Print the original to apply
This page lists the questions on the form so they can be read on any device. It is not a fillable form. To apply, download the PDF, print it, and complete it by hand.
Town of Herkimer
Vendor Application
- Business Name:
- Type of Business:
- Owner's Name:
- Address:
- Phone Number:
- Cell Number:
- Email Address:
- Web site Address:
- Applicants Name if different than owner:
- Address:
- Phone Number:
- Cell Number:
- Email Address:
Names of those will be working the event for/with the vendor:
1.
2.
3.
4.
Conditions:
Please provide a current certificate of Insurance naming the Town of Herkimer as additionally insured.
- Applicant Signature:
- Date:
For Town Office Use:
- Fee Accepted by: / Date:
- Certificate of Insurance Accepted: / Date:
- Access/Permission Granted: / Date:
- Town Approval Signature: