To Download the application click: Fil Am Friendship Festival Booth Application 2010.pdf
Or you can print this page, complete form, and forward to us:
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DALY CITY-QUEZON CITY SISTER CITY
COMMITTEE
16TH ANNUAL FIL-AM
FRIENDSHIP FESTIVAL
Serramonte Center Saturday &
Sunday, September 18-19, 2010
BOOTH APPLICATION 2010
Name of Business/Organization _________________________________________________________________
Contact Name ______________________________________________________________________________
Address ___________________________________________________________________________________
City _________________________________________________
State ______ Zip Code _________________
Phone _______________ Cell _______________ Fax _______________
Email __________________________
Make check
payable to DC-QC SISTER CITY COMMITTEE, INC. and mail with completed
application and waiver to: DC-QCSCC, Inc., Attention Denise Kelly, 71 Fairway
Drive, Daly City CA 94015-1215
Booth
Type Fee Qty Sub Total___
10’x10’
Food Booth
Includes
booth, 1 table, and 2 chairs
$750.00 ea ____ __________
San
Mateo County Health Permit Fee
$93.00 ea
____ __________
Please specify
the type of food___________________________________________________________________
10’x10’ Commercial
Booth ONLY (does not include tables or chairs)
Ex:
Banks, Cargo Company, etc. $250.00
ea ____ __________
Please
describe activity_____________________________________________________________________________
10’X10”
Arts & Crafts Booth ONLY (does not include tables or chairs)
Ex: Clothing, gifts, souvenirs, etc. $200.00 ea ____
___________
Please describe products and
price of merchandise
____________________________________________________________________________________________
____________________________________________________________________________________________
10’x10’
Non-profit Booth ONLY (does not include tables or chairs)
Ex:
Church, Chambers, Association, etc.
$125.00
ea ____ ____________ Taxpayer Identification
Number (TIN) _________________________
Please describe activity
__________________________________________________________________________
8’ Rectangular Table $20.00 ea
____ ___________
Folding Chair $2.00 ea
____
___________ Power – 120 volt, 20 amps; 1 plug
to distro box $40.00 ea
____ ___________
Payment after 09/01/10 $100.00 ____ ___________
TOTAL PAYMENT (MUST BE SUBMITTED WITH APPLICATION) _________________________________
SIGNED INDEMNITY SHEET MUST BE SUBMITTED WITH CHECK AND APPLICATION
____________________________________________________________________________________________________
Authorized
Signature
Date
FESTIVAL
BOOTHS SHOULD BE READY BY 10AM EACH DAY AND CLOSE NO EARLIER THAN 5PM. APPLICANTS ARE RESPONSIBLE FOR CLEANUP
OF THEIR AREA AT THE CLOSE OF EACH FESTIVAL DAY – FAILURE TO LEAVE AREA CLEAN
WILL RESULT IN $250.00 CLEANING FEE.
For additional
information, please contact Prime Image Media Group:
May
Briosos 415/336-7808; mbriosos@prime-image.com
This application is subject to
acceptance by Daly City-Quezon City Sister City Committee, Inc.
Committee Use Only:
Date
Rec’d __________
Date
Accepted __________
Booth
Number __________
DALY CITY-QUEZON CITY SISTER CITY
COMMITTEE
16TH ANNUAL FIL-AM
FRIENDSHIP FESTIVAL
Serramonte Center Saturday &
Sunday, September 18-19, 2010
INDEMNIFICATION AND HOLD
HARMLESS
The
undersigned, as a participant in the 16th Annual Fil-Am Festival and
Daly City–Quezon City Sister City Committee, Inc. agrees to indemnify and hold
16th Annual Fil–Am Festival and Daly City–Quezon City Sister City Committee,
Inc., Prime Image Media Group,
Serramonte Center, and any and all agents and employees of these
entities, free and harmless from any and all claims, liability, loss, damage,
or expenses resulting from the undersigned’s participation in the 16th
Annual Fil Am Festival and the undersigned’s use and occupation of any
facilities provided as a result of the undersigned’s participation,
specifically including, without limitation, any claim, liability, loss, or
damage arising by reason of:
- The death or injury
of any person or persons, including the undersigned or any person who is
an employee or agent of the undersigned, or by reason of the damage to or
destruction of any property including property owned by the undersigned or
any person who is an employee or agent of the undersigned, and caused or
allegedly caused by some act or omission of the undersigned or of an
agent, contractor, employee, servant, sub lessee, or concessionaire of the
undersigned;
or
- The undersigned’s
failure perform any provision of the agreement for participation in the 16th
Annual Fil – Am Festival or to comply with any requirement of law or any
requirement imposed on authorized governmental agency or political
subdivision.
Print
Name of Business/Organization _____________________________________________________
Signature/Title
_______________________________________________________________________
Print
Name of Signer__________________________________________________________________
Date_______________________________________________________________________________