2. Saturday, July 22, 2023
   Dillon's Woods  |  Purcellville, Virginia
   

4. Business Name (Entrant):*
5. Primary Contact:*
7. Address:*
9. City/State/Zip:*
10. Phone Number:*
12. Email:*
13. Website or Facebook Page:*
15. Describe the food/beverages you will be selling:*
17. Please upload a photo of your product:
18. If you have a logo, please upload it:*
20. Upload a copy of your Loudoun County Health Department Temporary Food Establishment or Virginia Department of Health Permit:*
22. How did you hear about the Purcellville Wine & Food Festival?
    -- Select One --EmailFacebook/social mediaWebsiteNewspaperOnline calendarWord of mouthOther
23. If other, please specify:
25. Purcellville Wine & Food Festival - Food Vendor Application, Deadlines, Terms & Conditions

    Applications, required supporting documents, and full payment must be received by June 30, 2023. The standard booth space (includes one 10' x 10' space) fee is $150. Online payments include a small fee. Vendors have the option to pay by check or online. Applications will be processed as received. The deadline is June 30, 2023 OR when all spaces are filled.

    Payment information will be emailed to you when your application has been approved.  

     

27. Food Vendor Responsibilities. Check each box to agree to the following:*

    1. Exhibitors must bring their own properly anchored canopy, tables, chairs, etc.
    2. Electricity is not provided and will not be available.
    3. Exhibitors/Entrants must adhere to all local, state and federal laws whether stated or unstated in this application. This includes but is not limited to permits and taxes.
    4. Exhibitors/Entrants are responsible for any taxes required in accordance with Virginia and local laws.
    5. Town of Purcellville business license requirements are waived for this event.
    6. Exhibitors/Entrants are responsible for the proper conduct/demeanor of employees, agents and/or volunteers during the festival.
    7. All activity must take place within the designated booth space including giveaways, contests, sales, signage, etc.
    8. Exhibitor/Entrant's Booth must remain open during the entire event. Failure to do so may result in exclusion from future events.
    9. Exhibitors are prohibited from using amplification devices.
29. Certificate of Insurance - You MUST provide this once your application is accepted:

    All vendors are required to maintain general liability insurance. Exhibitors who are serving and/or selling food, alcohol or any other product at the Purcellville Wine & Food Festival must maintain a general liability policy with a minimum coverage of $1,000,000 combined single limits. Coverage is to be on an occurrence basis with an insurer licensed to conduct business in the Commonwealth of Virginia. The insurer must have an A. M. Best rating of A- or better. The insurer must add the Town as an additional insured by endorsement to the general liability policy. A Certificate of Insurance (COI) and the additional endorsement shall be provided to the Town by the exhibitor prior to the event evidencing compliance with these insurance requirements. If you need information about how to obtain this insurance, please email Ashley - events@purcellvilleva.gov.

    You must provide a certificate of insurance or you will not be able to participate.

30. Food Safety and Loudoun County Health Department Requirements:

    Loudoun County Temporary Food Establishment Application

    A) Food Safety requirements and permits of the Loudoun County Department of Health Food Safety must be submitted and observed. B) All Permits and supporting documents must be submitted by Thursday, June 30, 2023. C) Temporary Food Establishment Permits and fees must be submitted with the Loudoun County Health Department to ensure operation of your booth space. Please visit the link above to complete your Loudoun County Health Department Temporary Food Establishment Application. Please provide a copy of this permit with your Food Vendor Application.

32. Cancellation Policy:

    The Purcellville Wine & Food Festival is an outdoor event. All exhibits and/or displays should be produced subject to weather conditions. There is no rain date and fees are not refundable after July 1, 2023. The Town of Purcellville will fully refund the registration fee if cancellation is received, in writing, on or before June 30, 2023. No refunds will be offered after June 30, 2023 – no exceptions.

34. Non-Discrimination Policy:

    The Town of Purcellville affords equal opportunity to all existing and prospective vendors without regard to race, color, sex, gender identity, sexual orientation, political affiliation, religion, age, marital status, disability or handicap, veteran status, or national origin or other criteria protected by law.

    Vendors are permitted to distribute and/or sell their products in compliance with all Virginia laws. All items to be sold must be listed on the exhibitor application and be reviewed by the Town of Purcellville.

36. Authorization and Indemnification:*

    By checking the box, the Entrant: (i) attests that he or she understands and shall comply with all of the guidelines and information provided on this Festival Application.

    The Exhibitor/Entrant, by his authorized signature, hereby agrees to indemnify, hold harmless, and defend the Town of Purcellville, Virginia, its elected and appointed officials, employees, agents and successors in interest from all claims, damages, losses and expenses including attorneys’ fees, arising out of or resulting, directly or indirectly, from the Entrant’s participation in the Purcellville Wine & Food Festival, provided that such claim, damage, loss or expense is: (1) attributable to personal injury, bodily injury, sickness, death, or to injury or destruction of property, including the loss of use resulting there from, and (2) not caused by the grossly negligent act or omission, or willful misconduct of the Town of Purcellville, Virginia, its elected and appointed officials, or its employees acting within the scope of their employment. This Hold Harmless and Indemnification Clause shall in no way be limited by any financial responsibility or insurance requirements and shall survive the termination of this Entrant's Application Form. The Entrant understands that any misrepresentation in this application, deviation from the final approved specifications and activities described herein, or failure to abide by all Federal, State and Local laws, ordinances, policies and procedures may result in the immediate revocation of this approved Event Entrant's Permit and refusal to issue a permit in the future. The Exhibitor/Entrant, by his authorized signature below, hereby authorizes the Town and/or its designee(s) to take photographs, videotape, record, or produce communications for this and/or future events for publicity, promotion, and media coverage.

    1. I agree
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field