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Vehicle for Hire - Broker Application

 

Fee
 

Applicant Information

Applicant is:
 
Which municipality will you be operating from?
 
Taxi Broker Licensing Requirements: (All items to be uploaded with application.)
 
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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Required:
 

Declaration of Applicant:

I acknowledge that I am the applicant. I have read the Town’s Licensing By-law and understand my duties and responsibilities as a broker and agree to comply with the by-law. The information contained in this application is true and correct.

Consent

I give my consent to the Town of Orangeville to share or disclose my contact information (telephone number, email address, mailing address) to the Town of Grand Valley, Town of Mono or Town of Shelburne with respect to the processing of a licence and related enforcement.

Personal information collected on this form is collected pursuant to Section 151, Municipal Act S.O. 2001, c.25, as amended, and will be used for the purpose of processing your application. Questions about this collection should be directed to the Clerks Division, 87 Broadway, Orangeville, ON L9W 1K1, 519-941-0440, Ext. 2239. 

The undersigned hereby releases the Corporation of the Town of Orangeville, Town of Grand Valley, Town of Mono and Town of Shelburne from any or all claims for damages which may arise in the carrying on of business within the Municipality under which the undersigned is licensed by the Municipality to do so. 

Clear
I have the authority to bind the corporation