2016 Liberty Festival Vendor Application

2016 Liberty Festival
Vendor Application
Vendor Setup: Monday July 4th, 7-11am
Monday July 4th, 12-9pm
When: July 4th, 2016
Where: Petrack Park, Pahrump, NV
Business Name:
Contact:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Description (List all services/products to be displayed):
$100 Description of Power Usage:
Food Booth - 12’ x 12’
$160 Vendor Booth - 12’ x 12’ (Non-member) $150 Food Booth-12’ x 12’ (Non-member)
$200 Vendor Booth - 12’ x 12’
Electrical Outlet ~ 15 Amps
Total Amount $25
Requirements for Food Vendors
Requirements for Non-Food Vendors
Fire Extinguisher (2A10BC)
Seller Permit
Liability Insurance
Vendor Indemnify & Hold Harmless Form
One Time Sales Tax Return Form (Due at end of event)
Fire Extinguisher (40BC Dry Chem)
Seller Permit
Health Permit
Liability Insurance
Vendor Indemnify & Hold Harmless Form
One Time Sales Tax Return Form (Due at end of event)
Full amount is due with application to reserve vendor booth. Applications with payments are due June
22nd, 2016. Please make checks payable to the Pahrump Valley Chamber of Commerce. No applications
will be accepted without proper payment. Fees will be refunded if the application is not accepted.
By signing this agreement, you are agreeing to the “2016 Liberty Festival Vendor Rules & Regulations” accompanied with this application. You have read the terms, conditions, rules, regulations and agree to abide by them
and any decisions made by the PVCC Board of Directors.
Signature
Print Name
Title
Date
Emergency Contact
Phone
Chamber Use Only:
Date Received
Booth Number
Check Number
Paid by CC
Cash
2016 Liberty
Festival Vendor
Rules & Regulations
When: Monday July 4th, 2016
Where: Petrack Park, Pahrump, NV
Vendor Setup: Monday July 4th, 7-11am
Monday July 4th, 12-9pm
1. Booth size is 12’x12’.
2. There is a $25 fee for an electrical outlet. Only (1)
one 15 amp circuit is available. Include intended usage on your application. Vendors are responsible for
bringing their own extension and power chords.
3. DO NOT SUBLET YOUR BOOTH. Vendors found
subletting or sharing their booths without consent
of PVCC will be closed.
4. Vendors are prohibited from selling items not listed
on their application. In addition, the items listed
must be listed with your resale license number and
submitted with application.
5. All vendors are responsible for payment of sales
tax to the State of Nevada Sales Tax Division and
will be required to obtain a Town of Pahrump Seller
Permit.
6. Food Vendors must obtain a Health Permit.
7. PVCC reserves the right to rearrange booths to better accomodate all vendors.
8. PVCC reserves the right to refuse any application at
its sole discretion.
9. Vendors must keep their immediate areas clean.
There will be NO dumping of residue, trash or litter
around the booth areas.
10.Vendors may choose to stay open after the completion of the fireworks show on Monday, July 4th.
Electricity will be required to operate lights after
nightfall. Vendors should plan their booth rental ac-
cordingly by requesting electricty, if intending to
stay open after 8pm.
11. Any checks returned for insufficient funds will be
charged a $30.00 service fee and must be paid in
full within 15 days by cash, money order or cashiers
check. Failure to make full payment will result in
forfeiture of booth space.
12.Neither PVCC nor the Town of Pahrump are responsible for vendor merchandise, their property or
vehicles.
13.PVCC reserves the right to have signage found to
be offensive removed. PVCC has the right to terminate any vendor relationship at any time.
14.One vehicle per booth is allowed to park behind the
vendor if space allows. Vendor vehicles are not allowed to be running while parked in the park.
15.Vendors may setup anytime after 7am on July 4th
and are expected to be ready to open by 12pm. Vendors will be expected to tear down booths on July
4th anytime after the conclusion of the Fireworks
show.
16.Each vendor must have a fire extinguisher in the
booth.
17.Vendor booths must be staffed from 12pm to 9pm.
18.Only food vendors may use A-frame signs advertising their items outside of their booth.
Chamber Use Only:
Date Received
Vendor Hours of Operation July 4th
7-11:30am Vendor Setup
12-9pm Vendors Open
9pm Vendor Tear Down
Booth Number
Check Number
Paid by CC
Cash
Vendor Indemnify &
Hold Harmless
When: Monday July 4th, 2016
Where: Petrack Park, Pahrump, NV
Vendor Setup: Monday July 4th, 7-11am
Monday July 4th, 12-9pm
Business Name: Hold Harmless
All vendors must have proof of liability insurance in the amount of one million dollars listing the town of Pahrump and the Pahrump Valley Chamber of Commerce. Please contact the PVCC regarding group vendor insurance availability.
Vendor shall be soley responsible for any and all injuries to persons or damages to property or any other injury,
claim damage or loss of whatever nature, arising form or related to the festival. Vendors shall indemnify, save
and hold harmless the Town of Pahrump, the Pahrump Valley Chamber of Commerce, its Board, staff, officers,
agents and employees from and against all liability loss, damages, claims, costs and expenses (including reasonable attorney’s fees) arising out of injury to person (including death) or damage to property or any other injury,
claim, damage, loss, cost or expense arising from the festival attended by vendor, including but not limited to, any
negligence, act or omission of vendor.
Signed:
Date:
Liability
The festival will provide minimal security during the event; however, participants are responsible for their own
merchandise and equipment, its protection and insurance. The Town of Pahrump, the Pahrump Valley Chamber
of Commerce, its Board and its staff will not be responsible for losses of any kind, whether by fire, theft, physical
violence, elements of nature or any other cause, however originating.
Signed:
Date:
Chamber Use Only:
Date Received
Booth Number
Check Number
Paid by CC
Cash
Town of Pahrump
400 N Highway 160
Pahrump, NV 89060
Phone: 775 727-5107 Fax: 775 727-0345
E-mail: businesslicense@pahrumpnv.org
Seller Permit
Must be on display for public view at all times.
Business Name: __________________________________________________________
Type of Items: ___________________________________________________________
Nevada Sales/Use Tax Permit: ______________________________________________
Dates of Sale: ___________________________________________________________
Location of Sale: _________________________________________________________
Signature of Applicant: ____________________________________________________
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Property Owner: __________________________________________________________
Address or APN#: _________________________________________________________
Signature: ________________________________________________________________
In signing this document the property owner authorizes the above named business/individual to offer products and/or a
service from the location listed and is not responsible for permits or licenses required.
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Application received by: _______________________________ Date: _______________
Expiration Date: _________________________________
# Vendors ___________ X $5.00 = Total Due $ ___________
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Fees: $5.00 per Vendor.
Issued in accordance with Pahrump Town Ordinance # 35, this permit is subject to renewal every 30 days.
Please attach the following:
A copy of the Nevada Business License and Sales/Use Tax Permit or Exemption
Certificates of Insurance for Workman’s Compensation for employees or Affirmation of Compliance
If you are a corporation or LLC, we also need a copy of your articles of incorporation or organization and list of officers.
If you are a sole proprietorship or partnership, we need child support declaration(s) filled out and signed by the owner(s).
If you are serving food or beverages, you must attach a copy of your health inspection.
Not Valid unless Embossed with Town of Pahrump Seal
Child Support Declaration
I, the above mentioned applicant, ( am; am not) subject to a court order for child support and (am; am
not; n/a) in compliance with the order or a plan approved by the District Attorney or other public agency
enforcing the order for the payment of the amount owed pursuant to the order.
Initial _________