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City of Bloomington, Illinois

cityclerk@cityblm.org

115 E. Washington St., Bloomington, IL, 61701, US

309-434-2509

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Entertainment Venue Operator License Renewal Affidavit

Below is a list of the document(s) that are required at the time of submission. 

Required Documentation
  • Affidavit of License Renewal - By signing the affidavit, the representative verifies that no significant changes have been made to the business operations or premises.
Conditional Document Requirements
If the following documentation is already on file, it is not required to be submitted with the renewal.
  • Lease for the licensed premises if renewed within the past 12 months or if the lease will expire during the proposed license term
  • Certificate of Liability Insurance (Not Policy Declaration Page) if not already provided for 2024-2025. The Certificate must show the establishment has liability insurance and must include:
    • the applicant’s name as the insured (i.e., if the applicant is a corporation, the corporation’s name must be listed);
    • the address of the establishment; 
    • the dates of coverage and the coverage limits (Must hold a minimum amount of $1,000,000 General Liability); and
    • the City of Bloomington, 115 E. Washington St. Bloomington, IL 61701 listed as the Certificate Holder and Additional Insured
  • Bond in the amount of $2,000 if not already provided for 2024-2025
Additional Requirements
The following are required in order for renewal to be considered, but documentation is checked internally so there is no submission requirement unless specifically requested.
  • DBA/Assumed Name must be registered. If the Applicant will use a different name with the public than the name of the legal entity, the DBA/Assumed Name must be registered with the State of IL or McLean County.
  • Entities must be in good standing with the State of IL.
All documents can be uploaded after the signature of the affidavit.
Please check that you agree before continuing.
By continuing, I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored. I agree to electronically sign and to create a legally binding contract between the City of Bloomington and myself, or the entity I am authorized to represent.
11/15/2024Click to Sign
Signature HereClick to Sign
Signature HereCity Clerk Designee Will Sign Here
11/15/2024

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Upload Attachment(s)

Please upload the following attachments:

There is a 250MB limit on each attachment.

Lease for the licensed premises if renewed within the past 12 months or if the lease will expire during the proposed license term Click Here to Upload
Certificate of Liability Insurance (Not Policy Declaration Page) if not already provided for 2024-2025 Click Here to Upload
$2,000 Bond if not already provided for 2024-2025 Click Here to Upload
Additional Attachments Click Here to Upload