Mobile Refreshment Vehicle Licence Application

By-law 90-2004 requires all Mobile Refreshment Vehicles to obtain a Licence to operate a mobile food service or refreshment vehicle in the Town of Kingsville. This includes, but is not limited to, a food truck, ice cream bicycle, ice cream truck, mobile lunch truck, and any mobile food and refreshment vehicle, but does not include, Mobile Refreshment Vehicles participating in special events in the Town of Kingsville.

The applicant hereby applies for a Mobile Refreshment Vehicle Licence in accordance with the provisions of the Municipal Act and Town of Kingsville By-law 90-2004. The applicant understands and acknowledges that neither the issuance of a Mobile Refreshment Vehicle Licence nor the carrying out of inspection by the Town shall relieve them from responsibility to comply with all applicable statutes, regulations, and by-laws.

For information pertaining to this form, or to arrange for any additional accessibility needs, please contact licensing@kingsville.ca.

Applicant Information

Applicant Name

Address

Town/City

Province

Postal Code

Email Address

Phone Number

Mobile Refreshment Vehicle Information

Name of Business

Type of Business

Mobile Food Service

Refreshment Cycle

Address of Operation

Town/City

Province

Postal Code

Are you the registered owner of this property?

Yes

No

Was this Mobile Refreshment Vehicle licensed in the previous year?

Yes

No

Number of Parking Spaces Available

Type of Parking Spaces Available

Public

Private

Supporting Documentation

Certificate of Insurance

The Certificate of Insurance must include the following:

An amount of at least one million dollars ($1,000,000) comprehensive against for property damage and bodily injury; and
Endorsed to the effect that The Corporation of the Town of Kingsville be given at least 10 days notice in writing of any cancellation, expiration, or variation in the amount of the policy.

Please upload a Certificate of Insurance.

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Allowed extensions pdf

Public Health Inspection

Has the Mobile Refreshment Vehicle been inspected by the Windsor-Essex County Health Unit within the last 30 days?

Yes

No

Fire Safety Inspection

Has the Mobile Refreshment Vehicle been inspected by Kingsville Fire & Rescue within the last 30 days?

Yes

No

Declarations

I, the undersigned, do hereby confirm and attest that

I am the sole proprietor of this business or, where the applicant is a corporation or partnership, I am a person who has authority to bind the corporation or partnership.

I shall release, waive and forever discharge The Corporation of the Town of Kingsville from all claims, demands, costs, expenses, in respect of death, injury, loss or damage; and that I shall at all times indemnify and save harmless the Town of Kingsville from and against any and all manner of claims, demands, losses, costs, charges, actions and other proceedings whatsoever made or brought against, suffered by, or imposed on the Town of Kingsville as a result of the Mobile Refreshment Vehicle.

I solemnly declare that all information provided in and with this application is factual and correct and agree to abide by and adhere to all relevant by-laws, rules and regulations, matters and things as are, or may be enacted by the Town of Kingsville, and to any applicable federal or provincial legislation or regulation in effect, enacted, or amended, from time to time, and make this solemn declaration conscientiously knowing that it is of the same force and effect as if made under oath.

Signature of Applicant

Clear

Date of Signature

Privacy Statement

Personal information collected on this form and any documents attached is requested under the authority of the Municipal Act and Kingsville's Mobile Refreshment Vehicle Licensing By-law 90-2004. The information will only be used for the purpose for which it is collected, and will not be distributed or used by the Town of Kingsville for any other purpose. Questions regarding this collection can be directed to the Town Clerk at 2021 Division Road North, Kingsville, ON N9Y 2Y9 or (519) 733-2305.