Download as pdf or txt
Download as pdf or txt
You are on page 1of 331

Ohio Medical Marijuana Dispensary Application

GREEN INVESTMENT PARTNERS, LLC


Application ID 806
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

Green Investment Partners, LLC

A-1.2 Other trade names and DBA (doing business as) names

Cure Ohio

A-1.3 Business Street Address

600 Stonehedge Parkway

A-1.4 City

Dublin

A-1.5 State

OH

A-1.6 Zip Code

43017

A-1.7 Phone

6143565502

A-1.8 Email

LSTEINER@BORROR.COM
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

LoriBeth

A-2.3 Middle Name

No response provided by applicant

A-2.4 Last Name

Steiner

A-2.5 Street Address

600 Stonehedge Parkway

A-2.6 City

Dublin

A-2.7 State

OH

A-2.8 Zip Code

43017

A-2.9 Phone

6143565502

A-2.10 Email

lsteiner@borror.com
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

02/17/2017

A-3.4 Business Name on Formation Documents

Green Investment Partners

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

NO
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

SOUTHEAST-3

A-5.2 Please select to indicate the medical marijuana dispensary Ohio county for which you are
applying for a dispensary license

Franklin
Demographic Information(Prospective Associated Key Employees Details)

Item 1 of 11

A-6.1 First Name

Todd

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Baumgartner

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

Consultant

A-6.6 Title in the Applicant’s business

Chief Compliance Officer

A-6.7 Applicant's business related compensation

Todd Baumgartner is an employee of Cure Ohio, LLC and will be paid a salary of $10000/month.

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

10

A-6.11 Voting percentage

A-6.12 Proposed Role

OFFICER

A-6.13 Please include any contributions of money, equipment, real estate and expertise

N/A
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

8691 Swisher Creek Crossing

A-6.17 City

New Albany

A-6.18 State

OH

A-6.19 Zip Code

43054

A-6.20 Phone

6143700403

A-6.21 Email

todd.baumgartner@fbopartners.com

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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:

23 years

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 2 of 11

A-6.1 First Name

LoriBeth

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Steiner

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

President, Development & Construction Company

A-6.6 Title in the Applicant’s business

Chief Executive Officer

A-6.7 Applicant's business related compensation

None

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

A-6.11 Voting percentage

33.3%

A-6.12 Proposed Role

OFFICER

A-6.13 Please include any contributions of money, equipment, real estate and expertise

n/a
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

845 N. High Street

A-6.17 City

Columbus

A-6.18 State

OH

A-6.19 Zip Code

43215

A-6.20 Phone

6143565502

A-6.21 Email

lsteiner@borror.com

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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:

35 years

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 3 of 11

A-6.1 First Name

Douglas

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Borror

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

CEO, Construction Company

A-6.6 Title in the Applicant’s business

Owner

A-6.7 Applicant's business related compensation

None

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

A-6.11 Voting percentage

A-6.12 Proposed Role

BOARD MEMBER

A-6.13 Please include any contributions of money, equipment, real estate and expertise

n/a
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

845 N. High Street

A-6.17 City

Columbus

A-6.18 State

OH

A-6.19 Zip Code

43215

A-6.20 Phone

6143565500

A-6.21 Email

dgborror@borror.com

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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:

62 years

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 11

A-6.1 First Name

William

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Mackiernan

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

Medical Marijuana Executive

A-6.6 Title in the Applicant’s business

Chief Operations Officer

A-6.7 Applicant's business related compensation

GIP (d/b/a Cure Ohio) has an operating agreement with Cure Ohio, LLC, which will be paid 30% of
Cure Ohio's net profits after taxes. William Mackiernan owns 100% of Cure Ohio, LLC.

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

A-6.11 Voting percentage

A-6.12 Proposed Role

PERSON EXERCISING SUBSTANTIAL CONTROL

A-6.13 Please include any contributions of money, equipment, real estate and expertise
n/a

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

3280 Cherryridge Road

A-6.17 City

Cherry Hills Village

A-6.18 State

CO

A-6.19 Zip Code

80113

A-6.20 Phone

3139180777

A-6.21 Email

bill@curecolorado.com

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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 11

A-6.1 First Name

Robert

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Yosaitis

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

Retired

A-6.6 Title in the Applicant’s business

Owner

A-6.7 Applicant's business related compensation

None

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

15

A-6.11 Voting percentage

33.3

A-6.12 Proposed Role

BOARD MEMBER

A-6.13 Please include any contributions of money, equipment, real estate and expertise

n/a
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

3750 Las Vegas Blvd S Unit 3304

A-6.17 City

Las Vegas

A-6.18 State

NV

A-6.19 Zip Code

89158

A-6.20 Phone

8082951819

A-6.21 Email

bob@yosaitis.com

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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 6 of 11

A-6.1 First Name

Daniel

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Larkin

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

Contractor

A-6.6 Title in the Applicant’s business

Owner

A-6.7 Applicant's business related compensation

None

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

15

A-6.11 Voting percentage

A-6.12 Proposed Role

BOARD MEMBER

A-6.13 Please include any contributions of money, equipment, real estate and expertise

n/a
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

P.O. Box 21552

A-6.17 City

Carson City

A-6.18 State

NV

A-6.19 Zip Code

89721

A-6.20 Phone

7757455068

A-6.21 Email

dan@capitalglassnv.com

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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 7 of 11

A-6.1 First Name

Ryan

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Smith

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

Medical Marijuana Executive

A-6.6 Title in the Applicant’s business

Operations Director

A-6.7 Applicant's business related compensation

Ryan Smith is an employee of Cure Ohio, LLC and will be paid a salary of $10000/month.

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

A-6.11 Voting percentage

A-6.12 Proposed Role

PERSON EXERCISING SUBSTANTIAL CONTROL

A-6.13 Please include any contributions of money, equipment, real estate and expertise

n/a
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

7445 S. Miller Ct

A-6.17 City

Littleton

A-6.18 State

CO

A-6.19 Zip Code

80127

A-6.20 Phone

4154883761

A-6.21 Email

ryan@curecolorado.com

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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 8 of 11

A-6.1 First Name

Gregory

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Ross

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

Retired

A-6.6 Title in the Applicant’s business

Owner

A-6.7 Applicant's business related compensation

None

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

A-6.11 Voting percentage

A-6.12 Proposed Role

BOARD MEMBER

A-6.13 Please include any contributions of money, equipment, real estate and expertise

n/a
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

16490 E. Berry Ave

A-6.17 City

Centennial

A-6.18 State

CO

A-6.19 Zip Code

80015

A-6.20 Phone

3039169942

A-6.21 Email

greg-ross@comcast.net

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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 9 of 11

A-6.1 First Name

Martin

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Jackson

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

Executive Vice President, Medical Group

A-6.6 Title in the Applicant’s business

Owner

A-6.7 Applicant's business related compensation

None

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

15

A-6.11 Voting percentage

A-6.12 Proposed Role

BOARD MEMBER

A-6.13 Please include any contributions of money, equipment, real estate and expertise

n/a
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

4732 Gettysburg Rd, Suite 401

A-6.17 City

Mechanicsburg

A-6.18 State

PA

A-6.19 Zip Code

17055

A-6.20 Phone

7179723814

A-6.21 Email

mjackson@selectmedical.com

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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 10 of 11

A-6.1 First Name

David

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Chernow

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

President & CEO, Medical Group

A-6.6 Title in the Applicant’s business

Owner

A-6.7 Applicant's business related compensation

None

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

15

A-6.11 Voting percentage

A-6.12 Proposed Role

BOARD MEMBER

A-6.13 Please include any contributions of money, equipment, real estate and expertise

n/a
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

4732 Gettysburg Road, Suite 401

A-6.17 City

Mechanicsburg

A-6.18 State

PA

A-6.19 Zip Code

17055

A-6.20 Phone

7179721348

A-6.21 Email

dchernow@selectmedical.com

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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 11 of 11

A-6.1 First Name

Robert

A-6.2 Middle Name

No response provided by applicant

A-6.3 Last Name

Ortenzio

A-6.4 Suffix

No response provided by applicant

A-6.5 Occupation

Chairman, Medical Group

A-6.6 Title in the Applicant’s business

Owner

A-6.7 Applicant's business related compensation

None

A-6.8 Number of shares owned

N/A (LLC)

A-6.9 Types of shares owned

N/A (LLC)

A-6.10 Percent interest in Applicant's business

15

A-6.11 Voting percentage

33.3

A-6.12 Proposed Role

BOARD MEMBER

A-6.13 Please include any contributions of money, equipment, real estate and expertise

n/a
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

4732 Gettysburg Road, Suite 401

A-6.17 City

Mechanicsburg

A-6.18 State

PA

A-6.19 Zip Code

17055

A-6.20 Phone

7179723821

A-6.21 Email

rortenzio@selectmedical.com

A-6.22 Race/Ethnicity: (Only answer if applying as an Economically Disadvantaged Business)

No response provided by applicant

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


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 11

B-3.1 First Name

Todd

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Baumgartner

B-3.4 Proposed Role

OFFICER

B-3.5 Position/Title

Chief Compliance Officer

B-3.6 Brief description of role

Head of Compliance

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

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 11

B-3.1 First Name

LoriBeth

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Steiner

B-3.4 Proposed Role

OFFICER

B-3.5 Position/Title

Chief Executive Officer

B-3.6 Brief description of role

In command of overall operations, responsible for giving the proper strategic direction as well as
creating a vision for success.

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

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 11

B-3.1 First Name

Douglas

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Borror

B-3.4 Proposed Role

OWNER

B-3.5 Position/Title

No response provided by applicant

B-3.6 Brief description of role

Board Member

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

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 11

B-3.1 First Name

William

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Mackiernan

B-3.4 Proposed Role

OFFICER

B-3.5 Position/Title

No response provided by applicant

B-3.6 Brief description of role

Chief of Operations

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

TCG Retro Market 1


dba Cure Oahu
727 Kapahulu Ave
Honolulu, HI 96816

Medical Cannabis Colorado, LLC


Cure Colorado
3960 Blake Street
Denver, CO 80205

Medical Cannabis Colorado, LLC


Cure Colorado
6200 East Yale Avenue, Unit B
Denver, CO 80222

Medical Cannabis Colorado, LLC


Cure Colorado
1315 Elm Avenue
Rocky Ford, CO 81067

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.

Medical Cannabis Colorado, LLC


Cure Colorado
3960 Blake Street
Denver, CO 80205

Medical Cannabis Colorado, LLC


Cure Colorado
6200 East Yale Avenue, Unit B
Denver, CO 80222

Medical Cannabis Colorado, LLC


Cure Colorado
1315 Elm Avenue
Rocky Ford, CO 81067

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 11

B-3.1 First Name

Robert

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Yosaitis

B-3.4 Proposed Role

OWNER

B-3.5 Position/Title

No response provided by applicant

B-3.6 Brief description of role

Board Member

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

TCG Retro Market 1


dba Cure Oahu
PO Box 2428
Honolulu, HI 96813

BioNeva Innovations of Carson City, LLC


1027 S. Carson St. Ste. L
Carson City, NV 89701
BioNeva Innovations of Henderson, LLC
1027 S. Carson St. Ste. L
Carson City, NV 89701

BioNeva Innovations of Washoe County, LLC


1027 S. Carson St. Ste. L
Carson City, NV 89701

Bumblebee Partners LLC


1000 N Division St Ste 201
Carson City, NV 89703

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

TCG Retro Market 1


dba Cure Oahu
PO Box 2428
Honolulu, HI 96813

BioNeva Innovations of Carson City, LLC


1027 S. Carson St. Ste. L
Carson City, NV 89701

BioNeva Innovations of Henderson, LLC


1027 S. Carson St. Ste. L
Carson City, NV 89701

BioNeva Innovations of Washoe County, LLC


1027 S. Carson St. Ste. L
Carson City, NV 89701

Bumblebee Partners LLC


1000 N Division St Ste 201
Carson City, NV 89703
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 11

B-3.1 First Name

Daniel

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Larkin

B-3.4 Proposed Role

OWNER

B-3.5 Position/Title

No response provided by applicant

B-3.6 Brief description of role

Board Member

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

TCG Retro Market 1


dba Cure Oahu
PO Box 2428
Honolulu, HI 96813

BioNeva Innovations of Carson City, LLC


1027 S. Carson St. Ste. L
Carson City, NV 89701
BioNeva Innovations of Henderson, LLC
1027 S. Carson St. Ste. L
Carson City, NV 89701

BioNeva Innovations of Washoe County, LLC


1027 S. Carson St. Ste. L
Carson City, NV 89701

Bumblebee Partners LLC


1000 N Division St Ste 201
Carson City, NV 89703

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

TCG Retro Market 1


dba Cure Oahu
PO Box 2428
Honolulu, HI 96813

BioNeva Innovations of Carson City, LLC


1027 S. Carson St. Ste. L
Carson City, NV 89701

BioNeva Innovations of Henderson, LLC


1027 S. Carson St. Ste. L
Carson City, NV 89701

BioNeva Innovations of Washoe County, LLC


1027 S. Carson St. Ste. L
Carson City, NV 89701

Bumblebee Partners LLC


1000 N Division St Ste 201
Carson City, NV 89703
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 11

B-3.1 First Name

Ryan

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Smith

B-3.4 Proposed Role

PERSON EXERCISING SUBSTANTIAL CONTROL

B-3.5 Position/Title

No response provided by applicant

B-3.6 Brief description of role

Operations Director

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 8 of 11

B-3.1 First Name

Gregory

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Ross

B-3.4 Proposed Role

OWNER

B-3.5 Position/Title

No response provided by applicant

B-3.6 Brief description of role

Board Member

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

Bumblebee Partners LLC


1000 N Division St Ste 201
Carson City, NV 89703

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

Bumblebee Partners LLC


1000 N Division St Ste 201
Carson City, NV 89703

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 9 of 11

B-3.1 First Name

Martin

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Jackson

B-3.4 Proposed Role

OWNER

B-3.5 Position/Title

No response provided by applicant

B-3.6 Brief description of role

Board Member

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

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 10 of 11

B-3.1 First Name

David

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Chernow

B-3.4 Proposed Role

OWNER

B-3.5 Position/Title

No response provided by applicant

B-3.6 Brief description of role

Board Member

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

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 11 of 11

B-3.1 First Name

Robert

B-3.2 Middle Name

No response provided by applicant

B-3.3 Last Name

Ortenzio

B-3.4 Proposed Role

OWNER

B-3.5 Position/Title

No response provided by applicant

B-3.6 Brief description of role

Board Member

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

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.

Green Investment Partners, LLC


dba Cure Ohio
1507 Alum Industrial Drive, North
Columbus, OH 43209

BAY, LLC
dba Cure Pennsylvania
475 W Governor Rd
Hershey, PA 17033

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: C1.1b_Lease Document_H.pdf


NOTE: This applicant uploaded document is the next 33 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.

Green Investment Partners, LLC

C-1.3 Trade names and DBA (doing business as) names

Cure Ohio

C-1.4 Business Address

5225 N. Hamilton Rd

C-1.5 City

Columbus

C-1.6 State

OH

C-1.7 Zip Code

43230

C-1.8 Phone

6143565502

C-1.9 Email

lsteiner@borror.com
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-2.1b_Renovation Plans and Specifications.pdf


NOTE: This applicant uploaded document is the next 11 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_Notice of Proper Zoning Form.pdf


NOTE: This applicant uploaded document is the next 2 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_Location Area Map.pdf


NOTE: This applicant uploaded document is the next 1 page(s) of this document.
Business Plan(Business Startup Plan)

C-3.1 A business startup plan is required for all dispensary provisional license applications. The
business startup plan must provide a comprehensive set of activities necessary for the startup of the
facility within six months of receiving a provisional license. Provide a timeline describing the process,
methods, or steps used to execute a compliant business startup plan that includes, at a minimum:
1. Security and surveillance
2. Employee qualifications and training
3. Storage of medical marijuana products
4. Inventory management
5. Record-keeping
6. Prevention of medical marijuana diversion

The Company has created a timeline detailing the steps necessary to build out the proposed facility
and become operational within the 180-day timeline required under OAC § 3796:6-2-04(J). The
owners’ and operators’ combined experience includes maintaining an excellent compliance record as a
licensed medical marijuana cultivation and dispensing entity in an established state medical marijuana
market and current build-out of dispensary and vertically integrated licenses in three states under
highly competitive medical marijuana licensing programs and comprehensive regulatory structures
similar to Ohio’s. Drawing from this vast experience, the Company will foresee potential roadblocks
and mitigate them to become operational on time. The dispensary’s start-up plan has been divided into
the necessary steps for becoming operational and is modeled after plans executed for the owners’ and
operators’ other licensed medical marijuana operations. Several necessary steps have already been
completed to meet the timeline, such as signing a lease and hiring an architect and mechanical
engineer to design the facility.

The Company anticipates taking possession of the proposed facility and beginning to execute this
timeline immediately after provisional licensure. Week 1 after licensing will be spent securing insurance
for the facility and beginning the 4-week process of finalizing the architectural plans. The operators
previously engaged with the architect for the plans for 2 licensed medical marijuana dispensaries in
another state. The architect is knowledgeable in the structural requirements for Ohio dispensaries, has
prepared the plans submitted with this application, and is ready to finalize the plans upon confirmation
that a provisional license was issued. Also in week 1, hiring will begin for management positions, which
is anticipated to occur over 15 weeks as relevant portions of the business are formed. Upon hiring,
each manager will undergo rigorous training to prepare them to train staff, including touring the owners’
and operators’ facilities in other states. The Dispensary Manager (DM), who will be the facility’s
designated representative, will receive training first from the Chief Compliance Officer and Operations
Director, then take part in training the Assistant Managers (AMs) and, separately, the Inventory
Manager (IM). Manager training, as described in detail in Question E-1.1, will include training on all
security and surveillance devices and protocols, emergency procedures, medical marijuana storage
and handling procedures, inventory management procedures and use of the inventory control software,
procedures for preventing diversion of medical marijuana and protocols to follow upon a suspected or
confirmed act of diversion, recordkeeping requirements as mandated by the OAC and according to
company policy, Health Insurance Portability and Accountability Act (HIPAA)-compliant processes, and
safety issues, including Occupational Safety and Health Administration (OSHA) training for medical
professionals and hazardous materials training.

Week 2 begins the process of designing the civil engineering plans, to be finished 4 weeks later. The
Company will also begin building relationships with cultivation and processing suppliers, a process that
will continue iteratively throughout the first 6 months of operations. The Company has an application
under review for a Level I cultivation license in Ohio. If awarded the license, the Company will
subsequently seek a plant-only processor license, allowing the Company’s cultivation facility to
expeditiously supply the dispensary with high-quality medical marijuana. The Company also intends to
apply for a processing license to manufacture derived products to be sold in the dispensary.

In week 4, the security, vault, mechanical, electrical, plumbing, and structural engineering plans will be
started and will be finished 2 weeks later when the civil engineering plan is complete. During this time,
the Company will interview local tenant improvement contractors, aiming to finalize a contract within 4
weeks. This contractor will be responsible for all construction necessary to transform the existing
premises into Ohio’s premier medical marijuana dispensary.

In week 6, an application for the building permit will be submitted to the local municipality. The
municipality is anticipated to take 2 weeks to review the application and provide feedback. A week will
be spent on revisions before resubmission. Meanwhile, window security shutters will be designed and
ordered, as will Internet and phone service. The IT company will design the IT system and order and
program the hardware; programming will take up to a month to complete. By completion of those steps,
the Company expects to receive the building permit from the local municipality. Simultaneously, a 2-
month process will begin to design a building sign, submit the design to the Board of Pharmacy (Board)
and local municipality, and receive approval for it.

From week 12 to 21, the tenant improvement contractor will execute the 9-week construction process,
converting the existing premises into a secured and state-of-the-art medical marijuana dispensary. In
week 14, installation of the security system will begin, to be completed approximately 2 weeks before
the rebuild is finished, allowing time for system testing. The security system, as described in Question
D-2.2, will meet the requirements of OAC § 3796:6-3-16(E). By the end of week 21, installation of the
IT hardware, phone system, hardline internet, cellular internet backup internet, networking equipment,
and point-of-sale (POS) software and hardware will be completed. The IT and POS systems will
guarantee confidentiality and conform to the recordkeeping requirements of OAC § 3796:6-3-17. The
POS system will double as the inventory control system (ICS) and has extensive data collection
capabilities. A major component of the Company’s inventory management protocols, the ICS will track
each medical marijuana product from receipt to sale, as well as keep a record of the patient or
caregiver to whom it was dispensed. The ICS will be customized to meet the recordkeeping
requirements of OAC Division 3796 and the tracking and recordkeeping needs of the Company. The
ICS will integrate with Metrc, as it does in other states, so that a record of each sale, purchase, or
return of medical marijuana is transmitted electronically in real time to the Department of Commerce.
The ICS will also generate American Society for Automation in Pharmacy (ASAP) files to submit
dispensing information to the Prescription Monitoring Program Clearinghouse so that it is available in
the Ohio Automatic Rx Reporting System (OARRS) within 5 minutes of completing a transaction.

In week 12, while construction is underway, the Company will begin recruiting, interviewing, hiring, and
training staff over a 3-month period. All staff will have, at minimum, a high school education;
managerial candidates with an Associate’s or Bachelor’s degree will be shown preference in hiring. A
background in retail sales, service, and/or operations is required for all managers. The DM will have at
least 5-7 years of progressive retail and operations experience. AMs will have 2-4 years of progressive
retail, service industry, and/or operations experience. The IM will have experience using a HIPAA-
compliant ICS and, ideally, experience with the vault security systems that will be in place, or systems
similar thereto. Patient Consultants and Fulfillment Associates must have 2-4 years of retail and/or
service industry experience. Additional consideration in hiring will be given to candidates who have
previous medical marijuana experience and/or knowledge of HIPAA processes or OSHA safety
requirements. As dispensary staff will be the public face of the Company, proper training is critical,
including training on HIPAA-compliant processes, the medical effects of marijuana, security, safety,
and the PRIDE customer service model described in Question E-1.1. All staff will receive thorough
training before interfacing directly with patients, including training in the same topics described above
for managers. The dispensary will retain training materials and attendance records for a minimum of 3
years and will make them available to the Board for inspection.

In week 15, the secure storage vault will be installed and operational within the week. The vault will be
in a properly secured area protected from unauthorized entry, per OAC § 3796:6-3-16(B)(8). With
multiple high-security features described in Question D-4.4, the vault will be a key factor in securing
medical marijuana products from contamination or diversion. Also in week 15, the Company will begin
the six-week process of ordering furniture and fixtures, as well as constructing and installing the
building sign. Amid that activity, the window security shutters will be installed and orders will be placed
for equipment such as radios, cash registers, counting machines, ID verification, and all other needed
supplies. With the vault installed and ready to securely store medical marijuana, the first product orders
will be sent to cultivators and processors in week 16 to be received in week 24 after final Board
approval.

By week 22, all major construction will be finished at the dispensary and it will be ready for final
inspection by the Board, in accordance with OAC § 3796:6-2-06. After approval, the dispensary will be
ready to begin receiving shipments of inventory from the cultivators and processors the Company
began building relationships with weeks prior. Medical marijuana product will be received at the
dispensary and added to the electronic inventory in the ICS, following the receiving procedure
described in Question D-3.3. Upon receipt of product in week 24, the Company will merchandise the
dispensary and prepare to serve Ohio’s qualifying patients and caregivers.

C-3.1.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures
described in C-3.1. The images or diagrams may contain a brief descriptive caption. Additional
language responding to the question will not be considered.

No response provided by applicant

C-3.2 The Business Startup Plan also must describe how the Applicant’s proposed business
operations will comply with statutory and regulatory requirements (as described in Chapter 3796 of the
Revised Code and division 3796:6 of the Administrative Code) necessary for the startup and continued
operation of the facility including, but not limited to:
1. Security and surveillance
2. Employee qualifications and training
3. Storage of medical marijuana products
4. Inventory management
5. Record-keeping
6. Prevention of medical marijuana diversion

The owners and board will draw from more than 200 years of combined experience founding and
operating successful businesses, including decades of experience in the medical marijuana industry, to
create an unparalleled patient experience. The Chief Compliance Officer (CCO) will be responsible for
ensuring all startup and continued operations adhere to all statutory and regulatory requirements of
ORC Chapter 3796 and OAC § 3796:6. The CCO will oversee and approve the writing of all compliant
Plans, Policies, and Procedures (PPPs) that will be used to train managers and staff to ensure clarity
throughout the business on operating legally.

(1) – All security and surveillance requirements of the OAC, including OAC §§ 3796:6-3-07, 3796:6-3-
11, 3796:6-3-16, and 3796:6-3-23, will be written into the facility’s PPPs, including the security plan
(OAC § 3796:6-3-16(A)(1)). An overview of the dispensary’s Ohio-compliant security plan and
equipment is provided in Question D-2.2. For installation of security and surveillance equipment, as
well as surveillance monitoring, the Company will leverage the operators’ existing relationship with an
award-winning security firm (SF) engaged to secure their licensed medical marijuana dispensaries in
another competitive licensing state. The SF will monitor the dispensary 24 hours a day, 7 days a week,
365 days a year. Together, the SF and dispensary staff, trained in all security PPPs, will ensure
execution of the security plan whether the dispensary is open or closed (OAC § 3796:6-3-04). Per OAC
§ 3796:6-3-16, the SF will install appropriate security and surveillance devices throughout the facility’s
exterior and interior, including areas where medical marijuana is received (OAC § 3796:6-3-06). Daily
review and weekly testing of these devices will occur to determine facility operability (OAC § 3796:6-3-
22(L)). In their first week, staff will learn the locations of all security cameras, video monitoring
equipment, panic buttons, fire extinguishers, emergency exits, and processes for workplace security,
access control, robbery or emergency response, active shooter protocol, diversion prevention, secured
medical marijuana receipt and storage, and fulfilling their duty to report. Unannounced security drills
will be conducted quarterly, in which staff will respond to hypothetical scenarios, initiating security
protocols and testing knowledge retention from training.

(2) – The dispensary will comply with ORC § 3796.13(A) by conducting thorough background checks
(OAC § 3796:6-2-08(D)) of all prospective staff. All staff will have, at a minimum, a high school
education and be at least 21 years old. Employee qualifications that include practical experience
complying with strict regulations (medical marijuana programs, HIPAA Privacy Rule, or OSHA safety
requirements) are preferred. The Dispensary Manager (DM), who will be the facility’s designated
representative, will ensure the staff training program is compliant with PPPs and established according
to OAC § 3796:6-3-19, including foundational training (OAC § 3796:6-3-19(C) and continuing
education that is Board approved (OAC § 3796:6-3-19(E)). Records of this training will be kept and
updated (OAC § 3796:6-3-19(B)). The DM will continually work with the CCO to ensure training
materials are consistent with security protocols. When new PPPs are implemented, all staff members
will be updated prior to beginning their next shift.

(3) – All storage requirements of the OAC, including OAC §§ 3796:6-3-06, 3796:6-3-07, and 3796:6-3-
16, will be written into the dispensary PPPs and be overseen by the DM and CCO. The secure storage
vault, which is the main storage area for medical marijuana products, will comply with all security and
surveillance requirements and be in a secured area protected from unauthorized entry (OAC §§
3796:6-3-04(C) and 3796:6-3-16(B)(8)), with a sign to note it is a restricted-access area (OAC §
3796:6-3-16(B)(2)). All product taken from and returned to the vault during dispensing activities will
immediately be recorded through a hand-held device in the inventory control software (ICS), NCR
Counterpoint. At close of business, any unsold medical marijuana product will be moved to the vault for
overnight storage. Should unauthorized access to the vault occur, the CCO will immediately notify the
Board, per OAC § 3796:6-3-04(E). All products sold will be in their original, sealed packaging, as
delivered from the cultivator or processor, per OAC § 3796:6-3-01(F), and all sales will be conducted in
a properly secured sales area. Inventory counts are conducted daily, and audits weekly.

(4) – The dispensary ICS, integrated with the state inventory tracking system (ITS) (OAC § 3796:6-3-
08(E)) will be managed by the DM (OAC § 3796:6-3-20(A)). The ICS is part of a comprehensive
inventory management system with processes for recordkeeping, receiving, storage, dispensing, daily
inventory counts, weekly inventory audits, recalls, and waste disposal that will be written into PPPs.
The Inventory Manager (IM) will oversee daily inventory counts and the DM will perform weekly
inventory audits of the IM’s counts, in accordance with OAC § 3796:6-3-20(D), to identify
inconsistencies in inventory and investigate for potential theft or diversion (OAC § 3796:6-3-11(C) and
OAC § 3796:6-3-12(B)). The ICS will conform to all regulatory requirements of OAC § 3796:6-3-20 and
ORC § 3796.07. Any inventory at the dispensary will be recorded in the ICS, per OAC § 3796:6-3-
07(B). Any expired or unsaleable inventory will be disposed of within one week of its discovery
according to the standards of OAC § 3796:6-3-07(D). As required by OAC § 3796:6-3-14(C)(5-6),
medical marijuana waste disposal containers will be locked in the vault and documentation of
destroyed product will be kept for at least three years. All inventory records, investigations,
reconciliations, and discrepancies, including any plans for amending standard operating procedures,
will be made available to the Board, per OAC § 3796:6-3-17(A).

(5) – All staff will be responsible for updating dispensary records, including patient, inventory, and sale
records (OAC §§ 3796:6-3-08(M) and 3796:6-3-10(A)). These records will be stored electronically in
Counterpoint in a 128-bit encryption system located on a private offsite server. Staff will be trained in
the recordkeeping requirements of OAC § 3796:6-3-17 and ORC § 3796.07 to further facilitate
compliance and records will retained of recordkeeping training (OAC § 3796:6-3-19(B)). Training
includes instruction on how long to keep which records and legal requirements, including HIPAA
compliance and the confidentiality requirements of OAC § 3796:6-3-18. The ICS shall keep a record of
all actions taken for at least three years. An overview of the dispensary’s Ohio-compliant
recordkeeping plan, including the encrypted electronic records storage system, is provided in Question
D-9.2.

(6) – The Company’s PPPs will include security controls to ensure risk mitigation of potential diversion,
theft, or loss of medical marijuana (OAC § 3796:6-3-19(C)(4)). Beyond security measures, all Patient
Consultants will be trained in proper dispensing procedures, including checking the patient registry for
patient purchases made in the last 90 days (OAC § 3796:6-3-08(H)(2)(c)) and identifying when legal
sales may lead to illegal use of products (OAC § 3796:6-3-11(A)), such as patients asking for multiple
exit bags. All staff will be trained to immediately report any irregularities they find that might indicate
loss, fraud, embezzlement, or any other illegal action taken against the dispensary, its staff and guests,
or their property. Lessons learned from security drills will be reviewed by management to further
mitigate risk of medical marijuana diversion. An overview of the dispensary’s Ohio-compliant diversion
prevention protocols is provided in Question D-7.1.
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.

Green Investment Partners, LLC (GIP) has a proven record of success in the medical marijuana
industry, with 2 decades of collective experience between members of the Board of Directors and the
company’s operators and medical marijuana operations in Pennsylvania, California, Nevada, Hawaii,
and Colorado. Based on their vast experience with state-compliant medical marijuana, GIP’s owners
and operators know the best way to assure that rigorous quality controls are used in the creation and
handling of products is by doing the cultivation and processing internally. GIP currently has an
application under review by the Ohio Department of Commerce for a Level I cultivator license and is
preparing an application for an Ohio processing license to be submitted this December. It is GIP’s goal
to be the premier vertically integrated medical marijuana business in Ohio, in order to ensure a reliable
supply of high-quality products.

GIP will be controlled by a Board of Directors made up of 9 investor/owners to whom the dispensary’s
2 contractual operators will report; these 11 individuals qualify as Prospective Associated Key
Employees under OAC §§ 3796:6-2-03 and 3796:6-2-07 and are listed in Question A-6. The 9
investor/owners are Daniel Larkin, David Chernow, Douglas Borror, Gregory Ross, LoriBeth Steiner,
Martin Jackson, Robert A. Ortenzio, Robert Yosaitis, and Todd Baumgartner, who will each have
voting rights, fiduciary responsibilities, and limited liability in GIP. The operators are William
Mackiernan and Ryan Smith. Of these 11 individuals, 4 will have duties and responsibilities in the daily
operations and strategy of GIP’s dispensing: Ms. Steiner, Mr. Mackiernan, Mr. Baumgartner, and Mr.
Smith. Their roles and responsibilities are described below. Though not responsible for management of
day-to-day operations, all Board members will have a substantial interest in dispensary operations and
will be available and accessible at all times to provide guidance to the executive team based on
extensive related experience and knowledge (described in Question C-6.9).

LoriBeth Steiner will serve as Chief Executive Officer (CEO), crafting and cultivating GIP’s culture,
vision, and strategy. She will build the executive and management teams, form external partnerships,
allocate capital, and delegate internal roles. As CEO, Ms. Steiner will draw from her experience as
President of Borror, a leading real estate company, to ensure GIP’s success. She seeks to recreate the
spirit of creative problem-solving she fostered in her previous team of 75 employees to bolster GIP’s
startup phase and continued operations. At GIP, some of her responsibilities will be to:
-Oversee hiring decisions for the executive and management teams
-Create and communicate GIP’s vision both internally and externally
-Build and manage relationships with key stakeholders and partners
-Manage and analyze team self-assessments to track effectiveness
-Regularly update the other members of the Board of Directors on GIP’s operations
-Work closely with the Controller to devise a financial strategy
-Develop high-level business plans and strategies to further GIP’s short- and long-term objectives

As Chief Operations Officer (COO), William Mackiernan will assist the CEO in defining the overall
vision, as well as apply that vision to GIP’s day-to-day operations by supporting managers and staff. To
accomplish this, he will draw from the considerable experience he has gained owning medical
marijuana cultivation and dispensing facilities in Colorado and managing the development of a
vertically integrated medical marijuana license in Hawaii. The knowledge gained from this experience
includes understanding the intricacies of compliance with state law to create legal operating
procedures that enable the dispensary to safely and effectively serve patients. Mr. Mackiernan will
work with the Operations Director to develop GIP’s standard operating procedures (SOPs). As COO,
he reports directly to the CEO. Some of his regular duties will be to:
-Oversee company operations and the management team
-Set goals for internal performance
-Create and implement state law compliant policies that promote GIP’s culture and vision
-Submit regular reports to the executive team on company operations
-Provide solutions to operational issues to remove barriers to success

Todd Baumgartner will be GIP’s Chief Compliance Officer (CCO) and will play a key role in both
strategy and daily operations. He will ensure both external compliance with applicable local, state, and
federal laws, regulations, and reporting requirements, as well as internal compliance with company
policies. This entails staying up-to-date on new or updated laws and regulations, amending SOPs, and
implementing any amended procedures by disseminating information to staff and overseeing any
necessary training. Mr. Baumgartner is a stakeholder in a fixed-base operator (FBO) chain as well as a
shareholder in an FBO consulting company where he provides clients with expertise in operations
management and infrastructure design, among other elements of FBO business operations. He joins
GIP with an extensive history in the regulated FBO industry, in which compliance with strict inventory
tracking, chain of custody, quality control, and security protocols are paramount to success, making
him well positioned to serve as CCO. Mr. Baumgartner will report to both the CEO and COO and will
work with the rest of the executive team to create a risk-free strategy and transparent company culture.
Some of his regular duties will be to:
-Oversee and monitor implementation of the compliance, security, quality assurance, and quality
control programs
-Evaluate and measure the state of compliance across the organization by conducting regular risk
assessments
-Manage investigations into any violation of regulatory or statutory requirements
-Manage utilization of the “Receiving Compliance Checklist” (described below) to ensure compliance
with all packaging and labeling requirements
-Develop and coordinate GIP’s compliance training program to ensure that all employees and
management are knowledgeable of, and comply with, pertinent federal and state standards
-Fulfill all external reporting requirements
-Ensure all records are kept for the requisite number of years, per OAC §§ 3796:6-1-01(H)(7), 3796:6-
3-20(G), and 3796:6-3-17(E)(11)
-Assist members of the legal team and law enforcement, as needed, per OAC § 3796:6-3-11(B)(2)

As Operations Director, Ryan Smith will oversee the daily operations of the dispensary and will help
the COO carry out GIP’s vision through dispensary SOPs. His previous experience operating in
Colorado’s medical marijuana program will play a crucial supporting role in informing the development
of comprehensive SOPs. A core component of Mr. Smith’s role will be implementing the use of a
“Receiving Compliance Checklist” to ensure compliance with Ohio’s medical marijuana packaging and
labeling requirements; the checklist will detail approximately 30 criteria each medical marijuana product
must meet to pass inspection and be accepted by the dispensary upon delivery from the originating
cultivator or processor. Mr. Smith will oversee the Inventory Manager, who handles storage, inventory
management, and recordkeeping. He will also be responsible for ensuring that all staff and managers
have received proper training for their positions, that they execute their job functions satisfactorily, and
that they receive disciplinary action if they do not. He will report to the COO and CCO. Some of his
responsibilities will be to:
-Ensure that GIP operates according to its mission statement and vision
-Coordinate the efforts of managers across all departments
-Create and oversee the implementation of GIP’s SOPs
-Assist the CCO with employee compliance training
-Ensure all safety regulations are followed
-Enhance patient satisfaction by investigating GIP’s customer support services

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-4.1_Table of Organization and Control.pdf


NOTE: This applicant uploaded document is the next 1 page(s) of this document.
Business Plan(Capital Requirements)

Item 1 of 2

C-5.1 Type of Capital

Cash/cash equivalent

C-5.2 Source of Capital

Investor Contributions

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-5.5.1_RO REDACTED.pdf


NOTE: This applicant uploaded document is the next 1 page(s) of this document.
Business Plan(Capital Requirements)

Item 2 of 2

C-5.1 Type of Capital

Cash/Cash Equivalent

C-5.2 Source of Capital

Investor Contributions

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-5.5.1_RWY REDACTED.pdf


NOTE: This applicant uploaded document is the next 55 page(s) of this document.
TRADE SECRET

This page intentionally left blank


TRADE SECRET

This page intentionally left blank


TRADE SECRET

This page intentionally left blank


Business Plan(Business History and Experience)

Item 1 of 11

C-6.1 First Name

Todd

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Baumgartner

C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person
Exercising Substantial Control, Support Employee)

Person Exercising Substantial Control

C-6.5 Business Name

1) NetJets 2) Ross Aviation 3) FBO Partners

C-6.6 Business Address

1) Columbus, OH 2) Denver, CO 3) Golden, CO

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1) 2003-2013 2) 2013-2014 3) 2014-Present


Business Plan(Business History and Experience)

Item 2 of 11

C-6.1 First Name

LoriBeth

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Steiner

C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person
Exercising Substantial Control, Support Employee)

Person Exercising Substantial Control

C-6.5 Business Name

1) Dominion Homes 2) Borror

C-6.6 Business Address

1) Dublin, OH 2) Dublin, OH

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1) 1989-2008 2) 2008-Present
Business Plan(Business History and Experience)

Item 3 of 11

C-6.1 First Name

Douglas

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Borror

C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person
Exercising Substantial Control, Support Employee)

Owner, Person Exercising Substantial Control

C-6.5 Business Name

1) Borror Corp./Dominion Homes 2) Borror

C-6.6 Business Address

1) Dublin, OH 2) Dublin, OH

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1) 1977-2009 2) 2008-Present
Business Plan(Business History and Experience)

Item 4 of 11

C-6.1 First Name

William

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Mackiernan

C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person
Exercising Substantial Control, Support Employee)

Person Exercising Substantial Control, Owner

C-6.5 Business Name

1) Miller Weingarten Realty LLC 2) Cure Colorado 3) Clarkson Capital LLC

C-6.6 Business Address

1) Engelwood, CO 2) Denver, CO 3) Denver, CO

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1) 2000-2011 2) 2010-Present 3) 2012-Present


Business Plan(Business History and Experience)

Item 5 of 11

C-6.1 First Name

Robert

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Yosaitis

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

1) Action Fuel 2) 808 Sky Catering 3) Picante Gaming 4) BioNeva Innovations 5) Ninth Island Group

C-6.6 Business Address

1) Kahului, Hi 2) Kahului, HI & Kona, HI 3) Costa Rica 4) Henderson & Carson CIty, NV 5) Honolulu, HI

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1) 2006-Present 2) 2006-Present 3) 2014-Present 4) 2014-Present 5) 2016-Current


Business Plan(Business History and Experience)

Item 6 of 11

C-6.1 First Name

Daniel

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Larkin

C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person
Exercising Substantial Control, Support Employee)

Owner, Person Exercising Substantial Control

C-6.5 Business Name

1) Capital Glass, Inc 2) BioNeva Innovations 3) BLM5 Investments, LLC

C-6.6 Business Address

1) Carson City & Reno, NV 2) Carson City, NV 3) Carson CIty, NV

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1) 2001-Present 2) 2014- Present 3) 2015-Present


Business Plan(Business History and Experience)

Item 7 of 11

C-6.1 First Name

Ryan

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Smith

C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person
Exercising Substantial Control, Support Employee)

Person Exercising Substantial Control

C-6.5 Business Name

1) GAP, Inc 2) Dollar General 3) Habitat For Humanity 4) The Clinic

C-6.6 Business Address

1) Denver, CO/San Francisco, CA 2) Nashville, TN 3) Denver, CO 4) Denver, CO

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1) 2005-2009 2) 2009-2012 3) 2012-2016 4) 2016-2017


Business Plan(Business History and Experience)

Item 8 of 11

C-6.1 First Name

Gregory

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Ross

C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person
Exercising Substantial Control, Support Employee)

Officer, Person Exercising Substantial Control

C-6.5 Business Name

1) Regent Aviation 2) Ross Aviation

C-6.6 Business Address

1) St. Paul, MN 2) Denver, CO

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1) 2002-2003 2) 2003-2014
Business Plan(Business History and Experience)

Item 9 of 11

C-6.1 First Name

Martin

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Jackson

C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person
Exercising Substantial Control, Support Employee)

Officer, Person Exercising Substantial Control

C-6.5 Business Name

1) CIBC Oppenheimer 2) Select Medical

C-6.6 Business Address

1) New York, New York 2) Mechanicsburg, PA

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1) 1997-1999 2) 1999-Present
Business Plan(Business History and Experience)

Item 10 of 11

C-6.1 First Name

David

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Chernow

C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person
Exercising Substantial Control, Support Employee)

Officer

C-6.5 Business Name

1) Oncure Medical Corp 2) Select Medical

C-6.6 Business Address

1) Englewood, CO 2) Mechanicsburg, PA

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1) 2007-2010 2) 2010- Present


Business Plan(Business History and Experience)

Item 11 of 11

C-6.1 First Name

Robert

C-6.2 Middle Name

No response provided by applicant

C-6.3 Last Name

Ortenzio

C-6.4 Previous Role (e.g. Owner, Officer, Board Member, Person with Financial Interest, Person
Exercising Substantial Control, Support Employee)

Officer, Person Exercising Substantial Controll

C-6.5 Business Name

1) Continental Medical Systems 2) Select Medical

C-6.6 Business Address

1) Mechanicsburg, PA 2) Mechanicsburg, PA

C-6.7 Position of management or ownership of a controlling interest

YES

C-6.8 Dates

1)1986-1996 2) 1996-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.

Green Investment Partners, LLC (GIP) will be controlled by a Board of Directors made up of nine
investor/owners to whom the dispensary’s two contractual operators will report; these 11 individuals
qualify as Prospective Associated Key Employees (PAKEs). Some PAKEs have less than a 10%
interest in GIP, but all exercise control over GIP’s operations, whether in the form of voting rights or
day-to-day operations management; specific duties and roles are described in Question C-4.1. No
PAKE on GIP’s team has ever had administrative disciplinary action taken against any of their
ventures.

GIP’s team brings to bear extensive collective successes in cultivation, extraction, product
development, testing, distribution, and dispensing of medical marijuana in tightly regulated markets.
Coupled with executive management in healthcare through the oversight of over 2,100 healthcare
facilities nationwide, the team’s relevant executive business background is further grounded by real
estate, property management, development, construction, and community-planning experience. This
relevant and applied expertise has allowed GIP to inherently understand that meeting the needs of
healthcare patients, especially medical marijuana patients, is a complex endeavor that now stretches
from state to state and requires experience with shifting regulatory landscapes and developing
statutory processes. The team will draw from more than 200 years of combined experience founding
and operating successful businesses, including 20 years in the medical marijuana industry, to create
an unparalleled patient experience.

Investor/owner Robert A. Ortenzio has 35 years’ experience operating healthcare businesses. As co-
founder and Executive Chairman of Select Medical (Select) for the past 21 years, he has directed the
company to successfully provide medical rehabilitation and post-acute care services in more than
2,100 locations in 46 states. Select has yearly revenues of over $4.0 billion, employs over 43,000 staff,
and treats approximately 60,000 patients daily. Previously, Mr. Ortenzio co-founded and served for 10
years as President of Continental Medical Systems and was a General Counsel Member of Rehab
Hospital Services Corporation for four years. In 2004, he founded the Robert and Angela Ortenzio
Family Foundation, a 501(c)(4) social welfare organization that has supported Pennsylvania education
and healthcare initiatives with contributions of $8 million over 13 years. Mr. Ortenzio is an owner and
board member of BAY, LLC (BAY), which is currently developing a license to operate three marijuana
dispensaries in Pennsylvania.

Investor/owner David Chernow has over 25 years’ experience in the healthcare industry, including in
various C-level positions with Select since 2010, where he has been President and CEO since 2014.
At Select, Mr. Chernow helps lead a culture focused on patient safety and quality. From 2007-2010,
Mr. Chernow served as President and CEO of Oncure Medical Corp., a national network of cancer
treatment centers. Mr. Chernow co-founded American Oncology Resources in 1992 and served as its
Chief Development Officer through a merger with Physician Reliance Network, Inc. in 1999, which
created US Oncology, Inc., where he then served as President of the Physician Services Group until
2001. He is an owner and board member of BAY. Mr. Chernow is a former board member for the
National Coalition of Cancer Survivors.
Investor/owner Martin Jackson has 29 years’ experience in the healthcare industry, including as
Executive Vice President (EVP) and Chief Financial Officer (CFO) for Select since 1999. Previously,
Mr. Jackson served as Vice President (VP) of Health Care Finance for Van Kampen Merritt for three
years, then held the same position for one year with McDonald and Co. Securities (McDonald),
followed by three years as President and CFO of L’Nard Associates, a medical patenting company,
and finally returning to McDonald as Senior Vice President (SVP) of Health Care Finance for four
years. He is an owner and board member of BAY.

Investor/owner Daniel Larkin has successfully participated in three prior medical marijuana application
processes and is currently an owner in several medical marijuana entities. He co-founded Ninth Island
Group in 2015 for the development of a successful partnership that earned one of three vertically
integrated medical marijuana licenses on the island of Oahu out of only eight licenses issued
statewide. He is CEO of BioNeva Innovations, a company he co-founded in 2014 that was awarded six
licenses for cultivation and processing in Nevada. He is also a part owner of two licensed medical
marijuana cultivation facilities and two dispensaries in California and is a member of the Cookies
Management Group. He is a co-founder, owner, and board member of BAY. As CFO for Capital Glass
since 2001, he has led the company to recognize nearly $20 million in increased yearly revenue.

Investor/owner Robert Yosaitis is an entrepreneur with a proven track record of growing successful
businesses. In 1998, he founded Bradley Pacific Aviation, a Hawaiian jet refueling company, every
aspect of which he managed until 2008, when he sold most of the business after growing it to over 180
employees. Mr. Yosaitis has partnered with Mr. Larkin in a number of medical marijuana-related
endeavors and has ownership in all of the medical marijuana entities described in the paragraph
above.

Investor/owner Gregory Ross co-founded and served as COO for Ross Aviation for 11 years, until the
business was sold to Landmark Aviation in 2014. Prior to that role, he served for one year as EVP for
Regent Aviation and five years as EVP for Aviation Resource Group International. Mr. Ross previously
served for six years as a manager for Innocan Realty Fund and two years as COO for Aerospace
Realties. From 2011-2015, he served as a board member of the Epilepsy Foundation of Colorado, a
non-profit organization working to assist more than 50,000 Coloradans living with epilepsy.

Investor/owner Todd Baumgartner is an Army veteran who worked as an intelligence specialist for a
decade. He is a graduate of Ohio State University and has lived in Ohio for nearly half his life. After
leaving the service, he spent two years as a sales manager with Pepsi-Cola, followed by 13 years with
NetJets, as Director, VP, then SVP, where he negotiated deals and restructured auditing and
purchasing, saving the company over $110 million per year. He joined Ross Aviation for one year as
SVP of Acquisitions before becoming a senior partner in FBO Partners in 2014, where he provides
consulting services for fixed-base operators (FBO) and led a successful effort to acquire another large
FBO operation in Hawaii.

Investor/owner Douglas Borror is a life-long resident of Columbus and graduate of Ohio State
University. He has been a licensed real estate agent since 1977 and has had active real estate
brokerage licenses in Ohio for 35 years and in Kentucky for over 20 years. Mr. Borror has a history of
successful start-ups, including growing Dominion Homes from a $20 million privately-held business to
a $600 million publicly-held company. He sold Dominion in 2009 when it was one of the largest
homebuilding companies in Ohio and Kentucky. In 2008, he founded Borror, a development,
construction, and property management company, where he serves as CEO. In 2004, Mr. Borror co-
founded the Borror Family Charitable Foundation, which gives to many organizations in the greater
Columbus area, including The James Cancer Hospital and Children’s Hospital.
Investor/owner LoriBeth Steiner, a graduate of Wittenberg University in Springfield, Ohio, has lived in
Columbus since 1982. She had a lengthy tenure at Dominion Homes from 1989 to 2008, where she
was promoted from Director of Marketing to VP to Chief Marketing Officer. When Dominion went
public, she was actively involved in both the primary and secondary public offerings. Ms. Steiner
assisted with the founding of Borror in 2008 and serves as its President. She has been a licensed
realtor in Ohio since 2008 and a registered General Contractor with the City of Columbus since 2009.

Operator William Mackiernan has owned Cure Colorado since July 2010, producing approximately
3,000 pounds of state regulated medical marijuana. His experience in the marijuana industry as an
owner and principal has enabled him to gain substantial knowledge about pills, oils, topicals, tinctures,
and vaporization devices. Previously, Mr. Mackiernan was VP of Miller Weingarten Realty for 11 years,
where he managed commercial real estate in both Utah and Colorado. He has an additional five years’
experience managing investments, including those in medical marijuana cultivation and sales, real
estate, and natural resources.

Operator Ryan Smith spent nearly eight years with the Gap Inc., as a Company Planning Manager and
Financial Analyst, then later as Director of Corporate Finance, and finally Director of Finance and
Strategy (Loss Prevention). After leaving the Gap Inc., he spent four years at Dollar General as a
Senior Director of Process Improvement, then four years as Chief Retail Officer for Habitat for
Humanity of Metro Denver, running five thrift stores that raised over $4 million to fund affordable
housing. Most recently, Mr. Smith served for one year as Director of Retail Operations for The Clinic,
one of the largest vertically integrated marijuana entities in Colorado and the country. At The Clinic, Mr.
Smith was responsible for all retail operations and managed 45 employees who, under his watch,
remained compliant with state law through over 30 inspections while profits increased by 25%.
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 Schematics.pdf


NOTE: This applicant uploaded document is the next 43 page(s) of this document.
SECURITY AND INFRASTRUCTURE

SURVEILLANCE, ACCESS CONTROL, AND ALARM

FIRE

Smoke detector

P Pull station
`

Strobe

Horn strobe
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE

North America: +1 949 732 2000


Toll Free: 1 800 237 7769
Europe, Middle East, Africa: +44 1440 714 850
Asia Pacific: +852 3160 9800
Latin America: +52 55 5081 1650 © 2011 HID Global Corporation. All rights reserved. HID and the HID logo are trademarks or registered trademarks of HID Global in the U.S.
and/or other countries. All other trademarks, service marks, and product or service names are trademarks or registered trademarks of their
respective owners.
h i dgl o b a l.co m 20110606-proxpointplus-ds-en
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE

Represented by:

Europe, Middle East, Africa: Germany: North America: Asia-Pacific:


Bosch Security Systems B.V. Bosch Sicherheitssysteme GmbH Bosch Security Systems, Inc. Robert Bosch (SEA) Pte Ltd, Security Systems
P.O. Box 80002 Robert-Bosch-Ring 5 130 Perinton Parkway 11 Bishan Street 21
5600 JB Eindhoven, The Netherlands 85630 Grasbrunn Fairport, New York, 14450, USA Singapore 573943
Phone: + 31 40 2577 284 Germany Phone: +1 800 289 0096 Phone: +65 6571 2808
emea.securitysystems@bosch.com www.boschsecurity.com Fax: +1 585 223 9180 Fax: +65 6571 2699
emea.boschsecurity.com onlinehelp@us.bosch.com apr.securitysystems@bosch.com
www.boschsecurity.us www.boschsecurity.asia

© Bosch Security Systems 2016 | Data subject to change without notice


2634162571 | en, V7, 03. Nov 2016
SECURITY AND INFRASTRUCTURE

6/09
SECURITY AND INFRASTRUCTURE

6/09
SECURITY AND INFRASTRUCTURE

6/09
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
SECURITY AND INFRASTRUCTURE
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
language responding to the question will not be considered.

No response provided by applicant


Operations Plan(Dispensing of Product)

D-5.1 By selecting "Yes", the Applicant attests that it is prepared and willing to join the American
Society for Automation in Pharmacy (ASAP) annually in order to facilitate near-real-time reporting to
the Ohio Automated Rx Reporting System (OARRS). American Society for Automation in Pharmacy;
OAC 3796:6-3-08; OAC 3796:6-3-10

YES

D-5.2 By selecting "Yes", the Applicant attests that it will use the patient registry to verify the
registration of a patient or caregiver. OAC 3796:6-3-08

YES

D-5.3 Please indicate the expected number of Patient Registry scanners needed for the Applicant's
facility (Information Only).

D-5.4 By selecting "Yes", the Applicant attests that it will have at least two employees physically
present at the dispensary location, one of whom is a dispensary key employee, when the dispensary is
open for the sale of medical marijuana. OAC 3796:6-3-03

YES

D-5.5 Please describe the Applicant's processes, procedures, and controls regarding the dispensing of
medical marijuana, updating the patient record, and product labeling. Describe how these will be
supported by the Applicant's internal inventory system including integration with the state inventory
tracking system and for reporting to OARRS using the current ASAP format. Please attach a sample
product label, with any identifiable information redacted or anonymized. OAC 3796:6-3-08; OAC
3796:6-3-09; OAC 3796:6-3-10

Control and supervision of medical marijuana products in the dispensary’s custody will be overseen by
the Dispensary Manager (DM) who will be the designated representative and hold a dispensary key
employee (DKE) license. The DM will strictly follow standard operating procedures to implement
adequate safeguards to ensure medical marijuana is dispensed in accordance with ORC Chapter 3796
and OAC Division 3796 and will have oversight of staff training in all policies and procedures. The DM
will have primary control of the dispensary’s internal inventory control system (ICS) used to track each
product from receipt to sale and record each dispensing transaction.

NCR Counterpoint (Counterpoint) will be the ICS because of its extensive and expandable data
collection capabilities for each product or transaction and will be customized to meet the requirements
of OAC Division 3796, including preset forms requiring the input of all information required under OAC
§ 3796:6-3-10(A). Counterpoint will integrate with Metrc, so that a record of each sale, purchase, or
return of medical marijuana is transmitted electronically in real time to the Department of Commerce. It
will also function as the point-of-sale (POS) and patient records systems, for which it will generate
American Society for Automation in Pharmacy (ASAP) files to submit dispensing information to the
Prescription Monitoring Program Clearinghouse so that it is available in OARRS. All required
information will be input to Counterpoint in ASAP format during a dispensing transaction and staff will
electronically submit the dispensing record to OARRS within 5 minutes of completing the transaction. If
the dispensary has no dispensing information over any 24-hour period, such as during a holiday
closure, a zero report will be submitted within 36 hours of the previous dispensing report, consecutive
and inclusive from the date and time of the previous report.

The dispensary will dispense medical marijuana only to qualified patients aged 18 and older and
designated caregivers. In order to be permitted into the access-controlled dispensary department (DD),
patients and caregivers must first check in with a Patient Consultant (PC) at the reception desk and
present their government-issued photo ID and current, valid registry ID card, or similar patient ID card
issued by a state with which Ohio has a reciprocal agreement. Photo IDs will be verified by a 3M
CR5400 Driver License Authenticator. A separate scanner provided or approved by the Board will be
used to verify patient and caregiver registry cards and retrieve patient registry data. The names on the
patient’s or caregiver’s registry card and photo ID must match exactly and the ID number on the photo
ID must be identical to the ID number included in the patient’s or caregiver’s registry record. If the
names or numbers do not match, the patient or caregiver will not be allowed to proceed into the DD.
The PC will review the patient registry to verify that the patient has not purchased more than a 90-day
supply of medical marijuana in the last 90 days or the caregiver has not purchased more than a 90-day
supply of medical marijuana for a single patient in the last 90 days. A patient or caregiver who has
reached the limit will not be permitted to proceed into the DD that day. Finally, the PC will confirm that
the patient’s recommendation is complete and contains all information required under OAC § 3796:6-3-
08(H)(3). The company will provide quarterly ID verification training for all staff who validate photo and
registry IDs.

After all verifications have been made, a patient who knows what s/he wants to purchase will be
permitted into the DD and proceed directly to the cashier station to complete the purchase. Patients
requiring more support through the selection process will be placed into a queue in Counterpoint and
remain in the waiting area until capacity opens in the DD to maintain a patient party-to-PC ratio of no
more than 3-1. An open-sell model will be used in the DD, allowing patients to peruse products on
display at their own pace and utilize an interactive touchscreen to access education modules, take a
product tour, or take a quiz to access their needs and receive tailored recommendations. PCs will roam
throughout the DD, assisting patients with selecting products and placing orders on mobile POS
devices running Counterpoint. PCs will be able to inform patients on the entirety of the dispensary’s
inventory, as well as advise and educate on individual patients’ needs.

Any portion of a patient’s 90-day supply of medical marijuana may be dispensed at any time, so long
as a patient does not receive more than a 90-day supply in a 90-day period and caregivers do not
receive more than the aggregate amount of medical marijuana authorized for each of their patients.
Each patient will have a unique record in Counterpoint that includes the amount of medical marijuana
the patient has purchased in any 90-day period. If a patient attempts to make a purchase that will
cause them to exceed the limit for any 90-day period, Counterpoint will prohibit the sale until the order
is below the limit. PCs will exercise judgment in taking orders if they suspect that dispensing to a
patient or caregiver may have negative health or safety consequences for the patient or for the public,
or when the patient exhibits signs of potential abuse or diversion. If staff refuses to dispense medical
marijuana for such reasons, the incident will be reported to the Board of Pharmacy (Board) within 24
hours.

When taking orders, PCs will update the patient record in Counterpoint to capture all information
required under OAC § 3796:6-3-08(H)(4) about the dispensary and the patient’s purchase. Information
contained in Counterpoint can be printed onto labels to be affixed to products. A patient-specific label
will be applied when a product is dispensed, containing all information required under OAC § 3796:6-3-
09(A)-(B). Labeling requirements may be partially satisfied if required information is included on the
cultivator or processor’s label, in which case the dispensary will include on its affixed label any required
information provided by the cultivator or processor that will be obscured, in whole or in part, by the
affixed label. The attached labels (see: D-5.5_Sample Labels.pdf) include all required information and
are demonstrative of labels that will be affixed to dispensed products if the cultivator or processor’s
label is wholly obscured. If it is impractical to place a patient-specific label directly onto any product,
due to its size, for example, the product will be placed in a legally-compliant, properly labeled
container.

After a patient has placed an order with a PC, the order will be retrieved from the vault by a Fulfillment
Associate, affixed with labels, placed into a basket marked with the patient’s name and order number,
then moved to the cashier station, where the order will be verified by the cashier and confirmed by the
patient. Before handing over dispensed items, the cashier will add necessary informational inserts to
the order. At minimum, a two-sided, branded brochure will be included containing all warnings required
under OAC § 3796:6-3-09(C) regarding pesticides. The brochure will also contain the following printed
statement per OAC § 3796:6-3-09(D): “If you have a concern that an error may have occurred in the
dispensing of your medical marijuana, you may contact the State of Ohio Board of Pharmacy, using the
contact information found at medicalmarijuana.ohio.gov.” All messages on the brochure will be in a
size and font that is easily legible by patients. The cashier will put all products and informational inserts
into an unmarked, opaque, child-resistant exit bag, collect payment, and hand over the exit bag. The
dispensing record will immediately be submitted to OARRS as described above.

D-5.5.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures
described in D-5.5. The images or diagrams may contain a brief descriptive caption. Additional
language responding to the question will not be considered.

Uploaded Document Name: D-5.5_Sample Labels.pdf


NOTE: This applicant uploaded document is the next 4 page(s) of this document.
Sample Label for Medical Marijuana Plant Material Received from a Licensed Cultivator Holding
a Plant-Only Processor Designation and Dispensed to a Registered Patient

ABC Cultivation Company | License #AA11111


Product Identifier #BB22222
Harvest Date: 8/15/2018

XYZ Dispensary | License #DD44444


123 CDEFG Street, Any Town, OH 11111
Date Dispensed: 9/8/2018 | Qty 1 | Net Wgt 20g
Patient Name: Jane Doe | Patient Reg #CC33333
Caregiver: None
12.3% THCA | 0.4% THC | 0.2% CBDA | 0.0% CBD | 0.0% CBN
0.3% Myrcene | 0.0% Pinene | 1.2% Limonene | 0.2% Caryophyllene

Warnings:
• This product may cause impairment and may be habit-forming.
• This product may be unlawful outside of the State of Ohio.
Sample Label for Medical Marijuana Plant Material Received from a Licensed Cultivator Holding
a Plant-Only Processor Designation and Dispensed to a Designated Caregiver on Behalf of a
Registered Patient

ABC Cultivation Company | License #AA11111


Product Identifier #BB22222
Harvest Date: 8/15/2018

XYZ Dispensary | License #DD44444


123 CDEFG Street, Any Town, OH 11111
Date Dispensed: 9/8/2018 | Qty 1 | Net Wgt 20g
Patient Name: Jane Doe | Patient Reg #CC33333
Caregiver: John Doe
12.3% THCA | 0.4% THC | 0.2% CBDA | 0.0% CBD | 0.0% CBN
0.3% Myrcene | 0.0% Pinene | 1.2% Limonene | 0.2% Caryophyllene

Warnings:
• This product may cause impairment and may be habit-forming.
• This product may be unlawful outside of the State of Ohio.
Sample Label for Medical Marijuana Product Received from a Licensed Processor and Dispensed
to a Registered Patient

ABC Cultivation Company | License #AA11111


Product Identifier #BB22222
Harvest Date: 8/15/2018

DEF Processor Company | License #EE55555


Date Processed: 9/10/2018
No Known Major Allergens
Ingredients: Cannabis extracted oil, Alcohol, Cellulose, Starch,
Hydroxypropyl cellulose, Sodium starch glycolate, Colloidal silicon
dioxide, Magnesium stearate
Solvent/s: CO2

XYZ Dispensary | License #DD44444


123 CDEFG Street, Any Town, OH 11111
Date Dispensed: 9/25/2018 | Qty 30 | Net Weight 9g
Patient Name: Jane Doe | Patient Reg #CC33333
Caregiver: None
Total: 0mg THCA | 300mg THC | 0mg CBDA | 300mg CBD | 0mg CBN
Per Dose: 0mg THCA | 10mg THC | 0mg CBDA | 10mg CBD | 0mg CBN

0mg THCA | 10mg THC | 0mg CBDA | 10mg CBD | 0mg CBN
0mg Myrcene | 0mg Pinene | 0mg Limonene | 0mg Caryophyllene

Warnings
• This product may cause impairment and may be habit-forming.
• This product may be unlawful outside of the State of Ohio.
• Caution: When eaten or swallowed, the effects and impairment
caused by this drug may be delayed.
Sample Label for Medical Marijuana Product Received from a Licensed Processor and Dispensed
to a Designated Caregiver on Behalf of a Registered Patient

ABC Cultivation Company | License #AA11111


Product Identifier #BB22222
Harvest Date: 8/15/2018

DEF Processor Company | License #EE55555


Date Processed: 9/10/2018
No Known Major Allergens
Ingredients: Cannabis extracted oil, Alcohol, Cellulose, Starch,
Hydroxypropyl cellulose, Sodium starch glycolate, Colloidal silicon
dioxide, Magnesium stearate
Solvent/s: CO2

XYZ Dispensary | License #DD44444


123 CDEFG Street, Any Town, OH 11111
Date Dispensed: 9/25/2018 | Qty 30 | Net Weight 9g
Patient Name: Jane Doe | Patient Reg #CC33333
Caregiver: John Doe
Total: 0mg THCA | 300mg THC | 0mg CBDA | 300mg CBD | 0mg CBN
Per Dose: 0mg THCA | 10mg THC | 0mg CBDA | 10mg CBD | 0mg CBN

Warnings
• This product may cause impairment and may be habit-forming.
• This product may be unlawful outside of the State of Ohio.
• Caution: When eaten or swallowed, the effects and impairment
caused by this drug may be delayed.
SECURITY AND INFRASTRUCTURE

The Company recognizes the significant responsibility licensed medical marijuana entities have to
safeguard any medical marijuana dispensed in Ohio from being diverted to non-patients or illicit
markets. Specifically, the Company seeks to serve the needs of its patients while protecting the
community by providing safe medical marijuana products in a tightly secured environment. The
Company’s core values of “service, safety, and security” provide guidance for its policies and
procedures that fulfill that responsibility. Motivated by these values, and with approval from the Board
of Pharmacy (Board), the dispensary will allow patients and caregivers to return unused medical
marijuana for it to be destroyed and disposed of in compliance with OAC § 3796:6-3-14 to help ensure
medical marijuana does not find its way into the hands of non-patients due to improper disposal. The
dispensary will not charge for disposal services and product may be returned in any quantity of unused
medical marijuana at any time after purchase, but refunds will not be issued for unused quantities.

When products are dispensed, a two-sided, branded brochure will be included with the purchase
providing information about returning products to the dispensary. The brochure will advise that patients
and caregivers must return a product in person. The dispensary is prohibited by law from transporting
medical marijuana at any time or for any purpose. When returning a product for destruction and
disposal, the patient or caregiver will be required to fill out a tracking form stating their name, date of
return, the product being returned, including quantity, and the reason for returning the product.

There may be instances when a patient or caregiver returns a product for reasons other than for
destruction and disposal, such as when the product becomes the origin of an adverse event, if the
patient has mold or shows another sign that the medical marijuana does not meet quality expectations,
or when the product is the subject of a recall. Since all products will be tested and packaged by the
originating facility, it is not anticipated that the dispensary will have cause to initiate a recall. Recalls will
be initiated by the originating cultivator or processor, though the dispensary may take patient
complaints that lead to the product’s recall by the cultivator or processor. The protocols the dispensary
will follow during recall events are described in Question D-6.8.

To return products for reasons other than disposal or collection during a recall, patients and caregivers
must file a complaint on the tracking form described above, which will be assigned an internal
complaint number and barcode that denotes the complaint designation through NCR Counterpoint, the
dispensary’s inventory control, point-of-sale (POS), and patient records system. A manager will work
with the patient or caregiver, the patient’s record in Counterpoint, and the patient registry to obtain as
much information about the complaint as possible, ensuring that all applicable laws and regulations
regarding patient confidentiality are complied with. The patient or caregiver submitting the complaint
will be given this number for their reference; the number may then be used to follow up on the status of
the complaint. The complaint number must also be entered into the patient record, along with a
scanned copy of the tracking form on which the complaint was made.

Within the first 24 hours of a complaint being made, the Dispensary Manager (DM) will review its
contents and determine what action should be taken; this plan will be known as the Action Plan. The
DM will enter any action taken regarding the complaint into the Action Plan and file it in the patient
complaint record contained in Counterpoint and tied to the original patient transaction. The DM will
determine if the complaint is substantive or describes a serious adverse event. If the DM determines
that the complaint warrants action, the dispensary will follow the adverse event protocols described in
Question E-2.2, including reporting the adverse event to the Board, the licensed cultivator or processor
from which the product originated, and the recommending physician caring for the patient.

All returned products will be tracked simultaneously through Counterpoint, as well as Metrc, the state
inventory tracking system (ITS) (OAC § 3796:6-3-08(E)). Because of their conjoining application
programming interface, all actions taken in Counterpoint will be transmitted electronically in real time to
the Department of Commerce (Department), allowing the dispensary to maintain inventory accuracy,
traceability, the ability to track the source of the product (i.e., the specific cultivator or processor), and
the ability to report on the quantity and frequency of returns. Once the tracking form has been
completed by the patient or caregiver, staff will add the returned product into the electronic inventory in
Counterpoint with the appropriate reason code (returned for disposal; recalled; patient complaint; other,
with a customizable field). Returned products will be assigned a Counterpoint barcode ID that is a
specific sequenced serial number used for tracking the product’s location. The barcode will be printed
on labels that are affixed to the returned product and the tracking form. The tracking form will be
scanned and saved electronically in the encrypted file system described in Question D-4.4. Tracking
forms related to products returned for any reason will be scanned and stored in the encrypted file
system and the originals will be filed by reason code in the vault filing cabinet. The electronic version of
tracking forms will be retained for a minimum of three years. Counterpoint will not allow returned
products to be checked back in the dispensary’s inventory as saleable product, thus preventing the
resale of returned product. By tracking returns in this manner, the dispensary can track the source of a
return and any persistent issues with specific cultivators or processors.

Returned products will be secured in the vault in an area designated for returned products,
sequestered from saleable medical marijuana, and separated by type (e.g., awaiting disposal,
damaged, recalled). Returned products, except those returned as part of a recall, will be disposed of
on a weekly basis in accordance with the dispensary’s waste disposal policy and in compliance with
OAC § 3796:6-3-14. The maximum amount of time that any individual non-recalled returned product
will be retained at the facility will be one week. Prior to destruction of product, the paper tracking forms
for non-recalled returned products will be verified against the physical returned product on-hand to
ensure all product is present for destruction. If there is any discrepancy in the physical inventory versus
the tracking forms, the DM will be notified and commence an investigation to locate the missing
product(s), as described in Question D-7.1. Recalled products will be collected and disposed of or
returned to the originating cultivator or processor by the protocols described in Question D-6.8.

All destruction and disposal activities will be performed in full view of the dispensary’s surveillance
system and performed by a dispensary key employee license holder. After destruction, the destroyed
products will be decremented from the dispensary’s electronic inventory in Counterpoint. Once
disposal is complete, the paper tracking forms will be shredded, as PDF versions will have been saved
previously to the electronic filing system. Surveillance footage of the destruction will be exported from
the dispensary’s surveillance system and archived with the PDF version of the tracking forms saved to
the dispensary’s electronic filing system.

D-6.9.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures
described in D-6.9. The images or diagrams may contain a brief descriptive caption. Additional
language responding to the question will not be considered.

No response provided by applicant


Operations Plan(Sanitation and Safety)

D-8.1 Please provide a summary of the intended sanitation and safety measures to be implemented at
the dispensary. These measures should include, but are not limited to, plans, procedures, and controls
to address the following:
1. Processes for contamination prevention
2. Pest protection procedures
3. Instruction to dispensary employees regarding the handling of medical marijuana
4. Hand-washing facilities
Please reference OAC 3796:6-3-02 for more information.

SECURITY AND INFRASTRUCTURE

The dispensary’s sanitation and safety protocols were developed based on best practices published in
the American Herbal Products Association (AHPA) Cannabis Committee’s guidelines, “Good Herbal
Compounding and Dispensing Practices.” AHPA is the national trade association and voice of the
herbal products industry, comprised of more than 350 domestic and foreign companies conducting
business as cultivators, processors, manufacturers, and marketers of herbs and botanical and herbal
products. AHPA actively engages with the federal agencies and offices that regulate herbal and
botanical products and is also an active participant in national and international scientific meetings on
herbal research, enabling the organization to provide informed guidance on the establishment of
natural product standards, including to the medical marijuana industry. Given AHPA’s reach to experts
in the medical marijuana industry, it is considered to be the authority on best practices for medical
marijuana dispensaries.

Control and supervision of medical marijuana products in the dispensary’s custody, including enforcing
sanitation and safety protocols to protect from contamination, will be overseen by the Dispensary
Manager (DM), who will be the facility’s designated representative and hold a dispensary key
employee (DKE) license. The DM will be supported in the supervision of staff in executing sanitation
and safety protocols by the Inventory Manager and Assistant Managers, who will each hold a DKE
license and report to the DM.

The vault will have adequate space for the orderly placement of all products, including saleable
products organized by vendor and separate, secure areas for recalled products and medical marijuana
awaiting destruction and disposal because it is expired, damaged, deteriorated, misbranded, or
adulterated. Surfaces on which product is handled by staff, such as the product check-in counter in the
receiving area and order fulfillment counters in the restricted-access staff area will be Dupont Zodiaq
food-preparation-grade quartz countertop, which is non-toxic, non-porous, and does not support
microbial growth or react adversely to chemical compounds used for cleaning and sanitation.

The DM will enforce the daily cleaning and sanitization schedule to ensure the facility and all
equipment used for the storage or sale of medical marijuana is maintained in a clean and sanitary
condition, free from infestation by insects, rodents, birds, or pests. Staff will be assigned daily cleaning
tasks that include sweeping, vacuuming, and mopping floors; cleaning glass; and sanitizing restrooms,
surfaces, and equipment. Areas storing medical marijuana will be sanitized at least once per day and
every time a product is restocked. Staff will be trained in proper handling and storage of cleaning and
sanitizing agents, which will be stored in a Department of Health and OSHA-compliant manner inside
the Janitor’s Closet. Liquid cleaning products will be stored below any paper goods to prevent soiling
paper products should a bottle leak. Material Safety Data Sheets for any toxic or hazardous chemicals
will be retained in a binder in the Janitor’s Closet. Trash bins located throughout the dispensary for the
collection of non-marijuana waste will be emptied at least once a day and the contents removed to the
dumpster outside, which will be serviced at least once a week by the local waste management
company.

A commercial pest management company (PMC) licensed by the Ohio Department of Agriculture and
a member in good standing of the Ohio Pest Management Association will be contracted to service the
dispensary on a quarterly basis. The PMC will inspect the interior and exterior of the facility and
surrounding property and apply appropriate preventive or remediation controls, including chemical
means or pest control devices, to prevent or terminate the infiltration of rodents, insects, or other pests.
Pest control services will only be performed during times when the dispensary is not open for business
and under the supervision of the DM or another manager. Pesticides or other chemical controls will not
be applied that could linger and contaminate or adversely affect products or staff. For safety, staff will
be prohibited from personally applying pest management controls; instead, the PMC will be on-call at
the first sign of any infestation.

Measures written into the facility’s plans, policies, and procedures covering hygiene and sanitation will
be taken to ensure persons who might be a source of microbial contamination due to a health condition
are excluded from any function involving contact with medical marijuana products, surfaces or
equipment with which medical marijuana products may come into contact, or with patients and
caregivers. Staff onboarding will include training on the dispensary’s communicable disease prevention
policy, which is enforced to prevent contamination throughout the facility. The policy dictates that staff
who have symptoms of an illness, infection, open lesion, or any other abnormal source of microbial
contamination must report them to management and may be prohibited, depending on the symptoms
and their severity, from being at the facility until the health condition no longer exists.

Personal hygiene training, included as part of safe handling training in the federal, state, and labor
standards training module (see: Question E-1.1), will instruct staff on proper hand-washing methods
and personal cleanliness to prevent the spread of germs and bacteria. Staff will be instructed to wash
hands before starting work, after using the restroom, and any other time when hands may have
become soiled or contaminated. Staff will wear nitrile gloves when checking in received products or
retrieving products from the vault to fill patient orders. Gloves will be changed anytime staff takes a
break or uses the restroom. Since all products are packaged by the originating facility, there is low risk
of contamination during these processes, but gloves are worn as an added precaution. Staff will store
personal belongings, including bags, purses, and cell phones, in designated lockers in the staff break
room, away from any surfaces with which medical marijuana may come into contact. Food and
beverages will not be allowed outside the break room and smoking or vaporizing any substance is
prohibited inside the facility.

The dispensary will be equipped with adequate, readily-accessible restrooms and hand-washing
facilities for staff and guests. Male and female restrooms will be located adjacent to the reception and
waiting area for patient and caregiver use. A single-stall staff restroom will be located in the restricted-
access staff area. The staff area will also include a break room equipped with sink, refrigerator, staff
lockers, and dishwasher, all cleaned and sanitized as part of regular cleaning protocols. Restrooms will
be maintained in a sanitary condition and in good repair and will be properly supplied with toilet paper,
hand soap, running water at a temperature suitable for sanitizing hands, and Dyson Airblade dB
electric hand dryers. The staff break room will likewise have potable, running water at a suitable
temperature for sanitizing hands and will be supplied with single-use paper towels. Hand sanitizers will
be available throughout the dispensary but will not substitute hand-washing and will not be used as the
sole method of hand cleaning. Signage in the staff restroom and break room will advise staff of the
necessity of washing hands prior to returning to work. Signage in the guest restroom will instruct
guests to alert staff if the restroom needs servicing, including restocking supplies or cleaning and
sanitizing fixtures or surfaces. If a staff member observes that a restroom or the break room is soiled or
unkempt, he or she will be expected to clean or tidy it, even if the task has not been assigned as part of
his or her daily work.
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 dispensary will offer a discount of 10% on all medical marijuana products and devices for all
qualified patients and designated caregivers of patients who have been approved by the Board of
Pharmacy as either indigent or veteran during the registration process. No paper coupons will be
provided (OAC § 3796:6-3-22(F)). The veteran and indigent status of a patient will be entered into the
dispensary’s electronic inventory control system (ICS) at their first visit. The ICS will automatically
apply the 10% discount anytime veteran or indigent patients or their caregivers make a purchase. The
dispensary’s discount policy will be published on the Company’s website, in the patient welcome
packet, and in a conspicuous place in the dispensary. The Company believes that serving these
populations goes beyond providing discounted products to increasing their awareness that medical
marijuana is available, how it may be safely consumed as a medicine, and how to obtain a patient ID
card.

To increase the participation of veterans in Ohio’s medical marijuana control program (MMCP), the
Company will partner with a local veterans’ service organization to give instructional talks to veterans
about:
-How to obtain a patient ID card
-Developments in Department of Veterans Affairs (VA) policies that allow veterans to participate in
state-approved medical marijuana programs without risking VA benefits
-Advocacy efforts to allow VA doctors to recommend medical marijuana
-A summary of what qualifying medical conditions and medical marijuana products are approved under
ORC § 3796

Veteran informational sessions will be focused on answering attendees’ questions about the state’s
MMCP and federal policy, rather than advertising the dispensary’s products, and will be led by the
Company’s Community Outreach Director. The information presented will also be provided on the
Company’s website and in an informational pamphlet in the dispensary waiting room, subject to the
restrictions of OAC §§ 3796:6-3-24(C) and 3796:6-3-24(G)(3). These publications will be updated as
needed to reflect changes in federal policy and medical marijuana research.

The dispensary’s regular community education sessions will also benefit veterans and their loved ones,
particularly when the rotating topic of focus is post-traumatic stress disorder (PTSD). The VA estimates
that 12-30% of veterans experience PTSD at some point in their lives, compared with 7-8% of civilians.
Although federal barriers to research and reliable marijuana products make clinical studies on the
therapeutic benefits of marijuana in treating PTSD difficult, researchers have found that people with
PTSD have lower serum levels of anandamide, the body’s endogenous cannabinoid that triggers the
same brain receptors as THC [endnote 1]. The dispensary’s community education session on PTSD
will outline this and other research on medical marijuana treatment, while also providing information
about how to obtain a physician’s recommendation and register with the Board as a patient or
caregiver.

To encourage the participation of the indigent population in Ohio’s MMCP, the Company has proposed,
in a separate application, to place one of its dispensaries in an area of one of the state’s largest cities
where many of the residents are likely to qualify as indigent, with household incomes below 133% of
the federal poverty level and who qualify for federal assistance programs such as Medicaid and the
Supplemental Nutrition Assistance Program. The presence of the dispensary’s 24-hour surveillance
monitoring, outdoor security lighting, and newly remodeled exterior will bring heightened security to the
area, where more crimes take place than almost any other area in this large city. Multiple studies,
including one released this year funded by the National Institute on Drug Abuse, indicate that medical
marijuana facilities’ duplicative security measures reduce crimes in the neighborhoods where they are
located [endnote 2].

In terms of indigent persons who are homeless or housing insecure, the Company will seek to partner
with a local organization serving these populations. Contributions will depend on the organization’s
advice, ranging from informational sessions about Ohio’s MMCP, donating funds and staff volunteer
time, and sponsoring individuals who suffer from Ohio’s qualifying medical conditions in obtaining a
physician’s recommendation and patient ID card. Without adequate research about the adverse effect
of marijuana on the mental health of people who struggle with mental illness, which includes 20-25% of
the homeless population according to the Substance Abuse and Mental Health Services
Administration, the Company will be careful to provide sponsorship opportunities only to indigent
persons who have adequate caregiver and physician supervision.

Through its partnership with long-time dispensary operators in a state where medical marijuana has
been legal for a number of years, the Company has observed an influx of homeless people struggling
from drug addiction since legalization, many of whom came hoping marijuana would help them reduce
their use of other drugs. This pattern of self-driven harm-reduction among the homeless struggling with
addiction may be an indicator of what emerging research is now showing: marijuana may be an
effective treatment for substance abuse [endnote 3]. Further research on medical marijuana and
substance abuse is still needed, and to that end the Company has established a charitable foundation
(the Foundation) that will donate to research institutions that study Ohio’s 21 qualifying medical
conditions per ORC § 3796.01(A)(6). The Foundation has already received a proposal from a local
nonprofit whose services focus on drug addiction treatment and prevention in Ohio. The nonprofit will
conduct an initial systematic review and critical assessment of existing research on the scientific
relationship between using medical marijuana to treat Ohio’s qualifying medical conditions and
reductions in opioid use and abuse. If awarded a license, this project will be the first funded by the
Foundation.

The Company will also contribute advocacy efforts to reschedule or deschedule marijuana at the
federal level, which would allow veterans and indigent populations to obtain medical marijuana paid for
by their insurance providers. The out-of-pocket expense of medical marijuana is an enormous barrier
for Ohio’s MMCP and for low-income populations, particularly those who are aging and depend on
Medicare and Medicaid benefits to obtain their medications. Until federally-funded and private insurers
cover medical marijuana, only a fraction of those whose lives could be saved or improved will have the
opportunity to benefit from it. The Company will donate regularly to organizations that advocate on
behalf of the medical marijuana industry, including the Drug Policy Alliance, the Marijuana Policy
Project, Americans for Safe Access, and the National Cannabis Industry Association. All marijuana
business owners owe a debt of gratitude to these and other advocates who have been actively
educating lawmakers and the public alike for many years about the benefits of medical marijuana.

Footnote 1: http://www.maps.org/news-letters/v23n3/v23n3_40-42.pdf

Footnote 2: See this summary of studies on dispensaries and crime published by the Marijuana Policy
Project: http://blogs.chicagotribune.com/files/crimedispensaries.pdf

Footnote 3: http://www.cnn.com/2017/05/17/health/addiction-cannabis-harm-reduction/index.html

D-10.3 Describe the Applicant's efforts to minimize the environmental impact of the proposed
dispensary. OAC 3796:6-2-02

The Company will operate an environmentally-conscious dispensary, employing energy-saving and


resource-conservation practices to minimize its carbon footprint, energy usage, environmental impact,
and resource needs. All build-out and construction projects will be designed to promote sustainability,
use renewable energy, and decrease overall resource consumption. Once operational, the Company
will evaluate the benefits of obtaining Leadership in Energy and Environmental Design (LEED), Clean
Green, and Energy Star certifications. The Clean Green Certified program, as applied to medical
marijuana dispensaries, is intended to regulate chemical additives and pesticides, ensure legality, and
reduce environmental devastation. Clean Green certification for dispensing facilities focuses
specifically on inventory tracking and diversion prevention. In order to maintain Clean Green
certification, the dispensary will employ environmentally sensitive and sustainable best practices with
regard to waste disposal, quality assurance, adverse events, recalls, and preventing contamination.
Energy Star-certified buildings and plants operate among the top 25% of similar facilities nationwide,
with no sacrifices in comfort or quality. Energy Star certification requires the dispensary to use energy-
saving equipment and policies in order to meet strict energy performance standards set by the
Environmental Protection Agency (EPA), using an average of 35% less energy than similar facilities.

Striving to meet these standards, the dispensary has been designed with features that reduce
environmental impact. Restrooms will be equipped with high-efficiency low-flow toilets that use only 0.8
gallons of water per flush and Dyson Airblade dB hand dryers that eliminate paper towel use and
produce up to 79% less CO2 than other electric hand dryers. The HVAC system will be a high-
efficiency model, as required under the LEED certification. Energy efficient appliances will also be
selected for the staff break room, including a refrigerator and dishwasher. Lighting throughout the
facility will consist of energy-efficient and long-lasting LED lights. Lights that are not in use will be
dimmed or switched off through motion-activated light switches, unless security measures require
otherwise. Cleaning supplies used throughout the facility will be EPA-certified environmentally-friendly
products.

A culture of environmental stewardship will also be fostered at the dispensary. Staff will be encouraged
to employ daily practices that reduce their individual environmental impact and to look for opportunities
to reduce, reuse, or recycle any consumable used in dispensing operations. Management will plan
periodic green service initiatives to be attended by staff, such as community cleanup and gardening
programs. Staff will also be encouraged to carpool or use public transportation to travel to and from
work. To facilitate the use of public transportation, staff who request it will be provided a monthly bus
pass, at no cost to the staff member. This enhances staff members’ quality of life by reducing their
commute costs and eliminating the stress of driving. It also serves the broader community by reducing
carbon emissions and overall traffic in the area. Staff will be encouraged to use reusable water bottles
instead of pre-bottled water. An Elkay Enhanced EZH2O Bottle Filling Station & Single ADA Cooler
water fountain will be installed in the reception and waiting area, available to staff and guests for filling
water bottles with filtered water. The Company will stock the break room with reusable, washable
utensils and dishware, instead of disposable options to further reduce consumption and waste.

Dispensary operations have been designed to promote the use of electronic files over paper files and
staff will be advised to forgo printing whenever possible. When files must be printed, recycled paper
and, if permissible for the document’s purpose, double-sided printing will be used. When paper files are
eligible for disposal, they will be recycled, or shredded and then recycled. Office supplies such as file
folders, labels, and binders will also be made from recycled or eco-friendly materials and will be reused
when practical. Waste will be recycled whenever possible and permissible, including empty medical
marijuana product packaging such as plastic canisters. Exit bags will be reusable and patients will be
encouraged to return them to the dispensary for reuse. Patients will also be encouraged to return
product containers for recycling at the dispensary if they are unable to do so elsewhere. Designated
and clearly-labeled recycling bins will be available throughout the dispensary at a higher ratio than
trash bins to promote recycling over throwing materials away. Staff will be advised about what
materials are eligible for recycling through the local waste management company and whether any
separation of materials is required. The dispensary will attempt to coordinate with licensed cultivation
and processing facilities in reducing waste for product deliveries, including combining shipments into
as few containers as possible and using reusable delivery bins. If deliveries are made in cardboard
boxes, the boxes will be broken down and recycled. By recycling and reusing applicable materials, the
need for new durable materials will be minimized while landfill waste is reduced.

D-10.3.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures
described in D-10.3. The images or diagrams may contain a brief descriptive caption. Additional
language responding to the question will not be considered.

No response provided by applicant


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
Patient Care(Staff Education and Training)

E-1.1 Describe the Applicant's education and training plan and how it will meet the foundational and
ongoing training required for dispensary employees to be authorized to dispense medical marijuana.
Include a summary of the substantive training content, the number of hours each dispensary employee
will receive for each mandatory training requirement, the number of training hours each dispensary
employee will receive for any elective training, and the anticipated source of each type of training
described. OAC 3796:6-3-19

Foundational Training
The Company’s foundational and ongoing staff training includes written policies, plans, and procedures
(PPPs) that have been customized for Ohio’s statutory and regulatory requirements. Training methods
will incorporate a variety of content digestion and skill-based comprehension tests based on outlines,
handouts, interactive presentations, online modules, videos, group discussion, mock scenarios,
shadowing superiors and/or co-workers, and additional applied methods supplemented by external
sources. Prior to or at the time of a training session, each participant will be provided with relevant
course materials in written, electronic, or other format that are of such quality and quantity to indicate
adequate time was devoted to their preparation and that they will be of value to participants, per OAC §
3796:6-3-19(J).

Manager Training
Managers and directors will first be trained on all standard operating procedures (SOPs) before training
other staff, per OAC § 3796:6-3-19(A), including the Human Resources (HR) Manager, Operations
Director (OD), Controller, Community Outreach Director, and Dispensary, Inventory, and Assistant
Managers. These staff members must complete 85 hours of mandatory foundational training, including
the following modules:

10 hours of training in the Company’s PRIDE customer service model, which stands for:
P - Professionally greet guests of the dispensary
R - Respect the patient and their privacy
I - Investigate the patient’s needs
D - Deliver the product that fulfills the patient’s needs
E - Educate the patient

The source of this training module is the Company’s written PRIDE framework used in its dispensaries
in other states.

25 hours training in federal, state, and labor standards, including:


-15 hours on Company employment and human resources policies, including labor law, discrimination
and harassment, Fair Labor Standards Act, and Ohio OSHA
-7 hours on the safe handling of medical marijuana, including common industry hazards, health and
safety standards, personal hygiene, and dispensary best practices, per OAC § 3796:6-3-19(E)(5)
-3 hours on Good Handling Practices based on the FDA and USDA’s recommended guidance on
minimizing microbial food safety hazards

Sources for this module include the Company’s written PPPs compliant with Ohio statutory and
regulatory requirements, supplemented by OSHA General Industry and Retail Safety Training and
HIPAA for healthcare organizations through local or online providers.

31 hours training in patient care procedures, including:


-8 hours on patient interaction, per OAC §§ 3796:6-3-19(C)(8) and 3796:6-3-19(E)(2)
-9 hours on patient privacy, confidentiality, and HIPAA, per OAC § 3796:6-3-19(C)(5)
-4 hours on patient consultation, per OAC § 3796:6-3-19(C)(5), including professionalism, patient
education, dispensary policies, including zero-tolerance regarding diversion, and investigating patient
needs
-6 hours on knowledge about medical marijuana products and accessories, such as medical marijuana
pharmacology and active components, routes of administration, drug interactions and reactions, and
dosing, per OAC §§ 3796:6-3-19(C) and 3796:6-3-19(E)(1)
-4 hours on recognition of symptoms of substance use disorders and acute toxicology, per OAC §§
3796:6-3-19(C)(3)(b) and 3796:6-3-19(E)(3)

Sources for this module include the Company’s written Ohio-compliant PPPs, which may be
supplemented by Patient Focused Certification through Americans for Safe Access and “Interpening”
through the Trichome Institute.

18 hours training in inventory control procedures, including:


-1 hour on the use of the toll-free telephone line established by the Board of Pharmacy (Board), per
ORC § 3796.17
-1 hour on allowed quantities of purchase, per OAC § 3796:8-2-04
-3 hours on relevant drug database training, per OAC § 3796:6-3-19(C)(1)
-3 hours on relevant inventory tracking training, per OAC § 3796:6-3-19(C)(2)
-2 hours on any reciprocity agreements established per ORC § 3796.16
-8 hours on safety and security, per OAC § 3796:6-3-19(C)(9), including instruction regarding
regulatory inspection preparedness and law enforcement interaction, building security, theft and
diversion prevention, awareness training, active shooter, and safety features

Sources for this module will include the Company’s Ohio-compliant PPPs, which may be supplemented
by in-person or online training from NCR Counterpoint, the Company’s inventory tracking system; in-
person training with local law enforcement and third-party security training experts; and the OARRS
user support manual and forthcoming online training system.

5 hours of hands-on training specific to each position’s responsibilities as described in its job
description, based on the experience and knowledge of the OD, who has been managing a medical
marijuana dispensary in another state for 8 years and large and small retail operations for 20 years.

Non-Managerial Training
Non-managerial staff, including Patient Consultants (PCs) and Fulfillment Associates, are required to
complete 63.75 hours of mandatory foundational training that includes all modules listed above, with
the same content, excluding managerial-level loss-prevention training. For non-managerial staff, the
number of hours dedicated to each module is 3/4 the amount listed for managerial staff. PCs will also
participate in twice-monthly patient care meetings led by the Dispensary Manager (DM).

External Training
External training courses will supplement rather than replace internal training. Managers will be
responsible for notifying the HR Manager of the date, time, and location of scheduled training modules.

Quarterly, Ongoing, and Elective Training


Medical marijuana research, findings on relevant PRIDE topics, and additional mandatory training will
be presented to staff quarterly by the OD. Managerial staff will receive 5 hours of quarterly training;
non-managerial staff will receive 2.5 hours. Managers will coordinate with the OD to schedule quarterly
trainings. The DM, who will be the facility’s designated representative, will ensure that staff is aware of
the legal requirement to maintain their status as a licensed dispensary employee. The DM will also
ensure employees receive additional training as needed, including in any other topics specified by the
Board per OAC § 3796:6-3-19(C)(11).

All staff will receive a minimum of 16 hours of continuing education (CE) on topics described in OAC §
3796:6-3-19(E) for each 2-year licensing period. CE hours will not be carried over from one licensing
period to another. Staff licensed within 6 months of a dispensary employee biennial renewal cycle will
be exempt from CE requirements. The DM will be responsible for ensuring that each dispensary key
and support employee receives CE during each biennial licensing period, per OAC § 3796:6-3-19(E).
Ongoing training will include advancements in medical marijuana research, Ohio Medical Marijuana
Control Program compliance updates, and other relevant information. Ongoing training may also
include elective training. Staff who elect additional training may be considered for promotion or
additional compensation.

Recordkeeping
All staff will have a training and probationary period of 90 days. At the end of each training module,
staff will complete an exam to demonstrate understanding of the topics presented. If a staff member
fails, they will repeat the relevant module or do on-the-job training pertaining to the portions answered
incorrectly. If job performance is unsatisfactory after foundational training, staff will be given additional
training and instruction. If performance does not improve within 14 days, the staff member may be
written up for poor job performance. All training will be completed through the company’s HR
Information System (HRIS), which tracks staff training and exam results. The HRIS retains electronic
records of all training and attendance records for at least 3 years, which will be available to the Board
upon request.

E-1.1.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures
described in E-1.1. The images or diagrams may contain a brief descriptive caption. Additional
language responding to the question will not be considered.

No response provided by applicant

E-1.2 Summarize how the Applicant's training plan will identify and incorporate advancements in
medical marijuana research. Include a description of the frequency with which the training plan will be
updated, how new information will be incorporated into the training plan, the method for providing
updated training to dispensary employees, and the frequency with which updated training will be
provided to dispensary employees. OAC 3796:6-3-19

The field of research into the medicinal use of marijuana has historically been limited due to federal
restrictions given marijuana’s classification as a Schedule I drug under the Controlled Substances Act.
However, research is seeing an increase in abundance as, nationally, public support for medical
marijuana increases while support for the War on Drugs dwindles and, globally, medical marijuana
moves into a consumer-based market. States like Pennsylvania and Colorado have created structures
for industry participants to perform research on medical marijuana that will expand the body of
research available. As access to and support for medical marijuana increases, findings and discoveries
both domestically and internationally are being published with increasing frequency.

The Ohio Department of Commerce (Department) is currently in the process of issuing 24 licenses for
medical marijuana cultivation, 12 of which have already been issued to Level II cultivators. Each
cultivator applicant was given the opportunity to submit a research plan with its application detailing a
proposal to conduct or facilitate a scientific study or studies related to the medicinal use of marijuana.
Further, applicants seeking one of 40 processor licenses through the Department are likewise being
given the opportunity to submit a research proposal in applications due this December. The Company
anticipates that the majority, if not all, of the cultivation and processor applicants awarded licenses will
have submitted a research proposal, which, once underway, will provide the Medical Marijuana Control
Program (MMCP) with approximately 64 studies on the medicinal use of marijuana. It is the Company’s
hope that all licensees under the MMCP will have access to the results of those studies, to incorporate
any advancements or developments into their training curricula.

To demonstrate the Company’s commitment to the State of Ohio and the success of the MMCP, it has
established a charitable foundation (the Foundation) to be funded by the Company’s profits whose
mission will be to enable 3rd-party, independent research of the Company and other licensed
cultivation, production, and dispensary businesses, as well as the use of medical marijuana throughout
the state. The Foundation will foster targeted and strategic giving and grants, focusing on organizations
whose efforts and goals are directly correlated to the medicinal use of marijuana or whose work will
directly evaluate, monitor, and reflect upon industry standards and impacts. Of particular interest to the
Foundation will be research institutions that study the 21 medical conditions that the MMCP recognizes
as effectively treated with medical marijuana. The Foundation has already received a proposal from a
local nonprofit whose services focus on drug addiction treatment and prevention in Ohio. The nonprofit
will conduct an initial systematic review and critical assessment of existing research on the scientific
relationship between using medical marijuana to treat Ohio’s qualifying medical conditions and
reductions in opioid use and abuse. If the Company is awarded a license, this project will be the first
funded by the Foundation. Any findings that may advance staff’s knowledge of medical marijuana as it
applies to Ohio’s qualifying conditions will be incorporated into the dispensary’s curriculum.

The Company’s owners and operators are already operating or developing multiple licensed medical
marijuana entities in 4 other states. The company will leverage its owners’ and operators’ presence in
these states to monitor research undertaken by licensees as part of the states’ medical marijuana
programs. Any relevant advancements or developments will be reported for implementation into the
Company’s curriculum.

The Dispensary Manager (DM), who will be the facility’s designated representative, will be required to
attend a minimum of 2 medical marijuana research conferences yearly. Conferences will be nationally
or internationally recognized by official organizations, such as the Department of Defense, National
Institutes of Health, or National Institute on Drug Abuse. Other staff may attend medical marijuana
conferences at their own expense. Sponsorship of staff to attend a conference may be available under
certain circumstances, at the discretion of management, if the staff member provides a compelling
argument as to how their attendance of the conference will enhance the Company’s training
curriculum.

The Company will hire dispensary staff who believe in the capacity of medical marijuana to provide
innovative treatment options for patients afflicted with Ohio’s qualifying conditions and who are
passionate about providing such treatment to Ohio’s qualifying patients. Staff will be encouraged to
read published medical marijuana research and report any noted advancements to management so an
analysis can be done to determine if training on the topic should be added to the curriculum or if an
update should be made to existing training materials on the topic. Staff will be further encouraged to
look for and report to management existing training courses relating to new advancements in medical
marijuana research. Such courses may be determined by management to be appropriate for all staff to
take and be incorporated into the training curriculum, or they may be determined to be an acceptable
elective training course.

Through the methods described above, and other sources of information the Company may discover
once operational, advancements in medical marijuana research will be identified and the findings
collected throughout the year. Once per quarter, the Operations Director, Chief Compliance Officer,
Human Resources (HR) Manager, and DM (the review team) will review the findings gathered in the
previous 3 months and evaluate whether they should be incorporated into the Company’s training
curriculum and, if so, in what format. Some findings may be determined to need further development
before they will add value to the Company’s training. Such findings will be assigned to a member of the
review team for monitoring. If that member observes that further developments are made, the research
will be added back into the collected findings for additional consideration during the next quarterly
review period.

The review team will modify the existing training curriculum (see Question E-3.1) to incorporate
advancements in research under the applicable subject matter. For example, findings from research
relating to medical marijuana products and accessories or drug interactions and reactions will be
incorporated into the 31 hours of foundational training in patient care procedures. Modification to the
curriculum includes developing or procuring any relevant materials to accompany or act as the training
module. The modified curriculum will be used to train all staff whose hire date and training occur after
the changes are implemented. To ensure existing staff receive the same training as new staff, the
review team will develop a separate training module specifically intended to provide training in the new
material.

The format of training incorporating advancements in medical marijuana research will depend on the
material being presented. Training formats include but are not limited to:
-In-person presentations at the dispensary provided by management or guest speakers who are
subject-matter experts
-Off-site courses or seminars
-Reading materials provided to staff
-Webinars
-Company culture of continuous learning and improvement

In addition, staff who have attended elective training or a conference will be asked to relay the
information to the rest of staff via notes taken during the training or conference and to provide a
summary of the material during the next bi-weekly staff meeting. Depending on the subject matter and
depth of information, the staff member may be further asked to assist the review team with
incorporating elective training or conference material into the Company’s training curriculum.

At least 60 days prior to implementing any new training curricula, the HR Manager will seek approval of
the training module from the Board of Pharmacy (Board) by submitting a proposal that includes all
information required under OAC § 3796:6-3-19(F). If the updated curriculum includes training to be
provided by a pharmacist, clinical nurse specialist, certified nurse practitioner, physician, or physician
assistant, the proposal will include all information required under OAC § 3796:6-3-19(G).

The Company intends to facilitate training for existing staff in medical marijuana advancements once
per quarter by following the procedure described above. Training times and scheduling may vary
depending on staff scheduling, but all staff must complete the training module within a timeline set by
the DM. Prior to or at the time of a training session, each participant will be provided with relevant
course materials in written, electronic, or other format that are of such quality and quantity to indicate
adequate time was devoted to their preparation and that they will be of value to participants, per OAC §
3796:6-3-19(J). The DM will be responsible for notifying the HR Manager of the date, time, and location
of a scheduled training module and when each staff member has completed it. If a training module
developed for existing staff includes subject matter that qualifies for continuing education credits under
OAC § 3796:6-3-19(E), the HR Manager will submit a request for continuing education credit approval,
by whatever method is preferred by the Board, following each staff member’s completion of the
module. In the event that, during a quarterly review of collected research, the review team does not
determine that any findings should be incorporated into the Company’s training curriculum at that time,
no modifications will be made and no additional training will be provided that quarter.

E-1.2.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures
described in E-1.2. The images or diagrams may contain a brief descriptive caption. Additional
language responding to the question will not be considered.

No response provided by applicant


Patient Care(Patient Care and Education)

E-2.1 Describe how dispensary employees will be trained to provide patient education regarding:
1. Recognizing the signs of abuse or adverse events in the medical use of marijuana
2. Instruction on use of medical marijuana to treat a qualifying condition
3. Risks associated with medical marijuana, including possible drug interactions
4. Guidelines for support to patients related to the patient's symptoms
5. Guidelines for refusing to provide medical marijuana to an individual who appears to be
impaired or abusing medical marijuana. Include the sources of the training and the sources'
qualifications to provide such training.
Please reference OAC 3796:6-3-19 for more information.

The dispensary is committed to providing best-in-class staff training to provide patient education
regarding medical marijuana use. Sources for these training modules include the Company’s written
policies, plans, and procedures (PPPs), including the policy regarding patient and caregiver education
and support, per OAC § 3796:6-3-15(A). The PPPs were developed based on the operators’
operations and the investment team’s experience developing and operating medical marijuana facilities
in four states, in addition to extensive healthcare facility and long-term acute care and inpatient
rehabilitation hospitals, as well as occupational health and physical therapy clinics throughout the
United States. In some occasions, training will be supplemented by information from organizations like
Americans for Safe Access, the respected non-profit that has been advocating for medical marijuana
patients for 15 years.

All staff will be trained by the Dispensary Manager (DM) to provide patient education on the following
topics using a variety of formats, including, but not limited to:
-In-person presentations at the dispensary provided by management or guest speakers who are
subject-matter experts
-Off-site courses or seminars
-Reading materials provided to staff
-Webinars

All PPPs will be compliant with Ohio statutory and regulatory requirements and supplemented by
Occupational Safety and Health Administration (OSHA) General Industry and Retail Safety Training
and Health Insurance Portability and Accountability Act (HIPAA) for healthcare organizations through
local and/or online providers. Staff who have attended elective training or a conference will also be
asked to provide a summary of the relevant information on any of the below topics during the next bi-
weekly staff meeting.

(1) – Recognizing the signs of abuse or adverse events (AE) in the medical use of marijuana is a
critical component of providing holistic patient care. Because marijuana is still a Schedule I drug and
the National Institute of Health (NIH) does not recognize medical marijuana as a valid medicine, NIH
standards of marijuana abuse do not actually apply to medical marijuana as defined by the state of
Ohio. Instead, the dispensary has adapted the clinical definition of abuse versus misuse of prescription
drugs. Though both include using a medication in a manner not originally prescribed or, in this case,
recommended, the intention of the patient to achieve a non-therapeutic response will be recognized as
abuse. However, because abuse of medication can often be confused with misuse, overuse, and even
addiction, all dispensary staff will be trained on the spectrum of these, as well as their potential
pathways in contributing to, and therefore ideally preventing, an AE.

Internal staff training will ensure recognition of the signs of abuse or potential abuse, such as a patient
frequently or consistently running out of their allowed supply of product, per OAC § 3796:6-3-08(D),
before the 90-day timeline ends, as well as any AE. Staff will be trained to document any AE as Grade
1-5, and report a potential product liability that could cause an AE as noted in Question E-2.1. in the
point-of-sale system, NCR Counterpoint, the dispensary’s patient database system and internal
inventory tracking system that is programmable to Metrc, yet includes firewalls to protect private patient
information, such as signs of abuse, according to HIPPA standards.

(2) – Patients and caregivers are always given the option to participate in a private in-person
consultation with a Patient Consultant (PC), including orally reviewing written instructions for each form
and method of administration, as well as discussing the risks, benefits, and laws surrounding medical
marijuana. Patient consultations will be provided on any visit by PCs who have received a minimum of
40 hours of training, as described in Question E-1.1, and passed an exam showing proficiency in each
topic. To ensure that patients and caregivers are adequately instructed to treat a qualifying condition,
staff training will cover, at minimum:
-Information about the purported effectiveness of various forms and methods of medical marijuana
administration, per OAC § 3796:6-3-15(B)(1), and of strains of medical marijuana for specific
conditions, per OAC § 3796:6-3-15(B)(2)
-Consulting with patients, per OAC § 3796:6-3-19(C)(5), including professionalism, patient education,
and investigating patient needs
-Patient privacy, confidentiality, and HIPAA, per OAC § 3796:6-3-19(C)(5)
-Safe techniques for the proper use of medical marijuana and medical marijuana paraphernalia, per
OAC § 3796:6-3-15(C)(2)
-Alternative methods and forms of consumption or inhalation by which one can use medical marijuana,
per OAC § 3796:6-3-15(C)(4)

(3) – Patients and caregivers will be instructed regarding the risks associated with medical marijuana,
including possible drug interactions. Consultations will include reviews of the patient’s symptoms and
desired health outcomes, as well as potentially related conditions, such as allergies, so that risks can
be mitigated. Written materials will include:
-Possible side effects and contraindications for medical marijuana, including possible impairment with
use and operation of a motor vehicle or heavy machinery, when caring for children, or of job
performance, per OAC § 3796:6-3-15(B)(5)
-Drug-to-drug interactions, including interactions with alcohol, prescription drugs, non-prescription
drugs, and supplements, per OAC § 3796:6-3-15(B)(8)
-Contacting the recommending physician if side effects or contraindications occur, per OAC § 3796:6-
3-15(B)(6)
-Knowledge of products and accessories, such as medical marijuana pharmacology and active
components, routes of administration, drug interactions and reactions, and dosing, per OAC §§ 3796:6-
3-19(C) and 3796:6-3-19(E)(1)
-Reciprocity agreements established per ORC § 3796.16 and how use of products from a reciprocal
state may counteract a patient’s Ohio-based treatment

Applying these patient safety data standards will help the dispensary support patients and caregivers
at the point of care and decision-making to mitigate risks and facilitate the collection of data to prevent
any possible AE.

(4) – Initial intake and ongoing interaction with PCs will support patients in treating their symptoms with
the lowest possible dose to maximize therapeutic effects. These one-on-one sessions will cover
symptoms and desired health outcomes, including documentation of the patient’s self-assessment or, if
applicable, assessment of the patient by the caregiver, per OAC § 3796:6-3-19(N)(2)(c). This
assessment will include a rating scale for symptoms associated with a qualifying condition, per OAC §
3796:6-3-19(N)(2)(b), and will be revisited in subsequent interactions with PCs, as noted above.
Ongoing self-guided education will be available to patients and caregivers through interactive displays
in the waiting room and dispensary department using a touchscreen to further education of the healing
properties and possible adverse effects of marijuana at an individual pace. Starting from a navigation
screen, users choose the information they want to access, such as education modules, a product tour,
or a quiz to assess needs and receive tailored recommendations based on responses to help the user
understand the product options and cannabinoid profiles that may treat their qualifying condition. Any
medical marijuana products and devices recommended through the interactive display will be limited to
those authorized by the Department of Commerce per OAC §§ 3796:5-8-01(A) and 3796:8-2-05(A).

Though these practices have helped the dispensary operators successfully treat thousands of patients
in the past, guidelines to reflect the needs of patients are ever evolving. Management will seek out
innovative training courses regarding covered conditions and read published medical marijuana
research to report advancements to the review team described in Question E-1.2 as well as share with
staff through an in-house monthly newsletter. Newsletters and all training materials will be under the
guidance and approval of a licensed pharmacist, per OAC § 3796:6-3-19(O). Additionally, the
Company has established a charitable foundation that will donate to research institutions that study
Ohio’s 21 qualifying medical conditions per ORC § 3796.01(A)(6) to review successful health
outcomes. An analysis of this research by the DM will determine if training should be added to the staff
training curriculum and patient education materials.

(5) – Individuals who appear to be impaired or abusing medical marijuana will never be dispensed
product. Strict security procedures and controls will be enforced to ensure that products sold by the
dispensary are consumed only by the registered patients for whom they are dispensed, in an
authorized method of administration, per OAC § 3796:8-2-01, and for the therapeutic outcomes
intended. Applied guidelines will include, but not be limited to:
-Use of the toll-free telephone line established by the Board of Pharmacy, per ORC § 3796.17
-Recognition of symptoms of substance use disorders and acute toxicology, per OAC §§ 3796:6-3-
19(C)(3)(b) and 3796:6-3-19(E)(3)
-Allowed quantities of purchase, per OAC § 3796:8-2-04
-Relevant drug database training, per OAC § 3796:6-3-19(C)(1)
-Relevant inventory tracking training, per OAC § 3796:6-3-19(C)(2)
-Opportunities to participate in substance abuse programs, per OAC § 3796:6-3-15(C)(7)

Because diversion could be a symptom of an individual who appears to be impaired or abusing


medical marijuana, staff will be knowledgeable in OAC Chapter 3796 and the requirements to report
incidents of diversion. Staff will be trained to not dispense medical marijuana if they suspect that
dispensing medical marijuana to the patient or caregiver may have negative health or safety
consequences, per OAC § 3796:6-3-08(B).

E-2.1.1 Applicants may include images or diagrams, in PDF format, demonstrating the measures
described in E-2.1. The images or diagrams may contain a brief descriptive caption. Additional
language responding to the question will not be considered.

No response provided by applicant

E-2.2 Describe the Applicant's processes, procedures and controls addressing reports of adverse
events. Include, at a minimum, a description of:
1. How reports will be documented
2. The circumstances that will require reports of adverse events will be reported to a cultivator,
processor, and / or the State Board of Pharmacy
3. The time frame for which to provide such reports

Motivated by core values of “service, safety, and security,” the dispensary will provide safe medical
marijuana to support desired patient health outcomes. Any report of an adverse event (AE) or potential
AE will be considered a documentable occasion; staff will follow the Company’s written AE reporting
procedures and associated checklists.

(1) – Oversight of and responsibility for the processes, procedures, control, and supervision of reports
related to AEs will be maintained by the Dispensary Manager (DM), the facility’s designated
representative who will hold a dispensary key employee (DKE) license. With training and oversight
provided by the DM, the Inventory and Assistant Managers, each holding a DKE license, will have
authority to fully document reports from patients, caregivers, the Department of Commerce
(Department), and the Board of Pharmacy (Board), any of whom may initiate a report of an AE.

AE documentation will always be in writing using the “AE Report Form.” If a product is alleged to have
the potential to cause an AE, or when a consumer who is a non-registered patient is alleged to have
consumed a dispensary product purchased by a patient or caregiver, the DKE will use the “Report of
Potential Product Liability” form. Both forms require the DKE to document extensive information
regarding the AE, including patient name, contact information for the patient, caregiver, and
recommending physician, product type, date dispensed, originating facility, circumstances relating to
the method(s) of administration and dosage of the product, as well as symptoms, effects, and
outcomes of the AE, at a minimum.

All AE-related complaints will be made on a tracking form (TF), which will be given a unique complaint
number and barcoded through NCR Counterpoint, the dispensary’s point-of-sale and inventory control
system (ICS), and designated as an AE. The complaint number will be entered into the patient record,
along with a scanned copy of the TF. The patient, caregiver, Board, or Department representative
initiating an AE report to the dispensary will be given this number to follow up on the status of the AE.
Documentation will only be shared with individuals who are legally allowed to receive information under
ORC, OAC, HIPAA, or release of liability as submitted by the patient to whom the AE relates.

Expired, damaged, deteriorated, misbranded, adulterated, or otherwise defective product will be


accepted free of charge for proper disposal, including product directly associated with an AE and/or
related to a recall. Returned AE-related product will be documented in the ICS using the product order
record and held until direction is given by the Department. The ICS will integrate with Metrc and each
returned product related to an AE will be transmitted electronically in real time to the Department
immediately upon documentation.

If an AE requires that remaining product be transported back to the originating facility, documentation
will be made in the transportation log (TL), which will contain the total weight, a description of each
individual package, and total number of packages. The completed “Returned Compliance Checklist” for
each package will be stapled to the TL copy and filed under the originating facility’s name in the secure
storage vault until pick-up. Any written AE-related documentation will be scanned into the electronic
filing system so that the integrity of the records and related follow-on process will be securely stored in
the offsite server. Electronic files of AEs will be retained for a minimum of 3 years.

(2) – AEs will be graded on a spectrum from non-serious to serious (Grade 1-5) and classified as
expected or unexpected (E or U); isolated or non-isolated (I or NI); and study-related, potentially study-
related, or not study-related (SR, PSR, or NSR). These classifications will enable the entities to which
the dispensary reports the AE to make an informed decision about how to proceed with further
disclosure, including initiating a recall. Ratings of I or NI, especially as they relate to the potential harm
to additional patients, will guide the DKE in determining the circumstances under which the AE must be
reported to the originating facility. A scenario list included in the AE Report form will help the DKE
make these decisions.

An Action Plan (AP) and related timeframes will be managed by the DM and include steps to identify
and contact originating facilities, the Board and/or Department, and patients to whom affected products
were dispensed. The AP may include details to collect recalled AE-related products, retain products in
quarantine, and destroy/dispose of them or coordinate their return to the originating facility, as
appropriate. An AE AP will include a physical copy of all documentation gathered during the recall.

Per OAC § 3796:6-3-11(G), serious AE (SAE) relating to security and administration of medical
marijuana that dispensary staff knows about will be reported to the Board within 24 hours. The
dispensary will never transport medical marijuana, but will arrange for the originating facility to pick up
recalled products. Destruction and disposal handled by the dispensary will be done in accordance with
OAC § 3796:6-3-14. Further protocols to be followed during recall events are described in Question D-
6.8.

(3) – Depending on the seriousness of the AE and the likelihood that it could be experienced by
additional patients or unintended consumers, each report of an AE will be assigned a series of codes
and corresponding timeframes within which it must be reported to the originating facility, Board, or
Department. Grade 1 (mild) and 2 (moderate) AEs, which shall generally be classified E, will be
reported to an originating facility within 24 hours. If the originating facility cannot be successfully alerted
within 24 hours, a DKE will immediately contact the Board to report that the originating facility has not
acknowledged the report of a Grade 1 or 2 AE. Any non-serious AE will be documented in a quarterly
summary sent to the Department and Board.

The dispensary will follow the US FDA definition of SAE as an occurrence that may have resulted in
death, life-threatening experience, inpatient or extension of hospitalization over 24 hours, significant
incapacity or inability to conduct normal life functions, birth defect or congenital anomaly, or Important
Medical Event based upon the judgment of the patient’s doctor that the outcome may subject the
patient to serious medical interventions to prevent the outcomes included in this definition. The
dispensary will report Grade 3 (severe) to originating facilities, the Board, and the Department within 6
hours or as soon as reasonably practical. Grades 4 (serious but non-life threatening) or 5 (serious and
death-related) will follow standards of clinical trial investigations by reporting to the Board and
Department within 2 hours or as soon as practical.

When mandated to initiate a recall because of an AE, the dispensary will update the ICS within 2 hours
of the mandate. When voluntarily initiating a recall related to a non-serious AE, or when processing a
recall relating to an AE that has been initiated by the originating facility, the dispensary will update the
ICS within the timeframe contractually agreed upon between the dispensary and the originating facility,
or as mandated by subsequent regulations of the Department or Board, whichever is sooner.

Any written AE-related documentation, including the AP, will be scanned into the electronic filing
system within 3 calendar days or as soon as practical. The DM will ensure that the ICS is maintained
as a perpetually-updated electronic inventory record of all medical marijuana related to any AE and will
enter any action taken regarding the complaint into the AP and file it with the TF. All accumulated
documentation will be digitized after the conclusion of the event and made available to the Board upon
request.
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

9am-9pm
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 4 page(s) of this document.
D-4.4: Storage of N/A The “Storage of Product” section under Applicant’s
Product Operations Plan includes information concerning
Applicant’s plans for the storage of medical marijuana,
including physical security measures, record maintenance,
and climate control. This information is and/or contains
technical information, processes, procedures, patterns,
compilations, programs, methods, techniques, and business
information and plans, all of which are designated trade
secrets as defined by Ohio Revised Code §1333.61(D).

Applicant has spent a substantial amount of money and


effort in obtaining and developing the information contained
in the “Storage of Product” section of Applicant’s
Operations Plan. If said information was to become public, it
would give Applicant’s competitors an unfair competitive
advantage without a substantial development expense.

The “Storage of Product” section found in Applicant’s


Operations Plan is confidential and proprietary information
closely guarded by Applicant and not known outside of
Applicant. Said section is only known to Applicant’s
Management and select employees with a need to know
basis. Applicant closely guards this information and the
information contained within is not shared with anyone
outside of the previously mentioned parties without the
protections of a signed confidentiality agreement and other
precautions.

D-9.2: Recordkeeping N/A The “Recordkeeping” section under Applicant’s Operations


Plan includes information concerning Applicant’s
recordkeeping plan at the dispensary, including maintenance
of employee records, operating procedures and controls,
audit records, staffing plans, business records, surveillance
records, attendance logs, and quality assurance review logs.
This information is and/or contains technical information,
processes, procedures, patterns, compilations, programs,
methods, techniques, and business information and plans, all
of which are designated trade secrets as defined by Ohio
Revised Code §1333.61(D).

Applicant has spent a substantial amount of money and


effort in obtaining and developing the information contained
in the “Recordkeeping” section of Applicant’s Operations
Plan. If said information was to become public, it would give
Applicant’s competitors an unfair competitive advantage
without a substantial development expense.

Dispensary Application Document E—Trade Secret Form  Page 3 of  4
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

You might also like