2022 CBCA Clayton BBQ Cookoff Vendor Application NOTE: Please note that we are no longer accepting food vendors for the 2022 CBCA Clayton BBQ Cookoff! Thank you! Vendor Type* Vendors on Street, Vending Food Vendors on Street, Not Vending Food Vendors on Street, Vending Prepackaged Food Flame* True False If you will have a flame of any kind at the event, please select 'True' here. Otherwise, select 'False.'Name* First Last dba* Email* Returning Vendor?* Yes No Have you been a vendor for the CBCA Clayton BBQ Cookoff in previous years under the same name/ company name?Address (no P.O. boxes)* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone (work)*Phone (cell)Seller's Permit Number* MenuPlease type out the items you plan to have on your menu.Your application will not be considered without the following: Certificate of Insurance - naming CBCA as additional insured for July 9-10, 2022. Hold Harmless Form (for Non-Food Vendors only) FOLLOWING FOR FOOD VENDORS ONLY Health Department Temporary Food Sales: please upload on this form or fill out from the attached form (below download link) (the Health Dept. has notified us that the amount may change and we will have to collect the difference – we will notify you if this takes place.) Fire Department: please upload on this form or fill out from the attached form (below download link.) Fire Department Form required for all competitors. All permit forms are to be returned to CBCA by 5:00 pm on Friday, June 17, 2022. Are you a Veteran?* Yes No DD-214Max. file size: 512 MB.A. Health Department https://claytoncbca.org/wp-content/uploads/2022/05/20220517_CCHS-Vendor-forms.pdf A. Submit Health Department Form*Max. file size: 512 MB.B. Fire Department If you are attending the event and have a flame of any kind, you are required to submit a completed Fire Department ‘Food Vendor Operations Permit' Application. https://claytoncbca.org/wp-content/uploads/2022/05/20190718_CCCFPD-vendor-permit.pdf B. Submit Fire Department FormMax. file size: 512 MB.Photos Drop files here or Select files Max. file size: 512 MB. Non-Food Vendor Insurance Option* Certificate of Insurance Hold Harmless As a non-food vendor, you have the option of either providing a Certificate of Insurance, or signing the CBCA's Hold Harmless Agreement.Certificate of Insurance Please submit proof of insurance in the below field. Submit Certificate of Insurance*Max. file size: 512 MB.Hold Harmless and Waiver of Liability As used herein, "YOU" and "YOUR" refers to the undersigned "Vendor." The Clayton Business & Community Association, Inc. (CBCA) requires that all vendors execute this Waiver of Liability and Hold Harmless Agreement as a condition of being accepted as a vendor at the 2022 CBCA Clayton BBQ Cookoff. YOU (the Vendor) hereby acknowledge that there may be risks to your person (physical injury) and/or property that you propose to sell at the 2022 CBCA Clayton BBQ Cookoff, including damage or theft of your property. YOU also understand that we remain in the midst of the COVID-19 pandemic, that YOU, inclusive of your staff, employees, or persons who assist you at this event, may become infected through interaction with members of the public regardless of your vaccination status. YOU also understand that CBCA may not require members of the public attending this event to wear approved masks and may not choose to validate and inspect the vaccination status of persons attending this event. YOU, on behalf of yourself, your business, heirs and assigns, and anyone who may assist you in your business while attending this event, hereby fully and voluntarily assume such risks and waive, release, and hold harmless CBCA, its officers and directors, individual and business members of CBCA, CBCA volunteers, and the City of Clayton from any and all claims for personal injury, property damage or death that may result from YOUR participation and presence at the event named herein, and to the fullest extent allowed by law. Further, YOU the undersigned vendor(s) hereby agree(s) to defend, indemnify and hold harmless the Clayton Business and Community Association, Inc., and the City of Clayton, from any and every claim, demand, lien, right, or cause of action of any kind or character, including all costs and attorney's fees, arising out of such participation and attendance at the 2022 CBCA Clayton BBQ Cookoff I hereby certify that I am of legal age and competent to execute this Waiver of Liability and Hold Harmless Agreement, that in doing so of my own free will and accord, voluntarily and without duress, and that I do so intending to bind myself, my executor, my heirs and administrators or assigns to the fullest extent of the law.Hold Harmless and Waiver of Liability SignatureDate MM slash DD slash YYYY Number of 10'x10' Booths Requested* Price: $350.00 Quantity: Corner (Optional)* Price: $175.00 Quantity: Addition to the booth: can request up to two corners per booth. Place 0 if no corner is requested. Ice Price: $10.00 Quantity: Do you want to order ice? 20 lb. bag for $10 a bag. Payment must accompany your application (no orders at the festival).Electricity Price: $50.00 Quantity: $50 charge for electricity, or you may provide your own (enter 0 here) but please advise us in advance for proper placement. Extremely limited.Food Vending Fee Price: $300.00 If you are vending food to the public, we will charge $300 per booth instead of a percentage of sales.Health Department Temporary Food Sales Price: Refundable Clean-Up Deposit Price: Veteran Discount Price: $0.00 Grand Total $0.00 SignatureDate MM slash DD slash YYYY Payment Option* Credit/Debit Card Check Checks must be made payable to "Clayton Business and Community Association" and can be sent to CBCA, BBQ Cookoff, P.O. Box 436, Clayton, CA 94517 Credit CardCard Details Cardholder Name Having issues submitting the form? Please contact support@claytoncbca.org
