FSA Application for Vendor Permit
Stony Brook University, 157 East Side Dining, Stony Brook, NY 11794-3260
Fax: 631.632.6573 Phone: 631.632.6517
Vendor Address:
Type of Goods/Services being sold or rendered (please be specific): *MUST BE COMPLETED
Phone Number:
Fax Number:
E-mail address:
NY State Tax ID # :
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Check and complete (ONLY) if this a Union, Goverment Agency/Politician or Religious Group
Sponsor Name:
Sponsor Phone: Sponsor Email:
Company Name:
Vendor Contact Name:
Event Name:
Event Date/s:
Number of tables needed:
Please submit a copy of your valid NYS Certificate of Authority
Note: Union, Goverment Agency/Politician or Religious Groups require a University department sponsor
Amount Paid:
Any fees due for the permit should be made payable to the Faculty Student Association
Note: checks must be written exactly as indicated above
Faculty Student Association
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Should the vendor be granted the permit so applied for, said vendor, by said acceptance, agrees to the following:
Signature:
TERMS & CONDITIONS
Today's Date:
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Vendors agree to indemnify and hold harmless the State of New York (SUNY), Stony Brook University (SBU), and the Faculty
Student Association of the State University of New York at Stony Brook Inc. (FSA), from and against any damage, fine judgment,
expense or charge suffered, imposed, assessed or incurred for any violation, or occasioned by any act, neglect, or omission of
Vendor acting by himself/herself or any or all, acting singly or together, of his-her employees, servants or agents. So too, as
concerns the obligations of SBU, or FSA, the permit shall be deemed executory only to the extent of monies received by them
hereunder and no liability shall be incurred by them beyond said monies.
The permit is only valid for the dates specified.
Vendors must comply with all regulations of SBU and FSA currently in effect or that may be in effect during the term of the
permit. FSA has the right to refuse any vendor offering samples or giveaways that violate any University policy
or contract. Sample sizes and products must be preapproved before permit is issued.
Our department is unable to act as a sponsor for unions, governmental agencies/politiicans, or religious groups. These must
obtain a sponsor from Labor Relations/Governmental Affairs, or Interfaith Center.
The permit may be revoked for failure to comply with any or all of the terms stated above. Such revocations may be without
notice and the permit fee, if any, will be forfeited by the vendor. No refunds will be issued for no shows or cancellations. If the
building is closed due to emergency or weather a new date will be assigned.
Permits are not transferable and can only be used for vendors specified.
Permits will be revoked if vendor becomes a nuisance or causes any commotion whatsoever.
SBU and/or FSA may delay enforcement of the above terms but any such delay shall not be construed to limit their authority to
enforce the rights of SBU or FSA.
Vendors shall be responsible to be aware of all regulations of any governmental entity, including Stony Brook University having
jurisdiction over the sale of the items proposed to be sold. Vendors shall be required to obtain the proper Health Department
permit, if applicable, and shall be required to show evidence of same if required. Vendors further agree to abide by all necessary
rules and regulations included but not limited to, the regulations for the sale of non-prepackaged foods. Any violation of the
health regulation shall be deemed to cancel the Permit without further notice.
Pursuant to Article 129-A of the New York State Education Law 6437 (Prohibition on the marketing of credit cards) the advertis-
ing, marketing, or merchandising of credit cards to students by vendors is prohibited by the University. Banks, credit unions and
other businesses approved to be present at student orientations/opening of school weeks or other campus activities may not
provide credit card applications to students during those events. For more information call the FSA Services Office at (631)
632-6517.
Vendors shall comply with all applicable Federal, State, and local laws and campus regulations regarding the sales of their
products/services.
Vendors at his/her own expense shall obtain a sales tax collection number from the State of New York, Department of Taxation
and Finance. Vendors must submit a copy of their New York State Certificate of Authority to collect sales tax on taxable sales
along with the completed FSA Application for Vendor Permit.
Vendors are required to carry appropriate insurance, including product liability insurance, vehicle insurance (for vehicles used on
campus), and commercial general liability insurance. Vendors must submit a Certificate of Liability Insurance (ACORD-25 Form)
along with the completed FSA Application for Vendor Permit. The Vendor's Certificate of Liability Insurance must include the
following additional insured language:
The Faculty Student Association, the State University of New York at Stony Brook, the State University of New York and
the State of New York are included as additional insureds under the Business Automobile liability, Commercial General
Liability and Product Liability Insurance policies to include severability of interest clause with respect to claims, demands,
suits, judgement, costs, charges, expenses arising out of, or in connection with any loss, damage or injury resulting from
activities of the vendor, its agents, representatives and employees, waiver of subornation included.