|
Sun. 10am - 1pm ~ May - Nov |
2008 |
Thurs. 5 - 8 pm ~ June - Aug |
| Cert. Prod. Certificate # | Organic Registration# | Health Permit # (if Applicable) |
Other License & Permits | |||||||
| Producers Name | Drivers Lic. # | |||||||||
| Mailing Address | Vehicle Insurance Info | |||||||||
| City/ State/ Zip | ||||||||||
| Physical Address | Carrier | |||||||||
| City/ State/Zip | Policy # | |||||||||
| General Contact | website | |||||||||
| Title | ||||||||||
| Office Phone | Cell | |||||||||
| Home Phone | FAX | Birth date | ||||||||
| Family & Employees Who May Sell | Days you expect to attend | |||||||||
| Sundays | ||||||||||
| Location of Farm or Business | ||||||||||
| Thurs. Night Summer Markets | ||||||||||
| County Of Production | WCFM Vendor Dues | |||||||||
| Other Markets at Which you sell |
$25.00 Annually | |||||||||
| Year applying for: | ||||||||||
| Non-Certified Agricultural Products | ||||||||||
| (Processed) | ||||||||||
| Non-Certified Non-Agricultural Products | ||||||||||
| (Artists and crafters) | ||||||||||
| 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 FARM 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 |
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| damage, injury or loss to any person or persons, including, but not limited to, persons to whom 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 way | ||||||||||
| connected with sellers use of the privileges herein granted. | ||||||||||
| Signature | Date | |||||||||