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Step 4: Insurance requirements Central Business District only
Select the option below that refers to your sign:
☐ The sign will remain on private property at all times.
☐ I have attached a certificate of general liability insurance in the amount of at
least $2,000,000.00 with the City of Guelph named as additional insured. I
understand it is my responsibility to ensure such insurance remains in effect as long
as the sign exists in such location.
Step 5: Declaration of applicant
I (print name) certify that:
1. The information contained in this application and other attached
documentation is true to the best of my knowledge.
2. I have authority to bind the corporation or partnership (if applicable).
3. I agree to comply with all relevant sections of the City of Guelph Sign By-law
(1996)-15245, as amended.
Signature of applicant:
Collection of Personal Information
Personal information is being collected and will be used for the purposes of
communicating with applicant and connecting them to the permit and their
declaration, and to connect applicant to insurance coverage as per City of Guelph
Sign By-law (1996)-15245.
Personal information, as defined by Section 2 of the Municipal Freedom of
Information and Protection of Privacy Act (MFIPPA), is collected under the authority
of the Municipal Act, 2001, and in accordance with the provisions of MFIPPA.
If you have questions about the collection, use or disclosure of this personal
information please call 519-822-1260 extension 2349 or email firstname.lastname@example.org.
Alternate formats of this document are available as per the Accessibility for
Ontarians with Disabilities Act by contacting Building Services at 519-837-5615 or
For use by Principal Authority
click to sign
click to edit