Fillable Mobile Food Truck Vending Permit Application PDF Mobile Food Stand Permit Application

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Mobile Food Truck Vending Permit Application PDF Mobile Food Stand Permit Application

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1
County of Hawai‘i Department of Research and Development
“Kona Street Eatz” Mobile Food Stand Permit Application
The County of Hawai‘i Department of Research and Development welcomes applications from
Mobile Food Truck Vendors to participate in its “Kona Street Eatz” Food Truck Program for twelve months
at the Old Kona Airport Recreation Area in Kailua-Kona, beginning on September 1, 2016.
Space is available for seven vendors each day. Applications are considered on a first-come-first-
served basis, with priority for space assignments given to full time vendors. Permit fees for full time
vendors operating up to five days per week is $400.00 per month. Permit fees for part time vendors
operating one day per week is $100.00 per month. Please refer to page 6 for more details on the term
and payments.
Please read this application package carefully. Requirements for a Mobile Food Stand Permit
include: signed application documents, a current Hawai‘i State General Excise Tax Number, a current Food
Establishment Number from the State of Hawai‘i Department of Health (“DOH”), and an approved and
registered commissary/certified kitchen with the DOH.
Approved vendors will receive a Permit which must be displayed at all times during operation in
the zone.
The Department of Research and Development will not consider incomplete applications. Be sure to
include the following items in your submission.
Required Documents
1. Complete application form, signed and dated (page 2)
2. Copy of your Hawai‘i Department of Health Food Establishment Permit
3. Copy of your menu and pricing
4. Certificate of insurance naming County of Hawai‘i as additional insured (see page 4, section 6 for
complete instructions)
5. Signed Mobile Food Vendor Rules (page 7)
6. Signed Photo Release Form (page (8)
Mail or deliver complete application to:
County of Hawai‘i
Department of Research and Development
Food Truck Program
74-5044 Ane Keohokalole Highway, Building C
Kailua-Kona, HI 96740
Or you may email your complete application to: FoodTruck@hawaiicounty.gov
For questions, contact Beth Dykstra, Project Manager at 808.961.8035 or email
FoodTruck@hawaiicounty.gov.
2
Application Form
APPLICATION FOR MOBILE FOOD STAND PERMIT
Please check one selection below:
Mobile Food Truck – Full Time
Mobile Food Truck Part Time
Part Time Vendor/Temporary Permit Holder
Vendor Information
Please Type or Print Clearly Below
Name of Applicant
DBA
Business Address
Contact Person
Business Phone
Cell Phone
Expected Hours of Operation
Day(s) of Operation
Hawai‘i State GE Tax Number
Food Establishment Permit #
Name of the Approved Commissary/Certified Kitchen as registered with the DOH
Does the Applicant have any criminal convictions within the past 10 years?
Yes
No
If yes, please list conviction(s) and disposition(s). Attach separate sheet of paper if needed.
Equipment/Vehicle Information
Please Type or Print Clearly Below
Type of Equipment/Vehicle to be used
Vehicle Year, Make and Model
*Tent Dimensions
*Umbrella Height
*No. of employees at the location
*If applicable
Licensee hereby agrees that it will indemnify and hold harmless the County of Hawai‘i, its Officers, Employees and Agents
from any and all claims of damage to person(s) or property which may result from the activities permitted hereunder,
and shall, if requested, furnish corporate surety or proof of insurance for such indemnity in such manner and amount as
may be deemed requisite.
It is understood that approved permit will be clearly displayed on vehicle/equipment during hours of operation.
Permit applied for and all terms and stipulation agreed to by:
Signature
Title
Print name above
Date
3
Mobile Food Vendor Rules
Rules to Operate a Mobile Food Stand
At Hawai‘i County Mobile Food Vendor Zone
Mobile Food Vendor Zone
Maximum # of Vendors
Hours of Operation
7 per day
7:00 a.m. to 4:00 p.m.
Monday through Friday
*See map on page 9 for specific space assignments. Mobile food vendor may only park in designated,
assigned space as indicated on an approved permit.
Mobile Food Vendor Rules at All Locations
I. General
1. Applications will be accepted on a first-come-first-served basis and will be date and time
stamped upon receipt. In the event there are more applications received than there are
spaces available, spaces will be assigned by lottery with time and place of such lottery to be
determined.
2. The Mobile Food Vendor agrees to comply with all Federal, State of Hawai‘i (“State”), and
County of Hawai‘i (“County”) statutes, ordinances, rules and regulations, including without
limitation, all rules and regulations of the State of Hawai‘i Department of Health (“DOH”) and
the Department of Taxation. All employees handling food and beverage must have a valid
current food handler’s certificate issued by the DOH.
3. All of the services offered by the Mobile Food Vendor shall be made to all persons without
discrimination as to sex, pregnancy, race, ancestry, national origin, religion, color, disability,
genetic information, age, marital status, military service, veteran’s status, sexual orientation,
gender identity, gender expression, lactation, arrest and court record, citizenship, or any
other classification protected by state or federal law.
4. The Mobile Food Vendor agrees to pay all taxes accrued by and assessed against the Mobile
Food Vendor for its operation of the food stand under the permit herein granted.
5. Pursuant to Executive Order No. 142, County of Hawai‘i, dated February 11, 2005: During the
permit period, the Mobile Food Vendor agrees as follows:
a. The Mobile Food Vendor shall comply with all requirements set forth in Federal and State
laws and regulations relative to Title VI of the Civil Rights Act of 1964, as amended, which
provide for non-discrimination in federally assisted programs.
b. The Mobile Food Vendor shall not discriminate against any employee or applicant for
employment because of race, ancestry/national origin, religion, color, disability, age,
marital status, military status, veterans’ status, sexual orientation, lactation, arrest and
court record, citizenship, or any other classification protected by state or federal law. The
Mobile Food Vendor shall assure that applicants are employed and that employees are
treated during employment without regard to race, ancestry/national origin, religion,
4
Mobile Food Vendor Rules
color, disability, age, marital status, military status, veteran’s status, sexual orientation,
lactation, arrest and court record, citizenship, or any other classification protected by
state or federal law. Such action shall include, but not be limited to, the following:
employment, upgrading, demotion, or transfer; recruitment or recruitment advertising;
layoff or termination; rates of pay or other forms of compensation; and selection for
training. The Mobile Food Vendor agrees to post in conspicuous places notices to be
provided by the contracting officer setting forth the provisions of the nondiscrimination
clause.
c. The Mobile Food Vendor shall in all solicitation or advertisements for employees placed
by or on behalf of the Mobile Food Vendor, state that all qualified applicants shall receive
consideration for employment without regard to race, ancestry/national origin, religion,
color, disability, age, marital status, military status, veteran’s status, sexual orientation,
lactation, arrest and court record, citizenship, or any other classification protected by
state or federal law.
d. In the event of the Mobile Food Vendor’s noncompliance with the nondiscrimination
clauses of this contract, this contract may be canceled or suspended in whole or in part
and the Mobile Food Vendor may be declared ineligible for further County contracts until
such time that the Mobile Food Vendor by satisfactory evidence, in good faith, ceases
such discriminatory practices or procedures.
e. The Mobile Food Vendor who subcontracts any portion of the contract shall assure the
County that such subcontractor shall abide by the nondiscrimination provisions stated
herein and agrees that any subcontractor who is found in violation of such provisions shall
subject the principal Mobile Food Vendor’s contract with the County to be terminated or
suspended pursuant to Section (4) above.
f. The County may direct any bidder, prospective contractor, or subcontractor to submit a
statement in writing signed by an authorized officer, agent, or employee of the
contracting party that the signer’s practices and policies do not discriminate on the
grounds of race, ancestry/national origin, religion, color, disability, age, marital status,
military status, veteran’s status, sexual orientation, lactation, arrest and court record,
citizenship, or any other classification protected by state or federal law, and that the
terms and conditions of employment under the proposed contract shall be in accordance
with the purposes and provisions stated herein.
6. The Mobile Food Vendor shall reimburse, save, defend and hold harmless the County of
Hawai‘i, and all of its officers, agents, employees, guests or business visitors from and against
all costs, expenses, damages and attorney’s fees resulting from any and all claims, demands,
suits, actions, or proceedings for property damage or personal injury, including death, arising
out of, resulting from, or in connection with the operation of the food stand by the Mobile
Food Vendor, irrespective or notwithstanding that the negligence of the County, its officers,
agents, or employees are alleged to have caused or contributed to such property damage or
personal injury. The Mobile Food Vendor shall procure a policy or policies of General Liability
Insurance and Motor Vehicle Insurance (if the mobile stand is in fact a licensed vehicle)
carrying a minimum amount of coverage of One Million Dollars ($1,000,000.00) per person
and One Hundred Thousand Dollars ($100,000.00) property damage, with a maximum
$500.00 deductible, with a company or companies authorized to do business in the State of
5
Mobile Food Vendor Rules
Hawai‘i. Such insurance shall be procured to cover all claims arising out of the operations,
premises, products and completed operations of the Mobile Food Vendor. The County of
Hawai‘i shall be named as additional insured on all policies and a certificate of insurance shall
be filed with the Director of Finance prior to entering into a contract. All expenses connected
with the procuring of such insurance shall be borne by the Mobile Food Vendor. If required
by law, the Mobile Food Vendor must carry Workers Compensation insurance for all
employees and provide a certificate to that effect.
7. All Mobile Food Vendors are cautioned to thoroughly investigate all aspects and risks involved
with the operation being requested. All Mobile Food Vendors are further cautioned to
investigate availability and cost of liability insurance prior to submitting an application.
8. All mobile food vendors are required to comply with the Americans with Disabilities Act
(“ADA”). An informational brochure is included with these Rules to inform vendors of their
responsibility to comply with the ADA. These procedures help vendors plan for accessibility
and reasonable modifications for people with disabilities. Through this ADA Compliance
Procedure, the County has placed the responsibility of compliance on the Vendor and will not
be held responsible for failure to comply with ADA requirements.
II. Operation of Mobile Food Vending Stand
1. The Mobile Food Vendor shall keep and maintain their space and the adjoining areas in a clean
and sanitary manner and shall be responsible for providing a minimum of one (1) refuse
container with lid. The Mobile Food Vendor will police the area and remove all rubbish at the
end of each work day. No equipment, structures or stands, mobile or otherwise will remain
at the site overnight or during non-working days.
2. The Mobile Food Vendor shall provide at its own expense, all equipment, dishes, furniture,
utensils and supplies necessary for the proper operation of the business for which the space
is granted.
3. All vendors must provide either completely self-contained mobile vending units or provide for
and pay for the cost of outside utilities. No temporary or permanent utility lines may be
installed without the written permission, in advance, of the Director of Research and
Development.
4. County will not be responsible for any damages to or losses of Mobile Food Vendor’s property
caused by vandalism or any other reason.
5. The Mobile Food Vendor shall not permit disorderly persons to remain or loiter about the
premises.
6. All signs posted must conform to the County Sign Ordinance. Signs will be displayed only
during the hours that the zone is open for business.
7. Hours of operation are 7:00 a.m. to 4:00 p.m. Monday through Friday.
8. Under no circumstances will the Mobile Food Vendor or its employees be allowed to reside
or camp in the zone.
6
Mobile Food Vendor Rules
9. The Mobile Food Vendor shall not alter, modify or change the designated area or any
improvements located thereon without first obtaining prior written approval from the
Director of the Department of Research and Development. Any improvements made shall
become the property of the County and shall remain at the site at the conclusion of the permit
period. Improvements made without the written approval of the Director of Research and
Development shall be either left in place or removed at Mobile Food Vendor’s expense, solely
at the option of the County.
10. The County-issued Approval Permit must be displayed at the premises at all times during
hours of operation.
III. Term
The permit term shall be for a twelve-month period beginning September 1, 2016, and ending
August 31, 2017, with the month of September fee-free. All permits shall be revocable on notice
of thirty (30) days or less for any reason by the County, provided that such notice shall be in
writing to the Mobile Food Vendor. The permit is issued in accordance with HRS Section 102-2
(b) (7) and shall not be considered a concession.
IV. Fees and Payments
1. Permit fee for full time vendors operating up to five days a week:
a. $400.00 per month for a twelve-month permit. The first month’s fee (September) will be
waived. Mobile Food Vendor’s total fee for the full twelve month permit is $4,400.00.
Vendors may make payments on a month to month basis.
2. Permit fee for part time vendors operating one day a week:
a. $100.00 per month for a twelve-month permit. The first month’s fee (September) will be
waived. Mobile Food Vendor’s total fee for the full twelve-month permit is $1,100.00.
Vendors may make payments on a month to month basis.
3. Payments will be made monthly, in advance, and made payable to the “County Director of
Finance” and submitted to:
County of Hawai‘i Department of Research and Development
74-5044 Ane Keohokalole Highway, Building C
Kailua-Kona, HI 96740
All payments must be accompanied by an explanation as to the payment period, the name of the
Mobile Food Zone (Kailua-Kona) involved and the name of the Mobile Food Vendor. Payments
must be received by the 25
th
of each month for the following month’s permit fee. Payments may
be made for more than one month at a time.
4. The Mobile Food Vendor shall not, without written consent of the County, sublet, assign,
hypothecate or mortgage its permit or any rights thereunder; any consent given by the County
shall not operate as a waiver of this condition for future subletting, assignment, hypothecating or
mortgaging.
5. In the case of non-payment of fees as provided above, or violation of any other of the foregoing
or following provisions by the Mobile Food Vendor, the County shall have the right to either
terminate the permit without notice, either by force or otherwise, without being liable to any
7
Mobile Food Vendor Rules
prosecution therefor, either for damage to or loss of any property belonging to the Mobile Food
Vendor or to the business of the Mobile Food Vendor and to re-let said vendor space for such
time expiring before or after the end of the term of the permit as specified herein and to receive
the rent therefor, holding the Mobile Food Vendor liable for any deficiency in the rent. Any act of
receipt of money by the County shall not operate as a waiver of the right to terminate the permit
for any then or theretofore existing or future breach of covenant or agreement by the Mobile
Food Vendor. The Mobile food Vendor hereby waives demand of rent or possession prescribed
by any statute whatsoever.
6. The Mobile Food Vendor will pay all reasonable costs, attorney’s fees, and expenses that shall be
made or incurred by the County in enforcing the provisions of this agreement. Provided, however,
that no such liability shall accrue unless and until an actual breach of the conditions shall have
been established.
7. In case of any doubt as to the interpretation of the terms of this agreement, the interpretation
given and made by the Corporation Counsel of the County of Hawai‘i shall govern and control.
I have read and understand the above rules. Upon issuance of the requested permit, I hereby agree
to all terms and conditions mentioned herein.
Signature
Date
Print Name
Company
8
Photo Release Form
Kona Street Eatz Standard Photo Release Form
I hereby authorize Kona Street Eatz and the County of Hawai‘i to publish the photos taken of me for use
in any Kona Street Eatz or County of Hawai‘i printed publications and website.
I acknowledge that since my participation in any publication and website produced by Kona Street Eatz
and the County of Hawai‘i is voluntary, I will receive no financial compensation.
I further agree that my participation in any publication and website produced by Kona Street Eatz and
the County of Hawai‘i confers upon me no rights of ownership whatsoever. I release Kona Street Eatz
and the County of Hawai‘i, its contractors, vendors, and employees from liability for any claims by me or
any third party in connection with my participation.
Signature
Date
Print or Type Name
9
Vendor Zone Layout and Map
Vendor Zone Layout and Map of New Location
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Mobile Food Truck Vending Permit Application PDF Mobile Food Stand Permit Application

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Completed 19 February 2020

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