PERMITS ARE FOR GROUPS SITES ONLY (per O.M.C Chapter 5.51) Applicant Name 1 : Applicant Mailing Address: City/State:

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CITY OF OAKLAND MOBILE FOOD VENDING GROUP SITE PERMIT APPLICATION 250 Frank H. Ogawa Plaza, Suite 2114, Oakland, CA 94612-2031 Zoning Information: 510-238-3911 www.oaklandnet.com/planning PERMITS ARE FOR GROUPS SITES ONLY (per O.M.C Chapter 5.51) 1. GENERAL INFORMATION Applicant Name 1 : Applicant Mailing Address: City/State: Phone No.: E-mail: Zip: 1 No applicant shall hold more than four (4) Food Vending Group Site Permits at the same time. (Administrative Guideline 3f) 2. PROPOSED GROUP SITE Mobile Food Vending Group Sites refer to the stationary operation of three (3) or more mobile food vendors clustered together on a single site. Group Site Type: Private/Public Property If you checked this box, you must submit written consent from the owner (if private property) or written consent/approval from the applicable public agency (if public property). Public Right-of-Way/Street Closure If you checked this box, you must submit your completed Application for a Short Term Encroachment Permit along with the Street Closure Petition. This will be forwarded to the Special Events Unit of OPD for approval. Public Right-of-Way/Curbside Parking If you checked this box, is there metered parking located on the block of your proposed Group Site? Location Indicate Street Address or Block Number - e.g. 100 Block of Brown Street, as applicable. Attach a scaled Site Plan that depicts the exact location and layout of the proposed Mobile Food Vending Group Site, indicating: e.g. a) the arrangement and maximum number of Food Vending Units (aka. the trucks, trailers, or other movable wheeled equipment or vehicles from which food vending is to occur); b) any proposed seating or amenities; and c) all existing structures, businesses, and parking spaces. Located within 300 feet of a school? Yes / No If Yes, you must submit written consent from the OUSD Nutrition Services; see page 8. Located within 300 feet of a restaurant ( Full Service, Limited Service?) Yes / No If Yes, you must submit written consent from the restaurant owner(s); see page 7. Mobile Vending Group Site Application (6-5-17.1)) 1

Per OMC 5.51.030 (D) All Food Vending Facilities (i.e. trucks, trailers, or other movable wheeled equipment or vehicles from which food vending is to occur) shall be entirely selfsufficient in regards to gas, electricity, water, and telecommunications, unless appropriate permits are reviewed and approved by City Departments, including but not limited to, the Building Services Division and the Fire Department. Any source of outside power? Gas Electricity Other: Public Amenities to be provided: Tables Seating Other: Employee Restroom Location: OMC 5.51.050(E)Mobile Food Vending Group Sites shall be located within two hundred (200) feet of an approved, readily available and fully functioning restroom facility per the California Retail Food Code, as may be amended. The Applicant shall provide documentation to the City demonstrating access to such restrooms for its Food Vendors and their employees. Documentation may include a letter from the property owner within two hundred (200) feet of the Food Vending Group Site location authorizing use of his or her restroom facilities by food vendors and their employees. Maximum Number of Vendors 2 : 2 Not to exceed reasonable capacity of site, as determined by staff. List of all Proposed Dates: Proposed Day(s) of the Week 1 st choice 2 nd 3 rd Hours of Operation 3 Total Number of Proposed Dates 4 Approximate Desired Duration (start and end date) 3 Maximum hours of operation: 5 hours per date (O.M.C. 5.51.150 (C)) 4 Shall not exceed two (2) dates per week on public street right-of-way (Administrative Guideline 3(e)(iv); not limitation for dates on private property. I, hereby accept total responsibility for set-up and maintenance of appropriate recycling, waste disposal and general site clean-up after each Food Vending Group Site operation date. Failure to properly recycle or dispose of materials generated by a Group Site or adequately clean up after a Food Vending Group Site operation date shall be grounds for denying an Applicant s request for Permit renewal and/or additional vending dates. Should the applicant fail to satisfactorily clean the site, and City staff is required to clean the site, the City has the right to seek reimbursement from the Applicant and deny any future requests from Applicant until such time reimbursement has been made. I accept all liabilities and legal responsibility for the Group Site. Signature of Applicant I declare under penalty of perjury that all foregoing statements are true and correct. Any false statement shall be cause for revocation of any permit issued under 5.51 of the Oakland Municipal Code. Signature of Applicant: Date: Mobile Vending Group Site Application (6-5-17.1)) 2

3. PROCEDURES Completed Mobile Food Vending Group Site Permit Application This application form signed and completed. Original signatures or clear & legible copies are required. Vendor & Applicant Required Documents: Photocopy of valid California Driver s License for Applicant and each Vendor Four photographs (showing different views) of the proposed site Four photographs (showing different views) of the vending vehicle/truck Sample of advertising signs (if not part of food truck) Sample menu / itemized food list Copy of Health Certificates for each vendor Copy of Event Sponsor form (Alameda County Environmental Health) Proof of Application and Payment for Oakland Business Tax Certificate for Applicant and each Vendor: 1. Group Site Organizer (Applicant) submits completed Oakland Business Tax Certificate Application Forms for self and each Vendor for preliminary approval; 2. Planning and Zoning signs off on all forms (thereby indicating that applicants are part of a Food Vending Group Site permit application) and returns all forms to Applicant. Applicant returns forms to Vendors: 3. The Applicant and all Vendors submit Business Tax Certificate Application forms to the Business Tax Office and pay applicable fees; 4. Applicant submits copies of receipt/acknowledgement of payment for Business Tax Certificate for self and all Vendors to Planning and Zoning staff, as final part of their application package. Copy of CA Seller s Permit for each Applicant and Vendor Completed Vendor Information Form for each proposed Vendor (Please see page 6 of this application packet. Attach supplemental pages if necessary.) Consent Forms and Permits Written documentation of proof of restroom access for Vendor/employees within 200 of Group Site If proposed location is in public right-of-way: Short-term Encroachment Permit Application and Street Closure Petition (OPD forms) If proposed location is on private property: Written consent from the property owner If proposed location is on park property: Written approval from Oakland Parks and Recreation If proposed location is within 300 feet of a school: Written approval for Healthy Vending from OUSD If proposed location is within 300 feet of a Full Service or Limited Service restaurant: Written consent from the owner of each applicable restaurant Permit for connection to on-site utilities (if applicable) Site Plan Scaled or dimensioned Site Plan displaying cross-streets and exact location of Group Site, and depicting a) arrangement of Food Vending Units; b) proposed seating or amenities; and c) existing structures, businesses, and parking spaces Mobile Vending Group Site Application (6-5-17.1)) 3

Fees Non refundable application fee: $150.00 (Due at the time of application submittal) Notification fee: $250.00 (paid after provisional approval is granted by the City) Enforcement fee: $500.00 (paid after provisional approval is granted by the City) Excess Litter fee: $100.00 (paid to Business Tax Office) OPD Street Encroachment Application Fee, if applicable - $35 (per two consecutive closure/vending dates) Oakland Fire Department annual inspection and clearance: $339.00 (paid to Oakland Fire Department) *Note: if proposed Group Site is during business hours and occupies metered parking spaces, site organizer is responsible for paying all meters; no pre-payment is available. Note: Please be advised that if Applicants or their vendors owe outstanding fees for back business taxes or special police services, Applicants must clear these debts prior to submitting their Mobile Food Vending Permit application. If any Applicant has received a citation related to food vending, a letter as to why your application should be considered should be submitted. Failure to pay monies owed to the City will cause the application to be considered incomplete and will not be processed until proof of payment has been provided. You can contact Phil Lim with the Business Tax Office at 510-238-7469 and for Police Services, Erica Vazquez at 510-238-6972 for questions regarding monies owed to the City. REQUIRED NOTICING Per O.M.C. 5.51.070D, Applicants are required to send notice of the proposed Group Site operation to all property owners, business owners, and building occupants located within three hundred (300) feet of the Group Site Location. The City will provide property owner addresses and street addresses within the required 300 foot radius of the proposed Group Site location. The notices will be prepared by the City and copying and delivery is the responsibility of the Applicant. A good faith effort to contact business owners is also required (physically delivering notices to current businesses). Notification must be provided by mail or hand delivery, and be completed by the Applicant as indicated on the notice provided by the City. VENDOR LIST Please list all licensed food vendors who will participate in the Group Site events. Owner Truck Name Phone Number 1 2 3 4 5 6 7 8 9 10 Mobile Vending Group Site Application (6-5-17.1)) 4

MOBILE FOOD VENDOR INFORMATION Please provide the following information for each proposed Vendor. Attach additional sheets as necessary. Mobile Food Vendor Name Legal and Business Name Mailing Address Mobile Phone Commissary Kitchen Name & Address Oakland Business Tax Certificate # Alameda County Health Permit # and Expiration Date (provide a copy) CA Seller s Permit # and Expiration Date (provide a copy) Type of Food Vending Unit (e.g. truck, trailer or other movable wheeled equipment or vehicle) DMV Vehicle Registration Registered Owner License Plate # Expiration Date Mobile Vending Group Site Application (6-5-17.1)) 5

RESTAURANT WAIVER OF BUFFER DISTANCE (IF APPLICABLE) Per O.M.C. 5.51.050 (B) (3), Group Sites selling within these buffer distances of a café or restaurant (open during the same hours as the vendor) must show a signed waiver from the restaurant owner(s) within the buffer distances. Three hundred (300) feet for vending sites in the permitted area; with the exception of: One hundred (100) feet for vending sites located on Telegraph Avenue, between West MacArthur Boulevard and Alcatraz Avenue; and Two hundred (200) feet for vending sites located on Leimert Boulevard between Clemens Road and Oakmore road; and Two hundred (200) feet of the lot at the Southeast corner of the intersection of Mountain Boulevard and Werner Court. Does not Apply (Not vending within 300 feet of a restaurant or cafe). Does Apply: Café / Restaurant #1 Name Address Owner Name: For the owners of a restaurant or café within a buffer distance of a site where a mobile vendor is seeking a permit to vend food: With my signature, I recognize this application from a mobile food vending business to sell from a location that is within a buffer distance established by the Oakland City Council in O.M. C. 5.51.050 (B). Further, with my signature, I waive the buffer distance, as permitted in 5.51.050 (B)(3), and the mobile vendor will apply to the City for a permit. Owner Signature: Café / Restaurant #2 Name Address Owner Name: For the owners of a restaurant or café within a buffer distance of a site where a mobile vendor is seeking a permit to vend food: With my signature, I recognize this application from a mobile food vending business to sell from a location that is within a buffer distance established by the Oakland City Council in O.M. C. 5.51.050 (B). Further, with my signature, I waive the buffer distance, as permitted in 5.51.050 (B)(3), and the mobile vendor will apply to the City for a permit. Owner Signature: For additional restaurants, use additional pages from the application form Mobile Vending Group Site Application (6-5-17.1)) 6

SCHOOLS WAIVER OF BUFFER DISTANCE (IF APPLICABLE) Group Sites selling within 300 feet of a school, between the hours of 6 a.m. to 6 p.m., Monday through Friday, must show proof of approval from the Oakland Unified School District Nutrition Services, which will confirm that food sales comply with healthy nutritional guidelines. Waiver for Charter or Private schools are approved by their supervising entity 1. Does not Apply (Not vending within 300 feet of a School). Does Apply: Name of OUSD School: Address of OUSD School: The following Charter schools are served by OUSD Nutrition Services, and vending within 300 of these schools requires this waiver: ASCEND (530 18th St.) Bay Tech (8251 Fontaine St.) Community School for Creative Education (2111 International Blvd.) Envision (1515 Webster St.) KIPP (1700 Market Street) Learning Without Limits (2035 40th Ave.) Oakland School for the Arts (530 18th St.) I, the undersigned, have attached a copy of my menu, which shows that customers will be able to buy healthy foods, including, but are not limited to: Fruits; Non-fried vegetables; dairy foods; food made from nuts, seeds, legumes, cheese; foods made from whole grains (defined as 51% or more); foods which do not contain trans-fat. Beverages for sale in this definition include: water; 100% fruit or vegetable juice; nonfat and 1% milk (including nonfat chocolate milk); and non-dairy milk, such as soy. I understand that no sugar-sweetened beverages are in this definition. I understand that no candy or soda are considered healthy under these guidelines. Signature of Applicant: Date: OUSD Nutrition Services review: Time of day when food vending is prohibited (i.e. lunch): (this is to be completed by OUSD Nutrition Services) Approve waiver Deny Waiver More Information OUSD Signature: Date: 1 See list of approved Charters: http://www.ousdcharters.net/uploads/4/1/6/1/41611/charter_schools_updated11.7.2016.pdf Mobile Vending Group Site Application (6-5-17.1)) 7