Mobile Food Vehicle Permit Application

Section one: Applicant details

Please note: This is not a food business registration.
This is an application to operate a registered business from an established location.

Name*

First Last

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Is your residential address the same as your mailing address?*

Yes

No

Residential Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone (Business Hours)*

Mobile Phone

Email

Business details*

Foodtrader registration details*

Section two: Type of permit

Select Type*

Annual – Registered vehicle

Annual – Non-registered vehicle

Seasonal/Quarterly – Registered vehicle

Seasonal/Quarterly – Non-registered vehicle

Single use

Requested location*

Requested date/s*

Requested time/s*

Section three: Insurance requirements

The permit holder must ensure they are adequately covered by Public Liability Insurance. To meet Council requirements the insurance policy must note Council’s interest and be for an amount not less than $20,000,000 in respect of any single occurrence.

Section four: Indemnity clause

This applicant agrees to indemnify and keep indemnified Moonee Valley City Council (Council), its servants and agents and each of them from and against all actions, costs, claims, charges, expenses, penalties, demands and damages whatsoever which may be brought or made or claimed against them, or any of them, arising out of or in any way related to the granting of this permit and be directly related to the negligent acts, errors or omission of the applicant.

The applicant’s liability to indemnify Council shall be reduced proportionately to the extent that any act or omission of Council contributed to the loss or liability. The applicant also agrees to hold harmless Council, its servants and agents, and each of them from claims resulting from damage, loss, death or injury whatsoever which may otherwise be brought or made or claimed by the applicant against Council, except to the extent that the principal is negligent.

Section five: Declaration

I have read, fully understand and agree to comply with Council’s Mobile Food Vehicle Policy Guidelines. I understand that my permit may be revoked by Council for any breach of those conditions or conditions outlined within my permit.

Section six: Privacy Statement

The personal information on this form is being collected by Moonee Valley City Council to enable the processing of a Mobile Food Vehicle Application and for the purpose of administration of relevant acts, regulations and local laws. The personal information will be used by Moonee Valley City Council for that purpose or directly related purposes only. The information will not be released unless required by law. The applicant may apply to Moonee Valley City Council for access to and/or amendments of the information.

Supporting Documentation

Map of proposed trading location and PLI.

Max. file size: 256 MB.

Print Name*

Signature*

Date*

Section seven: Fees and payment

A permit fee, in accordance with current Council fees and charges, will apply should the permit be approved. An invoice will be issued upon approval of any permit.

The application of fees is in accordance with the fee schedule set out in part 6.1 of the Mobile Food Vehicle Poly Guidelines.

Mobile Food Vehicle Permit Application