Fillable LICENSE APPLICATION FOR MOBILE FOOD VENDOR VEHICLE (MFV) (City of South Bend)

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LICENSE APPLICATION FOR MOBILE FOOD VENDOR VEHICLE (MFV) (City of South Bend)

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For all municipal business license questions, contact: Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR – MOBILE FOOD VENDOR VEHICLE (MFV)
MUNICIPAL CODE SECTION – 4-45 (SEE ALSO 4-46)
DEFINITIONS:
Mobile Food Vendor Vehicle means a licensed motorized vehicle that is enclosed, self-contained and
serves food items to the general public. Food items may be prepared, cooked, and assembled in the
vehicle or may have been prepared, wrapped or packaged in a licensed food establishment.
M
obile Food Vendor Vehicle Sales means 80% of all revenues must come from food and beverages.
IF DESCRIPTION DOES NOT APPLY, SEE
Food Vending Vehicle (§4-25)
GENERAL INSTRUCTIONS:
1.
Print legibly and complete all sections to ensure efficient processing.
2.
Assemble all required information and materials before filing application.
3.
Thoroughly review all applicable Municipal Code Sections listed above.
4.
Licenses expire March 1st for MFV names beginning with letters A-M; Licenses expire
Ap
ril 1st for MFV names beginning with letters N-Z.
5.
Add 10% to license fee for renewal after expiration date.
6.
Include $5.00 license application fee payable to City of South Bend.
7.
License fee payable to City of South Bend due at issuance - $525.00 for 1-year, $200.00 for 90-days,
$130.00 for 30-days, $50.00 for 1-day.
REQUIRED INFORMATION AND MATERIALS:
1.
Health Permit pursuant to inspection and approval by County Health Officer.
2.
Commissary health permit.
3.
St. Joseph County Health Department Plan and Review Application for new facilities.
4.
Fire Department Inspection as required by City Controller.
5.
Valid certificate needs to be signed by the Department of Weights and Measures if food is to be sold
by w
eight or measure.
6.
Certificate of liability insurance with the City of South Bend listed as the certificate holder.
7.
If operating on private property include a letter of permission from the property owner.
APPLICATION PROCESS:
1.
Review Municipal Code Sections 4-45 & 4-46 thoroughly.
2.
Submit Application with $5.00 Processing Fee.
3.
Inspection and approval by the County Health Officer, as evidenced by a valid Health Permit
4.
Inspections by the Fire Department.
5.
Applicants desiring to sell food by weight or measure shall file a valid certificate signed by the
Department of Weights and Measures that all scales and measures to be used in said business hav
e
b
een tested and approved, at the time of making application.
6.
License will be issued upon approval and payment of license fee.
1
For all municipal business license questions, contact: Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR – MOBILE FOOD VENDOR VEHICLE
MUNICIPAL CODE SECTION – 4-45 (SEE ALSO 4-46)
I. APPLICATION TYPE Check One: New Renewal
II. BUSINESS DATA
A. Business Name:
B. Business Address:
City: State: Zip:
C. Mailing Address (If different from above):
City: State: Zip:
D. Business Telephone Number:
E. Business Fax Number:
F. E-Mail Address:
G. Commissary Name:
H. Commissary Address:
I. Does the commissary have a valid Food Service Permit: Yes No
J. Does 80% of all revenues come from food and beverage sales: Yes No
K. Number of employees:
L. Insurance Carrier, Agency, and Amount of Liability Insurance:
M. Vehicle License Number and Issuing State:
N. Vehicle Identification Number (VIN):
O. Driver’s License Number and Issuing State:
P. Name of Vehicle:
Q. Do you plan to park in the Central Business and Entertainment Area (CBEA): Yes No
R. Will you be vending from private property: Yes No
For Office Use Only
Application Filed Fire Dept. Approval
Application Fee Paid Health Dept. Approval
Sent to Dept. License Fee Paid
Building Dept. Approval License Number
GIS Identifier MFV Decal Number
Not Approved
Reason
2
For all municipal business license questions, contact: Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR – MOBILE FOOD VENDOR VEHICLE
MUNICIPAL CODE SECTION – 4-45 (SEE ALSO 4-46)
III. PERSONAL DATA
A. Applicant's Legal Name:
B. Residential Address:
City: State: Zip:
C. Residential Telephone Number:
D. Cell Phone Number:
E. Position with Business:
F. E-Mail Address:
IV. GENERAL QUESTIONS
A. Will food be sold by weight or measure?
Yes No
If yes, please attach a certificate from the Department of Weights and Measures.
B. What type of license are you applying for? 1-day 30-day 90-day Annual
C. If participating in an event, what are the event dates?
V. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION
VI. INCLUDE A CERTIFICATE OF LIABILITY INSURANCE
VII. INCLUDE A COPY OF THE ST. JOSEPH COUNTY FOOD SERVICE PERMIT
VIII. INCLUDE A COPY OF THE COMMISSARY FOOD SERVICE PERMIT
IX. INCLUDE A LETTER OF PERMISSION FROM THE PROPERTY OWNER IF OPERATING ON PRIVATE
PROPERTY
X. AFFIRMATION
I, hereby, certify and affirm that all of the information I have given in this application is true and
accurate to the best of my knowledge. I further certify that I have in no way attempted to
mislead the City in this application by omitting facts known to me. I have read and understand
the required regulations for the Mobile Food Vendor License found in the City of South Bend
Municipal Code, Sections 4-45 and 4-46.
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LICENSE APPLICATION FOR MOBILE FOOD VENDOR VEHICLE (MFV) (City of South Bend)

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Completed 16 July 2020

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