Resolution Requiring the Registration of All ... - Delhi Township

Michael Davis, Trustee
Albert Duebber, Trustee
Jerome Luebbers, Trustee
_____________________
Kenneth Ryan, Fiscal Officer
________________________
Gerard Schroeder, Acting Administrator
Delhi Township
Transient Vendors Registration Form
RE: Section 505.94 O.R.C. and Resolution 2007-015
(Expires one year from date signed below )
Name:___________________________ Birth date ________________ SS#_______________
Home Address:________________________________________________________________
Home Phone:________________________________ Male___________ Female___________
Representing (Company Name ):__________________________________________________
Address:_____________________________________________________________________
Company Phone:______________________________________________________________
Supervisor' s Name:____________________________________ Phone:__________________
Describe' Product/Service:_______________________________________________________
Describe Sales Procedure/Approach (Door to Door, Phone, Etc.):________________________
____________________________________________________________________________
____________________________________________________________________________
Vendors License:______________________________________________________________
STATEMENT AND WAIVER
I hereby agree to furnish authentication documentation to verify the forgoing.
The undersigned hereby voluntarily assumes all risks of accidents, injury and of damage to
his/her person and property and hereby releases and discharges DELHI TOWNSHIP, its
elected officials, employees and agents from every claim, liability or demand of any kind.
SIGNED:______________________________________________ DATE:_________________
Delhi/trans· vendor-regis