Food Vendor Application - Orangevale Chamber of Commerce

Transcription

Food Vendor Application
May 16 – 19, 2013
Celebrating 50 years
Application Deadline – April 19, 2013
VENDOR INFORMATION – PLEASE FILL OUT COMPLETELY – PRINT OR TYPE
Business Name:
Business Phone:
Contact Person:
Mobile Phone:
Address:
Fax:
City, State, Zip:
Email:
CA Seller’s Permit #:
WWW: _____________________ Facebook Page: _____________________
Driver’s License/State ID #:
Orangevale Chamber Member: Y
N
New Application ___________ Returning Concessionaire _______ - Same Stand _________ New Stand____
Check all that apply: _______Cart _______ Stand/Trailer _______ End Serve___________ Side Serve____
This application is for (check one only):
___ Commercial– Pre Pkg/ Low Risk
___ Commercial – Food Prep/High Risk
LIST ALL ITEMS THAT YOU WISH TO SELL (REQUIRED) INCULDE COST: (use separate sheet if
needed)
I have read the regulations included with this application and agree to comply with the conditions
set forth.
Signature
Orangevale Chamber of Commerce
Date
916.988.0175
www.orangevalepowwowdays.com
Vendor Definitions:
Pre Pkg/Low Risk: "Prepackaged food" means any properly labeled processed food, prepackaged to prevent
any direct human contact with the food product upon distribution from the manufacturer, and prepared at an
approved source.
Food Prep/High Risk: "Food preparation" means packaging, processing, assembling, portioning, or any
operation that changes the form, flavor, or consistency of food, but does not include trimming of produce.
Festival Hours
The Festival operates 3 pm to 10 pm Thursday, 3 pm to 11 pm Friday, 11 am to 11 pm Saturday and 12 pm to
6 pm on Sunday.
Location
Orangevale Park, “7200 Block” Filbert Ave., behind Green Oaks Elementary School Orangevale, CA 95662
Please Read Carefully:
The Orangevale Chamber of Commerce has final say on menu items.
The Orangevale Chamber of Commerce is the exclusive seller of alcohol.
The Orangevale Chamber of Commerce does not guarantee vendor sales.
Pow Wow Days is a ‘rain or shine’ event. There are no refunds due to inclement weather.
Payment is due at time of application. If vendor is not accepted into the event, payment will be refunded within 3 - 5
weeks after deadline.
A limited number of vendors in any category will be accepted into the festival. Decisions are based on, but not limited to,
history, items to be sold, payment and date of paperwork received. Accepted vendors will receive a confirmation by email.
The Orangevale Chamber of Commerce will provide each food vendor with the appropriate space required for his or her
food booth, which will be situated on the grass. Booth space selection is based on date completed application and deposit
is received. Vendor will be given deadline for selection. All vendors are subject to committee approval. Vendors will be
given 1st choice and alternate choice. Placement of your booth is not guaranteed and is at the discretion of festival
management.
If electricity is needed; vendor must check the Electrical Requirement Fee and pay the additional fees listed. No private
generators will be allowed unless approved by event board.
Vendors can only sell from their designated space, no walking the grounds to sell merchandise or hand out fliers.
Every booth shall be equipped with a fire extinguisher bearing a current California State Fire Marshal service tag, and be
fully charged, and placed in an accessible location near the exit of the structure.
Food Vendors must sign and submit the forms from the Sacramento County Environmental Management Division
Temporary Food Facility Operators Packet. These forms must be sent with the completed application.
Food Vendors must comply with the Sacramento Metro Fire Department Conditions of Approval.
All County codes, laws, ordinances, and regulations pertinent to health, fire prevention, and public safety shall be strictly
obeyed.
All vendors are responsible for acquiring a seller’s permit through the California State Board of Equalization; a copy of
permit must be submitted with application and must be posted at your booth. Vendors are responsible for submitting their
own resale taxes.
Vendor agrees to allow the Orangevale Chamber of Commerce to take photos of your booth and product during the
Event, for no additional compensation. Photos taken of your product/booth may be used in Pow Wow Days promotions.
Vendor/staff/employees/agents will comply with all vendor policies. Failure to comply can result in expulsion from event
without a refund.
The Orangevale Chamber of Commerce will provide security beginning Wednesday night to Sunday day. The Chamber
is not responsible for lost, stolen or damaged property.
Vendors keep 1005 of the gross revenue. No tickets will be used; vendors will accept cash as payment.
Any Changes to approved menu must be approved in writing by the Orangevale Chamber.
Vendors can only sell from the space assigned. Walking the grounds to sell merchandise or hand out fliers is strictly
prohibited. *For questions/consideration, call the office.
Vendors must provide their own booth name sign. Booth Advertising is limited to host group.
Form BOE 410-D Swap Meets, Flea Market or Special Events Certification from Board of Equalization must be
completed and turn in with application
Vendor will be provided one (1) parking pass for designated Vendor area. Additional parking passes can be purchased
at a discount $15 each vehicle. Trailers are subject to additional parking fees.
916.988.0175
Vendor Insurance
ALL VENDORS ARE REQUIRED TO PROVIDE A CERTIFICATE OF INSURANCE COMPREHENSIVE GENERAL or
COMPREHENSIVE PERSONAL LIABILITY coverage for a minimum of $1,000,000 Per Occurrence, $2,000,000
Aggregate naming the Orangevale Chamber of Commerce and the Orangevale Recreation and Park District, additional
insured.
The vendor shall provide a certificate of insurance to the Orangevale Chamber of Commerce evidencing such coverage
with application or submit payment. The CERTIFICATE must name: Orangevale Chamber of Commerce, 9267
Greenback Lane, Ste B-91, Orangevale, CA 95662-4864. The following statement must appear on the certificate:
“Additional Insured Endorsement names the Orangevale Chamber of Commerce and Orangevale Recreation and Park
District, its directors, agents, or employees are included as additional insured.”
Non-Transferable
This application is not assignable or transferable without the express written consent of the Orangevale Chamber of
Commerce.
Independent Contractor
Vendor shall perform all services required under this application as an independent contractor of the Orangevale
Chamber of Commerce and shall remain, at all times as to the Orangevale Chamber of Commerce, a wholly independent
contractor with only such obligations as are required under this application. Neither vendor, nor any of its employees, shall
be considered an employee of the Orangevale Chamber of Commerce.
Indemnification
Vendor shall defend, indemnify and hold harmless the Orangevale Chamber of Commerce and Orangevale Recreation
and Park District its directors, trustees, officers, employees and agents, from and against any and all claims, actions,
liability, damage, loss or obligations, including all costs, demands, expenses, expert fees and costs, and attorney’s fees
arising out of Vendor’s activities pursuant to this application, including by way of illustration and not limitation, the
following: (a) any injury to or death of any person or damage to or destruction of any property occurring in or on Vendor’s
equipment, or any part therefore; (b) any default by Vendor’s in the observance or performance of any of the terms,
covenants, or conditions of this application ; or (c) the use, occupancy, or condition of Vendor’s equipment or activities
therein.
APPLICATION CHECKLIST
Make sure your application is complete and includes the following items:
___ Application filled out completely (Turn in page 1 & 7)
___ Sign and date your application
___ Included all required fees
___ Copy of Health permit (Current Multi Event Vendors)
___ Certificate of Insurance
___ Copy of Seller’s permit and/or Form BOE 410-D
___ Copy of menu (TFF FORM)
___ Booth Layout (Example attached)
___ Copy of food Safety Certificate
___ Photos of Booth, trailer or cart
Completed applications and payment must be submitted no later than April 19, 2013 and Payable to:
C/o PWD Food Vendor
9267 Greenback Lane, Ste B-91
Orangevale, CA 95662-4864
*Note: Applications received by email or fax must have credit authorization form included to be eligible for
booth selection. Emailed to [email protected] or Fax 760.418.4360
916.988.0175
TEMPORARY FOOD FACILITY (TFF) INFORMATION SHEET
Name of Event
Location of Event
Date(s) of Event
Name of Food Booth (TFF)
TFF Person in Charge (PIC)
2nd Phone
Phone
Contact Phone for day of event
Event Organizer
Phone
Number of
workers
Approximate number of meals to be served
If event is longer than one day:
 Where will utensils be washed? (example: restaurant, church, onsite)
 Where will the extra food be stored at the end of the
day?
IMPORTANT NOTES
1. Contact your local fire jurisdiction regarding applicable fire code requirements for use of cooking
equipment. A list of phone numbers has been provided on page 17 of this packet.
2. Complete the “TFF Self-Inspection Checklist” before beginning to operate and keep it available for
inspector review. (See pages 4-5 of packet)
Complete the following questions:
1. What is the final cooking temperature for chicken?
2. Do you need to set up a hand-wash station in your booth?
3. What do you need to bring to set up a hand-wash station?
4. Do you need to set up a warewash station? What do you need to bring to set up a ware-wash
station?
5. At what temperature should cold foods be kept?
6. At what temperature should hot foods be kept?
7. Is it ok to make food at home prior to the event for serving from your food booth?
Initial
I have received a copy of the “Temporary Food Facility Operating Requirements” including the
Self-Inspection Checklist, and agree to follow these requirements.
I have included a site plan that indicates the proposed layout of equipment, food preparation
tables, food storage, warewashing, and handwashing in my TFF.
I have attached a completed TFF menu sheet.
Signature
Date
Title/Position
Environmental Management Department ∙ 10590 Armstrong Avenue, ste B, Mather, CA 95655 ∙ PH: (916)
875-8440 Fax: ( 916) 875-8513
www.emd.saccounty.net
916.988.0175
TFF MENU SHEET
NAME OF FOOD BOOTH: ________________________________________________________
List all food and beverage
items (e.g., tacos, tortillas,
shredded chicken, salsa,
lemonade, etc.).
If food is prepared off site,
give the location name,
address, & phone number of
place (foods may not be stored
or prepared at home).
How will food be prepared
(e.g., BBQ, deep-fry, grill,
etc.)?
What type of insulated
container will be used to
transport potentially hazardous
foods to keep them above
135°F or below 41°F?
Type of food holding units in
booth (e.g., ice chest, freezer,
chafing dishes, crock pot, etc.).
Note: Use of BBQ grill to
hold food is strictly
prohibited.
How will the food be handled
and dispensed? (tongs, ladle,
etc.)
1.
2.
3.
4.
5.
OFFICIAL USE ONLY
916.988.0175
Example of Site Plan
916.988.0175
Vendor Name:
BOOTH SPECIFICATIONS & FEES
BOOTH FEES
Space Reservation
Spaces are 10x10
TOTALS
Commercial – Pre Pkg/ Low Risk
$300
$ __________
Commercial – Food Prep/High Risk
$450
$ __________
Health Permit Fee
TFF (Food prep/High Risk) -
$141 or (Low Risk) - $ 67
$ __________
Additional Space(s) 200 x ___________
$ __________
Electrical Service
500 Watt Service = $60
20 Amps Dedicated Service = $120
50 Amps (208 volts) = $220
Application Fee $25 (waived if payment is money order or cashier’s check)
$ __________
$ __________
*A non-refundable deposit totaling half the amount of the balance (booth, health permit + electrical fee) is due
at time of application submission. Space selection will not be permitted without completed application, deposit
and committee approval. Selection opportunity is based date application and fees are received.
Please list all appliances or items that will need electricity:
Late Fee (Application or balance received after April 19, 2013)
$150
$ __________
Total Booth Fees (Cash, Money Order, Credit Card ONLY)
Deposit
$___________
Balance due by April 19, 2013
916.988.0175
$ ___________
$___________

Food Vendor Application - Orangevale Chamber of Commerce

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