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AMENDMENT TO APPLICATION Receipt # Receipt # Date Submitted Date Submitted Amunt paid Amunt paid COMMERCIAL VENDOR APPLICATION PEDDLING, SOLICITING, SPECIAL EVENT VENDOR, VENDOR AT ATHLETIC EVENT Chapter 26, Businesses, Article IV, Peddlers, Cmmercial Vendrs & Slicitrs Applicatins must be submitted n later than furteen days prir t the requested effective date. 26-113(a) Fees listed belw. Fees are nn-refundable. Peddling - traveling by ft r autmtive vehicle frm place t place r frm street t street, carrying, cnveying r transprting gds, wares, merchandise, including fd prducts, ffering and expsing the same fr sale r making sales and delivering articles t purchasers, r taking r attempting t take rders fr the sale f gds, wares and merchandise, bks r magazines, persnal prperty f any nature whatsever fr future delivery, r fr services t be furnished r perfrmed in the future, whether r nt such individual has, carries r expses fr sale a sample f the subject f such sale r whether the subject is cllecting advanced payments n such sales r nt. Fees: Applicatin Fee: $50.00 Daily Fee Optin: $10.00 per day/peddler Backgrund check All applicants and listed peddlers must submit a criminal backgrund check valid within 30 days f applicatin. Please visit www.michigan.gv/ichat t perfrm backgrund check t be submitted with the applicatin. Backgrund check fee Yearly Fee Optin: $1,825.00 (calendar year January 1 t December 31) Amendment t the Applicatin: $16.00 Sliciting - charitable, religius, plitical rganizatin any persn wh requests mney, credit, prperty, financial assistance r ther thing f value, by persnal interview r therwise, n the plea r representatin that such mney, credit, prperty, financial assistance r ther thing f value, r the net prceeds ver reasnable expenses theref, will be used fr a charitable, religius, patritic, civic, educatinal r philanthrpic purpses. N applicatin fee Fees: Backgrund check: All applicants and listed slicitrs must submit a criminal backgrund check valid within 30 days f applicatin. Please visit www.michigan.gv/ichat t perfrm backgrund check t be submitted with the applicatin. Backgrund check fee Vending during special events - any cmmercial vendr engaged in the sale f gds, wares, r merchandise, including fd prducts, n public prperty at a statinary r fixed lcatin during a special event in the lcatin f the special event. (see definitin f cmmercial vendr) NOTE: Vendrs wh wish t perate during a special event must btain apprval frm the event crdinatr. The vendr applicatin must be submitted at least tw weeks prir t the event. Fees: *Applicatin Fee: $50.00 *Daily Fee: $10.00 per day/per peddler/per lcatin *50% discunt fr Birmingham licensed merchants Backgrund check: All applicants and listed vendrs must submit a criminal backgrund check valid within 30 days f applicatin. Please visit www.michigan.gv/ichat t perfrm 1

backgrund check t be submitted with the applicatin. Backgrund check fee Vending at schl r ther athletic events in city parks - any cmmercial vendr engaged in the sale f gds, wares, r merchandise, including fd prducts, n City prperty at a statinary r fixed lcatin during schl r ther athletic events at City parks. (see definitin f cmmercial vendr) Fees: *Applicatin Fee: $50.00 *Daily Fee: $10.00 per day/per peddler/per lcatin *50% discunt fr Birmingham licensed merchants Backgrund check: All applicants and listed vendrs must submit a criminal backgrund check valid within 30 days f applicatin. Please visit www.michigan.gv/ichat t perfrm backgrund check t be submitted with the applicatin. Backgrund check fee Definitin f Cmmercial Vendr: Cmmercial vendr shall mean any persn ffering, expsing fr sale r making available fr a price r dnatin, making sales and delivering articles t purchasers, r taking r attempting t take rders fr sale f gds, fdstuffs r services f any kind, fr immediate r future delivery r perfrmance, whether r nt such persn has, carries r expses fr sale a sample f the subject f such sale r whether r nt the persn is cllecting advance payment n such sale, by any f the fllwing: (1) Frzen Cnfectin Vendrs, (2) Special Event Vendr, (3) Schl Vendr r ther Vendr at an athletic event in a City park. APPLICANT INFORMATION - PLEASE PRINT 1. Full Name: 2. Address (residence): (include city, state, and zip) 3. Phne: Fax: 4. Email: 5. Length at residence: years mnths 6. Driver s License #: Vehicle Plate #: If vehicle is t be used: Year Make Mdel 7. Height: Weight: Clr f Hair: Clr f Eyes: Date f Birth: ORGANIZATION/BUSINESS INFORMATION - PLEASE PRINT 1. Organizatin/Business Name: 2. Address (business): (include city, state, and zip) 2

3. Phne: Fax: 4. Is the rganizatin/business tax exempt/charitable? 5. Is the rganizatin/business licensed t slicit by the State f Michigan? 6. Type f rganizatin/business? 7. If emplyed r acting as an agent fr a parent cmpany: Organizatin: Phne Address (business): (include city, state, and zip) Type f Organizatin: DETAILS OF ACTIVITY 1. Date & Time f Operatin: (Nte: Sliciting and peddling is allwed frm 9:00 AM t 5:00 PM EST and frm 9:00 AM t 8:00 PM during State f Michigan daylight savings time.) Dates: Frm:, 20 (Mnth and Day) T:, 20 (Mnth and Day) Hurs: Frm: A.M. / P.M. T: A.M. / P.M. 2. Brief Descriptin f activity t be cnducted: 3. Indicate type f sliciting/peddling/vending: FOOD ( ) MERCHANDISE ( ) 4. Gds r services t be sld: (Sales are limited t the prducts specified n the applicatin.) 5. Lcatin f activity t be cnducted (check all applicable): residential - dr t dr business - dr t dr special event (apprval by event crdinatr is required) ther 6. Number f peddlers, slicitrs r vending lcatins (as set by event crdinatr): 3

ADDITIONAL INFORMATION 1. Is this yur first time applying fr a sliciting/peddling/vending permit in Birmingham this year? If n, list the dates f yur previus applicatin: 2. Have yu r yur emplyer ever been cnvicted f any crime, misdemeanr, felny, r vilatin f any municipal rdinance? YES NO If answer is yes, give particulars f each charge and state dispsitin f each: 3. Have yu r yur emplyer ever had a vendr/sliciting/peddling license revked in anther City? YES NO If answer is yes, please describe the circumstances, including the year(s) the license was revked: 4. List three references, wh will certify as t the applicant s gd mral character and business respnsibility: Name: Phne #: Name: Phne #: Name: Phne #: 5. Vendrs Only: D yu plan t use a tent? If yes, hw many? Size f each tent: Tent #1 Tent #2 Tent #3 Cntact the Cmmunity Develpment Department fr infrmatin n tent, electrical, and sign permits. (248.530.1850) 6. Slicitrs, peddlers, and vendr must include the fllwing infrmatin fr each slicitr/peddler/vendr. Attach additinal sheet if necessary. PLEASE PRINT CLEARLY. Include a cpy f the Drivers License r State ID. Please nte: All applicants and vendrs/slicitrs listed belw must submit a criminal backgrund check valid within 30 days f applicatin. Please visit www.michigan.gv/ichat t perfrm backgrund check t be submitted with the applicatin. Backgrund check fee 4

LIST OF SOLICITORS, PEDDLERS, VENDORS Full Name Address Phne # Sex Date f Birth Driver s License # SIGNATURE OF APPLICANT The issuance f a sliciting/peddling/vending permit is fr the individual r cmpany applying fr such permit. Permit(s) are nt transferable. Vilatins resulting frm transfer f wnership will result in lss f permit(s). Vilatrs will be subject t a municipal civil infractin. In accrdance with City Ordinance, slicitrs/peddlers/vendrs must display the license issued s that it is visible t any persn dealing with the slicitr/peddler/vendr. The City shall have the right t investigate and verify the infrmatin cntained in this applicatin. I understand that any amendments t the riginally apprved applicatin must be submitted t the City Clerk fr review and apprval and shall nt be effective prir t such apprval. I understand that my peddler/vendr/slicitr license may be revked by the City fr any f the reasns stated in Chapter 26 f the City Cde. I hereby certify that the freging statements are true and accurate t the best f my knwledge and belief and that I have read the city s sliciting/peddling/vending rdinance and agree t abide by its terms. Signature f Applicant: Date: (See next page fr a list f items t be submitted with this applicatin.) 5

The fllwing infrmatin must be submitted with the applicatin: Applicatin and Daily Fees (payable t the City f Birmingham) Insurance Certificate (See Standard Insurance Requirements) 2 x 2 phtgraph f applicant (taken within 60 days) Cpies f drivers license r state ID fr applicant and each slicitr, peddler, vendr Criminal backgrund check fr applicant and each slicitr, peddler, vendr Cpies f licenses/permits required by state law (example: State f MI slicitr license r tax exempt/charitable status) List dcument(s) submitted: Must cmply with all requirements f the Oakland Cunty Health Department FOR CITY USE ONLY DEPARTMENT REVIEWS: APPROVAL BY CLERK S OFFICE (review f applicatin t cnfirm all required infrmatin has been submitted) APPROVAL BY POLICE DEPT (review f applicant and emplyee backgrund, inspectin f frzen cnfectin vehicle) If denied, reasn fr denial: APPROVAL BY TREASURER (review fr utstanding fees due t the city) APPROVAL BY FINANCE (review f insurance certificate t cnfirm it meets the City requirements) Revised 05/13/14 6

STANDARD INSURANCE REQUIREMENTS Where insurance is required t be carried t make applicatin fr a permit r license, the applicant shall prcure and maintain the fllwing cverages and limits unless therwise specified in this dcument. Wrkers cmpensatin insurance. Wrkers cmpensatin insurance, including emplyers liability cverage, in accrdance with all applicable statutes f the state. Cmmercial general liability (CGL) insurance. Cmmercial general liability insurance n an ccurrence basis, with limits f liability nt less than $1,000,000 per ccurrence cmbined single limit, persnal injury, bdily injury and prperty damage. Cverage shall include brad frm general liability extensins r equivalent. Mtr vehicle liability insurance. Mtr vehicle liability insurance, including all applicable n-fault cverages, with limits f liability f nt less than $1,000,000 per ccurrence cmbined single limit bdily injury and prperty damage. Cverage shall include all wned vehicles, all nn-wned vehicles, and all hired vehicles. Additinal insured. Cmmercial general liability insurance and mtr vehicle liability insurance as described abve shall include an endrsement stating the fllwing shall be Additinal Insureds: The City f Birmingham, including all elected and appinted fficials, all emplyees and vlunteers, all bards, cmmissins and/r authrities and bard members, including emplyees and vlunteers theref. This cverage shall be primary t any ther cverage that may be available t the additinal insured, whether any ther available cverage be primary, cntributing r excess. Prfessinal liability. Prfessinal liability insurance with limits f nt less than $1,000,000 per claim if prviding service that is custmarily subject t this type f cverage. Cancellatin ntice. Thirty days advance written ntice f insurance cancellatin, nn-renewal and/r reductin r material change in cverage shall be prvided t the city. Ntice f cancellatin, material change r reductin shall be attached t the certificate f insurance, r therwise evidenced as in effect under the plicy listed. Prf f insurance cverage. The city shall be prvided with certificates f insurance evidencing the cverages utlined abve. Expiratin. If any f the abve cverages expire, renewal certificates and/r plicies must be prvided t the city at least ten days prir t the expiratin date. Acceptability f insurance cmpany. All cverages shall be with insurance carriers licensed t d business in the state. All cverages shall be with carriers acceptable t the city. 7