Some parks have additional requirements for businesses that offer services to visitors relating to the safety and welfare of the visitors and protection of the resources. These requirements may include applicable operating licenses, certificates showing proof of training, operating plans, emergency response plans, group size limitations, etc. 1. Service for which you are applying: [attach diagram, attach additional pages, if necessary, include locations within the park, frequency, estimated number of participants (per trip and annually), number of vehicles, support equipment (trailers, generators, etc.)] 2. Will you be providing this service in more than one park? Yes No If “Yes”, list all parks and services provided. 3. Applicant’s Legal Business Name: [Include any additional names (DBA) under which you will operate.] 4. Authorized Agents: (Name and title of owner, and any onsite person authorized to manage the operation or service.) 5. Mailing Addresses PRIMARY CONTACT INFORMATION (Dates to contact you at this address, if seasonal. ) Address: City, State, Zip: Email: Website: Day Evening Phone: Fax: ALTERNATE CONTACT INFORMATION (Dates to contact you at this address, if seasonal. ) If same as “Primary Contact Information, check here and go to question 6. Address: City, State, Zip: Email: Website: Day Phone: Evening Phone: Fax: 6. What is your Business Type? (Please check one below) Sole Proprietor Partnership (Print the names of each partner. If there are more than two partners, please attach a complete list of their names.) Name: Name: Limited Liability Company: (State: Entity Number: ) Corporation: (State: Entity Number: ) Non-Profit (Please attach a copy of your IRS Ruling or Determination Letter) 7. State Business License Number: Expiration Date: 8. Employer Identification Number (EIN):
9. Liability and Vehicle Insurance: Provide proof of insurance. The CUA operator must maintain General Liability insurance naming the United States of America as additional insured. Minimum coverage amount is $500,000 per occurrence. Some activities will require increased coverage; see Park-Specific CUA Insurance Requirements (“Attachment A”). Auto Liability insurance is required, if applicable, in the minimum coverage amounts described below. COMMERCIAL GENERAL LIABILITY INSURANCE Single Purpose Activities (includes day and overnight hiking, photography and art classes, bicycling, and group camping) $500,000 Commercial Vehicle Insurance – Passenger Transport (bodily injury and property damage) Minimum per Occurrence Liability Limits* Up to 6 passengers $1,000,000 7 – 15 passengers $1,500,000 16 – 25 passengers $3,000,000 26+ passengers $5,000,000 * Indicated minimum per occurrence liability limit or minimum State liability requirement (for intrastate operations only). Will your business operate vehicles (car, van, bus, taxicab, vessel, aircraft, etc.) within NPS boundaries? Yes No If “Yes,” please give a description of each vehicle. Use additional paper, if necessary. All vehicles are required to be registered and the operators are required to have the proper licenses to operate them commercially, as required by law or regulation. of Vehicle License Number Year Max # Passenger Capacity Own/Rent Make of Aircraft Tail Number Max # Passenger Capacity Own/Rent Make/Model of Vessel Registration Number or USCG Documentation Length Max # Passenger Capacity Own/Rent 11. Employee Licenses and Certifications: Parks typically require proof of applicable licenses, registrations and certificates of training, such as; valid driver’s or pilot’s license, fishing license, vessel registration, dive certification, CPR certification, or others. Provide copies of licenses and certifications. 12. NPS Employment: Are you, your spouse, or minor children employed within the National Park Service? Yes No If “Yes”, please provide information below: Employee Name: Title: Park and Office Employed: