2026 Semi-Annual Renewal Affidavit

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Semi-Annual Liquor License Renewal Affidavit
Note that this affidavit is applicable to current licensees whose information and statements contained in their last approved application have not changed. If an unapproved change has occurred, please notify the City Clerk Department at cityclerk@cityblm.org immediately.
Below is a list of the document(s) that are required in order for your renewal to be considered complete.
Required Documentation
The following are required to be submitted by all licensees looking to renew their current license(s).
  • Affidavit of License Renewal - By signing the affidavit, the representative verifies that no significant changes have been made to the business operations or premises.
Conditional Document Requirements
The following are required to be active and on file at all times for all licensees. If the document listed below is currently active and on file, there is no need to include it with your submission.
  1. Lease Agreement (if establishment is not owned). To be accepted, the Lease Agreement must include:
    1. Name of Entity or Person(s) under Ownership;
    2. Term Dates.
  • Certificate of Liquor Liability Insurance (Not Policy Declarations). To be accepted, your Certificate of Liability Insurance must include all of the following:
    • Insured Name — The applicant’s name must be listed as the insured. If the applicant is a corporation, the corporation’s legal name must appear here.
    • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County.
    • Establishment Address — The address of the location where business is operated.
    • Coverage Dates & Limits— The certificate must show the start and end dates of coverage as well as coverage limits (dictated by the State of IL Liquor Control Commission).
    • Additional Insured — The City of Bloomington must be listed as an Additional Insured (can be included in the “Description of Operations” box).
      • Please ensure the phrase “only when required by written contract” or similar is not included as the license application is not considered a contract between the City and the applicant.
    • Certificate Holder — The following must be listed in the Certificate Holder section (bottom left of the form): City of Bloomington, 115 E. Washington St., Bloomington, IL 61701
  • $2,000 Surety/Penal Bond. To be accepted, your bond must include all of the following details:
    • Entity Name — The applicant’s name must be listed. If the applicant is a corporation, the corporation’s legal name must appear here.
    • DBA/Assumed Name (if applicable) — If you plan to use a business name that is different from your legal entity name, you must register that name (DBA/Assumed Name) with either the State of Illinois or McLean County.
    • Establishment Address — The address of the location where business is operated.
    • Bond Amount
    • Bond number
    • Term Dates — Start and end dates of the bond.
    • Obligee (who the bond is for) — The following must be listed as the Obligee: City of Bloomington, 115 E. Washington St., Bloomington, IL 61701
Additional Requirements
The following are required in order for renewal to be considered, but documentation is checked internally so there is no submission requirement unless specifically requested.
Doing Business As (DBA)/Assumed Name Registration
DBA/Assumed Names are required to be Registered if the Public-Facing Name is not an exact match to the Legal Entity Name (Example: If ABC Biz, LLC uses the name ABC Pizza with the public, then ABC Pizza must be registered. If ABC Pizza, LLC uses the name ABC Pizza, no need to be registered.)
To register your DBA/Assumed Name. You can find registration information at:
All Licensed Entities must be in Good Standing with the State of IL
All entities holding a license must remain in good standing with the State of Illinois. Note that this requirement does not apply to those who are not classified as entities with the State of Illinois.
Outstanding Amounts/Forms to the City of Bloomington
All licensees must be in good standing with every City of Bloomington Department. If you owe anything, you will receive a separate email with information on who to contact to resolve the issue.
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All documents can be uploaded by clicking the paperclip on the top-left of the form.
Please check that you agree before continuing.
By continuing, I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored. I agree that I am authorized to electronically sign on behalf of the business applying for renewal.
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Signature HereClick to Sign
Your Name HereClick to Sign
09/20/2026Click to Sign
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Signature HereCity Clerk Designee Will Sign Here
09/20/2026
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