Form 10-550 - Instructions Commercial Use Authorization Application - National Park Service

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NPS Form 10-550 (Rev. 11/2016)
OMB Control No. 1024-0268
INSTRUCTIONS
National Park Service
Expiration Date: 11/15/2019
COMMERCIAL USE AUTHORIZATION APPLICATION
APOSTLE ISLANDS NATIONAL LAKESHORE]
415 Washington Avenue
Bayfield, WI 54814
Chris Smith, CUA Coordinator
Phone Number: 715-779-3398, Ext: 1801
The following explanations correspond directly with the numbered items on the Application Form. Please read this entire
document prior to completing the application. Include the nonrefundable application fee when submitting this application.
Enter the service you are proposing to provide. These are the services which are currently approved in the park:
1.
Fishing Charters
Sailboat Charters
Vessel Towing/Salvage
Backcountry Activities
Scuba Diving
Kayak/Canoe Expeditions
Water Taxi-Boating Adventures
2.
Respond “N/A” or list other parks where you will be providing this service.
N/A
Park:__________________________
3.
Enter the legal name of your business. If you have a secondary name under which you are doing business (d.b.a.), please enter
that name also.
4.
Give the name(s) of persons designated as Authorized Agents for your business. This may include the on-site general manager
responsible for day to day operations.
5.
Provide contact information for both the main season and the off-season. Over the term of your authorization, it may be
necessary to contact you to obtain or share information. Your contact information may also be published in the NPS Commercial
Services Directory.
6.
Check the box that identifies your type of business.
7.
If the state in which you operate or the state where your business is domiciled requires a state business license, provide the license
number and year of expiration.
8.
Provide your Employer Identification Number (EIN). The Debt Collection Improvement Act of 1996 requires us to collect an EIN or
Social Security Number (SSN). The NPS will not collect SSNs, only EINs. The EIN is issued by the Internal Revenue Service.
You may receive a free EIN at We
will use the EIN that you provide as needed to collect debts.
9.
Provide proof of General Liability Insurance naming the United States of America, as additional insured in the amounts designated in
the application. Provide proof of vehicle/vessel/aircraft liability insurance, if required by law, or if visitors are transported by
vehicle/vessel/aircraft within the park, or if vehicle/vessel/aircraft are engaged in providing the service (i.e., hauling horses used in the
activity). Insurance companies must be rated at least A- by the most recent edition of A.M. Best’s Key Insurance Reports
(Property-Casualty edition) or similar insurance rating companies (Moody’s, Standard and Poor’s, or Fitch). Refer to “Attachment
B”.
10.
Provide a description of and registration number of each vehicle/vessel/aircraft you will utilize during the course of the proposed
commercial service.
11.
Provide copies of all licenses, vehicle/vessel registration, and certificates of training as required by “Attachment A”.
12.
NPS Management Policy prohibits employees of the NPS and their spouses and minor children from acquiring or retaining any
authorization for conducting commercial services in a park area.
13.
If your business or business owners or current employees or proposed employees have been convicted or are currently under
charges for violation of State, Federal, or local law or regulation in the last 5 years, please give details (does not include minor traffic
tickets).
14.
Please sign and date your application. If the person SIGNING this application is an Authorized Agent for the business, proof of
signing authority must accompany this application.
Attachment A: Provisions and Required Documentation
Attachment B: Insurance Requirements
RECORDS RETENTION. TEMPORARY. Destroy/Delete 3 years after closure. (NPS Records Schedule, Commercial Visitor Services,
Page i of iii
(Item 5D) (N1-79-08-4))

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