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APPLICATION FOR CITY OF JEROME FOOD VEHICLES, VENDORS, TEMPORARY MERCHANT’S OR SOLICITOR LICENSE This application must be signed by the applicant if an individual, by all partners if a partnership, by all members if a limited liability company, by the president and secretary of a corporation and by other similar authorized officer or official of any other entity, permanent address or addresses of each person signing the application, the capacity in which the person signing the application will act; the name of the corporation or other entity on whose account the business will be conducted; and, if a partnership, limited liability company, corporation or other entity, the state in which the entity was organized. The undersigned, upon penalty of perjury, represents to the City of Jerome, Idaho, that: 1. Name and permanent address of the applicant: Mailing address of applicant if different: Telephone number(s) of the applicant: 2. Name and mailing address of Corporation or entity for whom the business will be conducted: 3. Capacity in which the person(s) signing the application will act: 4. Name and telephone number of the person supervising applicant’s business: 5. Name and Permanent addresses of each person signing the application (a business affidavit may be attached): ---PAGE BREAK--- 6. If partnership, limited liability company, corporation or other entity, attach State certificate of existence or similar proof showing the state in which the entity was organized. 7. Idaho State Sales Tax License number: 8. Every address or location of where business will be conducted: 9. Length of time during which it is proposed the business will be conducted, together with signed lease, license or other permission from the owner of the real property at which the business will be conducted stating authority to operate at the location: 10. Exact nature of the goods, merchandise, wares or services which will be dispensed or solicited: 11. Has the applicant(s) been convicted of any crime, misdemeanor or felony? If so, state date, place, and nature of every such conviction: 12. Please provide a valid, government issued ID or Driver’s License for every person who will conduct the business of the applicant whether as a food vehicle, vendor, solicitor, or temporary merchant. 13. If the temporary business involves the dispensing of food or drink for human consumption, provide a current certificate from the South Central Idaho Health District authorizing such activity as being in compliance with law. 14. Please attach a site plan showing the location of the temporary business, outdoor seating arrangements and any other information required by the City Clerk. Description of how any and all waste and grease will be disposed of. The wastewater department shall review and approve such plans. 16. A license fee shall be payable to the City of Jerome in the initial amount of one hundred dollars ($100.00) for a food vehicle, vendor, solicitor or temporary ---PAGE BREAK--- merchant. Each license shall be for a period of six months. Licenses may be renewed for additional six month terms. The renewal fee shall be one hundred dollars ($100.00). 17. Bond Required: Every food vehicle, vendor, solicitor, or temporary merchant shall, prior to commencement of the conduct of business, post a bond with the city clerk in the form of a surety bond, upon a surety license to conduct business in the state of Idaho, deemed appropriate by the city clerk, or a cashier's check made payable to the City of Jerome, in the amount of five hundred dollars ($500.00). After expiration of a license, the city clerk shall, upon application of the licensee, return the bond or cashier's check within six months of an application for return being filed with the city clerk, demonstrating that the terms of the bond had been complied with. The bond shall be forfeited to the City of Jerome upon the affidavit of the city clerk or a police officer of the City of Jerome to the effect that the food vehicle, vendor, solicitor or temporary merchant has not complied with the provisions of this section. 18. If the application is determined to be complete and accurate, the City Clerk shall forward the application and supporting materials to the various city departments for review and recommendation for approval or denial prior to the issuance of a temporary merchant license to each applicant upon the payment of the fee hereafter required. 19. Any license issued under this section shall be conspicuously posted at any place of business at which the food vehicle, vendor or temporary merchant is conducting business, or, if a solicitor, a copy of the license shall be kept by every solicitor to be displayed upon the request of any property owner being solicited or by a police officer of the City of Jerome. Applicant’s Signature Office Use Only Date License Granted: License Renewal: License No. Renewal Expiration: Expiration Date: Bond Returned: SIGN