicant is currently doing business in Ohio)
No response provided by applicant
A-3.8 Ohio Workers’ Compensation Policy Number (if Applicant is currently doing business in Ohio)
No response provided by applicant
A-3.9 The Applicant attests that workers’ compensation insurance will be obtained by the time the State of Ohio Board of Pharmacy determines the Applicant to be operational under the Act and regulations.
YES
A-3.10 Has the Applicant operated and conducted business in any jurisdiction other than Ohio in the past three years? If you select "Yes", answer question A-3.10.1 below.
NO
A-3.10.1 If "Yes" to question A-3.10, for each instance relevant to question A-3.10, provide the following: -Legal Business Name -Business Address -Federal Employee ID Number No response provided by applicant Demographic Information(Economically Disadvantaged Business)
A-4.1 The Applicant attests that at least fifty-one percent of the business, including corporate stock if a corporation, is owned by persons who belong to one or more of the groups set forth in this division, and that those owners have control over the management and day-to-day operations of the business and an interest in the capital, assets, and profits and losses of the business proportionate to their percentage of ownership. ORC 3796.10
YES Demographic Information(District Information )
A-5.1 Please select to indicate the medical marijuana dispensary Ohio district for which you are applying for a dispensary license
NORTHEAST-2
A-5.2 Please select to indicate the medical marijuana dispensary Ohio county for which you are applying for a dispensary license
Cuyahoga Demographic Information(Prospective Associated Key Employees Details)
Item 1 of 7
A-6.1 First Name
Donald
A-6.2 Middle Name
James
A-6.3 Last Name
Kenney
A-6.4 Suffix
No response provided by applicant
A-6.5 Occupation
Director of the Non-Profit Delta Dental of Massachusetts
A-6.6 Title in the Applicant’s business
Chief Executive Officer
A-6.7 Applicant's business related compensation
$100,000
A-6.8 Number of shares owned
2
A-6.9 Types of shares owned
Common
A-6.10 Percent interest in Applicant's business
2%
A-6.11 Voting percentage
2%
A-6.12 Proposed Role
OFFICER
A-6.13 Please include any contributions of money, equipment, real estate and expertise
Construction and Facility Design Expertise, Managing Highly-Regulated Businesses A-6.14 Date of birth
This response has been entirely redacted
A-6.15 Social Security Number (use "N/A" if unavailable)
This response has been entirely redacted
A-6.16 Street Address
8327 Glenwyd Dr.
A-6.17 City
Kalamazoo
A-6.18 State
OH
A-6.19 Zip Code
49009
A-6.20 Phone
2693756282
A-6.21 Email
No response provided by applicant
A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)
Non-Minority
A-6.23 If the Prospective Associated Key Employee maintains an Ohio residence, please provide the length of time for which Ohio residency has been established:
No response provided by applicant
A-6.24 Attach verification of identity. The following are acceptable forms of verification of identity: -Unexpired, valid state-issued driver's license. -Unexpired, valid photographic identification issued by the Ohio Bureau of Motor Vehicles or the equivalent from another state. -Unexpired, valid United States passport.
This response has been entirely redacted
A-6.25 Tax Authorization: Each Prospective Associated Key Employee with an aggregate ownership interest of ten percent or more in the Applicant, must print, manually sign and attach a copy of the Tax Authorization Form. The State Board of Pharmacy may, in its discretion, require an owner or person who exercises substantial control over a proposed dispensary, but who has less than a ten percent ownership interest, to comply with statutory and regulatory ownership requirements. ORC 3796.10, OAC 3796:6-2-02
No response provided by applicant Demographic Information(Prospective Associated Key Employees Details)
Item 2 of 7
A-6.1 First Name
Ethan
A-6.2 Middle Name
Michael
A-6.3 Last Name
Moon
A-6.4 Suffix
No response provided by applicant
A-6.5 Occupation
COO of Virdios Systems, LLC
A-6.6 Title in the Applicant’s business
Chief Operating Officer
A-6.7 Applicant's business related compensation
$75,000
A-6.8 Number of shares owned
2
A-6.9 Types of shares owned
Common
A-6.10 Percent interest in Applicant's business
2%
A-6.11 Voting percentage
2%
A-6.12 Proposed Role
OFFICER
A-6.13 Please include any contributions of money, equipment, real estate and expertise
Technological Expertise in Medical Marijuana Equipment and Experience as a COO A-6.14 Date of birth
This response has been entirely redacted
A-6.15 Social Security Number (use "N/A" if unavailable)
This response has been entirely redacted
A-6.16 Street Address
35 Brook St.
A-6.17 City
Whitinsville
A-6.18 State
MA
A-6.19 Zip Code
01588
A-6.20 Phone
7745516875
A-6.21 Email [email protected]
A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)
Non-Minority
A-6.23 If the Prospective Associated Key Employee maintains an Ohio residence, please provide the length of time for which Ohio residency has been established:
No response provided by applicant
A-6.24 Attach verification of identity. The following are acceptable forms of verification of identity: -Unexpired, valid state-issued driver's license. -Unexpired, valid photographic identification issued by the Ohio Bureau of Motor Vehicles or the equivalent from another state. -Unexpired, valid United States passport.
This response has been entirely redacted
A-6.25 Tax Authorization: Each Prospective Associated Key Employee with an aggregate ownership interest of ten percent or more in the Applicant, must print, manually sign and attach a copy of the Tax Authorization Form. The State Board of Pharmacy may, in its discretion, require an owner or person who exercises substantial control over a proposed dispensary, but who has less than a ten percent ownership interest, to comply with statutory and regulatory ownership requirements. ORC 3796.10, OAC 3796:6-2-02
No response provided by applicant Demographic Information(Prospective Associated Key Employees Details)
Item 3 of 7
A-6.1 First Name
Shane
A-6.2 Middle Name
Patrick
A-6.3 Last Name
Kenney
A-6.4 Suffix
No response provided by applicant
A-6.5 Occupation
Real Estate Developer and Entrepreneur
A-6.6 Title in the Applicant’s business
Chief Financial Officer
A-6.7 Applicant's business related compensation
$75,000
A-6.8 Number of shares owned
45
A-6.9 Types of shares owned
Common
A-6.10 Percent interest in Applicant's business
45%
A-6.11 Voting percentage
45%
A-6.12 Proposed Role
OFFICER
A-6.13 Please include any contributions of money, equipment, real estate and expertise
Financial and Construction Expertise A-6.14 Date of birth
This response has been entirely redacted
A-6.15 Social Security Number (use "N/A" if unavailable)
This response has been entirely redacted
A-6.16 Street Address
9 Strathmore Rd., Unit 1
A-6.17 City
Brookline
A-6.18 State
OH
A-6.19 Zip Code
02445
A-6.20 Phone
2694910378
A-6.21 Email [email protected]
A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)
Non-Minority
A-6.23 If the Prospective Associated Key Employee maintains an Ohio residence, please provide the length of time for which Ohio residency has been established:
No response provided by applicant
A-6.24 Attach verification of identity. The following are acceptable forms of verification of identity: -Unexpired, valid state-issued driver's license. -Unexpired, valid photographic identification issued by the Ohio Bureau of Motor Vehicles or the equivalent from another state. -Unexpired, valid United States passport.
This response has been entirely redacted
A-6.25 Tax Authorization: Each Prospective Associated Key Employee with an aggregate ownership interest of ten percent or more in the Applicant, must print, manually sign and attach a copy of the Tax Authorization Form. The State Board of Pharmacy may, in its discretion, require an owner or person who exercises substantial control over a proposed dispensary, but who has less than a ten percent ownership interest, to comply with statutory and regulatory ownership requirements. ORC 3796.10, OAC 3796:6-2-02
This response has been entirely redacted Demographic Information(Prospective Associated Key Employees Details)
Item 4 of 7
A-6.1 First Name
Tomas
A-6.2 Middle Name
Gabriel
A-6.3 Last Name
Casals
A-6.4 Suffix
No response provided by applicant
A-6.5 Occupation
Real Estate Design and Engineering Entrepreneur
A-6.6 Title in the Applicant’s business
Chief Development Officer
A-6.7 Applicant's business related compensation
$75,000
A-6.8 Number of shares owned
51
A-6.9 Types of shares owned
Common
A-6.10 Percent interest in Applicant's business
51%
A-6.11 Voting percentage
51%
A-6.12 Proposed Role
OFFICER
A-6.13 Please include any contributions of money, equipment, real estate and expertise
Technology and Construction Design Expertise in Medical Marijuana Industry A-6.14 Date of birth
This response has been entirely redacted
A-6.15 Social Security Number (use "N/A" if unavailable)
This response has been entirely redacted
A-6.16 Street Address
207 Eagle Street
A-6.17 City
Fairport Harbor
A-6.18 State
OH
A-6.19 Zip Code
44077
A-6.20 Phone
6173781612
A-6.21 Email [email protected]
A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)
Hispanic
A-6.23 If the Prospective Associated Key Employee maintains an Ohio residence, please provide the length of time for which Ohio residency has been established:
No response provided by applicant
A-6.24 Attach verification of identity. The following are acceptable forms of verification of identity: -Unexpired, valid state-issued driver's license. -Unexpired, valid photographic identification issued by the Ohio Bureau of Motor Vehicles or the equivalent from another state. -Unexpired, valid United States passport.
This response has been entirely redacted
A-6.25 Tax Authorization: Each Prospective Associated Key Employee with an aggregate ownership interest of ten percent or more in the Applicant, must print, manually sign and attach a copy of the Tax Authorization Form. The State Board of Pharmacy may, in its discretion, require an owner or person who exercises substantial control over a proposed dispensary, but who has less than a ten percent ownership interest, to comply with statutory and regulatory ownership requirements. ORC 3796.10, OAC 3796:6-2-02
This response has been entirely redacted Demographic Information(Prospective Associated Key Employees Details)
Item 5 of 7
A-6.1 First Name
Kristi
A-6.2 Middle Name
Elena
A-6.3 Last Name
Fults
A-6.4 Suffix
No response provided by applicant
A-6.5 Occupation
Social Worker
A-6.6 Title in the Applicant’s business
Head of Human Resources
A-6.7 Applicant's business related compensation
$75,000
A-6.8 Number of shares owned
0
A-6.9 Types of shares owned
N/A
A-6.10 Percent interest in Applicant's business
0
A-6.11 Voting percentage
0
A-6.12 Proposed Role
OFFICER
A-6.13 Please include any contributions of money, equipment, real estate and expertise
Human Resources Experience A-6.14 Date of birth
This response has been entirely redacted
A-6.15 Social Security Number (use "N/A" if unavailable)
This response has been entirely redacted
A-6.16 Street Address
1229 East Colona Street
A-6.17 City
Philadelphia
A-6.18 State
PA
A-6.19 Zip Code
19125
A-6.20 Phone
2157046254
A-6.21 Email
No response provided by applicant
A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)
Non-Minority
A-6.23 If the Prospective Associated Key Employee maintains an Ohio residence, please provide the length of time for which Ohio residency has been established:
No response provided by applicant
A-6.24 Attach verification of identity. The following are acceptable forms of verification of identity: -Unexpired, valid state-issued driver's license. -Unexpired, valid photographic identification issued by the Ohio Bureau of Motor Vehicles or the equivalent from another state. -Unexpired, valid United States passport.
This response has been entirely redacted
A-6.25 Tax Authorization: Each Prospective Associated Key Employee with an aggregate ownership interest of ten percent or more in the Applicant, must print, manually sign and attach a copy of the Tax Authorization Form. The State Board of Pharmacy may, in its discretion, require an owner or person who exercises substantial control over a proposed dispensary, but who has less than a ten percent ownership interest, to comply with statutory and regulatory ownership requirements. ORC 3796.10, OAC 3796:6-2-02
No response provided by applicant Demographic Information(Prospective Associated Key Employees Details)
Item 6 of 7
A-6.1 First Name
Judith
A-6.2 Middle Name
No response provided by applicant
A-6.3 Last Name
Cassel
A-6.4 Suffix
No response provided by applicant
A-6.5 Occupation
Attorney
A-6.6 Title in the Applicant’s business
Advisory Board Member
A-6.7 Applicant's business related compensation
$0
A-6.8 Number of shares owned
0
A-6.9 Types of shares owned
0
A-6.10 Percent interest in Applicant's business
0
A-6.11 Voting percentage
0
A-6.12 Proposed Role
OTHER
A-6.13 Please include any contributions of money, equipment, real estate and expertise
Regulatory Compliance Expertise A-6.14 Date of birth
This response has been entirely redacted
A-6.15 Social Security Number (use "N/A" if unavailable)
This response has been entirely redacted
A-6.16 Street Address
345 N. Broad Street
A-6.17 City
Lititz
A-6.18 State
PA
A-6.19 Zip Code
17543
A-6.20 Phone
No response provided by applicant
A-6.21 Email
No response provided by applicant
A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)
Non-Minority
A-6.23 If the Prospective Associated Key Employee maintains an Ohio residence, please provide the length of time for which Ohio residency has been established:
No response provided by applicant
A-6.24 Attach verification of identity. The following are acceptable forms of verification of identity: -Unexpired, valid state-issued driver's license. -Unexpired, valid photographic identification issued by the Ohio Bureau of Motor Vehicles or the equivalent from another state. -Unexpired, valid United States passport.
This response has been entirely redacted
A-6.25 Tax Authorization: Each Prospective Associated Key Employee with an aggregate ownership interest of ten percent or more in the Applicant, must print, manually sign and attach a copy of the Tax Authorization Form. The State Board of Pharmacy may, in its discretion, require an owner or person who exercises substantial control over a proposed dispensary, but who has less than a ten percent ownership interest, to comply with statutory and regulatory ownership requirements. ORC 3796.10, OAC 3796:6-2-02
No response provided by applicant Demographic Information(Prospective Associated Key Employees Details)
Item 7 of 7
A-6.1 First Name
Kevin
A-6.2 Middle Name
Michael
A-6.3 Last Name
Evans
A-6.4 Suffix
No response provided by applicant
A-6.5 Occupation
Dispensary Management Consultant
A-6.6 Title in the Applicant’s business
Regional Dispensary Manager
A-6.7 Applicant's business related compensation
$60,000
A-6.8 Number of shares owned
0
A-6.9 Types of shares owned
0
A-6.10 Percent interest in Applicant's business
0
A-6.11 Voting percentage
0
A-6.12 Proposed Role
PERSON EXERCISING SUBSTANTIAL CONTROL
A-6.13 Please include any contributions of money, equipment, real estate and expertise
Dispensary Sales Experience and Expertise A-6.14 Date of birth
This response has been entirely redacted
A-6.15 Social Security Number (use "N/A" if unavailable)
This response has been entirely redacted
A-6.16 Street Address
128 Jacobs Creek Drive
A-6.17 City
Hershey
A-6.18 State
PA
A-6.19 Zip Code
17033
A-6.20 Phone
No response provided by applicant
A-6.21 Email
No response provided by applicant
A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)
Non-Minority
A-6.23 If the Prospective Associated Key Employee maintains an Ohio residence, please provide the length of time for which Ohio residency has been established:
No response provided by applicant
A-6.24 Attach verification of identity. The following are acceptable forms of verification of identity: -Unexpired, valid state-issued driver's license. -Unexpired, valid photographic identification issued by the Ohio Bureau of Motor Vehicles or the equivalent from another state. -Unexpired, valid United States passport.
This response has been entirely redacted
A-6.25 Tax Authorization: Each Prospective Associated Key Employee with an aggregate ownership interest of ten percent or more in the Applicant, must print, manually sign and attach a copy of the Tax Authorization Form. The State Board of Pharmacy may, in its discretion, require an owner or person who exercises substantial control over a proposed dispensary, but who has less than a ten percent ownership interest, to comply with statutory and regulatory ownership requirements. ORC 3796.10, OAC 3796:6-2-02
No response provided by applicant Compliance(Compliance with Applicable Laws and Regulations)
B-1.1 By selecting “Yes”, the Applicant, as well as all individually identified Prospective Associated Key Employees listed in this provisional license application, agree to comply with all applicable Ohio laws and regulations relating to the operation of a medical marijuana dispensary.
YES
B-1.2 By selecting “Yes”, the Applicant understands and attests that it must establish and maintain an escrow account or surety bond in the amount of $50,000 as a condition precedent to receiving a medical marijuana certificate of operation. OAC 3796:6-2-11
YES Compliance(Civil and Administrative Action)
B-2.1 Has the Applicant been the subject of an action resulting in sanctions, disciplinary actions or civil monetary penalties or fines being imposed relating to a registration, license, provisional license or any other authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-2.2 Has the Applicant been the subject of a civil or administrative action relating to a registration, license, provisional license or authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-2.3 Has criminal, civil, or administrative action been taken against the Applicant for obtaining a registration, license, provisional license or other authorization to operate as a cultivator, processor, or dispensary of medical marijuana in any jurisdiction by fraud, misrepresentation, or the submission of false information?
NO
B-2.4 Has criminal, civil or administrative action been taken against the Applicant under the laws of Ohio or any other state, the United States or a military, territorial or tribal authority, relating to any of the Applicant's Prospective Associated Key Employees' profession or occupation?
NO
B-2.4.1 If "Yes" to any question in B-2, provide the following: Respondent / Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved, and the Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant Compliance(Prospective Associated Key Employee Compliance)
Item 1 of 7
B-3.1 First Name
Donald
B-3.2 Middle Name
James
B-3.3 Last Name
Kenney
B-3.4 Proposed Role
OFFICER
B-3.5 Position/Title
Chief Executive Officer
B-3.6 Brief description of role
Develop, implement, and execute company management goals.
B-3.7 Has this individual served, or are they currently serving as an owner, officer, or board member of another medical marijuana entity in Ohio or the United States?
NO
B-3.7.1 If "Yes" to B-3.7, please provide the entity Name and Address.
No response provided by applicant
B-3.8 Has this individual had ownership or financial interest, or do they currently have ownership or financial interest of another medical marijuana entity in Ohio or the United States?
NO
B-3.8.1 If "Yes" to B-3.8, please provide the entity Name and Address.
No response provided by applicant
B-3.9 Has this individual ever been convicted of, or are charges pending for, a disqualifying offense? Include instances in which a court granted intervention in lieu of treatment (also known as treatment in lieu of conviction, ILC, or TLC), or other diversion programs. Offenses must be reported regardless of whether the case has been sealed, as described in section 2953.32 of the Revised Code, or the equivalent thereof in another jurisdiction.
NO B-3.9.1 If "Yes" to B-3.9, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.10 Has the individual ever been convicted of, or are charges pending for, any other felony offense under state or federal law?
NO
B-3.10.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.11 Has the individual ever been convicted of, or are charges pending for, a crime (felony or misdemeanor) involving an act of moral turpitude?
NO
B-3.11.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.12 Has this individual ever been disciplined by the State of Ohio Board of Pharmacy or any other licensing body.
NO
B-3.12.1 If "Yes", please provide the following: Name, Name and Address of Licensing Board, License Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved
No response provided by applicant
B-3.13 Has the individual ever been denied a license by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction, or is such action pending?
NO
B-3.13.1 If "Yes" to B-3.13, the reason for doing so must be provided below.
No response provided by applicant
B-3.14 Has the individual ever been the subject of an investigation or disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction that resulted in the surrender, suspension, revocation, or probation of the individual's license or registration?
NO B-3.14.1 If "Yes" to B-3.14, the reason for doing so must be provided below.
No response provided by applicant
B-3.15 Has the individual ever been the subject of a disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state jurisdiction that was based in whole or in part, on the Applicant's prescribing, dispensing, diverting, administering, storing, personally furnishing, compounding, supplying, or selling a controlled substance or other dangerous drug (i.e. prescription drug), or is any such action pending?
NO
B-3.15.1 If "Yes" to B-3.15, the reason for doing so must be provided below.
No response provided by applicant
B-3.16 By selecting "Yes", this individual agrees to be enrolled in the Retained Applicant Fingerprint Database (Rapback) should the Applicant be awarded a provisional license.
YES
B-3.17 Has the individual been the subject of an action resulting in sanctions, disciplinary actions or civil monetary penalties being imposed relating to a registration, license, provisional license or any other authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.17.1 If "Yes" to B-3.17, the reason for doing so must be provided below.
No response provided by applicant
B-3.18 Has the individual been the subject of a civil or administrative action relating to a registration, license, provisional license or authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.18.1 If "Yes" to B-3.18, the reason for doing so must be provided below.
No response provided by applicant
B-3.19 Has the individual been accused of obtaining a registration, license, provisional license or other authorization to operate as a cultivator, processor, or dispensary of medical marijuana in any jurisdiction by fraud, misrepresentation, or the submission of false information?
NO
B-3.19.1 If "Yes" to B-3.19, the reason for doing so must be provided below.
No response provided by applicant
B-3.20 Has civil or administrative action been taken against the individual under the laws of Ohio or any other state, the United States or a military, territorial or tribal authority, relating to the individual's profession or occupation? NO
B-3.20.1 If "Yes" to B-3.20, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.21 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees are a physician who has a certificate to recommend medical marijuana or who has applied for a certificate to recommend medical marijuana under section 4731.30 of the Revised Code.
YES
B-3.22 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees have ownership, investment interest, or a compensation arrangement with a laboratory licensed under Chapter 3796 of the Revised Code or an Applicant for a license to conduct laboratory testing.
YES Compliance(Prospective Associated Key Employee Compliance)
Item 2 of 7
B-3.1 First Name
Ethan
B-3.2 Middle Name
Michael
B-3.3 Last Name
Moon
B-3.4 Proposed Role
OFFICER
B-3.5 Position/Title
Chief Operating Officer
B-3.6 Brief description of role
Provide day-to-day management of dispensary that ensures company policies SOPs remain current and compliant with Board regulations.
B-3.7 Has this individual served, or are they currently serving as an owner, officer, or board member of another medical marijuana entity in Ohio or the United States?
YES
B-3.7.1 If "Yes" to B-3.7, please provide the entity Name and Address.
Ethan is an owner and officer of Viridios Systems, LLC, a medical marijuana equipment manufacturer that designs and manufacturers processing equipment used in the medicine extraction and processing phases. Viridios was founded in 2016 in Massachusetts at:
9 Strathmore Road Brookline, MA 02445
Viridios is not required to be nor is it licensed in any state as a cultivator, extractor, processor, or dispensary of medical marijuana.
B-3.8 Has this individual had ownership or financial interest, or do they currently have ownership or financial interest of another medical marijuana entity in Ohio or the United States?
YES
B-3.8.1 If "Yes" to B-3.8, please provide the entity Name and Address.
Ethan is an owner and officer of Viridios Systems, LLC, a medical marijuana equipment manufacturer that designs and manufacturers processing equipment used in the medicine extraction and processing phases. Viridios was founded in 2016 in Massachusetts at:
9 Strathmore Road Brookline, MA 02445
Viridios is not required to be nor is it licensed in any state as a cultivator, extractor, processor, or dispensary of medical marijuana.
B-3.9 Has this individual ever been convicted of, or are charges pending for, a disqualifying offense? Include instances in which a court granted intervention in lieu of treatment (also known as treatment in lieu of conviction, ILC, or TLC), or other diversion programs. Offenses must be reported regardless of whether the case has been sealed, as described in section 2953.32 of the Revised Code, or the equivalent thereof in another jurisdiction.
NO
B-3.9.1 If "Yes" to B-3.9, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.10 Has the individual ever been convicted of, or are charges pending for, any other felony offense under state or federal law?
NO
B-3.10.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.11 Has the individual ever been convicted of, or are charges pending for, a crime (felony or misdemeanor) involving an act of moral turpitude?
NO
B-3.11.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.12 Has this individual ever been disciplined by the State of Ohio Board of Pharmacy or any other licensing body.
NO
B-3.12.1 If "Yes", please provide the following: Name, Name and Address of Licensing Board, License Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved No response provided by applicant
B-3.13 Has the individual ever been denied a license by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction, or is such action pending?
NO
B-3.13.1 If "Yes" to B-3.13, the reason for doing so must be provided below.
No response provided by applicant
B-3.14 Has the individual ever been the subject of an investigation or disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction that resulted in the surrender, suspension, revocation, or probation of the individual's license or registration?
NO
B-3.14.1 If "Yes" to B-3.14, the reason for doing so must be provided below.
No response provided by applicant
B-3.15 Has the individual ever been the subject of a disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state jurisdiction that was based in whole or in part, on the Applicant's prescribing, dispensing, diverting, administering, storing, personally furnishing, compounding, supplying, or selling a controlled substance or other dangerous drug (i.e. prescription drug), or is any such action pending?
NO
B-3.15.1 If "Yes" to B-3.15, the reason for doing so must be provided below.
No response provided by applicant
B-3.16 By selecting "Yes", this individual agrees to be enrolled in the Retained Applicant Fingerprint Database (Rapback) should the Applicant be awarded a provisional license.
YES
B-3.17 Has the individual been the subject of an action resulting in sanctions, disciplinary actions or civil monetary penalties being imposed relating to a registration, license, provisional license or any other authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.17.1 If "Yes" to B-3.17, the reason for doing so must be provided below.
No response provided by applicant
B-3.18 Has the individual been the subject of a civil or administrative action relating to a registration, license, provisional license or authorization to cultivate, process, or dispense medical marijuana in any state?
NO B-3.18.1 If "Yes" to B-3.18, the reason for doing so must be provided below.
No response provided by applicant
B-3.19 Has the individual been accused of obtaining a registration, license, provisional license or other authorization to operate as a cultivator, processor, or dispensary of medical marijuana in any jurisdiction by fraud, misrepresentation, or the submission of false information?
NO
B-3.19.1 If "Yes" to B-3.19, the reason for doing so must be provided below.
No response provided by applicant
B-3.20 Has civil or administrative action been taken against the individual under the laws of Ohio or any other state, the United States or a military, territorial or tribal authority, relating to the individual's profession or occupation?
NO
B-3.20.1 If "Yes" to B-3.20, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.21 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees are a physician who has a certificate to recommend medical marijuana or who has applied for a certificate to recommend medical marijuana under section 4731.30 of the Revised Code.
YES
B-3.22 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees have ownership, investment interest, or a compensation arrangement with a laboratory licensed under Chapter 3796 of the Revised Code or an Applicant for a license to conduct laboratory testing.
YES Compliance(Prospective Associated Key Employee Compliance)
Item 3 of 7
B-3.1 First Name
Shane
B-3.2 Middle Name
Patrick
B-3.3 Last Name
Kenney
B-3.4 Proposed Role
OFFICER
B-3.5 Position/Title
Chief Financial Officer
B-3.6 Brief description of role
Develop company financial goals consistent with the CEO's company vision and implement strategies to meet said goals.
B-3.7 Has this individual served, or are they currently serving as an owner, officer, or board member of another medical marijuana entity in Ohio or the United States?
YES
B-3.7.1 If "Yes" to B-3.7, please provide the entity Name and Address.
Shane is an owner and officer of Viridios Systems, LLC, a medical marijuana equipment manufacturer that designs and manufacturers processing equipment used in the medicine extraction and processing phases. Viridios was founded in 2016 in Massachusetts at:
9 Strathmore Road Brookline, MA 02445
Viridios is not required to be nor is it licensed in any state as a cultivator, extractor, processor, or dispensary of medical marijuana.
B-3.8 Has this individual had ownership or financial interest, or do they currently have ownership or financial interest of another medical marijuana entity in Ohio or the United States?
YES
B-3.8.1 If "Yes" to B-3.8, please provide the entity Name and Address.
Shane is an owner and officer of Viridios Systems, LLC, a medical marijuana equipment manufacturer that designs and manufacturers processing equipment used in the medicine extraction and processing phases. Viridios was founded in 2016 in Massachusetts at:
9 Strathmore Road Brookline, MA 02445
Viridios is not required to be nor is it licensed in any state as a cultivator, extractor, processor, or dispensary of medical marijuana.
B-3.9 Has this individual ever been convicted of, or are charges pending for, a disqualifying offense? Include instances in which a court granted intervention in lieu of treatment (also known as treatment in lieu of conviction, ILC, or TLC), or other diversion programs. Offenses must be reported regardless of whether the case has been sealed, as described in section 2953.32 of the Revised Code, or the equivalent thereof in another jurisdiction.
NO
B-3.9.1 If "Yes" to B-3.9, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.10 Has the individual ever been convicted of, or are charges pending for, any other felony offense under state or federal law?
NO
B-3.10.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.11 Has the individual ever been convicted of, or are charges pending for, a crime (felony or misdemeanor) involving an act of moral turpitude?
NO
B-3.11.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.12 Has this individual ever been disciplined by the State of Ohio Board of Pharmacy or any other licensing body.
NO
B-3.12.1 If "Yes", please provide the following: Name, Name and Address of Licensing Board, License Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved No response provided by applicant
B-3.13 Has the individual ever been denied a license by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction, or is such action pending?
NO
B-3.13.1 If "Yes" to B-3.13, the reason for doing so must be provided below.
No response provided by applicant
B-3.14 Has the individual ever been the subject of an investigation or disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction that resulted in the surrender, suspension, revocation, or probation of the individual's license or registration?
NO
B-3.14.1 If "Yes" to B-3.14, the reason for doing so must be provided below.
No response provided by applicant
B-3.15 Has the individual ever been the subject of a disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state jurisdiction that was based in whole or in part, on the Applicant's prescribing, dispensing, diverting, administering, storing, personally furnishing, compounding, supplying, or selling a controlled substance or other dangerous drug (i.e. prescription drug), or is any such action pending?
NO
B-3.15.1 If "Yes" to B-3.15, the reason for doing so must be provided below.
No response provided by applicant
B-3.16 By selecting "Yes", this individual agrees to be enrolled in the Retained Applicant Fingerprint Database (Rapback) should the Applicant be awarded a provisional license.
YES
B-3.17 Has the individual been the subject of an action resulting in sanctions, disciplinary actions or civil monetary penalties being imposed relating to a registration, license, provisional license or any other authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.17.1 If "Yes" to B-3.17, the reason for doing so must be provided below.
No response provided by applicant
B-3.18 Has the individual been the subject of a civil or administrative action relating to a registration, license, provisional license or authorization to cultivate, process, or dispense medical marijuana in any state?
NO B-3.18.1 If "Yes" to B-3.18, the reason for doing so must be provided below.
No response provided by applicant
B-3.19 Has the individual been accused of obtaining a registration, license, provisional license or other authorization to operate as a cultivator, processor, or dispensary of medical marijuana in any jurisdiction by fraud, misrepresentation, or the submission of false information?
NO
B-3.19.1 If "Yes" to B-3.19, the reason for doing so must be provided below.
No response provided by applicant
B-3.20 Has civil or administrative action been taken against the individual under the laws of Ohio or any other state, the United States or a military, territorial or tribal authority, relating to the individual's profession or occupation?
NO
B-3.20.1 If "Yes" to B-3.20, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.21 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees are a physician who has a certificate to recommend medical marijuana or who has applied for a certificate to recommend medical marijuana under section 4731.30 of the Revised Code.
YES
B-3.22 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees have ownership, investment interest, or a compensation arrangement with a laboratory licensed under Chapter 3796 of the Revised Code or an Applicant for a license to conduct laboratory testing.
YES Compliance(Prospective Associated Key Employee Compliance)
Item 4 of 7
B-3.1 First Name
Tomas
B-3.2 Middle Name
Gabriel
B-3.3 Last Name
Casals
B-3.4 Proposed Role
OFFICER
B-3.5 Position/Title
Chief Development Officer
B-3.6 Brief description of role
Coordinate with the CEO and CFO to develop realistic company growth goals and develop and implement strategies to meet these goals.
B-3.7 Has this individual served, or are they currently serving as an owner, officer, or board member of another medical marijuana entity in Ohio or the United States?
YES
B-3.7.1 If "Yes" to B-3.7, please provide the entity Name and Address.
Tomas is an owner and officer of Viridios Systems, LLC, a medical marijuana equipment manufacturer that designs and manufacturers processing equipment used in the medicine extraction and processing phases. Viridios was founded in 2016 in Massachusetts at:
9 Strathmore Road Brookline, MA 02445
Viridios is not required to be nor is it licensed in any state as a cultivator, extractor, processor, or dispensary of medical marijuana.
B-3.8 Has this individual had ownership or financial interest, or do they currently have ownership or financial interest of another medical marijuana entity in Ohio or the United States?
YES
B-3.8.1 If "Yes" to B-3.8, please provide the entity Name and Address.
Tomas is an owner and officer of Viridios Systems, LLC, a medical marijuana equipment manufacturer that designs and manufacturers processing equipment used in the medicine extraction and processing phases. Viridios was founded in 2016 in Massachusetts at:
9 Strathmore Road Brookline, MA 02445
Viridios is not required to be nor is it licensed in any state as a cultivator, extractor, processor, or dispensary of medical marijuana.
B-3.9 Has this individual ever been convicted of, or are charges pending for, a disqualifying offense? Include instances in which a court granted intervention in lieu of treatment (also known as treatment in lieu of conviction, ILC, or TLC), or other diversion programs. Offenses must be reported regardless of whether the case has been sealed, as described in section 2953.32 of the Revised Code, or the equivalent thereof in another jurisdiction.
NO
B-3.9.1 If "Yes" to B-3.9, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.10 Has the individual ever been convicted of, or are charges pending for, any other felony offense under state or federal law?
NO
B-3.10.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.11 Has the individual ever been convicted of, or are charges pending for, a crime (felony or misdemeanor) involving an act of moral turpitude?
NO
B-3.11.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.12 Has this individual ever been disciplined by the State of Ohio Board of Pharmacy or any other licensing body.
NO
B-3.12.1 If "Yes", please provide the following: Name, Name and Address of Licensing Board, License Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved No response provided by applicant
B-3.13 Has the individual ever been denied a license by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction, or is such action pending?
NO
B-3.13.1 If "Yes" to B-3.13, the reason for doing so must be provided below.
No response provided by applicant
B-3.14 Has the individual ever been the subject of an investigation or disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction that resulted in the surrender, suspension, revocation, or probation of the individual's license or registration?
NO
B-3.14.1 If "Yes" to B-3.14, the reason for doing so must be provided below.
No response provided by applicant
B-3.15 Has the individual ever been the subject of a disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state jurisdiction that was based in whole or in part, on the Applicant's prescribing, dispensing, diverting, administering, storing, personally furnishing, compounding, supplying, or selling a controlled substance or other dangerous drug (i.e. prescription drug), or is any such action pending?
NO
B-3.15.1 If "Yes" to B-3.15, the reason for doing so must be provided below.
No response provided by applicant
B-3.16 By selecting "Yes", this individual agrees to be enrolled in the Retained Applicant Fingerprint Database (Rapback) should the Applicant be awarded a provisional license.
YES
B-3.17 Has the individual been the subject of an action resulting in sanctions, disciplinary actions or civil monetary penalties being imposed relating to a registration, license, provisional license or any other authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.17.1 If "Yes" to B-3.17, the reason for doing so must be provided below.
No response provided by applicant
B-3.18 Has the individual been the subject of a civil or administrative action relating to a registration, license, provisional license or authorization to cultivate, process, or dispense medical marijuana in any state?
NO B-3.18.1 If "Yes" to B-3.18, the reason for doing so must be provided below.
No response provided by applicant
B-3.19 Has the individual been accused of obtaining a registration, license, provisional license or other authorization to operate as a cultivator, processor, or dispensary of medical marijuana in any jurisdiction by fraud, misrepresentation, or the submission of false information?
NO
B-3.19.1 If "Yes" to B-3.19, the reason for doing so must be provided below.
No response provided by applicant
B-3.20 Has civil or administrative action been taken against the individual under the laws of Ohio or any other state, the United States or a military, territorial or tribal authority, relating to the individual's profession or occupation?
NO
B-3.20.1 If "Yes" to B-3.20, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.21 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees are a physician who has a certificate to recommend medical marijuana or who has applied for a certificate to recommend medical marijuana under section 4731.30 of the Revised Code.
YES
B-3.22 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees have ownership, investment interest, or a compensation arrangement with a laboratory licensed under Chapter 3796 of the Revised Code or an Applicant for a license to conduct laboratory testing.
YES Compliance(Prospective Associated Key Employee Compliance)
Item 5 of 7
B-3.1 First Name
Kristi
B-3.2 Middle Name
Elena
B-3.3 Last Name
Fults
B-3.4 Proposed Role
OFFICER
B-3.5 Position/Title
Head of Human Resources
B-3.6 Brief description of role
Provide direct management over company employees, including recommending hiring and terminating employees and coordinating all employee training.
B-3.7 Has this individual served, or are they currently serving as an owner, officer, or board member of another medical marijuana entity in Ohio or the United States?
NO
B-3.7.1 If "Yes" to B-3.7, please provide the entity Name and Address.
No response provided by applicant
B-3.8 Has this individual had ownership or financial interest, or do they currently have ownership or financial interest of another medical marijuana entity in Ohio or the United States?
NO
B-3.8.1 If "Yes" to B-3.8, please provide the entity Name and Address.
No response provided by applicant
B-3.9 Has this individual ever been convicted of, or are charges pending for, a disqualifying offense? Include instances in which a court granted intervention in lieu of treatment (also known as treatment in lieu of conviction, ILC, or TLC), or other diversion programs. Offenses must be reported regardless of whether the case has been sealed, as described in section 2953.32 of the Revised Code, or the equivalent thereof in another jurisdiction.
NO B-3.9.1 If "Yes" to B-3.9, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.10 Has the individual ever been convicted of, or are charges pending for, any other felony offense under state or federal law?
NO
B-3.10.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.11 Has the individual ever been convicted of, or are charges pending for, a crime (felony or misdemeanor) involving an act of moral turpitude?
NO
B-3.11.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.12 Has this individual ever been disciplined by the State of Ohio Board of Pharmacy or any other licensing body.
NO
B-3.12.1 If "Yes", please provide the following: Name, Name and Address of Licensing Board, License Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved
No response provided by applicant
B-3.13 Has the individual ever been denied a license by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction, or is such action pending?
NO
B-3.13.1 If "Yes" to B-3.13, the reason for doing so must be provided below.
No response provided by applicant
B-3.14 Has the individual ever been the subject of an investigation or disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction that resulted in the surrender, suspension, revocation, or probation of the individual's license or registration?
NO B-3.14.1 If "Yes" to B-3.14, the reason for doing so must be provided below.
No response provided by applicant
B-3.15 Has the individual ever been the subject of a disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state jurisdiction that was based in whole or in part, on the Applicant's prescribing, dispensing, diverting, administering, storing, personally furnishing, compounding, supplying, or selling a controlled substance or other dangerous drug (i.e. prescription drug), or is any such action pending?
NO
B-3.15.1 If "Yes" to B-3.15, the reason for doing so must be provided below.
No response provided by applicant
B-3.16 By selecting "Yes", this individual agrees to be enrolled in the Retained Applicant Fingerprint Database (Rapback) should the Applicant be awarded a provisional license.
YES
B-3.17 Has the individual been the subject of an action resulting in sanctions, disciplinary actions or civil monetary penalties being imposed relating to a registration, license, provisional license or any other authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.17.1 If "Yes" to B-3.17, the reason for doing so must be provided below.
No response provided by applicant
B-3.18 Has the individual been the subject of a civil or administrative action relating to a registration, license, provisional license or authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.18.1 If "Yes" to B-3.18, the reason for doing so must be provided below.
No response provided by applicant
B-3.19 Has the individual been accused of obtaining a registration, license, provisional license or other authorization to operate as a cultivator, processor, or dispensary of medical marijuana in any jurisdiction by fraud, misrepresentation, or the submission of false information?
NO
B-3.19.1 If "Yes" to B-3.19, the reason for doing so must be provided below.
No response provided by applicant
B-3.20 Has civil or administrative action been taken against the individual under the laws of Ohio or any other state, the United States or a military, territorial or tribal authority, relating to the individual's profession or occupation? NO
B-3.20.1 If "Yes" to B-3.20, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.21 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees are a physician who has a certificate to recommend medical marijuana or who has applied for a certificate to recommend medical marijuana under section 4731.30 of the Revised Code.
YES
B-3.22 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees have ownership, investment interest, or a compensation arrangement with a laboratory licensed under Chapter 3796 of the Revised Code or an Applicant for a license to conduct laboratory testing.
YES Compliance(Prospective Associated Key Employee Compliance)
Item 6 of 7
B-3.1 First Name
Judith
B-3.2 Middle Name
No response provided by applicant
B-3.3 Last Name
Cassel
B-3.4 Proposed Role
OTHER
B-3.5 Position/Title
Advisory Board Member
B-3.6 Brief description of role
Reviewing and provide guidance on company policies.
B-3.7 Has this individual served, or are they currently serving as an owner, officer, or board member of another medical marijuana entity in Ohio or the United States?
NO
B-3.7.1 If "Yes" to B-3.7, please provide the entity Name and Address.
No response provided by applicant
B-3.8 Has this individual had ownership or financial interest, or do they currently have ownership or financial interest of another medical marijuana entity in Ohio or the United States?
NO
B-3.8.1 If "Yes" to B-3.8, please provide the entity Name and Address.
No response provided by applicant
B-3.9 Has this individual ever been convicted of, or are charges pending for, a disqualifying offense? Include instances in which a court granted intervention in lieu of treatment (also known as treatment in lieu of conviction, ILC, or TLC), or other diversion programs. Offenses must be reported regardless of whether the case has been sealed, as described in section 2953.32 of the Revised Code, or the equivalent thereof in another jurisdiction.
NO B-3.9.1 If "Yes" to B-3.9, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.10 Has the individual ever been convicted of, or are charges pending for, any other felony offense under state or federal law?
NO
B-3.10.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.11 Has the individual ever been convicted of, or are charges pending for, a crime (felony or misdemeanor) involving an act of moral turpitude?
NO
B-3.11.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.12 Has this individual ever been disciplined by the State of Ohio Board of Pharmacy or any other licensing body.
NO
B-3.12.1 If "Yes", please provide the following: Name, Name and Address of Licensing Board, License Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved
No response provided by applicant
B-3.13 Has the individual ever been denied a license by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction, or is such action pending?
NO
B-3.13.1 If "Yes" to B-3.13, the reason for doing so must be provided below.
No response provided by applicant
B-3.14 Has the individual ever been the subject of an investigation or disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction that resulted in the surrender, suspension, revocation, or probation of the individual's license or registration?
NO B-3.14.1 If "Yes" to B-3.14, the reason for doing so must be provided below.
No response provided by applicant
B-3.15 Has the individual ever been the subject of a disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state jurisdiction that was based in whole or in part, on the Applicant's prescribing, dispensing, diverting, administering, storing, personally furnishing, compounding, supplying, or selling a controlled substance or other dangerous drug (i.e. prescription drug), or is any such action pending?
NO
B-3.15.1 If "Yes" to B-3.15, the reason for doing so must be provided below.
No response provided by applicant
B-3.16 By selecting "Yes", this individual agrees to be enrolled in the Retained Applicant Fingerprint Database (Rapback) should the Applicant be awarded a provisional license.
YES
B-3.17 Has the individual been the subject of an action resulting in sanctions, disciplinary actions or civil monetary penalties being imposed relating to a registration, license, provisional license or any other authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.17.1 If "Yes" to B-3.17, the reason for doing so must be provided below.
No response provided by applicant
B-3.18 Has the individual been the subject of a civil or administrative action relating to a registration, license, provisional license or authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.18.1 If "Yes" to B-3.18, the reason for doing so must be provided below.
No response provided by applicant
B-3.19 Has the individual been accused of obtaining a registration, license, provisional license or other authorization to operate as a cultivator, processor, or dispensary of medical marijuana in any jurisdiction by fraud, misrepresentation, or the submission of false information?
NO
B-3.19.1 If "Yes" to B-3.19, the reason for doing so must be provided below.
No response provided by applicant
B-3.20 Has civil or administrative action been taken against the individual under the laws of Ohio or any other state, the United States or a military, territorial or tribal authority, relating to the individual's profession or occupation? NO
B-3.20.1 If "Yes" to B-3.20, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.21 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees are a physician who has a certificate to recommend medical marijuana or who has applied for a certificate to recommend medical marijuana under section 4731.30 of the Revised Code.
YES
B-3.22 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees have ownership, investment interest, or a compensation arrangement with a laboratory licensed under Chapter 3796 of the Revised Code or an Applicant for a license to conduct laboratory testing.
YES Compliance(Prospective Associated Key Employee Compliance)
Item 7 of 7
B-3.1 First Name
Kevin
B-3.2 Middle Name
Michael
B-3.3 Last Name
Evans
B-3.4 Proposed Role
PERSON EXERCISING SUBSTANTIAL CONTROL
B-3.5 Position/Title
Regional Dispensary Manager
B-3.6 Brief description of role
Provide direct management oversight of the dispensary manager and when needed provide on-site assistance at the dispensary.
B-3.7 Has this individual served, or are they currently serving as an owner, officer, or board member of another medical marijuana entity in Ohio or the United States?
NO
B-3.7.1 If "Yes" to B-3.7, please provide the entity Name and Address.
No response provided by applicant
B-3.8 Has this individual had ownership or financial interest, or do they currently have ownership or financial interest of another medical marijuana entity in Ohio or the United States?
NO
B-3.8.1 If "Yes" to B-3.8, please provide the entity Name and Address.
No response provided by applicant
B-3.9 Has this individual ever been convicted of, or are charges pending for, a disqualifying offense? Include instances in which a court granted intervention in lieu of treatment (also known as treatment in lieu of conviction, ILC, or TLC), or other diversion programs. Offenses must be reported regardless of whether the case has been sealed, as described in section 2953.32 of the Revised Code, or the equivalent thereof in another jurisdiction.
NO B-3.9.1 If "Yes" to B-3.9, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.10 Has the individual ever been convicted of, or are charges pending for, any other felony offense under state or federal law?
NO
B-3.10.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.11 Has the individual ever been convicted of, or are charges pending for, a crime (felony or misdemeanor) involving an act of moral turpitude?
NO
B-3.11.1 If "Yes", please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.12 Has this individual ever been disciplined by the State of Ohio Board of Pharmacy or any other licensing body.
NO
B-3.12.1 If "Yes", please provide the following: Name, Name and Address of Licensing Board, License Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved
No response provided by applicant
B-3.13 Has the individual ever been denied a license by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction, or is such action pending?
NO
B-3.13.1 If "Yes" to B-3.13, the reason for doing so must be provided below.
No response provided by applicant
B-3.14 Has the individual ever been the subject of an investigation or disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state or jurisdiction that resulted in the surrender, suspension, revocation, or probation of the individual's license or registration?
NO B-3.14.1 If "Yes" to B-3.14, the reason for doing so must be provided below.
No response provided by applicant
B-3.15 Has the individual ever been the subject of a disciplinary action by the Drug Enforcement Administration or appropriate issuing body of any state jurisdiction that was based in whole or in part, on the Applicant's prescribing, dispensing, diverting, administering, storing, personally furnishing, compounding, supplying, or selling a controlled substance or other dangerous drug (i.e. prescription drug), or is any such action pending?
NO
B-3.15.1 If "Yes" to B-3.15, the reason for doing so must be provided below.
No response provided by applicant
B-3.16 By selecting "Yes", this individual agrees to be enrolled in the Retained Applicant Fingerprint Database (Rapback) should the Applicant be awarded a provisional license.
YES
B-3.17 Has the individual been the subject of an action resulting in sanctions, disciplinary actions or civil monetary penalties being imposed relating to a registration, license, provisional license or any other authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.17.1 If "Yes" to B-3.17, the reason for doing so must be provided below.
No response provided by applicant
B-3.18 Has the individual been the subject of a civil or administrative action relating to a registration, license, provisional license or authorization to cultivate, process, or dispense medical marijuana in any state?
NO
B-3.18.1 If "Yes" to B-3.18, the reason for doing so must be provided below.
No response provided by applicant
B-3.19 Has the individual been accused of obtaining a registration, license, provisional license or other authorization to operate as a cultivator, processor, or dispensary of medical marijuana in any jurisdiction by fraud, misrepresentation, or the submission of false information?
NO
B-3.19.1 If "Yes" to B-3.19, the reason for doing so must be provided below.
No response provided by applicant
B-3.20 Has civil or administrative action been taken against the individual under the laws of Ohio or any other state, the United States or a military, territorial or tribal authority, relating to the individual's profession or occupation? NO
B-3.20.1 If "Yes" to B-3.20, please provide the following: Defendant, Name of Case and Docket Number, Nature of Charge or Complaint, Date of Charge or Complaint, Disposition, Name and Address of the Administrative Agency Involved, and Jurisdictional Court (Specify Federal, State and/or Local Jurisdictions)
No response provided by applicant
B-3.21 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees are a physician who has a certificate to recommend medical marijuana or who has applied for a certificate to recommend medical marijuana under section 4731.30 of the Revised Code.
YES
B-3.22 By selecting “Yes”, you attest to the following statement: None of the Applicant's Prospective Associated Key Employees have ownership, investment interest, or a compensation arrangement with a laboratory licensed under Chapter 3796 of the Revised Code or an Applicant for a license to conduct laboratory testing.
YES Business Plan(Property Title, Lease, or Option to Acquire Property Location)
C-1.1 Attach one of the following: -Evidence of the Applicant’s clear legal title to or option to purchase the proposed site and facility. -A fully-executed copy of the Applicant’s unexpired lease for the proposed site and facility and a written statement from the property owner that the Applicant may operate a medical marijuana organization on the proposed site for, at a minimum, the term of the initial provisional license. -Other evidence that shows that the Applicant has a location to operate its medical marijuana organization.
Uploaded Document Name: C-1.1_Executed Lease Agreement.pdf NOTE: This applicant uploaded document is the next 31 page(s) of this document.
C-1.2 Business Name, as it appears on the Applicant’s certificate of incorporation, charter, bylaws, partnership agreement or other official documents.
Hanging Gardens OH LLC
C-1.3 Trade names and DBA (doing business as) names
Hanging Gardens LLC
C-1.4 Business Address
6201 Stumph Road
C-1.5 City
Parma Heights
C-1.6 State
OH
C-1.7 Zip Code
44130
C-1.8 Phone
7745516875
C-1.9 Email [email protected] Business Plan(Site and Facility Plan)
C-2.1 Applicants must show that they can expeditiously use a site and facility to meet the activities described in the provisional license by attaching one of the following: -If the facility is in existence at the time that the provisional license application is submitted, submit plans and specifications drawn to scale for the interior of the facility. -If the facility is in existence at the time that the provisional license application is submitted, and the Applicant plans to make alterations to the facility, submit renovation plans and specifications for the interior and exterior of the facility. -If the facility does not exist at the time that the provisional license application is submitted, submit a plot plan that shows the proposed location of the facility and an architectural drawing of the facility, including a detailed drawing, to scale, of the interior of the facility.
Uploaded Document Name: C-2.1_Floor Plans.PDF NOTE: This applicant uploaded document is the next 4 page(s) of this document.
C-2.2 The Applicant also must submit evidence that it is in compliance with any local ordinances, rules, or regulations adopted by the locality in which the Applicant's property is located, which are in effect at the time of the application. Include copies of any required local registration, license or permit. If no relevant zoning restrictions have been enacted, provide a professionally prepared survey which demonstrates that the Applicant is not in violation of restrictions pertaining to prohibited facilities and is not located within 500 feet of a community addiction services provider as defined under section 5119.01 of the Revised Code. OAC 3796:5-5-01
Uploaded Document Name: C-2.2_Zoning Compliance.pdf NOTE: This applicant uploaded document is the next 4 page(s) of this document.
C-2.3 Provide a location map of the area surrounding the proposed facility that establishes the facility is at least 500 feet from a prohibited facility or a community addiction services provider as defined under section 5119.01 of the Revised Code. In establishing the distance between a proposed dispensary and such a facility, the distance shall be measured linearly and shall be the shortest distance between the closest point of the property lines of the proposed dispensary and the prohibited facility or community addiction services provider. The map must be clearly legible and labeled and may be divided into 8.5*11 inch sections. OAC 3796:5-5-01
Uploaded Document Name: C-2.3_Prohibited Facility Location Map.pdf NOTE: This applicant uploaded document is the next 2 page(s) of this document.
Business Plan(Description of Employee Duties and Roles)
C-4.1 Please provide a description of the duties, responsibilities, and roles of each Prospective Associated Key Employee. Please attach a Table of Organization and Control for the business. Include all individuals listed in question A-6.
TRADE SECRET
Chief Operating Officer – Donald Kenney As CEO, Donald Kenney is the architect for the Company’s business plan. Donald draws on decades of managerial and healthcare experience. In conjunction with his team, Donald develops the short and long-range goals for the Company as well as the benchmarks by which the team will be evaluated. He is involved with overseeing, coaching, motivating, and guiding the leadership team. Donald creates and preserves the Company’s brand. He also oversees and participates in the design, construction, and ongoing review of facilities to insure the facility is operating as planned. Also, he also is tasked with insuring the Company’s full engagement with the community it serves. He currently helps administer a $700 million dollar medical non-profit.
Chief Operating Officer – Ethan Moon As COO Ethan Moon, works directly under the CEO and is tasked with implementing the CEO’s vision and policies by overseeing the daily dispensary operations of the Company, which includes the following: ensuring diligent adherence to the Company’s policies and procedures; delegating tasks and responsibilities and ensuring successful completion of said tasks by dispensary employees; coordinating with the CDO to develop improvements to the Company’s systems and procedures; coordinating with third-party vendors; and acting as the primary liaison between the executive team and dispensary employees to communicate operational successes and deficiencies through various reports.
Chief Financial Officer – Shane Kenney As CFO Shane Kenney is responsible for designing and implementing the fiscal and market strategy for the Company by overseeing the Company’s administrative, financial, and risk management operations. Shane is responsible for managing the Company’s investment and capital funds necessary to design and construct the facility, fund start-up costs, and secure ongoing operations. Shane is the Company’s liaison with banking institutions. Shane is also responsible for reviewing the financial reports to determine the Company’s health and success. Shane will contract and manage the outside financial auditors to insure accurate and transparent results. Shane is a board member and as such will be responsible for assisting the CEO and the board in developing financial strategies, as well as reporting to the board on the Company’s financial results. Shane is experienced and well qualified in this capacity.
Chief Development Officer – Tomas Casals As CDO Tomas Casals is an instrumental part of the dispensary’s operations. Tomas is tasked with developing and overseeing the systems the Company uses to monitor medicine, patients, employees and work flow. Tomas also oversees the day-to-day dispensary operations to insure correct implementation of the RFID tracking, scanning, and collection of information. Tomas will also identify operational redundancies and deficiencies in order to develop and coordinate policies to improve efficiency of operations; Tomas manages the physical and software systems, operating procedures, and patient interface in order to insure the Company’s founding principles of providing safe and effective treatment to patients are achieved. Head of Human Resources – Kristi Fults As HHR Kristi Fults is responsible for managing the operational and compliance aspects of employee management by completing administrative tasks and overseeing the employee and patient educational aspect of the Company’s operations. She draws on her decade of non-profit healthcare experience performing similar duties to those required in this position, including: developing and maintaining employee schedules; maintaining personnel files and monitoring employee attendance; overseeing the Educational Training Program (ETP) and the Employee Training Advising Committee (ETAC); overseeing all internal issues involving occupational safety, discrimination, and employee behavior; creating and maintaining various records and reports that, as directed.
Regional Dispensary Manager – Kevin Evans The Company will hire 1 Regional Dispensary Manager for its operation that will be tasked with managing and assisting the on-site dispensary manager with daily dispensary operations for the Company which include the following duties: interacting and assisting patients; managing dispensary employees; communicating regularly with the COO; monitoring inventory levels and ordering additional medicine when needed; conducting inventory audits; completing other administrative and maintenance tasks as necessary or assigned by the executive team.
Compliance Officer – Judith Cassel The position of CO is being filled by Judith Cassel, the Company’s legal counsel as well as an Advisory Board Member. The CO’s duties include: review and constant monitoring of local, state, and federal law to ensure the Company’s operations remain compliant; communicating legal and regulatory requirements to the executive team; coordinating with the HHR to address any employee-related issue; attending executive team meetings on an as needed basis; hiring local counsel as appropriate, and communicating with the Board, concerning all regulatory and legal issues.
Physician/Pharmacist – Position Currently Being Filled The Company will hire 1 Ohio-licensed pharmacist or physician that will be charged with the following responsibilities: providing patient consultations to discuss primary care physician’s medical recommendations; discuss benefits and side effects of the medicine; working with HHR to develop educational training and materials for employees; developing educational materials for patients; and other tasks as assigned by the Dispensary Manager or the executive team.
Dispensary Technicians – Candidates Currently Being Solicited The Company will be hiring 8 Dispensary Technicians that will have the following responsibilities: interacting with and dispensing medicine to patients; following all Company policies and SOPs to ensure safe, sanitary, and effective service and medicine; maintaining all necessary certifications and training needed to dispense medical marijuana medicines; and completing other tasks as assigned by the Dispensary Manager or COO.
Security Personnel – Candidates Currently Being Interviewed The Company will hire 3 security guard personnel certified by Ohio that will have the primary responsibility of keeping all employees and patients safe during the dispensary’s operational hours by: verifying identification of all individuals that enter the dispensary; working with the Dispensary Manager to coordinate employee emergency drills; overseeing the Dispensary Manager in processing and inventorying deliveries and movements of medical marijuana; ensuring on a day-to-day basis that all security measures are properly functioning; and any other task that is assigned by the Dispensary Manager or COO related to security.
C-4.2 Please attach a Table of Organization and Control for the business. Include all individuals listed in question A-6. Uploaded Document Name: C-4.2_Org Chart, Resumes, and Job Stats.pdf NOTE: This applicant uploaded document is the next 13 page(s) of this document.
TRADE SECRET
Donald J Kenney 8327 Glenwynd Dr. Kalamazoo MI 49009 (269) 375-6282
EXECUTIVE PROFILE
Senior executive with extensive experience in managing large complex processing businesses. Particular strength in information technology and decision science. Broad strategic insight and experience in leading change initiatives resulting in improved profitability and process improvement.
PROFESSIONAL EXPERIENCE
EQUISERVE, Canton, Massachusetts
Chairman, President and CEO 2000-2005 CEO of largest Stock Transfer Agent in US. Serviced over 25 million registered shareholders of the largest US and foreign companies. Dramatically improved profitability through a 38% reduction in costs and by increasing customer satisfaction to 98%. Integrated distinct and diverse operations of two large transfer companies into a single operating entity.
NATIONAL CITY CORPORATION, 1986-1999 (Formally First of America Bank)
Executive Vice President, National Processing (1998-1999) Directed 5,000 employees in four international processing business units.
Executive Vice President First of America (1993-1998) Developed strategies and implemented technology and operations capability to acquire and assimilate 100 banks. Refined assimilation techniques to enable acquired bank to be completely folded into company within 3 months. Reduced costs to pay for acquisition premium within one year. ?Directed the transformation of a money losing mortgage lending unit into a very profitable $1.2 billion national mortgage banking company. Developed strategies for loan origination, acquisitions and servicing. Using technology, reduced approval cycle time from 30 days to 1 day and improved servicing costs by 30%. ?Improved profitability of $1.4 billion credit card business and $1 billion consumer finance business by 25%. Reduced approval cycle time to nearly instantaneous and developed national marketing strategies. Credit card operations were rated to be one of the most efficient in the country.
Chairman and CEO, FOA Champion Bank (1991-1993) Led the turnaround of a failed multibillion bank to profitability in excess of 1% ROA within a year.
Senior Vice President, Operations and Technology (1986-1991) Developed the technology and operations infrastructure to enable the company to grow from $4 billion to $25 billion. Built a fail-safe data center and consolidated five data centers into the single site with no customer disruption. TRADE SECRET
Implemented an extensive multi-site communication network with 99.98% reliability. One of the first multibank holding companies in the country to convert all banks to a common set of systems.
SIGNET BANK OF MARYLAND, Baltimore, Maryland 1983-1986
Senior Vice President Technology and Operations Managed technology and operations for $3 billion bank. Expedited the creation of common system architecture for the newly created holding company and consolidated the Maryland bank into this structure.
FEDERAL RESERVE BANK OF BOSTON, Boston, Massachusetts 1967-1983
Vice President Payments Systems (1981-1983) Designed new national check clearing system for the Federal Reserve to provide a 60% improvement in national check clearing speed. The change was so significant that it required a redefinition of the money supply. Awarded commendation from Chairman Volker.
EDUCATION
Masters of Science in Management - M.I.T Thesis Topic - Competitive Impact of Bank Deregulation
Bachelor of Science, MIS - Northeastern University Magna Cum Laude
AFFILIATIONS
Director Delta Dental of Massachusetts (Chairman Finance Committee Chairman Audit committee, member compensation and executive committee) Director StructureTec Director DentaQuest Foundation Trustee Waring School Member MIT Alumni Association Director Big Brothers Big Sisters Director Leadership Kalamazoo Chairman United Way Kalamazoo TRADE SECRET Ethan M. Moon [email protected] |774-551-6875| 285 Hamilton Ave, Worcester, MA 01604
RELEVANT WORK EXPERIENCE Chief Operating Officer, Viridios Systems, LLC., Meredith, NH | November 2016 – Present Founded company with lead engineer and built into multi-state operation. Develop and improve company operating procedures and oversee design initiatives to the release of new product lines. Filled key role overseeing optimization of manufacturing processes and supplier negotiations. Customer Support and Deployment Engineer, aPriori Technologies, Concord, MA | May 2015 – December 2017 Ensure customer success with all aspects of the aPriori Cost Management software, this includes deployment of the database to everyday use. Communicated with a variety of individuals across all levels of the corporate structure and numerous countries. Developed outward facing documentation for recurring customer issues to streamline support process. Accounting Intern, WinnCompanies, Lowell, MA | June 2014-January 2015 Evaluated procedures and policies utilized throughout the company to increase productivity. Created visually appealing and easy to follow procedural guidelines as well as facilitated creation of a monthly accounting dashboard to store tasks by completion date. Research Assistant, WPI Math Department| August 2013-August 2014 Collaborated on microwave modeling techniques in a Sairem Miniflow 200ss system.
PUBLICATIONS E.M. Moon, J.F. Gerling, C.W. Scouten, and V.V. Yakovlev, Modeling-based optimization of thermal processing in microwave fixation, Proc. 49th IMPI's Microwave Power Symp. (San Diego, CA, June 2015), pp. 54-55. E.M. Moon, C. Yang, and V.V. Yakovlev (2015), Microwave-induced temperature fields in cylindrical samples of graphite powder - experimental and modeling studies, Intern. J. Heat & Mass Transfer, vol. 84, No. 8, pp. 359- 368. E.M. Moon, C. Yang, M. Patel, H. He, and V.V. Yakovlev (2014), Microwave-induced temperature fields in graphite powder heated in a waveguide reactor, In: IEEE MTT-S Intern. Microwave Symp. Dig. (Tampa, FL, June 2014), 978-1-4799-3869-8/14, pp. 1-4.
EDUCATION Worcester Polytechnic Institute (WPI), Worcester, MA Bachelor of Science in Mathematical Sciences, Minor in Computer Science, GPA: 3.35 | May 2015
PROJECT EXPERIENCE Modeling-Based Optimization of Thermal Processing in Microwave Fixation, WPI, Worcester, MA | August 2014-May 2015 Sponsored by Gerling Applied Engineering Inc. and NeuroScience Tools. Recommended design of microwave cavity such that a uniform temperature distribution is produced. Recommendations based on series of simulations performed with a fully parametrized 3D model. Utilized MATLAB and QuickWave.
Pre-Mission Flight Plan Optimization, WPI, Worcester, MA | August 2014-April 2015 Sponsored by Draper Laboratory. Developed and implemented algorithm to guide un-manned aircraft through multi-target missions for observation of Earth based phenomena. Algorithm developed for viable fleet size, number of targets and proximity of targets. Utilized MATLAB, CPLEX, LaTex.
SKILLS AND CERTIFICATIONS Computer Applications: MS Office, Visio, MATLAB, LaTex, CPLEX, QuickWave, COMSOL, SAS, SmartDraw, JIRA, CREO Parametric, SolidWorks, aPriori Programming Languages: Python, SQL, C++, Java, CSL Certifications: A+, First Aid, CPR, OSHA, Wilderness First Aid
ADDITIONAL EXPERIENCE Office Assistant, WPI Math Department, Worcester, MA | August 2014- Present Teacher’s Aide, Bancroft School, Worcester, MA | August 2013-June 2014 Apprentice Electrician, Cunningham Electric, Rochdale, MA | May 2012-May 2014 TRADE SECRET 207 Eagle Street Fairport Harbor, OH 44077 Tomas Casals (617) 378-1612 [email protected]
EXPERIENCE SKILLS
• Proficient in multiple CAD/CAM suites Viridios Systems, LLC., including Dassault and Siemens Boston MA — Chief Development Officer • Trained CNC Operator – 5-Axis November 2016 - PRESENT • Soundproof engineering and construction Lead design engineer for all new product lines. Primary designer of the • TIG and MIG welding including vacuum and
VTCV-20 a revolutionary addition to the supercritical CO2 extraction high pressure vessel applications industry. • Thermal and fluid systems engineering • Industrial production and automation design Casals Development and Innovation, • Logic control programming and automation Boston MA — Owner Operator hardware configuration December 2013 - PRESENT Designs and manages teams of 10+ vendors and contractors for custom AWARDS construction fabrication solutions. Works on projects from architectural welding to commercial kitchen and clean environment construction. Provost’s Award: Fabricated an Inertial Electrostatic Confinement reactor which successfully achieved fusion. Abbess Instruments and Technologies, Holliston MA — Systems Technician June 2009 - August 2011 LANGUAGES Designed and fabricated high vacuum and cryogenic systems for groups English, Spanish such as NASA, JPL, and Alcatel. Worked on systems for the Lawrence Livermore National Ignition Laboratory
EDUCATION
Worcester Polytechnic Institute, Worcester MA — Mechanical Engineering
Boston College High School, Boston, MA TRADE SECRET 9 Strathmore Rd Brookline, MA 02445 Shane Kenney (269) 491-0378 [email protected]
EXPERIENCE Skills Kenney Realty Trust, Boston, MA Chief Executive Officer • Microsoft suite proficiency September 2007 – PRESENT • Cost estimation Founder of the company. Makes all development and project decisions including • Project management which properties to buy and their locations. Designs properties to maximize • Data analysis rental rates and capture capital appreciation. • Mathematics
Brown Brothers Harriman, Boston MA Fund Accountant January 2007 – September 2007 Valued multi-billion dollar portfolios and mutual funds.
Professional Affiliations National Cannabis Industry Association Sponsoring Member August 2016 – PRESENT
Massachusetts Citizens for Responsible Marijuana Regulation Member August 2017 – Present Legislative Representative December 2016 – August 2017
Certifications Licensed Construction Supervisor Massachusetts License August 2011 – PRESENT
EDUCATION Boston College, Boston MA BS/BA Finance & Film, Collegiate Athlete: Varsity Crew Team
TRADE SECRET
Judith Cassel [email protected] 717-703-0804
Education Dickinson Law School – Pennsylvania State University State College, PA Honors in Negotiations and Russian Law – Graduated top 25% of Class
Lebanon Valley College Masters Business Administration – Graduated Summa Cum Laude
Professional Hawke McKeon & Sniscak LLP Harrisburg, PA Partner • Represent commercial clients in complex litigation before state and federal regulatory agencies and courts. • Represent clients in entity formation, raising capital, and contract negotiations. • Create and manage medical marijuana practice group. • Member of Pennsylvania approved continuing medical education provider that certifies physicians to recommend medical marijuana for patient use. • Assisted medical marijuana growers/processors, dispensaries, laboratories, and physicians groups with state application process.
Stevens & Lee LLP Harrisburg, PA
• Represent commercial clients in litigation before regulatory agencies and court. • Represent commercial clients in organizational structure, raising of capital, and contract negotiations. • Assisted clients in state and federal application process to obtain major grant funding. • Represent clients before the Bureau of Minority and Women Business Opportunities and the Pennsylvania Department of Community and Economic Development.
Organizations • National Cannabis Bar Association • PA Medical Marijuana Bar Association – Legislative Chair • NORML, Legal Committee Member • Nurse Family Partnership, Advisory Board Member – Lancaster General Hospital • Law & Government Institute Advisory Board – Widener University
Publications and Presentations • Pennsylvania Creates Ideal Market for Investors, MJ VENTURE, Oct. 2016, at 144. • Pennsylvania’s Medical Program Now in Jeopardy, MJ VENTURE, Nov., 2017, at 162. • Next Steps for Medical Marijuana in PA: Evolving Issues in a Growing Industry, October 25, 2017. • Lancaster Bar Association, “Planting the Seed: Legalities & Realities of Medical Marijuana in Pennsylvania” (June 13, 2017). • Widener Law Commonwealth, “Opioid Epidemic: Law and Policy” (Mar. 29, 2017). • Interviewed by Bart Schaneman for Pennsylvania medical marijuana program on track, but legal issues loom, Marijuana Business Daily (October 3, 2017). TRADE SECRET
Kevin Evans Denver, CO/Hershey, PA 303-565-6260 [email protected]
MARIJUANA RELATED EXPERIENCE Owner/Principal Consultant, KME Consulting LLC — Jan 2017 - present As an independent consultant, I guided businesses from the idea phase to optimization of their new or existing practices to hit aggressive revenue and profit goals. I created standard operating procedures, oversaw prospective hiring and created pro forma financial statements based on a proprietary model.
Packaging Manager, Native Roots — May 2016 - Dec 2016 Starting as an entry level trimmer, I was promoted twice, first to lead operator of an automatic trimming machine and then to Packaging Manager. As Packaging Manager, I led a team of 12-24 professional packagers supplying 26 licensed dispensaries in both medical and recreational pre-packaged flower and trim.
PRESENTATIONS/CONFERENCES I presented and/or attended the following professional conferences:
• Presented “Realities of Seed to Sale” to the Lancaster Bar Association, PA - 2017
• Attended MJBizCon in Washington, DC - 2017
• Attended CannTenCon in Tel Aviv, Israel (Scientific/Medical track) – 2016
MISCELLANEOUS EXPIERENCE • Held a Colorado Support Badge from the Marijuana Enforcement Division (MED) exp. 05/18; number M44353
• Veteran of the US Navy as a Midshipmen at the US Naval Academy (1992-1996) — Honorable Discharge for Medical Reasons
• Clean Criminal and Driving History
ADDITIONAL WORK EXPIERENCE Senior Pre-Sales Engineer, Sungard, London, UK — 2012-2015 I demonstrated to sell a software as a service (SaaS) solution to C suite level stakeholders of institutional investment managers, insurance firms and brokers. My role involved consultative selling practices and resulted in increasing revenue from $2m to over $15m/yr.
Chief Technology Officer, ReMatch Ltd, London, UK — 2008-2012 I led the development and operations teams for a credit risk reduction solution in the inter-dealer brokerage market. My role also included creating standard operating policies, liaising with legal and regulatory departments, roadshow presentations and senior stakeholder meetings with our parent company (ICAP LLC) and risk managers.
Senior Pre-Sales Engineer, Sungard, New York, NY — 2005-2008 I demonstrated to sell a trading risk software solution to hedge funds, institutional investment managers and insurance firms. Through consultative selling practices I TRADE SECRET helped product development to streamline the company’s product offerings while increasing overall profit by over 50% yoy.
Credit Data Sales Engineer, GFI, New York, NY — 2004-2005 I sold credit data generated by the company’s brokerage services to institutional asset managers and insurance firms. I also helped develop the equity to credit tool sold in the company’s quantitative derivatives software.
Institutional Sales Support, Morgan Stanley, New York, NY — 2002-2004 I led a team of 7 transcription professionals to effectively communicate trading ideas to the sales desk. The role required significant credit derivatives experience as well as knowledge of company sales practices and regulatory requirements.
Equity Derivatives Analyst, Deutsche Bank, New York, NY — 1997-2002 I managed two portfolios of equity derivatives investments in support of a multi-billion dollar equity mutual fund group. I was able to exceed my benchmark of 250bps of absolute return in each of my four years of investment management.
EDUCATION NYU-POLY (formerly Polytechnic University) — MSc Financial Engineering, 2004 Awarded Summa Cum Laude (3.7/4.0); Elected Student President of Dept New York University — BA Economics, 2001 Awarded Cum Laude (3.6/4.0) Job Creation Initiative – Statistics
Although Ohio has mostly followed the national job growth curve (alternatively decrease in unemployment), Ohio has recently seen a plateau in job growth and an occasional monthly increase in unemployment as demonstrated in the chart below. The medical marijuana industry can create new jobs for which our dispensaries can be a major contributor.
Our commitment is to provide professional wages and advancement to a diverse workforce.
Source: http://www.deptofnumbers.com/unemployment/ohio/ Diverse Hiring – Statistics
Our hiring practices and inclusive environment will represent the diversity of our region as illustrated below.
Source: U.S. Census Bureau, https://www.census.gov/quickfacts/fact/table/OH,US/PST045216 Business Plan(Capital Requirements)
Item 1 of 3
C-5.1 Type of Capital
Mix of Cash and Securities
C-5.2 Source of Capital
Shane Kenney
C-5.3 Name and Address of financial institution
This response has been entirely redacted
C-5.4 Account Number
This response has been entirely redacted
C-5.5 Illustrate that the Applicant has adequate liquid assets to cover all expenses and costs for the first year of operation as indicated in the dispensary's proposed Business Startup Plan (Question C-3). The total amount of liquid assets must be no less than $250,000. Provide unredacted documentation from the Applicant's financial institution to support these capital requirements. (ORC 3796:6-2-02)
This response has been entirely redacted
C-5.5.1 Please attach a redacted copy of documentation from the Applicant's financial institution to support the capital requirements. (ORC 3796:6-2-02)
Uploaded Document Name: C-5.5_Redacted Proof of Funds No. 1.pdf NOTE: This applicant uploaded document is the next 2 page(s) of this document.
Business Plan(Capital Requirements)
Item 2 of 3
C-5.1 Type of Capital
Mix of Cash and Securities
C-5.2 Source of Capital
Shane Kenney
C-5.3 Name and Address of financial institution
This response has been entirely redacted
C-5.4 Account Number
This response has been entirely redacted
C-5.5 Illustrate that the Applicant has adequate liquid assets to cover all expenses and costs for the first year of operation as indicated in the dispensary's proposed Business Startup Plan (Question C-3). The total amount of liquid assets must be no less than $250,000. Provide unredacted documentation from the Applicant's financial institution to support these capital requirements. (ORC 3796:6-2-02)
This response has been entirely redacted
C-5.5.1 Please attach a redacted copy of documentation from the Applicant's financial institution to support the capital requirements. (ORC 3796:6-2-02)
Uploaded Document Name: C-5.5_Redacted Proof of Funds No. 2.pdf NOTE: This applicant uploaded document is the next 2 page(s) of this document.
Business Plan(Capital Requirements)
Item 3 of 3
C-5.1 Type of Capital
Mix of Cash and Securities
C-5.2 Source of Capital
Shane Kenney
C-5.3 Name and Address of financial institution
This response has been entirely redacted
C-5.4 Account Number
This response has been entirely redacted
C-5.5 Illustrate that the Applicant has adequate liquid assets to cover all expenses and costs for the first year of operation as indicated in the dispensary's proposed Business Startup Plan (Question C-3). The total amount of liquid assets must be no less than $250,000. Provide unredacted documentation from the Applicant's financial institution to support these capital requirements. (ORC 3796:6-2-02)
This response has been entirely redacted
C-5.5.1 Please attach a redacted copy of documentation from the Applicant's financial institution to support the capital requirements. (ORC 3796:6-2-02)
Uploaded Document Name: C-5.5_Redacted Proof of Funds No. 3.pdf NOTE: This applicant uploaded document is the next 2 page(s) of this document.
Business Plan(Business History and Experience)
Item 1 of 2
C-6.1 First Name
Shane
C-6.2 Middle Name
Patrick
C-6.3 Last Name
Kenney
C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person Exercising Substantial Control, Support Employee)
Owner
C-6.5 Business Name
Shane Realty Trust
C-6.6 Business Address
9 Strathmore Road, Brookline, MA 02445
C-6.7 Position of management or ownership of a controlling interest
YES
C-6.8 Dates
2005 - present Business Plan(Business History and Experience)
Item 2 of 2
C-6.1 First Name
Tomas
C-6.2 Middle Name
Gabriel
C-6.3 Last Name
Casals
C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person Exercising Substantial Control, Support Employee)
Owner
C-6.5 Business Name
Viridios Systems, LLC
C-6.6 Business Address
9 Strathmore, Road Brookline, MA 02445
C-6.7 Position of management or ownership of a controlling interest
YES
C-6.8 Dates
2016 - present Business Plan(Business History and Experience Narrative)
C-6.9 Provide a narrative description not to exceed 1500 words demonstrating any previous experience at operating other businesses or non-profit organizations and any demonstrated knowledge or expertise with regard to the medical use of marijuana to treat qualifying conditions (for all Prospective Associated Key Employees with an ownership interest of ten percent or more in the prospective dispensary). Include the number of years of experience, the type of business, and any administrative discipline history associated with each business.
TRADE SECRET
The Company leadership have years’ diverse experience running small and large businesses and non- profit organizations, and they have demonstrated expertise and leadership in the medical marijuana field.
Tomas Casals (CDO) – 51% equity owner and minority business owner Tomas is perfectly suited to developing the Company’s systems and SOPs. Tomas comes from an engineering and project management background that includes 5 years of experience as a small business owner working on specialty construction and engineering projects from ISO cleanrooms to sound isolation chambers. Tomas has worked in multiple fields of procedural development and execution, including ISO 9001 quality assurance programs, Hazard Analysis and Critical Control Point (HACCP) plan development, and user interface and diagnostic procedure development for a myriad of industrial equipment. Tomas has worked on projects for NASA and companies such as Tesla.
Together with Shane Kenney and Ethan Moon, Tomas operates Viridios Systems: a business that manufactures high-pressure extraction equipment for the medical marijuana industry. His experience with Viridios has necessitated that he have a wealth of knowledge on the chemical processes and interactions involved with medical marijuana. His system is the only commercially available system that can extract many of the more difficult to capture terpenes. He is extremely conscious of the importance of safe, responsible treatment: a note which is evident in the FDA CGMP compliant design of the systems he builds. Tomas has in depth expertise on all facets of marijuana medicine, with an analytical understanding seldom rivaled in this industry. Tomas is regarded as an expert on the subject of testing and quality control in medical marijuana and has been requested on multiple occasions by Massachusetts marijuana regulatory bodies and legislators. As an advocate for effective testing standards, Tomas has worked closely with the legislation in Massachusetts to change existing pesticide, fertilizer, and testing regulations in the medical marijuana industry thereby ensuring immune- compromised patients are not endangered by medicine prescribed to them. Tomas’s experience as a business owner and expertise in medical marijuana makes him well suited to operate a dispensary.
Shane Kenney (CFO) – 45% equity owner Shane brings to the Company a strong and impressive managerial and financial background. Shane has 12 years’ experience as a business owner and manager. As the founder of his multimillion dollar development company, he has demonstrated the skills required for the dispensary to open within its operational timeline. Shane’s qualifications as CFO stem from his work in financial services at an international private bank. Eventually Shane opted to start his own business, the Kenney Reality Trust, which started with the sale of a single row-house and has grown, under Shane’s leadership, into a multi-million dollar real estate portfolio and development firm. Shane has managed as many as 40 fulltime employees at one time, as well as numerous subcontractors. Shane entered the medical marijuana industry for family reasons, and has applied the same vigor as his previous occupational endeavors. Like Tomas, Shane believes strongly in the efficacy of marijuana medicine but is concerned about quality control and necessary research in the industry. As such, he developed the mechanism for the Viridios filtration system which removes contaminants from marijuana medicine. Shane regularly attends industry conferences and guides many company research initiatives, with our partner CESC, and has the expertise to interpret and implement that knowledge. In some regards Shane has unique expertise in the marijuana industry. Shane’s work history of real estate development, and business has equipped him with the meticulous, detail-oriented skill set needed to translate tight budgets and deadlines into thriving and profitable businesses.
Other Key Principals and Advisors with Medical Marijuana and Related Experience
Donald Kenney (CEO) – 2% equity owner Donald has decades of experience successfully operating within highly-regulated and secured businesses that emphasize thriving partnerships with their local communities. Donald has 40 years executive experience and more recently as the Chairman, President, and CEO of Equiserve, the largest stock transfer agent in the U.S. that serves over 25 million shareholders. Throughout his career, Donald has managed 1000s of employees while successfully mentoring start-up companies, and directing non-profit organizations.
Don has developed the Federal Reserve Bank’s check-recovery system, the primary system in which banks from across the country process checks; developed the technological and operations infrastructure for National City Bank to grow from a $4 billion to a $25 billion bank in the span of 5 years; lead Champion Bank to a dramatic turnaround in profitability in under 1 year; managed 5,000 employees in 4 international processing business units as the Executive VP for National City Bank; and increased Equiserve’s profitability by reducing costs by 38% and increasing customer satisfaction to 98%.
Currently Don is a director of Delta Dental of Massachusetts a $700 million non-profit healthcare foundation. Don has also served as a director of Borgess Catholic Hospital. His other non-profit management experience includes director of United Way of Kalamazoo and Big Brother Big Sisters.
Ethan Moon (COO) – 2% equity owner Ethan brings a fierce passion for the advancement of medical marijuana, coupled with experience as a founder and the chief operating officer for Viridios Systems, a nationwide medical marijuana processing equipment manufacturing company. Propelled by his brother’s struggle and hard-earned recovery from an opioid addiction, Ethan has been actively involved with both state and national patient advocacy and advisory groups advocating for the legalization of medical marijuana as a less addictive method of pain treatment; specifically, Ethan plays an ongoing role with initiatives sponsored by the National Organization for the Reform of Marijuana Laws (NORML), the Minority Cannabis Business Association (MCBA), the Marijuana Policy Project (MPP), and MediCann.
As a result of Ethan’s passion for an alternative to opioids, he helped found Viridios Systems, a manufacturer of safe medical marijuana extraction equipment. Ethan regularly communicates with medical marijuana stakeholders concerning the administration and research of medical marijuana. Ethan oversees the non-profit branch of the Company in its research endeavors, including with the Clinical Endocannabinoid System Consortium (CESC) on the Dosing Project to study how cannabinoids and related molecules interact with the physiological system and to develop better guidelines for medical marijuana administration practices. Ethan has published several papers in scientific journals and will speak on a paper in the next few months at the National Cannabis Industry Association’s “Seed to Sale” show in Denver.
Kevin Evans – Regional Dispensary Manager Kevin learned the realities of the cannabis industry by working in multiple grows, processing facilities and dispensaries in Colorado. Kevin was a lead operator for one of the premiere dispensaries in the country. Kevin has participated in the application process in both Colorado and Pennsylvania. Kevin has also participated in the CannTenCon scientific and medical conference on medical marijuana in Tel Aviv, Israel. With a BA in Economics and a MS in Financial Engineering and Risk Management, Kevin is well prepared to oversee the operations in our dispensaries.
Kristi Fults – Head of Human Resources Kristi Fults, the Head of Human Resources, has ten years of experience as a social worker in Pennsylvania, working extensively with members of the community effected by AIDS and HIV. Starting as a Disease Investigator and later a Director of Case Management for Philadelphia FIGHT, her experiences with this community has galvanized her desire to insure safe, effective access to medical marijuana. Bringing Kristi’s experience from years of work with this community allows Hanging Gardens to better understand the needs of every patient that walks through our door. She has helped us to create an inclusive, non-invasive, private dispensary experience that allows patients to effectively vocalize their situation and get educated on the products allowing them to choose the absolute best treatment method.
Kristi also brings an in depth understanding on effectively maintaining patient privacy and HIPAA compliance. She has experience developing educational material and documentation for employees and patients from time spent developing policies and protocol manuals in cooperation with the Center for Disease Control. Her roles at St. Christopher’s Hospital for Children and Philadelphia FIGHT have involved training and managing personnel in a similar capacity as her duties with Hanging Gardens, including regulatory compliance considerations.
Judith Cassel – Compliance Officer Our Compliance Officer, Judith Cassel sits: on the National Cannabis Bar Association, on Widener School of Law’s Law and Government Board, and as the Legislative Chair for the PA Medical Marijuana Bar Association.
Judith has recently given presentations at: Widener School of Law on the “Opioid Epidemic Law and Policy”; the Lancaster General’s Healthy Mothers, Healthy Babies Conference on “Understanding the Legalities and Research of Medical Marijuana as an Alternative to Opioids”; and “Realities of Medical Marijuana” for the Pennsylvania Bar Institute. She has written articles for Marijuana Ventures and MJ Biz Daily. She is a member of Extra Step Assurance, an Ohio company providing physicians with continued education courses on medical marijuana. She also sits on the Advisory Board of Nurse Family Partnerships. Operations Plan(Dispensary Oversight)
D-1.1 By selecting "Yes", the Applicant attests that it will appoint a designated representative responsible for the oversight, supervision and control of operations of the medical marijuana dispensary. When there is a change in the appointed designated representative, the Applicant will notify the State Board of Pharmacy within 10 business days of appointment. OAC 3796:6-3-05
YES Operations Plan(Security and Surveillance )
D-2.1 By checking “Yes,” the Applicant attests that it is able to continuously maintain effective security, surveillance and accounting control measures to prevent diversion, abuse and other illegal conduct regarding medical marijuana and medical marijuana products.
YES
D-2.2 Please provide a summary of the Applicant's proposed security and surveillance equipment and measures that will be in place at the proposed facility and site. These measures should cover, but are not limited to, the following: 1. General overview of the equipment, measures and procedures to be used 2. Alarm systems 3. Surveillance system 4. Surveillance storage 5. Recording capability 6. Records retention 7. Premises accessibility 8. Inspection/servicing/alteration protocols Please reference OAC 3796:6-3-16 for more information.
This response has been entirely redacted
D-2.2.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures described in D-2.2. The images or diagrams may contain a brief descriptive caption. Additional language responding to the question will not be considered.
Uploaded Document Name: D-2.2_Security Overlays and Equipment.pdf NOTE: This applicant uploaded document is the next 18 page(s) of this document.
D-2.3 By selecting “Yes”, the Applicant attests that the answer provided in response to Question D-2.2 is voluntarily submitted to the State Board of Pharmacy in expectation of protection from disclosure as provided by section 149.433 of the Revised Code.
YES
D-6.8.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures described in D-6.8. The images or diagrams may contain a brief descriptive caption. Additional language responding to the question will not be considered.
Uploaded Document Name: D-6.8_SharpRx Spec Sheet.pdf NOTE: This applicant uploaded document is the next 4 page(s) of this document.
Operations Plan(Other )
D-10.1 Please provide a summary of any other services or products to be offered by the Applicant at the dispensary. OAC 3796:6-2-02
The Company has applied for all necessary vertical licenses in an effort to fully participate in Ohio’s research, development, processing and providing of medical marijuana as a safe, and effective medicine to patients suffering in Ohio. However, if the The Company is only granted a dispensary license, it will still continue to substantially invest in research to support Ohio’s program. Thus far, The Company, through its world renowned non-profit research affiliate, has made several discoveries that relate to: a) methods of administration (“MOA”); b) better time release binding agents; c) the entourage effect of certain terpenoids and flavonoids; and d) proper medical dosage of cannabinoid compounds. The Company has already devoted thousands of dollars to advance medical marijuana research. Our principle research partner has 40 years’ experience in pharmaceutical research. Pursuant to OAC § 3796:8-2-02, The Company will seek Board approval prior to introducing or disseminating new products or educational material at its dispensary.
Educational Materials The Company has developed specific SOPs to train employees on precise and complete communications with patients and caregivers. The Company understands that even with the best communication, it is important to provide take-away literature for patients to review once at home. The Company is in the process of developing with Ohio-licensed medical professionals print material for patients on: appropriate dosing, responsible use, and different forms of medicine and MOAs. All Company educational materials will include dispensary contact information so customers can call with questions. Prior to dissemination the material will be approved by the Board of Pharmacy and comply with the strict requirements for advertisements set out in OAC § 3796:6-3-24.
Medical Marijuana Devices Beyond the medicine, The Company will sell the important marijuana devices necessary to administer the medicine. The Company will sell three vaporization units which do not get hotter than 455°F (the temperature required to combust marijuana) and in which the marijuana does not directly contact the heating element as required by OAC § 3796:8-2-01(B)(1) and (2). The Company has carefully and thoroughly researched the vaporizers to be carried at the dispensary. Few vaporizers are of the necessary medical grade: many have heating elements that release poisonous nickel or zinc from the wire, are inconsistent with their dosing, are difficult to clean, or cause explosions. The best option is the PAX 3 by PAX Labs. The PAX 3 has a ten-year warranty, is easy to clean, can be used with flower or resin, is inconspicuous, and is made from safe, high quality parts. The second option is the Plenty from Storz and Bickel. It has a ceramic coated heating element, does not reach temperatures above 420°F, has a three-year warranty, and utilizes a unique stainless steel cooling coil to cool the vapor for more patient comfort. The third option is the PAX ERA, a quality low cost vaporization pen. The PAX ERA has the same build quality as the PAX 3 but in a compact $20 package that utilizes cartridges exclusively.
Other devices include: • The Kannastor 1.5” 2pc grinder/sifter: a compact, inexpensive, durable unit; • The PenSimple an automated grinding, sifting, and storage tool that works at the push of a button. The automated ease of use allows patients impeded by pain or lack of motor control to self-administer; • The BlueSky hand crank grinder: a durable, $14 unit with a hand crank as a low-cost alternative to the PenSimple for people with poor motor control, and; • An inexpensive portable grinder card. The Company will offer these products and cleaning kits, replacement batteries, and other minor, Board-approved accessories.
Translation Services Accidental misuse of medication is a problem which plagues the country, and is an issue which we intend to reduce. A major source of accidental misuse is due to misunderstanding important printed information accompanying the medicine. To mitigate this issue, The Company will provide translation services to all patients and caregivers using the service RxTran. RxTran is a pharmacy software and service which can translate label documentation and educational materials from English to over 150 languages. The Zebra ZT410 printer uses a Unicode-supported character set which covers almost 100,000 characters from all the world’s major languages, including complex non-Western languages that can be challenging to print. RxTran will also provide translation services via telephone for patients and caregivers with limited understanding of English at the dispensary so they can speak with our well- trained dispensary staff.
In addition to patients with limited English skills, The Company will use the service ScripTalk to provide audible labels for patients who are vision-impaired, low literacy, or otherwise have difficulty reading labels. ScripTalk interfaces directly with the Zebra ZT410 printer to encode all of the printed label information on an RFID chip in the label. This chip relays this information to a small audible reader, which The Company will provide at no cost to patients who request it.
Private Consultation The dispensary will be furnished with individual Private Consultation Rooms (PCR) where patients and caregivers can discuss treatment on a one-on-one basis with our trained dispensary technicians. These rooms will have sample literature on each product in order to discuss and consider future medical options. The Company’s on-staff Clinical Director will be available for both scheduled and walk-in consultations regarding treatment and use questions. The PCRs are important in making patients feel comfortable with their recommended medical marijuana products and to give patients a much-needed opportunity to ask questions that would otherwise embarrass them or go unanswered. During private consultations, our technicians will work to inform every patient that translation and audible label services are available to them.
Additional Services With the permission of the Board, The Company will offer additional free services as part of our commitment to ensure the success of Ohio’s Medical Marijuana Control Program. These include: a 1- 800 number that patients, physicians, or caregivers can call to consult with our Clinical Director on adverse events, questions on use, concerns, or suggestions; a myriad of educational print material to create an informed community; free returns of medical marijuana (with a Board-approved buyback program) and; a list of local prescription drug drop boxes.
The Company’s mission is to provide safe medicine and never compromise on quality or deviate from our mission for the purpose of profit.
D-10.1.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures described in D-10.1. The images or diagrams may contain a brief descriptive caption. Additional language responding to the question will not be considered.
Uploaded Document Name: D10.1_MOA Spec Sheets.pdf NOTE: This applicant uploaded document is the next 32 page(s) of this document.
Device Anatomy 03 DEVICE ANATOMY Get to know each part of the device 1 Mouthpiece before you get started. Pop out the mouthpiece to turn on Pax. 2 Indicator The color changes based on the temperature and status of device. 3 Oven Lid Press on either side of the lid to tilt and remove. 1 2 3
Clean 19 CLEAN Pax is a precision device. It’s important to clean Device Body Pax on a regular basis. If your Pax isn’t operating at its After removing the mouthpiece and lid, moisten best, cleaning it thoroughly will likely do the trick. If you a pipe cleaner with an alcohol wipe. see liquid of any kind collecting in your device, clean it! Starting from the mouthpiece end, insert the moistened Mouthpiece pipe cleaner through the stainless steel vapor tube until While on, gently pull the mouthpiece to remove it. it pushes out the oven screen. Floss until shiny and new. It can be cleaned with soap and water. Allow it to Use a wipe, moistened bent pipe cleaner or moistened dry completely before replacing. Apply mouthpiece swab to clean the oven area and screen. Replace screen lubricant per instructions found on www.ploom.com. before enjoying Pax. Safety 21 SAFETY Warning Handling 3 Do not attempt to repair or modify a Pax yourself. Choking Hazards Failure to follow these safety instructions could result 1 Do not drop, crush, bend, deform, puncture, 4 Do not use a damaged Pax Charger or non-Ploom Pax contains small parts which may be a choking in injury or damage. Users of this product do so at their shred, microwave, incinerate, paint, or insert charger. Use caution when handling Pax, as the hazard to small children. Keep Pax away from children. own risk. Neither Ploom nor its retailers assume any foreign objects into a Ploom Pax.™ heater area is hot when the device is turned on. responsibility or liability associated with the use of this product. Ploom branded products are for adult use and 2 Do not clean Pax other than as instructed consumption only. by Ploom. Warranty Info 23
WARRANTY Exclusions and Limitations modified to alter functionality or capability without the written permission of Ploom; (d) to cosmetic The Limited Warranty applies only to products 10 Year Ltd Warranty Information 1 repair the product defect, damage, including but not limited to scratches, manufactured by Ploom Inc. that can be identified Ploom Inc. warrants this Ploom-branded device exchange the product with a product dents, and broken plastic. 2 by the “Ploom” trademark, trade name, or logo affixed against defects in materials and workmanship under that is new or is at least a functionally to them. The Limited Warranty does not apply to any normal use for a period of ten (10) years from the equivalent product, or date of retail purchase by the original end-user non-Ploom products. This warranty does not apply Warranty applies to original end-user purchaser refund the purchase price of the product. purchaser. If a physical defect arises and a claim is 3 to (a) damage caused by accident, abuse, misuse, only and is non-transferable. Ploom warranties only received within the Warranty Period, at its option and The Limited Warranty does not apply to normal flood, fire, earthquake, acts of piracy, or other external apply to devices purchased at an authorized retailer to the extent permitted by law, Ploom will either: performance degradation of batteries or neglecting causes; (b) to damage caused by operating the product serviced by an authorized Ploom distributor. For to adhere to cleaning instructions. outside the permitted or intended use as described questions regarding authorized retailers and additional by Ploom; (c) to a product or part that has been warranty details, please see www.ploom.com.
INSTRUCTIONS FOR USE
Table of Contents...... Page
1. Product Overview, Service...... 4
2. Explanation of Symbols, Safety Recommendations...... 6
3. Intended Use...... 10
4. Overview of Plants...... 11
5. Factors Influencing Vaporization...... 12
6. The Hot Air Generator PLENTY...... 12
7. Commissioning and Operation...... 14 7.1. Heating Up...... 15 7.2 . Temperature Setting...... 16
8. Filling the Filling Chamber...... 18
9. Application...... 23
10. Disassembling, Cleaning and Assembling...... 25 10.1. Disassembling and Reassembling the PLENTY Vaporization Unit...... 25 10.2. Disassembling the Mouthpiece...... 26 10.3. Disassembling the Filling Chamber Cap...... 27 10.3.1. Cleaning the Cooling Coil...... 27
10.4. Disassembling the Filling Chamber...... 28 10.5. Assembling the Filling Chamber...... 28
11. Technical Specifications...... 29
12. CE Declaration of Conformity...... 29
13. Warranty, Liability, Repair Service...... 30
3
D-10.2 Please provide a summary of intended services for veterans and/or the indigent. OAC 3796:6- 2-02; OAC 3796:6-3-22
The Company is dedicated to providing quality and affordable services to all Ohio patients, but the Company strongly believes that all Americans have an obligation to serve and honor America’s Veterans and those that have fallen on tough financial times. To best serve these vulnerable cross- sections of Ohio patients, Company is implementing reduced-cost and other policies to help remove obstacles and allow access to life-changing medical marijuana products no matter a patient’s income level.
Company’s Commitment to Helping Veterans According to a 2015 report by the U.S. Department of Veterans Affairs, there are approximately 820,000 veterans residing in Ohio. In a much more recent study from November 2017, the Department of Veterans Affairs found that upwards of 9.8% of veterans nationwide are employed yet still live under the federal poverty line. This same study found that veterans that suffer from a disability – including those in this Program – are more likely than veterans not suffering from a disability to be working but unable to earn a livable wage. In short, veterans are not just burdened with the physical and emotional consequences of their service, but are also faced with an unacceptably high rate of poverty. The Company is dedicated to lessening the burden faced by America’s heroes.
A member of the Company’s Advisory Board is himself a veteran having served as an Army field surgeon in the Gulf War and has impressed upon the Company just how important it is to serve those that have served this country. Specifically, the Advisory Board member has been shocked and disappointed to see our veterans come home plagued with injuries, both physical and emotional, and in near-automatic fashion be prescribed opioids, which in many cases have exacerbated existing or created entirely new problems for already-struggling veterans. He believes that medical marijuana products are a viable solution to the opioid epidemic for the general population and specifically for the Ohio-veteran population.
To assist veterans by removing obstacles to access medical marijuana programs, the Company is implementing the following policies to veterans and their dependents:
1) Jobs – The Company is committing to a workforce goal of 20% veterans. The Company has already discussed this commitment with HempStaff, the third-party entity that is assisting the Company in hiring dispensary support employees. 2) Veterans Discount – instituting a 20% discount to all veterans and their dependents upon proof of service and dependent relationship. 3) Disabled Veterans Discount – instituting a 30% discount to all veterans and their dependents upon proof of service and dependent relationship. 4) Veterans Reimbursement Program – a $200 dispensary credit after cumulatively spending $200 at the dispensary. This credit is to offset the expense associated with getting a marijuana prescription.
Although the preferred method of identification is a Uniformed Services ID Card because it is color- coded and differentiates between disabled veterans, veterans, active military, and dependents, the Company will accept the following forms of veteran identification:
• Ohio Driver’s License with Veteran Designation • A copy of orders • DD214 discharge papers • Uniformed Services Identification Card All dispensary employees will be trained in the acceptable forms of identification and will have access to documentation that shows and explains acceptable forms of ID for both the veteran and indigent program.
Company’s Commitment to Helping Low-Income Individuals According to the February 2017 Report, “The Ohio Poverty Report”, 15.8% of all Ohio Residents or 1,775,836 Ohio residents live below the federal poverty line, including 17.2% of Ohio Women, and 22.5% of Ohio Children. The Company recognizes that there are many factors that contribute to hard times for Ohio Residents, chief among these are health related issues that disallow one to provide for themselves and their loved ones. The Company is fortunate enough to be in the position to assist a large number of these individuals and families by offering life-changing medication to, in many instances, combat their poverty, health and/or addiction problems. However, the Company recognizes that simply offering these products to the authorized Ohio patient network at-large does little to assist those living at or under the poverty line unless products are affordable. As stated elsewhere in this application, the Company commits to offering affordable products, but the Company will commit further to offer additional benefits to Ohio’s low-income population. Specifically, the Company is implementing the following policies:
1) Jobs – Company anticipates this dispensary will create 14 local good-paying jobs with benefits and the Company will offering a training and mentoring program to any individual that demonstrates dedication to offering quality service in a responsible manner. 2) Employee Assistance Programs – Company will offer employees childcare, housing, and transportation assistance programs so that employees can afford to keep working 3) Patient Reimbursement Program – a $200 dispensary credit after cumulatively spending $200 at the dispensary. This credit is to offset the expense associated with getting a marijuana prescription. 4) Indigent Person Discount - instituting a 20% discount to all low-income individuals including their dependents upon proof of indigent and relationship status.
For purposes of these programs, the Company uses the definition of indigence as found in Oh. Admin. Code § 120-1-03; as such, the Company will accept any of the following to demonstrate a patient’s indigent status:
• Proof of enrollment in a poverty-based public assistance program such as federal supplemental social security income, Ohio Works First, Temporary assistance to needy families, Medicaid, Aid to Families with Dependent Children, Supplemental Nutrition Assistance Program, Refugee Cash Assistance, Refugee Medical Assistance, Poverty-Related Veterans' Benefits, or other poverty-based governmental assistance. • Proof of Commitment to a mental health facility • Proof patient is under 18 years old (regardless of parents income) The Company’s Leadership Team strongly believes in the discount policy for all children under 18 years old regardless of their families’ income level because they have seen the financial hardships for families with children suffering from debilitating diseases.
Company’s commitment to compliance with all applicable laws and regulations The Company is committed to remaining compliant with all applicable laws and regulations governing the medical marijuana program. For instance, the Company has opted for the reimbursement programs as opposed to other assistance-based programs such as coupons to combat diversion and abuse by employees and patients alike, which is aligned with the intent of O.A.C. § 3796:6-03-22 (F) which states “No dispensary shall offer coupons except in the case of coupons intended to benefit patients registered as indigent or as a veteran.”
Operations Plan(Security & Infrastructure Records )
D-11.1 By selecting "Yes", the Applicant attests that all responses identified as containing security and infrastructure are voluntarily submitted to the State Board of Pharmacy in expectation of a protection from disclosure as provided by section 149.433 of the Revised Code.
YES
Source: Ohio Department of Health, The Impact of Chronic Disease in Ohio: 2015
Source: Ohio Department of Health, The Impact of Chronic Disease in Ohio: 2015
Sponsorship Programs 20170317
The CESC - CONFIDENTIAL 1 The Clinical EndoCannabinoid System Consortium (CESC) Mission: To align Cannabis science, clinical practice, and public policy to ensure best outcomes.
Founders & Roles: • John S Abrams, PhD - Abrams BioConsulting: Scientific direction; overall study design • Jean L Talleyrand, MD - MediCann: Patients, clinical expertise • Stephen McCamman - McCamman Cannabis Consulting, LLC: Logistics, public relations Advisors: • Development & Fundraising – Netherland & Associates: • Software / Application development – 420Tech: – Andrologica
The CESC - CONFIDENTIAL
Sponsorship Agreements MOU
Consulting Agreement
Sponsored Research Agreement Sponsored Research Programs
• Chemotyping & Natural Product Profiling • Clinical Studies – The Dosing Project™ • Clinical Trials • Formulation Development • Alternatives to Whole Plant Production
Patient Care(Patient Care Facilities)
E-3.1 Describe the adequacy of the size of the proposed dispensary to serve the needs of patients and caregivers, including building and construction plans with supporting details. Such plans shall illustrate, at a minimum, the size and location of the following within the prospective dispensary location: 1. The dispensary department 2. Restricted access areas 3. Waiting room 4. Patient care areas or other areas designated for patient and caregiver consultation and instruction. Include a summary of the patient flow through each area, the maximum patient and caregiver occupancy in each area at any given time, the amount of time the Applicant expects to interact with both new and returning patients, and the number of dispensary employees who will staff each area Please reference OAC 3796:6-2-02 for more information.
Pursuant to OAC § 3796:6-3-16(B)(5), we designed a facility that promotes safety, patient accessibility and comfort, which enables quality service. We designed and staffed our dispensary to accommodate up to 31 patients. The average will be closer to 15 patients at one time. There will never be more patients than dispensary technicians (DT) in the pharmacy room (PR). Our facility meets the OBC Accessibility Standards with wheelchair access, 36” doorways and hallways, ramps, and ADA- compliant restrooms.
Lobby Patients will enter the Lobby and present patient and secondary IDs to an Security Guard (SG) sitting behind a bulletproof glass window. The SG will confirm and scan the patient’s IDs into the our system creating a record of the patient’s visit. Facial recognition software will further confirm the patient’s credentials. Only after the ID is verified and registry is confirmed under the MMCP will the SG electronically release the door into the waiting room. If patients are unable to open the door on their own, an employee will provide assistance. The lobby is 54sqft. which holds 2 patients at one time. This process is expected to take no more than 2 minutes per patient.
Waiting Room Patients will automatically be entered into the patient queue as they are granted access to the waiting room which is 298sqft. and can comfortably seat 14 patients. This area is monitored at all times by the our robust surveillance video system and at least one security guard. The seating will be wide enough so that patients in wheelchairs and other mobile-assisting devices can easily navigate the room even while at maximum capacity. This area will also have a unisex ADA-compliant bathroom. The waiting room will have literature, and other amenities, including Board-approved medical marijuana educational material for patients to enjoy while they await a DT to assist them in their dispensary transaction. Patients can expect to spend no more than 5-10 minutes in this area during an average visit to the dispensary.
ADA Compliant Restrooms Adjoining the waiting room is an ADA compliant patient restroom (68sqft.) and adjoining the employee hallway is an ADA compliant employee restroom (56sqft.) These restrooms have grab bars, high clearance sinks, ample open floor-space and all other requirements of the ADA.
Pharmacy Room Medical marijuana is dispensed in the pharmacy room (PR). The DTs will be alerted to the next patient in the electronic queue, retrieve the patient from the waiting room, and escort the patient back to the PR. Patients will always be served 1-to-1 in the PR. This room is 527sqft. and can accommodate 15 people. A minimum of 6 DTs will be working at all times to lead patients through the dispensary process. DTs will be equipped to answer questions about the medical marijuana treatments being offered by the dispensary.
On average, we expect patients to spend 5-10 minutes in a transaction with a DT. However, we recognize that initial visits to our dispensary and patients using medical marijuana for the first time may have additional questions and require additional time in the PR, so we have a designed private consultation rooms (PCR) extending off of the PR where DTs and patients can consult further on various treatments. The PCR 112sqrft and allows patients to speak to a DT or medical personnel openly without compromising their medical privacy. PCRs will be held to strict security standards; every PCR will be monitored by cameras; patients will always be accompanied by employees; and no transaction will be completed in a PCR.
The PR is where medical marijuana treatments will be located. Medicine will be locked in a shatterproof glass compartment with a glass front so that patients in wheel chairs may view the medicine. Once a patient has selected medicine permitted by their recommendation, the DT will retrieve the medicine from their authorized day safe, will enter it into METRC, collect the payment and deposit it in the cash register, place it in a bag, and will escort the patient out of the pharmacy room to the doorway in the waiting room leading to the lobby. Only when the DT and patient get to the waiting room door will the DT hand the medicine to the patient. Once handed to the patient, the transaction is complete and the DT will proceed to the next patient in the electronic queue.
We anticipate that total time spent in the dispensary will range from 10-30 minutes depending on the patient’s familiarity with and questions concerning medical marijuana treatments. We encourage patients to take as much time as they feel necessary to discuss their health needs.
Limited and Restricted Access Areas As can be seen in our floor plan, areas that are not the lobby, waiting room, or pharmacy room are considered limited or restricted access areas. Each time an employee enters a limited or restricted access area (e.g. break room) they will swipe their ID and enter a unique pin number so that access can be constantly monitored, and recorded throughout the dispensary.
Medicine Room The medicine room is at the rear of the building and is accessible through the receiving area and the pharmacy room. It is 120sqft. This room is only accessible by key employees to perform authorized tasks and a secondary employee to witness and verify those tasks. The primary function of the medicine room is to carry out the transactional procedures of deliveries.
Vault Adjoining the Medicine room is the Army Corp of Engineers designated “secret” vault. This most secure part of the facility is where medicine will be stored as well as important records. The vault is 72sqft., and has similar access restrictions to the medicine room.
Receiving Area The receiving area is an obscured, secured chain link fenced paddock at the rear of the building and it is accessible to delivery vehicles through a lockable gate. Approved processors only will enter this area and the gate will close behind them. Once their ID is verified they will be allowed into the medicine room to complete the delivery. They will always be supervised by the two employees authorized to be in the medicine room and surveillance. The receiving area is 432sqft. Manager’s Office The dispensary manager’s office is attached to the breakroom and an employee-only hallway. The dispensary manager will primarily utilize the office for clerical work and private employee meetings. It is 129sqft.
Mechanical Room The mechanical room for the dispensary is accessible through the receiving area in the rear of the building. This will only be accessed during regular facility maintenance and will have no employees stationed there. This room is subject to the same security and surveillance procedures as the rest of the dispensary. The room is 82sqft.
Security office The security office is located at the end of an employee-only hallway off the pharmacy room. It has bulletproof glass windows into the lobby and waiting room. This is manned by a security guard. The surveillance system is also monitored from the security office. The security office is 54sqft.
Employee Break Room The employee breakroom can accommodate 8 people and is adjacent to the employee restrooms. Both rooms are accessible through a hallway off of the pharmacy room. The break room is also connected to the dispensary manager’s office. There is no employee stationed in the break room. This room is 200sqft., and contains a mop sink, a handwashing sink and kitchenette. There is no food or drink permitted outside of this room.
Parking Lot The adjoining parking lot is very large and can accommodate more than 20 cars, so that the dispensary never causes a traffic problem. This includes 3 handicapped spots. This parking lot also allows for further facility expansion if necessary. And is further secured by a fence and gate which will be secured outside of business hours. The parking lot is 10,000 sq. ft.
E-3.1.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures described in E-3.1. The images or diagrams may contain a brief descriptive caption. Additional language responding to the question will not be considered.
Uploaded Document Name: E-3.1.1_Patient Movement.PDF NOTE: This applicant uploaded document is the next 1 page(s) of this document.
Patient Care(Dispensary Operating Hours)
E-4.1 By selecting "Yes", the Applicant attests that it will make the dispensary available to patients and caregivers to purchase medical marijuana for a minimum of 35 hours per week, between the hours of 7 am and 9 pm, except as authorized by State Board of Pharmacy. OAC 3796:6-3-03
YES
E-4.2 Provide the proposed hours of operation during which the prospective dispensary will available to dispense medical marijuana to patients and caregivers. (Information only) OAC 3796:6-3-03
Monday - Friday: 8AM - 6PM Saturday: 8AM - 12PM Patient Care(Patient Information)
E-5.1 By selecting "Yes", the Applicant attests that it will post a sign directing patients and caregivers with medical marijuana inquiries or adverse reactions to the toll-free hotline established by the State Board of Pharmacy. OAC 3796:6-3-15
YES
E-5.2 By selecting "Yes", the Applicant attests that it will make information regarding the use and possession of medical marijuana available to patients and caregivers. The Applicant agrees to submit all such information to the State Board of Pharmacy prior to being provided to patients and caregivers. OAC 3796:6-3-15
YES Attestations and Acknowledgements(Attestations and Acknowledgements)
F-1.1 Fill out and attach the “Trade Secret Form” to Question F-1.1, specifying the question and / or attachment references of the application submission that are exempt from disclosure under Ohio public records law and articulate how the information meets the definition of “trade secret” under Ohio Revised Code section 1333.61(D). If no material is designated as trade secret information, a statement of “None” should be listed on the form.
Uploaded Document Name: F-1.1_Trade Secret Form.pdf NOTE: This applicant uploaded document is the next 9 page(s) of this document.
Trade Secret Form
(Attachment to Application Section F-2.1)
Business Name of Applicant: Hanging Gardens OH LLC
The undersigned is an Applicant for a medical marijuana Dispensary license. The Applicant understands that the State of Ohio Board of Pharmacy is an entity of the State of Ohio and any documents or data submitted to the State of Ohio may be disclosed by the State pursuant to an Ohio Public Records Act request.
While the Ohio Public Records Act permits certain exclusions from disclosure, Applicant understands the State makes no guarantee or promises that such data will not be disclosed. Applicant has reviewed the Ohio Public Records Act, as well as relevant case law.
Applicant understands that the documents or data it provides to the State of Ohio may not be confidential, or if confidential, may or may not be disclosed pursuant to an Ohio Public Records Act request.
Applicant understands that there are additional requirements in order to claim a trade secret record exception. Applicant understands that materials consisting of trade secrets must be clearly marked, specifying the pages of the application question, attachment name related to the material that is to be restricted and justifying the trade secret designation for each item.
Printed Name of Authorized Representative
Ethan Moon Signature Date
11-17-18
Dispensary Application Document E—Trade Secret Form Page 1 of 2
who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
C-4.2 Narrative marked The Company has invested significant time, Trade Secret research, expertise, creativity, ingenuity, and resources into developing this unique and proprietary business plan and assembling a talented team to execute its business plan. The Company has made significant efforts to maintain the secrecy of the Company’s business plan, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
C-4.2.1 C-4.2_Org Chart, The Company has invested significant time, Resumes, and Job research, expertise, creativity, ingenuity, and Stats resources into developing this unique and proprietary business plan and assembling a talented team to execute its business plan. The Company has made significant efforts to maintain the secrecy of the Company’s business plan, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
C-6.9 Narrative marked The Company has invested significant time, Trade Secret research, expertise, creativity, ingenuity, and resources into developing this unique and proprietary business plan and assembling a talented team to execute its business plan. The Company has made significant efforts to maintain the secrecy of the Company’s business plan, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
D-2.2 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary security plan. The Company has made significant efforts to maintain the secrecy of the Company’s security plan, and the security plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
D-2.2.1 D-2.2_Security The Company has invested significant time, Overlay and research, expertise, creativity, ingenuity, and Equipment (also resources into developing this unique and marked Security proprietary security plan, including a floor plan and Infrastructure) with a security overlay (first 4 pages of attachment). The Company has made significant efforts to maintain the secrecy of the Company’s security plan, and the security plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
D-3.3 Narrative marked The Company has invested significant time, Trade Secret research, expertise, creativity, ingenuity, and resources into developing this unique and proprietary plan to receive medical marijuana treatment from licensed cultivators and processors. The Company has made significant efforts to maintain the secrecy of the Company’s plan to receive medical marijuana, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
D-4.4 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary plan to safely store medical marijuana treatments at its facility in a manner compliant with Board regulations. The Company has made significant efforts to maintain the secrecy of the Company’s storage plan, and its plan not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
D-5.5 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary plan to dispense medical marijuana treatment to patients. The Company has made significant efforts to maintain the secrecy of the Company’s plan to dispense medicine, and itsis not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
D-6.8 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary plan to procure a backup inventory plan which is ensured. The Company has made significant efforts to maintain the secrecy of the Company’s inventory plan, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
D-8.1 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary plan to properly dispose of medical marijuana waste as required by the Board. The Company has made significant efforts to maintain the secrecy of the Company’s waste disposal plan, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
D-9.2 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary plan to remain compliant with all Board record keeping requirements. The Company has made significant efforts to maintain the secrecy of the Company’s record keeping plan, and it is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
D-10.3 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary environmental plan. The Company has made significant efforts to maintain the secrecy of the Company’s environmental plan, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
E-1.1 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary employee training plan. The Company has made significant efforts to maintain the secrecy of the Company’s its training plan, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
E-1.2 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary employee training plan. The Company has made significant efforts to maintain the secrecy of the Company’s its training plan, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
E-2.1 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary employee training plan. The Company has made significant efforts to maintain the secrecy of the Company’s its training plan, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
E-2.2 Narrative marked The Company has invested significant time, Trade Secret (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary plan to respond to patient adverse events. The Company has made significant efforts to maintain the secrecy of the Company’s patient response plan, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
E-3.1.1 E-3.1_Patient The Company has invested significant time, Movement (also research, expertise, creativity, ingenuity, and marked Security resources into developing this unique and and Infrastructure) proprietary business plan. The Company has made significant efforts to maintain the secrecy of the Company’s floor and security plans, and its plan is not generally known or readily ascertainable by other persons who could obtain economic value from its disclosure, and is therefore properly redacted as a trade secret pursuant to Ohio Revised Code sections 149.43(A)(1)(v) and 1333.61 through 1333.69 as determined by the Ohio Supreme Court in State ex re. Besser v. Ohio State Univ. 89 Ohio St. 3d 398 (2000).
F-1.2 To be considered complete, each application must be submitted with an Attestation and Release Authorization. The form must be completed by a Prospective Associated Key Employee who may legally sign for the Applicant and who can verify the information provided in the application is true, correct, and complete.
This response has been entirely redacted