Beach Operations 924 Hwy 83 South, Santa Rosa Beach, Florida Phone BEACH VENDOR CHECK LIST VENDOR NAME:

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1 BEACH VENDOR CHECK LIST VENDOR NAME: 1. Acknowledgement Letter 2. Completed Application a. Inventory list per site b. Notarized affidavit 3. Area identified w/site plan 4. Liability Insurance (Must indicate Walton County Board of County Commissioners as the certificate holder) Address: 76 N 6 th Street Defuniak Springs, FL Phone Numbers (Marine radio or cell phone/proof For Watersports) 6. Permission/consent letter or current contract 7. Lifesaving Training Certification(s) Mandatory for ALL Watersports 8. Check payable to: Walton County BCC (due when approved) 9. Attended Meeting/Watched Video

2 BEACH VENDING APPLICATION Beach Vendor Permit Fee: $ Miscellaneous Operations Permit Fee: $ Additional Fees May Apply NAME/TITLE: BUSINESS NAME: MAILING ADDRESS: TELEPHONE: MOBILE: FAX NUMBER: ADDRESS (REQUIRED): PRIMARY BEACH LOCATION: APPLICATION TYPE (I.E. Delivery, Site-Specific, Misc. Operations, etc.): VENDING TYPE (I.E. Chairs, Paddleboards, Wedding Officiant, etc.): ONLY LIST PRIMARY BEACH LOCATION INVENTORY BELOW QUANTITY DESCRIPTION

3 Submittal Requirements 1. Land based location with direct access to the beach in the immediate area where the vending services are being provided (Proof of Ownership or Lease of Property, Notarized Affidavit from property owner, and 911 address of each location site). 2. Detailed drawing of vendor location that includes all of the following items: a) Boundary lines of the beach vendor location. b) Placement of all temporary structures, including storage boxes, beach chair locations and water based activity, and beach access corridors (min 10 ft. wide if needed). 3. Proof of Liability Insurance within Walton County guidelines. 4. Proof of telephone or marine radio at operations center, for each location site. 5. List of all inventory to be stored at each vendor site. 6. All water-based activities must be shown on site plan. 7. Proof of certification for lifesaving, for each site (Required for Water Based Activities only). 8. Make checks payable to: Walton County BCC Note: Permits do not grant vending rights seaward of the Erosion Control Line. (Exception: Water Based Activities with additional specific permit) Set-up time for vendors will be as stated in the ordinance. Take-down time for vendors will be 1 hour after dusk.

4 REQUIRED SIGNATURE I agree that the Walton County personnel or any assigned agents may inspect for the purpose of verifying the conditions that affect this application and to verify information that I provided as part of this application. FLORIDA STATUTES FALSE OFFICIAL STATEMENT Whoever knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his official duty shall be guilty of a misdemeanor of the second degree. I have read and understand all the information provided in this application, the requirements listed within the application, and agree to provide the necessary information requested by Walton County. The information I have provided on this application is true and correct to the best of my knowledge. Applicant s Signature Printed Name Date of Signature STATE OF COUNTY OF BEFORE ME, the undersigned Notary Public in and for said County and State, appeared, who is personally known to me or who has produced as identification, and who executed the foregoing instrument. Given under my hand and seal this day of,. Signed Name of Notary Public {Seal} Printed Name of Notary Public Commission Number: Expiration Date: NOTE: This application will not be processed without a Notary Public Witnessed Signature by the Applicant. THIS SUBMITTAL WAS CHECKED BY: Walton County Staff Signature _ Date

5 Acknowledgment of Receipt of, and Acknowledgment to Comply with, Walton County Ordinance No (Referred to as the Walton County Beach Activities Ordinance) The undersigned, by and for, by execution of this document hereby acknowledges receipt of the Walton County Ordinance No commonly referred to as the Walton County Beach Activities Ordinance, and hereby agrees to read said ordinance and require all persons working for the above named entity to adhere, abide and comply with and to the provisions contained therein. I further acknowledge and agree that I have attended the mandatory vendor meeting, and during said meeting the provisions of this ordinance, including implementation and administration were explained to me. The undersigned acting on behalf of and with full authority to commit the entity identified below, acknowledge receipt of, and agrees to be bound by all terms contained in, the above-referenced ordinance. IN WITNESS WHEREOF, the undersigned have signed of this acknowledgement as of, 2018 Printed Name Signature Date Title