Food Event Licence Application Form printable pdf download

Food Event Licence Application Form

Food Event Licence Application

Payment Information

Fee $ 100.00 per event



Payment:

Cash

Debit

Cheque

Visa/MC

Card # ________________________________________

Expiry Date: ________________

Business Information

Business Name:

Business Location: (Incl. Unit #)

City:

Postal Code:

Phone: (

)

Fax: (

)

Name of Event:

Date of Event:

Applicant Information

Full Name:

Sole Proprietor

*Partnership

Full Names of all Partners:

*Corporation

Full Name of Corporation:

Name(s) of authorized signing officers:

Applicant Address: (Incl. Unit #)

City:

Postal Code:

Phone: (

)

Fax: (

)

E-mail:

Documentation Required:

Articles of Incorporation and/or Business Name Registration

Certificate of Insurance with the Town of Halton Hills listed as the Certificate Holder ($2,000,000 general liablilty)

Signature of Applicant:



The information contained in this application is true and complete to the best of my/ our knowledge, and that failure to

provide complete or accurate information may delay the licensing process;



I/We acknowledge that the Licence is subject to the provisions of the Town of Halton Hills Business Licensing By-law

2005-0067 and agrees to comply with these provisions;



I am the applicant or in the case of a corporation or partnership, I am the person who has the authority to bind the

applicant’

It is an offence under to provide false or misleading information on this application or at any time hereafter to any

person having authority for the enforcement or administration of the by-law and that the provision of false or misleading

information may result in the prosecution and/ or penalties as set out in the by-law, or the refusal, suspension or

revocation of the business licence;

Applicant Name(s) (Print)

Signature(s)

Date

Food Event Licence Application Form

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