Staff Daily Acknowledgement Sheet

• Store Name

  Select The Bottle-Tawa The Bottle-O Hutt Park The Bottle-O Stokes Valley The Bottle-O Naenae The Bottle-O Mangatera The Bottle-O Wairoa The Bottle-O Regent The Bottle-O Tikipunga The Bottle-O Kamo The Bottle-O Kaitaia Merchants Liquor Petone Hotel Mangatera

  • The Bottle-Tawa
  • The Bottle-O Hutt Park
  • The Bottle-O Stokes Valley
  • The Bottle-O Naenae
  • The Bottle-O Mangatera
  • The Bottle-O Wairoa
  • The Bottle-O Regent
  • The Bottle-O Tikipunga
  • The Bottle-O Kamo
  • The Bottle-O Kaitaia
  • Merchants Liquor Petone
  • Hotel Mangatera

• Today's Date

  Date

• Staff Name

• Location
  Address

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• Do you agree to comply and understand the SSAA 2012?

  Yes

  No

  N/A

• Can you identify if any of your customers in your store will require intervantion to prevent intoxication?

  Yes

  No

  N/A

• Are there intoxicated persons on the premises? What actions have been taken?

  Yes

  No

  N/A

• Are there minors on the premises that shouldn't be? Have they purchased?

  Yes

  No

  N/A

• Is the licence displayed clearly? Have you read it?

  Yes

  No

  N/A

• Is the duty manager's name displayed clearly and can it be easily read?

  Yes

  No

  N/A

• Do you hold a duty manager's certificate?

  Yes

  No

  N/A

• Is the named duty manager authorised? i.e the holder of a Manager's Certificate

  Yes

  No

  N/A

• Is food available at all times?

  Yes

  No

  N/A

• Do you have a reasonable range of non-alcoholic and low alcohol beverages available? Is free water available?

  Yes

  No

  N/A

• Is prohibited person signage that relates to minors and intoxicated persons clearly displayed?

  Yes

  No

  N/A

• Are you trained on serving alcohol? Have you completed LCQ and Servewise Training?

  Yes

  No

  N/A

• What are the acceptable forms of ID's?

  Select 18+ Kiwi Access Card Overseas Drivers License NZ Or Overseas Passort NZ Drivers License College ID or Club Membership ID HANZ 18+ Card

  • 18+ Kiwi Access Card
  • Overseas Drivers License
  • NZ Or Overseas Passort
  • NZ Drivers License
  • College ID or Club Membership ID
  • HANZ 18+ Card

Disclaimer:

• I, undersigned, assume responsibility or liability for any errors or omissions in the content of this acknowledgement form. Under the SSAA 2012, I will ensure that the sale and supply of alcohol will be taken safely and responsibly, and the harm caused by excessive or inappropriate will be minimized.

  Yes

  No