SECTION 1: VENDOR INFORMATION

Business Name: *

Date *

Contact Person: *

Email Address: *

Address *

Country

City

State

Zip code

Work/Office Phone:

Cellular Phone: *

Name of Event:

Name of the Sponsoring Organization:

SECTION 2: VENDOR DETAILS

Type of Vendor: *

Direct Sales (over the counter)

Exhibitors (not selling/display only)

Indirect Sales (taking orders/leads)

Food Vendor (see section 4)

Type of Booth *

Food Truck

Tent

Stand

Table

Name item(s) to be sold, exhibited, or promoted: *

Food Vendors provide types of food to be sold:

SECTION 3: INSURANCE REQUIREMENTS

Vendor will be required to provide an original Certificate of Insurance evidencing the following insurance minimums:

Commercial General Liability – minimum $1,000,000 per occurrence

Final acceptance of applicant is contingent on applicant naming the City of Harvey, their employees, agents, and officials as additional insured.

SECTION 4: FOOD VENDOR REQUIREMENTS

All Food Vendors will be required to provide proof of the following:

Completion of American National Standards Institute (ANSI) food handler training certificates.

Current Business License or Mobile Food License in the City/Town/Village they operate.

Application must include the following documentation *

Vendor Application

Certificate of Insurance

Copy of ANSI food handler training certificates (Food Vendors)

INDEMNITY/HOLD HARMLESS AGREEMENT

To the fullest extent permitted by law, the Vendor hereby agrees to defend, indemnify and hold harmlessthe City of Harvey, its officials, agents and employees, against all injuries, deaths, loss, damages, claims, patent claims,suits, liabilities, judgments, cost and expenses, which may in any way accrue against the City of Harvey, its officials, agents and employees, arising in whole or in part or in consequence of the Event, and/or its employees, and or subcontractors’ participation in Event, or which may in any way result therefore. The Vendor shall, at its own expense, appear, defend and pay all charges of attorneys and all costs and other expenses arising therefore or incurred in connection therewith, and, if any judgment shall be rendered against the City of Harvey, its officials, agents and employees, in any such action, the Vendor shall, at its own expense, satisfy and discharge the same.

The Vendor expressly understands and agrees that any performance bond or insurance policies required by the City of Harvey, or otherwise provided by the Vendor shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City of Harvey, its officials, agents and employees as herein provided.

The Vendor expressly understands and agrees that the City shall be named as an additional insured party on the insurance policy and that the Organization shall have no permission or authority to engage in the Event until evidence deemed acceptable to the City has been provided to establish that the City has been named as an additional insured party on the insurance policy .

Name: *

Title/Position:

Date *

Check the box below to sign the INDEMNITY/HOLD HARMLESS AGREEMENT: *

Signed

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