Mobile Food Vendor / Food Truck License Application

2. Overview and Instructions
   Please read the official municipal code regarding Mobile Food Vendors before filling out this application. All vendors and applicants are expected to know, understand, and follow the code as written and approved by the City Commission. At the end of the application process, you will be required to electronically sign the form affirming that you have read and understand the provisions in this policy. Please reach out to the City Clerk - 785-690-7246 - with any questions.

   Please read the official municipal code regarding Mobile Food Vendors before filling out this application. All vendors and applicants are expected to know, understand, and follow the code as written and approved by the City Commission. At the end of the application process, you will be required to electronically sign the form affirming that you have read and understand the provisions in this policy. Please reach out to the City Clerk - 785-690-7246 - with any questions.

4. Application Process
   1. Fill out the form, upload the required documents, e-sign and submit <br> 2. The City Clerk’s office will review the application and respond within 2-3 business days <br> 3. Once approved, visit city hall to make payment ($100 annually), provide a copy of your driver’s license, and finalize approval <br> 4. Permit Issued

   1. Fill out the form, upload the required documents, e-sign and submit
   2. The City Clerk’s office will review the application and respond within 2-3 business days
   3. Once approved, visit city hall to make payment ($100 annually), provide a copy of your driver’s license, and finalize approval
   4. Permit Issued

6. Eudora City Code
   Mobile Food Truck Vendors

8. Business Information

10. Name of Business*

12. Business Owner's First Name*

    Registered Business Owner

13. Last Name*

15. Permanent Business Address*

17. Address Line 2

19. City*

20. State*

21. Zip*

23. Phone Number*

24. Email Address*

26. Type of Business*

27. Upload State of Kansas Business License

    Your official business license issued by the State.

31. Applicant or On-Site Contact

33. First Name

34. Last Name

36. Birth Date of Applicant
    Birth Date of Applicant

37. Applicant Phone Number

41. Vehicle Information

43. Vehicle Make & Model*

44. Vehicle License Plate #*

46. Picture of Mobile Food Unit*

50. Insurance Information

52. Insurance Agent*

53. Insurance Agent's Phone Number*

55. Upload Certificate of Insurance*

    Please list The City of Eudora, 4 E. 7th St. Eudora, KS 66025, as the policy holder. This information is usually listed on the bottom of the form.

59. Food & Sales Tax Licenses

61. Kansas Food Truck Establishment License*

63. Kansas Food Truck Sale Tax Registration*

67. Proper Storage of Mobile Food Unit*

    I certify that when the Mobile Food Unit associated with this license application is not in use, it will be stored or parked in compliance with all ordinances and regulations of the City of Eudora and that failure to legally store the Mobile Food Unit may result in the suspension or revocation of the applicant’s license

    1. I have read and affirm this statement to be true
69. Registered Sex Offender*

    I certify that no person whose duties include working upon the premises of the Mobile Food Unit is a registered sex offender, and that I, the applicant, has, subject to audit, performed the necessary background check of all such persons to ensure that the statement is correct.

    1. I have read and affirm this statement to be true
71. License Information & Fee
    No license shall become effective until the required business license and certificate of insurance has been submitted and is on file with the city. The Mobile Food Vendor license fee is $100 annually, valid January 1 - December 31.

    No license shall become effective until the required business license and certificate of insurance has been submitted and is on file with the city. The Mobile Food Vendor license fee is $100 annually, valid January 1 - December 31.

73. Electronic Signature*

    I certify that I am familiar with the provisions of this chapter and will comply with all requirements set forth within; and that all of the information provided in the application is true and correct. By checking the box below I agree and acknowledge my electronic signature is valid and binding in the same force and effect as a handwritten signature.

    1. I have read and understand these statements
Leave This Blank:


75. 1. Receive an email copy of this form.
76. Email address

    This field is not part of the form submission.

77. Submit Submit and Print

* indicates a required field