Health Permit

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Company Name

Day-of event contact name

Day-of event contact phone

Applicant's Driver's State & License Number

Food Items to be served (only listed foods & beverages may be served)

Place of Preparation & Storage

Texas Sales and Use Certificate

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Health Permit (permanent) and/or Manufacturer's Permit

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Latest Health Inspection Report

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If not required (e.g. you are inspected daily) you may skip this. If it is required and this is skipped, we may not be able to get your permit and all booth fees are non-refundable.

Certificate of Insurance – AI (Brewvolution, LLC)

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NOTE OUR NEW ADDRESS ->
Brewvolution, LLC,
6636 Gentle Wind Ln,
Dallas, TX 75248

Terms and Conditions

I have read and agree to the terms and conditions

All vendors will need to submit a printed copy of the current local health permit and a printed copy of the last health inspection conducted by the local health department. Vendors that do not have their own licensed kitchen will also need to provide a printed permission letter from the owner of the kitchen where the food will be prepared.

Food manufactures must submit a printed copy of the state manufacture’s license.

All vendors must provide a printed copy of the invitation or letter form the event organizer granting permission to take part in the event. (Brewvolution to provide)

I acknowledge reading a copy of City of Dallas Guidelines for Temporary Food Establishments found at dallascityhall.com and understand that failure to meet provisions for a Temporary Food Establishment described in the Dallas City Code, Chapter 17 – Food Establishments, can result in citations for violations and penalties to be assessed in court. I certify that all facts stated in this application are true and correct to the best of my knowledge and belief.

Special Conditions: Comply with all TEMPORARY FOOD GUIDELINES as required by the City of Dallas. Home preparation of food is not allowed. Must have MECHANICAL HEATING OR REFRIGERATION for all potentially hazardous foods. Provide hand and utensil wash set up, stem type dial thermometers for measuring internal food temperature. NO CUTTING OF ANY FOOD ON-SITE. NO STERNO FOR OUTSIDE USE. NO ICE CHEST FOR FOOD STORAGE. NO HOME COOKING

Signature

Name