Vendor Application
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1
2FOOD AND NON-FOOD VENDOR SIGN UP FORM
Columbus Junction
A) GENERAL BACKGROUND INFORMATION
Vendor type:
Profit
Non-profit
Louisa County
Non-LC
Organization/Business Name:
Contact Person:
Mailing Address:
Telephone: (
)
-
Cellular:
(
)
-
Email:
Website:
Sales Tax Number:
Non-profit EIN:
B) PROPOSED FOOD PRODUCTS OR GOODS TO BE SOLD
1st Item:
Wrist band Price $
Without Wrist band price $
nd
2
Item:
_________Wrist band Price $
Without Wrist band price $
rd
3
Item:
_______ Wrist band Price $
Without Wrist band price $
th
4
Item:
_________Wrist band Price $
Without Wrist band price $
C) BOOTH INFORMATION
Number of 15’ wide by 10’ deep booth spaces:
each
Do you need electricity from a City provided connection:
Yes
No
Planned set up time: Date:
Hour:
List all hazardous materials that will be at your site (gasoline, propane, solvents, etc):
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Parent category: Business