SENIOR HEALTH AND RESOURCE FAIR VENDOR INFORMATION When: Friday, October 4th | 9:00 AM - 1:00 PM Where: Fifth Street Senior Center, 600 West 5 th Street, San Bernardino, CA 92410 Contact the Senior Services for details or more information at (909) 384 - 5430 or Jackson_La@sbcity.org
VENDOR CONTACT INFORMATION ( please print legibly )
Contact Person:
Please check if this will also be the event day contact person. Company Name:
Mailing Address:
Phone:
Cell:
Fax:
Email Address:
Social Media: Facebook: _______________________Instagram: ___________________________
BOOTH INFORMATION ( please print legibly )
Describe Your Product and/or Services:
Insurance Company Name and Policy #: If selected you will need to provide a Certificate of Insurance listing the “ City of San Bernardino ” as additional insured.
We are a non - profit, 501 (c)3 #:
Do you need electricity? Limited availability. No Yes
CONTRIBUTION LEVEL
GOLD PRESENTING SPONSOR
$1000
SILVER TITLE SPONSOR BRONZE TITLE SPONSOR
$500 $250
HEALTH FAIR SPONSOR $25 or 2 Raffle Prizes SPEAKER: Topic____________________________________________
Please make checks payable to : The City of San Bernardino
Applicant assumes all responsibility for any loss or damage in connection with their vendor entry in the Senior Health and Resource Fair. The City of San Bernardino, and all other parties directly involved will not be liable for any damage, theft or loss of property or injury in connection to this event. Applicant assumes the responsibility of making sure that everyone in his or her unit understands and will abide by vendor guidelines which were outlined in the Vendor Information
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