Certified Producer (Year-Round) Application "*" indicates required fields Business InformationBusiness Name* Legal Name (If Different) Certified Producer Certificate Number* Issuing County* Contact Person* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Phone*Cell or Daytime Phone*Email* Entity NameIf Applicable Type of EntitySole Proprietor, Corporation, etc. Social Media HandlesPlease Include Handle and Platform, or URL(s)Previous Market Participant?* Yes No Dates of Participation:Start Month Day Year End Month Day Year Will You Distribute Samples?* Yes No ELECTRICITY IS NOT PROVIDED.TO BE CONSIDERED FOR PARTICIPATION, YOU MAY BE ASKED TO SUBMIT THE FOLLOWING: Signed Agreement (see below) Current Copy of all Certified Producer Certificates Copy of any of the following as applicable based upon the product(s) produced and sold: Community Event Food Vendor Application; Health Dept. Permit; Food Registration Permit; Nursery License; Nursery Certified Producer Permit; Organic Registration Copy of Seller’s Permit, and Business License or Exemption Certificate Certificate of Insurance naming B.O.O.T. as additional insured $51.00 Sampling Fee made payable to B.O.O.T. (if applicable) By signing this you agree to pay for a booth space at peak/off-peak pricing per morning per space. Fees are due prior to leaving the Market each Saturday morning. ALL vendors are also required to pay a weekly Department of Agriculture fee of $2.00 in addition to their regular vendor fees. Peak Pricing (April - September): 15% of gross sales, $15.00 minimum Off-Peak Pricing (October - March): 10% of gross sales, $10.00 minimum Agreement* I, the Applicant/Participant declare I have read the Farmers Market Governing Rules and Regulations and agree to abide by them and the other rules pertaining to the Event.Read the Farmers Market Governing Rules and Regulations Here In return for the Business Organization of Old Town (B.O.O.T.) considering the application of the undersigned for participation in the Old Town Farmers Market, the undersigned Applicant declares and agrees as follows: Applicant agrees to pay fees as follows: • Peak Pricing (April - September): 15% of gross sales, $15.00 minimum • Off-Peak Pricing (October - March): 10% of gross sales, $10.00 minimum Fees are due prior to leaving the Market each Saturday morning. (See Rules & Regulations for more information.) ALL vendors are also required to pay a weekly Department of Agriculture fee of $2.00 in addition to their regular vendor fees. Applicant has read and, if this Application is approved, agrees to comply with all Farmers Market Governing Rules and Regulations, as may be amended from time to time, and any and all other rules and regulations pertaining to Applicant that may be promulgated by B.O.O.T. Applicant agrees to indemnify and hold harmless B.O.O.T., the City of Clovis, any Event Sponsors, and all Event Location Property Owners and each of their respective officers, directors, representatives, attorneys, employees, and agents from and against any and all claims, demands, causes of action, damages (including but not limited to damages to any of the property of any of the indemnified parties), liabilities (including but not limited to liabilities of an indemnified party with respect to their respective officers, directors, representatives, employees, and agents), attorney fees and costs, of every kind and nature whatsoever, whether foreseeable or unforeseeable, directly or proximately resulting from or caused by, or arising in connection with, the participation of Applicant in the Old Town Farmer’s Market, and/or the use or occupation of the property or facilities herein where the Market is conducted, whether such use or occupation is authorized or not, or from any act or omission of Applicant or any of its officers, directors, representatives, agents, employees, and invitees; and the Applicant shall pay and satisfy any judgment or decree which may be rendered against any of the indemnified parties in any such suit, action, or other legal proceedings; and Applicant shall pay for any and all damages to property of any of the indemnified parties, including loss or theft of such property, directly or proximately resulting from or caused by Applicant, or any of its officers, directors, representatives, agents, employees, and invitees. If this agreement is signed in a representative capacity, the person signing represents and warrants that he or she is authorized to bind the entity on whose behalf this agreement is executed. Applicant agrees to pay a flat fee of $10.00 per market. (See Rules & Regulations for more information). Applicant has read and, if this Application is approved, agrees to comply with all Farmer’s Market OTC Year-Round Farmers Market Governing Rules and Regulations, as may be amended from time to time, and any and all other rules and regulations pertaining to Applicant that may be promulgated by B.O.O.T. Applicant agrees to indemnify and hold harmless B.O.O.T., the City of Clovis, any Event Sponsors, and all Event Location Property Owners, and each of their respective officers, directors, representatives, attorneys, employees, and agents from and against any and all claims, demands, causes of action, damages (including but not limited to damages to any of the property of any of the indemnified parties), liabilities (including but not limited to liabilities of an indemnified party with respect to their respective officers, directors, representatives, employees, and agents), attorney fees and costs, of every kind and nature whatsoever, whether foreseeable or unforeseeable, directly or proximately resulting from or caused by, or arising in connection with, the participation of Applicant in the Old Town Farmer’s Market, and/or the use or occupation of the property or facilities herein where the Market is conducted, whether such use or occupation is authorized or not, or from any act or omission of Applicant or any of its officers, directors, representatives, agents, employees, and invitees; and the Applicant shall pay and satisfy any judgment or decree which may be rendered against any of the indemnified parties in any such suit, action, or other legal proceedings; and Applicant shall pay for any and all damages to property of any of the indemnified parties, including loss or theft of such property, directly or proximately resulting from or caused by Applicant, or any of its officers, directors, representatives, agents, employees, and invitees. If this agreement is signed in a representative capacity, the person signing represents and warrants that he or she is authorized to bind the entity on whose behalf this agreement is executed.Digital Signature* Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920