Fossil Food Application - Aurora Fossil Festival

advertisement
AURORA/RICHLAND TOWNSHIP
CHAMBER OF COMMERCE
Fossil Festival Committee
Aurora, NC 27806
FOOD VENDORS ONLY
VENDOR NAME: _______________________________________________
CONTACT PERSON: _____________________________________________
MAILING ADDRESS: _____________________________________________
PHONE: (____) _________________ Email: __________________________
LIST ALL FOODS TO BE SOLD (This is required):
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
PLAN TO BRING YOUR OWN GENERATOR IF YOU NEED ELECTRICITY.
FEE (PER UNIT):
COMMERCIAL VENDORS
LOCAL, NON PROFIT VENDORS
_____ $100.00
_____ $ 50.00
SUBTOTAL
x NUMBER OF UNITS
____________
____________
TOTAL FEE ENCLOSED
____________
**If the application is not complete with all required information it will not
be accepted**
Date Rec: ______________
Vendor #:________________
Amount Rec: ____________
___ Cashier’s Check
Hold Harmless Agreement ___yes ___no
___ Money Order
___ Cash
Please mail forms and payment to:
Fossil Festival
c/o Bridgett Bonner
2173 Herring Run Rd
Blounts Creek, NC 27814
bridgett73@live.com
252-670-1832
AURORA/RICHLAND TOWNSHIP
CHAMBER OF COMMERCE
Fossil Festival Committee
Aurora, NC 27806
HOLD HARMLESS AGREEMENT
I, ______________________________________, a vendor at the Fossil Festival
in Aurora, NC certify that I do not have an event insurance certificate. I agree to hold
the Aurora/Richland Township Chamber of Commerce, the Town of Aurora and the
Fossil Festival Committee harmless for any injury or loss to any person or goods for any
cause whatsoever. I also agree that the stated organizations cannot be held responsible
for any claims for damage, injury or loss arising out of or in connection with the use of
the space or grounds in the Fossil Festival.
I affixed my hand on the _____________ day of ____________, 2015.
(Date)
(Month)
____________________________________________________________
Signature of Responsible Party
____________________________________________________________
Printed Name of Responsible Party
____________________________________________________________
Witness Signature
____________________________________________________________
Printed Name of Witness
Download