Fillable Administrative Approval Form for Food Vendors (San Diego City College)

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Administrative Approval Form for Food Vendors (San Diego City College)

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Form for Request for Administrative approval for Food Vendors, October 25, 20018
Administrative Approval Form for Food Vendors
Per the District, the following items are required for consideration of food
vendors on campus. Please note that the following steps have been provided
already to Student Services:
Authorized signature from Food Service Supervisor, Vince Margetta,
vmargett@sdccd.edu
or phone: (619) 388-3850; located on the Request for
Use of Facilities form under Food Services
Temporary Food Facility Permit
Food handler Certificates for vendor staff who will be working at the site
Liability insurance in the minimum amount of $1mm must be provided.
The District must be listed as co-insured or certificate holder on the
certificate of insurance
Hold Harmless Agreement - completed by the vendor
Vendor-Seller Agreement - completed by the vendor
Administrative approval (Vice President or designee signature is pending)
Approved: ______________________________________
VP of Student Services Date
Requested by: ______________________________________
Dean of Student Affairs Date
Date of Event: ______________________________________
Event Name: ______________________________________
Form for Request for Administrative approval for Food Vendors, October 25, 20018
Hold Harmless Statement
_____________________
Individual or Company Name
Agrees to same and hold harmless the San Diego Community College District, it’s employees, trustees, and
students from any and all liability, costs, litigation or claims for injury or death to any person, including,
Vendor or Vendor’s employees; or for damage to any property, including but not limited to that of Vendor or
the San Diego Community College District arising from any cause related to Vendor’s direct or indirect
participation on City College. Vendor will arrange insurance to insure this potential liability in amounts
sufficient to protect itself and the San Diego Community College District.
I agree with the above information and have read and understand City College’s Procedures and Rules for
Selling and the Hold Harmless Statement.
____________________________ ______________ _____________________
Signature of Requestor Date Telephone
____________________________ _______________________________________
Company Name Seller’s Permit #/ Tax I.D.
____________________________ _______________________________________
Address Seller’s CDL# Exp. Date
____________________________ _______________________________________
Food Handling Card # Dean of Student Affairs
*IMPORTANT TO NOTE:
THIS FORM MUST BE IN POSSESSION OF VENDOR WHILE ON CAMPUS AND MUST BE PRODUCED WHEN
ASKED BY COLLEGE OFFICIALS
____
____
____
____
____
____
____
____
SAN DIEGO CITY COLLEGE
ASSOCIATED STUDENT GOVERNMENT
VENDOR AGREEMENT
The _________________________________ (Club/Organization) agrees to sponsor _________________________________
(Business) to sell their merchandise which includes: __________________________________________________ to
the students of San Diego City College.
As part of the following activity the Vendor will be allowed on campus on the following date(s):
_________________________________________, during the hours of _____________________________________.
In exchange for this right, the Vendor agrees to pay $___________ ($100 Non-profit), ($150 Small business),
($150 Food Vendor), ($200 Corporate) per day for a total of $_____________. This amount must be paid at
the Cashier/Accounting Office (B-203) at least 5 working days IN ADVANCE of the scheduled event.
VENDOR INFORMATION:
Representative Name: __________________________________________________________
Business Name:
Address:
Phone:
Tax I.D.:
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
_______________________________________ _______________________________________
Signature of Vendor Print Vendor Name
_____________________________ _____________
______________________________ _____________
Signature:
A.S. President Date: Approved: Dean of Student Affairs Date:
A.S. Vice President
A.S. Public Events Coordinator
Vendor Agreement Checklist – Copy Submitted:
Caterer’s License
Yes
No
Restaurant License
Yes
No
Proof of Insurance
Yes
No
Food Handler Certificate Yes No
N
Special Note: Vendors MUST pay first in order to set up for the scheduled event.
Copy Distribution:
1) Original – Student Affairs
2) Cashiers
Revised 7/2018 mr
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Administrative Approval Form for Food Vendors (San Diego City College)

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Completed 25 July 2020

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