Required fields are marked with asterisks (*)

Refreshment Vehicle License Special Event Application

Name of Event:

Name of Business (if applicable):

Type of Merchandise:

Address (of business):

Phone Number:

Email:

Name of Applicant:

Address (if different than above):

Phone Number (if different than above):

REQUIRED ATTACHMENTS

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Required Attachments

- Application Fee ($115.00)

- Proof of Insurance ($5 mil + Township of Scugog as additional insured – see next pg)

- Fire Extinguisher / Fire System

- Health Department Approval

- Propane/Gas Certificate (If applicable)

- Written Permission from Event Organizer

As owner and/or managing operator of the above, I do solemnly declare that the statements contained in this application are true, and that I am responsible for all individuals under my employment/supervision for the duration of any and all events covered by this application including ensuring that any individuals under my employment/supervision obtain a criminal reference check. I further declare that all fees & charges associated with this application are non-refundable.

Signature of Applicant:

Clear

Date:

How would you like to pay for this application?

In Person (Debit/Cash/Cheque)

Online (Debit/Credit Card)

Insurance

All vendors are required to carry liability insurance when using a Township owned or operated facility (parks, halls, etc.). Vendors have two options when providing liability insurance to the Township of Scugog:

Option 1: Vendor's Insurance Policy A liability insurance policy may be purchased from any insurance provider of the Vendor’s choice. A certificate of insurance coverage must be completed by the insurance broker and submitted to the Township of Scugog for proof of coverage.

Option 2: Liability Insurance Program Vendor's may purchase insurance through the Liability Insurance Program offered by Armour Insurance Broker's Ltd. This program provides a straightforward and affordable avenue for users to obtain liability insurance protection.

To purchase insurance through the Armour Liability Insurance Program use the link below. https://scugog.instantriskcoverage.com/login

For further information contact: Armour Insurance Brokers Ltd. 30 Topflight Drive, Suite #1, Mississauga, ON L5S 0A8 Phone: 905-452-5127 Toll Free: 1-877-452-5127 Direct Contact Puneet Batra 905-452-5127 ext. 252 647-615-4656 puneet@armour-insurance.com

NOTE: All insurance policies must have the Township of Scugog listed as an additional insured.