Fill - Free fillable CITY OF WOODSTOCK Peddler / Vendors License General (City of Woodstock) PDF form

CITY OF WOODSTOCK

Peddler / Vendor’s License

General Information

No person shall do business on public property in the City of Woodstock as a peddler without a

license, unless part of an approved event on the Square.

Possession of a Peddler / Vendor’s License is a privilege, not a right; and the City reserves the

right in its sole discretion to determine the number of temporary vendor licenses to be issued and

to refuse issuance of or to rescind said license.

Any peddler who violates the terms or conditions of the license is subject to revocation of the

license.

Applications for a Peddler / Vendor’s license shall be made to the City upon forms supplied by

the City, not less than seven business days in advance of the date for which the license is

requested. No license shall be issued unless the application has been completed in full.

The fee for a Peddler / Vendor’s License for the first vehicle/concession is $100 per season,

defined as the calendar year, January 1

through December 31

. The fee for a Peddler /

Vendor’s License for each subsequent vehicle/concession owned by the same applicant shall be

$50.00 per calendar year. All Peddler / Vendor’s licenses shall terminate on December 31

following date of issuance.

This application is for either to vend in Public Property and/or Public Property. The $100 per

season is for each type of Vendor. If you would like to apply for both Public and Private, the per

season fee is $200.

If determined necessary by the City, applicant and all designated employees must submit to and

satisfactorily pass a background check. Actual cost for a City-approved background check shall

be paid for in advance by the applicant. The City reserves the right in its sole discretion to

determine if a background check is considered to have been satisfactorily passed. Upon approval

of and at the discretion of the City Manager, the requirement for a background check may be

waived for any individual able to present proof of a satisfactory background check conducted

within the calendar year of the application.

Applicant must abide by all other conditions for approval as set forth by the City of Woodstock,

including, but not limited to location of concession(s), duration of stay, placement of signage,

use of auxiliary equipment, and trash collection. Further, applicant must agree to vend only in

approved locations and abide by any exclusivity arrangement set forth by organizers of any

special event as recognized by the City of Woodstock.

The Peddler / Vendor’s License issued in conformity with the provisions of this act shall be

displayed at all times in a prominent place in said concession.

Any and all Peddler / Vendor’s Licenses shall be subject to any restrictions or conditions deemed

desirable by the City.

CITY OF WOODSTOCK

Application for a Temporary Vendor’s License

Public Property Private Property Public & Private Property

Corporate Information:

__________________________________________ ________________________________

Corporate Business Name (as listed on State Taxes) DBA (if applicable)

_______________________________________________________________ ____________________ ________ _________________

Business Address City State Zip

(_____) _____-________ __________________________________________ ___________________________________

Business Phone Business Email Tax ID Number

________________________________________________________ __________________

Nature of Business Length of Time

Owner Information

_______________________________ ______________ _________________________________ (_____) _____-_________

First Name Middle Last Name Residential Phone #

________________________________________________________

____________________________________ ________________ _____ ___________

Residential Address City State Zip

Description of Vehicle/Concession

Description of items to be sold

Description of Dates and Location

Date

Location

(attach site sketch)

Power?

Water?

Waste

Disposal?

Owner

(if applicable)

Owner Phone

(if applicable)

______ I understand that all sales taxes collected in Woodstock need to be reported on the appropriate form and

paid to Woodstock. Failure to properly report sales taxes could lead to the rescinding of an existing

permit or ineligibility for a future permit.

______ I hereby apply for a Peddler / Vendor’s License to vend in the City of Woodstock. I understand that

possession of said license is a privilege, not a right and that the City reserves the right in its sole

discretion to determine the number of Peddler / Vendor’s licenses to be issued and to refuse issuance of

or to rescind said license. I have read and agree to abide by all regulations and conditions for

application, approval and possession of said license.

Applicant Signature_____________________________________ Date: _________________

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CITY OF WOODSTOCK

Application – Additional Employees

Peddler / Vendor’s License

Please complete the following information for each employee who will be vending in Woodstock.

Additional Employee #1

_______________________________ ______________ _________________________________ (_____) _____-_________

First Name Middle Last Name Residential Phone #

________________________________________________________

_______/_______/________ ____________________________ ________-_______-_______ ___________________________

Date of Birth Place of Birth Social Security Number Driver’s License #

Additional Employee #2

_______________________________ ______________ _________________________________ (_____) _____-_________

First Name Middle Last Name Residential Phone #

________________________________________________________

_______/_______/________ ____________________________ ________-_______-_______ ___________________________

Date of Birth Place of Birth Social Security Number Drive’rs License #

Additional Employee #3

_______________________________ ______________ _________________________________ (_____) _____-_________

First Name Middle Last Name Residential Phone #

________________________________________________________

_______/_______/________ ____________________________ ________-_______-_______ ___________________________

Date of Birth Place of Birth Social Security Number Driver’s License #

Additional Employee #4

_______________________________ ______________ _________________________________ (_____) _____-_________

First Name Middle Last Name Residential Phone #

________________________________________________________

_______/_______/________ ____________________________ ________-_______-_______ ___________________________

Date of Birth Place of Birth Social Security Number Driver’s License #

Additional Employee #5

_______________________________ ______________ _________________________________ (_____) _____-_________

First Name Middle Last Name Residential Phone #

________________________________________________________

_______/_______/________ ____________________________ ________-_______-_______ ___________________________

Date of Birth Place of Birth Social Security Number Driver’s License #

HOLD HARMLESS/INDEMNIFICATION AGREEMENT

The applicant signing below (the “Applicant”) has requested permission to operate as a Food

Truck Vendor in the City of Woodstock, IL (the “City”). In consideration of such permission and

the issuance of a permit, the Applicant hereby fully releases and discharges the City, its officers,

agents and employees from any and all claims of any kind (including, but not limited to claims

for damage to property, injury to any person, or attorneys’ fees) which arise or which may be

alleged to have arisen out of, or in connection with, Applicant’s operations as a Food Truck

Vendor in the City. The Applicant further agrees to indemnify and hold harmless and defend

the City, its officers, agents, and employees from any and all claims of any kind (including, but

not limited to claims for damage to property, injury to any person, or attorneys’ fees), which may

arise or which may be alleged to have arisen out of, or in connection with, Applicant’s operations

as a Food Truck Vendor in the City.

Print Name of Applicant: ____________________________

Date: _________________

Authorized Signature of Applicant: _______________________________

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REQUEST, AUTHORIZATION, CONSENT AND RELEASE FOR

BACKGROUND INFORMATION

PLEASE TYPE OR PRINT

I: _______________________________________________________________________________________________

LAST NAME FIRST NAME MIDDLE NAME (PLEASE INCLUDE Jr., Sr., II, III Etc.)

Understand that in conjunction with my application for license, the

CITY OF WOODSTOCK-VENDOR/PEDDLER LICENSE

PROGRAM

will use the services of an outside agency to research and verify the information I have provided on my application

for license including my personal background, character, professional standing, work history and qualifications. This agency will

provide a report to the

CITY OF WOODSTOCK-VENDOR/PEDDLER LICENSE PROGRAM. The CITY OF

WOODSTOCK-VENDOR/PEDDLER LICENSE PROGRAM

uses Backgrounds Online, a consumer-reporting agency, as an

agent to perform background verifications.

Backgrounds Online will utilize various sources of information it deems appropriate including but not limited to: credit reporting

agencies, Workers Compensation records, Department of Motor Vehicle records, criminal conviction records, current and former

employers, military records, education records, professional and personal references. I request, authorize and consent to the

release and disclosure of any and all information including but not limited to the above to the

CITY OF WOODSTOCK-

VENDOR/PEDDLER LICENSE PROGRAM

and Backgrounds Online.

I request, authorize and consent to the procurement of an Investigative Consumer Report and understand that it may contain

information about my background, mode of living, character, personal characteristics and general reputation. This authorization

in original or copy form shall be valid for one year from the date indicated next to my signature. According to the Fair Credit

Reporting Act, I will be notified by the

CITY OF WOODSTOCK-VENDOR/PEDDLER LICENSE PROGRAM if licensure is

denied because of information obtained from a Consumer Reporting Agency. Additionally, I understand that if requested within

60 days, I will be given a full and accurate disclosure as to the nature and substance of all information provided to the

CITY OF

WOODSTOCK-VENDOR/PEDDLER LICENSE PROGRAM.

I further understand that when requesting a copy of the report,

proper identification will be required and I should direct my request to: Backgrounds Online, 1915 21

Street, Sacramento, CA

95811, phone: 800-838-4804. Backgrounds Online’s website may be found at http://www.backgroundsonline.com

LAW ENFORCEMENT AGENCIES AND OTHER ENTITIES FOR POSITIVE IDENTIFICATION PURPOSES REQUIRE THE

FOLLOWING INFORMATION WHEN CHECKING PUBLIC RECORDS. IT IS CONFIDENTIAL AND WILL NOT BE USED FOR ANY

OTHER PURPOSES. I HEREBY RELEASE THE

CITY OF WOODSTOCK-VENDOR/PEDDLER LICENSE PROGRAM AND

ITS AGENTS, BACKGROUNDS ONLINE AND ALL PERSONS, AGENCIES, AND ENTITIES PROVIDING INFORMATION OR

REPORTS ABOUT ME FROM ANY AND ALL LIABILITY ARISING OUT OF THE REQUEST FOR OR RELEASE OF ANY OF THE

ABOVE MENTIONED INFORMATION OR REPORTS.

__________ __________

Signed Today’s Date

__________

Printed Name License Applied For

_______---_____---________ ____/_____/____ ________________

Social Security Number Date of Birth Driver’s License Number State

Other names you have used or are also known as: ________________________

PLEASE PROVIDE ALL RESIDENTIAL ADDRESSES FOR THE PAST 7 YEARS

Current Address: _________________________________________________________________________________________________________

Street Apt.# City County State Zip Code How long here?

Current Address: _________________________________________________________________________________________________________

Street Apt.# City County State Zip Code How long here?

Current Address: _________________________________________________________________________________________________________

Street Apt.# City County State Zip Code How long here?

Current Address: _________________________________________________________________________________________________________

Street Apt.# City County State Zip Code How long here?

Would you like a copy of this form? Yes

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TEMPORARY VENDOR

BACKGROUND CHECK COST SHEET

Opon 1: Basic Check $29.95

To be used for: Temporary Vendors/Employees who have lived in only one county for the past seven (7) years.

Includes:

 Social Security Number Trace

 County Criminal Court Search* (single county)

 Naonal Criminal Database Search

 Sex Oender Registry Search

 Terrorist Watch List Search

Opon 2: Standard Package $49.95

Includes:

 Social Security Number Trace

 County Criminal Court Search* (up to 3)

 Federal Criminal Court Search (single district)

 Naonal Criminal Database Search

 Sex Oender Registry Search

 Wants & Warrants Search

 Terrorist Watch List Search

Opon 3: Deluxe Package $79.95

Includes:

 Social Security Number Trace

 County Criminal Court Search* (up to 3)

 Federal Criminal Court Search (up to 3)

 Naonal Criminal Database Search

 Sex Oender Registry Search

 Wants & Warrants Search

 Terrorist Watch List Search

 Motor Vehicle Record Search

Add- Ons:

 County Criminal Searches (can be used with Basic, Standard and Deluxe for addional county searches): $18.50

 Employment Credit Report Searches (can be used with Basic, Standard and Deluxe searches): $14.00

 Motor Vehicle Record Searches – Addional States (can be used with Basic, Standard and Deluxe – rates vary):

$ 20.00 (IL) $18.00 (WI), IA ($20.00), IN ($20.00), MO ($20.00) etc.

NOTE: If applicant wishes to take advantage of the lower cost of the Standard Package, he/she must sign a waiver acknowledging

that the City will be obtaining addional informaon which may be used in the background check process and stang that it is his/

her wish to have the Standard Package background check performed.

I have chosen:

___ OPTION 1 at a cost of $29.95 ___ OPTION 2 at a cost of $49.95 ___ OPTION 3 at a cost of $79.95

I would like ___ addional county searches at a total cost of $_______ .

CITY OF WOODSTOCK

Application Checklist

Peddler / Vendor’s License

A license will not be issued without the complete documentation.

______ Complete Application

______ Health Department Certificate

______ Certificate of General Liability Insurance with City of Woodstock named as

additional insured

______ Proof of Vehicular License and Liability insurance (if applicable)

______ Hold Harmless Agreement

______ Background Check Authorization Form

______ Fee Amount ____________ Check #_____________

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CITY OF WOODSTOCK Peddler Vendors License General (City of Woodstock)

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