Vendor Registration Form

Organization/Business Name

Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Point of Contact

First NameLast Name

Phone Number

Area CodePhone Number

E-mail

Please list your social media account information:

Please indicate which events you will participate in this year 2026:

What services will you be providing (Check option below)

If classified as an "Other" vendor; please indicate what type of services is provided:

How will you set-up?

Please indicate how many parking spaces you will need for set-up:

Liability Insurance Coverage: Please indicate if you have liability insurance with coverage of at least one million dollars. (Required for food and beverage vendors only)

SERV Safe Certificate: Please indicate if you have a valid SERV Safe Certificate. (Required for food and beverage vendors only)

Date

Vendor Registration Statement:

To complete your vendor registration, please provide a certificate of insurance for liability coverage in the amount of $1,000,000 and a SERV Safe certificate. These documents are mandatory for all vendors serving food or beverages.

Please ensure Rockdale County Board of Commissioners is listed as the policyholder on the Certificate of Insurance, with the following address: 962 Milstead Ave, Conyers, Georgia 30012.

Kindly upload the required documents. Please note that your application will not be approved until we receive these documents.

Acknowledgment and Signature
By signing below, you acknowledge that all information provided in this application is accurate and complete. You also agree to comply with all vendor requirements, including liability insurance coverage, SERV Safe certification (if applicable), and the $125 vendor fee.

Company Representative Signature

File Upload