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FIREWORKS VENDORS APPLICATION

2. 

3. APPLICATION FOR FIREWORKS VENDORS

5. Company*

6. Representative*

7. Telephone Number*

9. Street Address*

10. City, State, Zip Code*

11. Alternate Phone Number

13. Sales Location*

14. Date of Sales*

15. Hours of Operation*

17. List types of fireworks to be sold:*

19. For Dumpster Rental contact the City Office for an application at 402-729-5261. NOTE: The Sanitation Department does not service other company dumpsters.

    For Dumpster Rental contact the City Office for an application at 402-729-5261. NOTE: The Sanitation Department does not service other company dumpsters.

21. I/We understand the ordinances regulating the sales of fireworks in the city limits of Fairbury, Nebraska. I/We do not sell/dispense fireworks that have been deemed illegal by the State of Nebraska, Jefferson County, and Fairbury, Nebraska.

    I/We understand the ordinances regulating the sales of fireworks in the city limits of Fairbury, Nebraska. I/We do not sell/dispense fireworks that have been deemed illegal by the State of Nebraska, Jefferson County, and Fairbury, Nebraska.

23. I/We understand that the application must be accompanied by a current liability insurance certificate to be considered valid. A peddler license will be presented after approval by the Fairbury Police Chief, and the appropriate fee(s) collected. All fireworks vendors will be inspected by the Fairbury Fire Chief during period of vending. Violation of safety regulations and/or ordinance will nullify licensing.

    I/We understand that the application must be accompanied by a current liability insurance certificate to be considered valid. A peddler license will be presented after approval by the Fairbury Police Chief, and the appropriate fee(s) collected. All fireworks vendors will be inspected by the Fairbury Fire Chief during period of vending. Violation of safety regulations and/or ordinance will nullify licensing.

25. Applicant Signature*

26. Date of Application*

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27. 1. Receive an email copy of this form.
28. Email address

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29. Submit Submit and Print

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