Vendor Registration VENDOR PROFILE Note: If you would rather print, sign, and send in a paper version of this form, download it by clicking here. * = Required fields. Company Name Contact Name* Mailing Address* City* State* AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaPR - Puerto RicoRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming ZIP Code* Phone* Cell Email Address* (required) Type of Vendor - Check One CommercialGeneral Retail ProductsOther WE APOLOGIZE!! FOOD VENDORS ARE NOT ALLOWED FOR THIS EVENT. List Of Items*: (ALL ITEMS MUST BE LISTED, IF YOU ARE SELLING AN ITEM NOT ON LIST, YOU WILL BE REQUIRED TO REMOVE THAT ITEM.) ELECTRICITY ACCOMMODATIONS ELECTRICITY IS NOT INCLUDED with each booth at the event. All vendors must bring their own portable generator. All generators must have a sound level of 65 dB or lower. LIABILITY INSURANCE REQUIRED Liability Insurance with the following named as additional insured, Auto Club Speedway & Just Cruzin’ Productions Inc., Just Cruzin Life Foundation. The Liability Insurance policy MUST include a minimum of $1,000,000 coverage naming “Just Cruzin Productions & Auto Club Speedway as additionally insured. It will also have to be primary and noncontributory and must include a waiver of subrogation. If you do not currently have insurance and need to purchase a policy, please contact K&K Insurance Group, Inc. Web site: www.sportsinsurance-kk.com Phone: 1-877-648-6404 Fax: 1-260-459-5502 Email: info@eventinsurance-kk.com Short Term Special Event https://www.kandkinsurance.com/sites/events/pages/CEVEligibility.aspx Upload Your Certificate of Insurance (PDF, PNG, JPEG, or Word Documents ONLY) Vendor Spaces: 10’ x 10’ - $200.00 10’ x 20’ - $300.00 10’ x 30’ - $400.00 10’ x 40’ - $500.00 SPACE LOCATION NOT GUARANTEED!!! We will place you based on the type of product you sale and when your vendor form is submitted with payment. Thank you!! You must submit a copy of your liability insurance and have all fees paid prior to load-in day. You will not be allowed to set up without them — NO EXCEPTIONS!!! I agree to the VENDOR RULES & INFORMATION, CODE OF CONDUCT, and RELEASE OF LIABILITY sections in this document: Vendor Application
