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Application Information

Type of Application *
Please select one option below. If you are submitting an update, please note all updates must be submitted within 15 days of change.
Type of Sidewalk Vendor*
Applicant Information
First Name*
Last Name*
Phone Number*
Email Address*
Street Address*
City*
State*
Zip Code*
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Start Date in Modesto*
Start Date in Modesto
Business Name *
Business Email Address
Business Phone Number*
California Seller's Permit Number*
Ownership Type*
Business Category *
Describe Business Category *
Insurance Requirement Acceptance *
1. I understand that I am required to provide proof of general liability insurance with my permit application as outlined below.
Proof of general liability insurance with a minimum limit of liability per occurrence of $1,000,000 for bodily injury and property damage. This insurance shall indicate on the certificate of insurance the following coverage and indicate the policy aggregate limit applying to: premises and operations; broad form contractual; independent consultants and subcontractors; products and completed operations as applicable.
Business Description*
Description of Desired Location*
Describe and provide drawings of intended location.
Proposed Times and Days of Operations*
List physical dimensions of intended equipment displays, shade cover, table and chairs, carts, kiosk or other items:*
For example, cart (3' wide by 4' height)
Food Preparation On-site*
Heating Element Location*
Type of Heating Element*
Describe Type of Food Sold*
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Permit Issuance Acknowledgement *
1. I understand my sidewalk vendor permit will be issued under the provisions of Modesto municipal code title 4, chapter 1, article 12.
Municipal Code Reference
Title 4, Chapter 1, Article 12
Responsibility Acknowledgement *
Please check both in acceptance of this acknowledgement.
1. I declare under penalty of perjury that to the best of my knowledge and belief, the statements made herein are correct and true.
2. I understand that the information provided in this application is subject to verification.
Payment Acknowledgement
Please check both in acceptance of this acknowledgement.
1. I understand that acceptance of payment by the city does not constitute approval of the cannabis delivery service permit.
2. I understand that authorization to conduct business as a sidewalk vendor is not granted until issuance of the permit.
Applicant Signature
Please sign application.
Signature Date
Signature Date
Turning in your Application
To turn in this application, please print, sign, date and bring this form to 1010 Tenth Street Suite 3100, Modesto, California 95354.

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