LSR7 Food Vendor Application

To Be Completed by Vendor

Vendor Name
Contact Name
Contact Phone Number Contact Phone Number - ### - ### ####
Contact Email
Website (if Applicable)
Please upload Vendor W9
*W9 Must be the most current IRS Form (Rev. March 2024) and must be signed within the last 6 months.

Attach Files
Certificate of Insurance (COI) Requirements:

*The COI must be provided on Acord Form 25 and adhere to the District's insurance requirements found on our Purchasing website under Quicklinks, Standard Insurance Requirements.
https://www.lsr7.org/departments/purchasing-distribution

*The Lee's Summit R-7 School District (301 NE Tudor Rd, Lee's Summit, MO 64086) must be listed as both additionally insured and the certificate holder.

Attach Files
Certificate of Insurance Expiration Date Certificate of Insurance Expiration Date / MM / DD YYYY
Jackson County Mobile Food Facilities Permit required.
Please upload your most current Jackson County Mobile Food Facilities permit.

Attach Files
Jackson County Mobile Food Facilities Permit expiration date. Jackson County Mobile Food Facilities Permit expiration date. / MM / DD YYYY
Menu and/or Pricing Sample

Attach Files
Please Upload Additional Documents if applicable

Attach Files
Please Upload Additional Documents if applicable

Attach Files
Do you have a written cancellation policy?

Do you have a written cancellation policy? Yes No
If you answered yes to having a written cancellation policy please upload the document

Attach Files
I have read and understand that all my staff are subject to a background check through the National Sex Offender Registry as soon as they arrive on district property.

Everyone is required to check in with the school building office to have their driver's license or State issued ID scanned before providing any services. Background checks will be required each time and at each location within the district that you serve.

If the building office will be closed at the time you serve, you may prepare for the background check to be done no more than 2 days earlier at that location or at the Purchasing office located at 702 SE 291 Hwy, Lee's Summit, MO 64063. The hours are 7:30am - 4pm, M-F. Phone #816-986-2190. No appointment is necessary at the Purchasing Office.

I have read and understand that all my staff are subject to a background check through the National Sex Offender Registry as soon as they arrive on district property.

Everyone is required to check in with the school building office to have their driver's license or State issued ID scanned before providing any services. Background checks will be required each time and at each location within the district that you serve.

If the building office will be closed at the time you serve, you may prepare for the background check to be done no more than 2 days earlier at that location or at the Purchasing office located at 702 SE 291 Hwy, Lee's Summit, MO 64063. The hours are 7:30am - 4pm, M-F. Phone #816-986-2190. No appointment is necessary at the Purchasing Office. Yes No