Windsor Certified Farmers Market Seller Application
Sun. 10am -1 pm ~ April 22 ~ December 16, 2012
Thurs. 5-8pm ~ June 14 -August 30, 2012
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| Cert. Prod. |
Organic |
Other License |
| Certificate# |
Registration# |
& Permits |
| Producers Name |
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Drivers Lic # |
| Mailing Address |
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| City/State/Zip |
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Vehicle Insurance Info. |
| Physical Address |
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Carrier |
| City/State/Zip |
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Policy# |
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| General Contact |
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website |
| Title |
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| Office Phone |
Cell: |
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email |
| Home Phone |
FAX: |
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Birth Date |
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| Family & Employees |
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| Who May Sell |
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| Location of |
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Days you expect to attend |
| Farm or |
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Sundays |
| Business |
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Thurs. Night Summer Markets |
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| County Of Production |
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WCFM Application Fee |
| Other Markets |
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$25.00 Annually |
| at which you sell |
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2012 |
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Non-Certified Agricultural Products
(Processed)
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Non-Certified Non-Agricultural Products
(Artists & Crafters)
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I HAVE READ THE RULES AND REGULATIONS FOR THE WINDSOR FARMERS MARKET AND AGREE TO CONFORM TO THE REGULATIONS CONTAINED THERIN AND I UNDERSTAND THAT ARM MARKET INSURANCE POLICY DOES NOT COVER THE EMPLOYEES, MY FAMILY MENBER OR ME.
The seller agrees to indemnify and hold harmless the WCFM, it's Board of Directors, agents and employees from any damage, injury or loss to any person or persons, including, but not limited to, persons to w hom the seller may be liable under any Workers Compensation law and the producer, and from any loss, damages, caused by action, claims or suits for damages, including, but not limited to, loss of property, goods, or merchandise, caused by, or arising out of, or in any w ay connected w ith sellers use of the privileges herein granted. |
| Signature: |
Date: |
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| Return To: WCFM P.O. Box 1877 - Windsor, CA 95492 - (707) 838-1320 - FAX (707) 433-4595 |
Printable view
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PDF
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