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DocuSign Envelope ID: DE978A80 -2A4E- 4731- A2EC- 27325E248667 <br />VENDOR APPLICATION <br />VENDOR NAME: Piedmont wildlife Center, Inc. <br />Primary Contact Person: <br />Address: 364 Leigh Farm Rd <br />Telephone: <br />Website: <br />PRODUCTS / DISPL AY <br />7oshua starling <br />Durham <br />City: <br />NC 27707 <br />State: Zip: <br />Email Address: joshua @piedmontwildlifecenter.org <br />List ALL of the products which you will be displaying or selling during the Orange County Local Fest. Vendor locations <br />will be assigned based on this list. <br />FOOD VENDORS SHOULD ATTACH THEIR FULL MENU. <br />Education and Informational Flyers and volunteers will be handling animals for educational purposes <br />Electrical generator needed? Yes No X <br />SIGNATURE / ACKNOWLEDGMENT <br />The applicant understands that this is an APPLICATION for space ONLY, and it is NOT a CONTRACT with Orange <br />County. <br />I have read and understand the Vendor Rules and Regulations in their entirety and will comply with all terms and <br />conditions within. I will make the Rules and Regulations available to all persons operating booths) /stand(s) and <br />ensure their compliance as well. The individual executing below represents to Orange County that such individual has <br />the authority to represent any entity purported to be represented by such individual. By my signature below, I hereby <br />agree to all terms and conditions set above. <br />I understand that Orange County reserves the right to cancel at any time all contracts made with vendors for ANY <br />conduct at any time deemed unprofessional by Orange County that would have resulted in denial of this application. I <br />understand and agree to abide by all applicable local, state, and federal laws. <br />I certify that the information stated in this application is complete and true to the best of my knowledge. <br />GocuSigned by: <br />Signature of Applicant: ClE2F37BUOC4497... 65C" Sf tll' iln.,l� _Date: 8/22/2018 <br />Print Name: <br />