Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

VENDOR APPLICATION

  1. Plattsburgh-Logotype-2015_thumb.png

  2. LENGTH OF TIME WHICH LICENSE WILL BE USED:

  3. NO LICENSE IS TO BE ISSUED TO A PERSON UNDER THE 18 YEARS OF AGE. IF LICENSE IS REVOKED, NO APPLICATION CAN BE MADE FOR A PERIOD OF SIX MONTHS. EVERY LICENSEE SHALL CARRY HIS/HER LICENSE WITH HIM/HER. NO REFUNDS WILL BE MADE FOR A REVOKED LICENSE. VENDOR LICENSE AND HEALTH DEPARTMENT PERMITS WILL BE PROPERLY DISPLAYED.

  4. CERTIFICATE OF INSURANCE PROVIDED: NAMING CITY OF PLATTSBURGH AS ADDITIONAL INSURED. PUBLIC LIABILITY IN THE AMOUNT OF $1,000,000.00 FOR DAMAGES TO PROPERTY FROM ANY ONE ACCIDENT OF INCIDENT (COMBINED SINGLE LIMIT FOR PERSONAL INJURY OR DEATH OR PROPERTY DAMAGE) $2,000,000.00 AGGREGATE.

  5. Leave This Blank: