OFFICE USE ONLY
APPLICATION
FOR
JULY 21-26, 2015
Date Received __________
OUTDOOR FOOD
CONCESSIONS
Check Number __________
Date __________________
Amount _______________
LIST ALL FOOD ITEMS YOU WILL SELL:
____________________________________________________________________________
____________________________________________________________________________
Size of space needed: ___________________________________________________________
Electricity Needed: ____________________________________________________________
Company Name ______________________________________________________________
Contact Person _______________________________________________________________
E-Mail ______________________________________________________________________
Address _____________________________________________________________________
City ___________________________________ State ________ Zip ____________________
Telephone: Home _________________ Work _________________ Cell _________________
Space Rental Cost ............................................$ __________
(Needing Electricity)
Supply Trucks - $90.00 ......................................
$ __________
(No Electricity)
Supply Trucks - $35.00 .....................................
$ __________
RV Site - Water, Electricity $125.00 .................$ __________ (Limited Space)
Reserved Parking Space (Red Lot) - $30.00 ........$ __________ (Limited Space)
General Week Parking Pass - $20.00 .................$ __________
Please Note:
Every vehicle
Requires a
parking pass.
Contract does not
come with a
parking pass.
TOTAL ENCLOSED .........................................$ __________
To ensure a space ALL CONTRACTS ARE DUE BY APRIL 1, 2015.
Late entries will be accepted upon space available.
Please fill out ST19 Form on back and return with your Certificate of Liability Insurance.
I HAVE READ THE EXHIBITOR’S MANUAL AND UNDERSTAND
ALL RULES AND REGULATIONS AND WILL ABIDE BY ALL.
Exhibitor’s Signature _______________________________________
Date _______________
Rice County Fair Manager ___________________________________
Date _______________
Please return this contract along with your check, payable to the Rice County Fair to:
Rice County Fair, Attn: John Dvorak, PO Box 393, Faribault, MN 55021
ANY QUESTIONS, PLEASE CALL JOHN DVORAK AT (952) 594-4599
ST19
Operator Certificate of Compliance
Read the information on the back before completing this certificate. Person selling at event: Complete this certificate and give it to the
operator/organizer of the event. Operator/organizer of event: Keep this certificate for your records.
Do not send this form to the Department of Revenue.
Name of business selling or exhibiting at event
S eller’s complete address
Minnesota tax ID number
City
State
Zip code
Name of person or group organizing event
Name and location of event
Date(s) of event
Describe the type of merchandise you plan to sell.
Complete this section if you are not required to have a Minnesota tax ID number.
I am selling only nontaxable items.
I am not making any sales at the event.
I participate in a direct selling plan, selling for
(name of company), and the home
office or top distributor has a Minnesota tax ID number and remits the sales tax on my behalf.
This is a nonprofit organization that meets the exemption requirements described below:
Candy sold for fundraising purposes by a nonprofit organization that provides educational and social activities for
young people primarily aged 18 and under
(MS 297A.70, subd. 13[a][4]).
Youth or senior citizen group with fundraising receipts of $10,000 or less per year
(MS 297A.70, subd. 13[b][1]).
A nonprofit organization that meets all the criteria set forth in MS 297A.70, subd. 14
.
I declare that the information on this certificate is true and correct to the best of my knowledge and belief and that I am
authorized to sign this form.
Signature of seller
Print name here
Date
Daytime phone
(
)
PENALTY — Operators who do not have Form ST19 or a similar written document from sellers can be fined a penalty of $100 for
each seller that is not in compliance for each day of the selling event.
Stock No. 2100190
(Rev. 9/02)