City of CentervilleMobile Food Vendor Application

City of Centerville

Mobile Food Vendor Application

All of the following documentation must be submitted to the City of Centerville prior to being considered for a Mobile Food Vendor Permit. Documentation can be uploaded at the bottom of this application.

Please allow at least 10 business days for processing. Failure to provide all documentation could lead to a delay in processing of an application.

Completed application (fill out below)
Copy of valid driver’s license for owner and all operators
Transient vendor’s sales tax certificate issued by the Ohio Department of Taxation (this requirement is waived if the applicant states they do not sell any taxable items)
Copy of front and back of current food service operators license issued by the Ohio Department of Health/County
Copy of valid Ohio Department of Motor Vehicle registration
Proof of insurance to include (highlighted language must be included on the policy):
Commercial General Liability Insurance, including products-completed operations, bodily injury, property damage, and personal & advertising injury with limits not less than one million dollars ($1,000,000) per occurrence. The policy shall cover the City of Centerville, its officials, employees and volunteers as additional insureds. Such coverage shall be primary and noncontributing as respects the City of Centerville, its officials, employees and volunteers. The policy shall further provide that it may not be canceled except upon thirty days written notice served upon the City Manager.

Upon review of your application, the City of Centerville will contact you to arrange payment for your permit. Please indicate on your application whether you would prefer to pay via credit card, check/money order or cash.

Please review our quick reference guide to Chapter 844 "Mobile Food Vehicle Vendors" of the codified ordinances of the City of Centerville

Applicant Information:

First name*

Last name*

Middle name*

Home address*

City*

State*

Zip code*

Phone number*

Date of birth*

Driver's license number*

State of issuance*

Email*

Business Information:

Business Name*

Tax ID Number*

Phone number*

Website

Business Address*

City*

State*

Zip code*

Does your business sell any taxable items?*

Yes

Additional information required:

Please upload a transient vendor's sales tax certificate issued by the Ohio Department of Taxation at the bottom of this application.

Vehicle Information:

Make*

Model*

Year*

Color*

License Plate Number*

License Plate State*

VIN*

Corporate Officers:

First name*

Last name*

Title*

Date of Birth*

Home address*

City*

State*

Zip cide*

Phone number*

Does your business have an additional corporate officer?*

Select or enter value

First name

Last name

Title

Date of birth

Home address

City

State

Zip code

Phone number

Documentation upload*

Please upload the following documents prior to submitting this application:

Copy of valid driver’s license for owner and all operators
Transient vendor’s sales tax certificate issued by the Ohio Department of Taxation (this requirement is waived if the applicant states they do not sell any taxable items)
Copy of front and back of current food service operators license issued by the Ohio Department of Health/County
Copy of valid Ohio Department of Motor Vehicle registration
Proof of insurance to include (highlighted language must be included on the policy):
Commercial General Liability Insurance, including products-completed operations, bodily injury, property damage, and personal & advertising injury with limits not less than one million dollars ($1,000,000) per occurrence. The policy shall cover the City of Centerville, its officials, employees and volunteers as additional insureds. Such coverage shall be primary and noncontributing as respects the City of Centerville, its officials, employees and volunteers. The policy shall further provide that it may not be canceled except upon thirty days written notice served upon the City Manager.

Drag and drop files here or

Form of Payment*

Please indicate what form of payment you intend to pay the $50 licensing fee when contacted by the City of Centerville.

Select or enter value

Information:

License is valid for the vehicle listed on this application. License is non-transferable without the written approval of the City Manager.

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