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1 Vendor Application/Agreement Debbie Pye, Market Manager Business Name: Owner(s) Name: Mailing Address: City: State: Zip: Physical Address: City: State: Zip: Phone (Work): State of Georgia Sales Tax ID #: Phone (Cell): Website(s): Social Media Link(s): CHECK ALL PRODUCT CATEGORIES you wish to sell at the Wayne County Farmers Market. Note: the terms home-grown and home-made indicate the products are grown or made by the applicant. Brokered items are any item not produced by the applicant, but obtained for the purpose of resale at the market. PRODUCE: GEORGIA home-grown produce Certified organic produce Broker, selling locally grown produce Broker, selling produce from wholesaler FLORAL/PLANT: GEORGIA home-grown bedding plants GEORGIA home-grown flowers GEORGIA home-grown trees/shrubs Broker, selling flowers from wholesaler Broker, selling plants from wholesaler OTHER FARM/AGRICULTURE: GEORGIA home-made bakery goods GEORGIA home-made bread GEORGIA raised eggs / other dairy GEORGIA raised meat/poultry/seafood MISCELLANEOUS: FOOD prepared and sold at market OTHER: OTHER: OTHER: OTHER: If you are a broker selling goods from a wholesaler AND you are also selling GEORGIA home-grown or homemade items, please specify the percent of your inventory that is GEORGIA home-grown/home-made: % Vendors must request and receive approval from the Market Manager before adding mid-season inventory. Wayne County Farmers Market reserves the right to limit inventory sold at any time and to discard produce that is not fresh.

2 Please submit all required items listed below. The application is not considered complete until all items are received: Completed Application # of spaces requested (2 maximum). Market reserves right to assign number of spaces based on total number of requests. Deposit (50% of current rate at time of submission). Balance is due prior to first market day. State of Georgia Department of Revenue Taxpayer Certificate of Registration Growers Certificate (required provided by local UGA Extension office) Food Service Permit (required for prepared foods vendors only) All other certificates, licenses and permits as required for product to be sold SNAP (EBT) Certification # (optional) WIC Certification # (optional) PLEASE READ, SIGN AND DATE All authorized vendors participating in the Agriculture Market are independent operators and not partners or joint ventures, and shall be individually and severally liable for any loss, personal injury, deaths, and/or any other damages that may occur as a result of the vendor s negligence or that of its employees, agents and associates. In consideration for being allowed to participate, all vendors agree to indemnify and hold harmless Wayne County Farmers Market, City of Jesup, Wayne County, affiliates, and volunteers from any loss, costs, damages, and other expenses including attorneys fees, suffered or incurred by Wayne County Farmers Market by reason of vendor s negligence or intentional misconduct or that of its employees, agents and associates; provided that the vendor shall not be liable for nor required to indemnify Wayne County Farmers Market, City of Jesup or Wayne County, affiliates, and volunteers for any negligence of any of them or that of their servants, agents, employees or associations. Vendor further agrees that the terms and conditions, entitled Market Guidelines, are made a part hereof, and, therefore, are binding upon Vendor. Vendor further agrees that Vendor has been provided with a copy of such Market Guidelines, and consents to, agrees to be bound by, and otherwise comply with those said Market Guidelines. I further give approval for Agriculture Market to use photographs and/or video images taken at this event, which might include images of personnel, affiliates, and products, for publicity purposes. Signature: Date: Printed Name: Completed applications with deposit may be submitted in person or mailed to: Wayne County Farmers Market Post Office Box 193 Jesup, GA 31598

3 Vendor Fee Schedule APPLICATION FEE $25.00/year The application fee covers the time and expenses associated with maintaining our market and ensuring that we always have a diverse selection of vendors and products. This is an annual, non-refundable fee payable by all vendors. Applications are not reviewed until the fee is paid. VENDOR FEES The vendor fees contribute to the cost of market management, promotions, and marketing. The fees are determined by a vendor s frequency of participation. DAILY VENDOR $10.00/Day Space will be assigned at the discretion of the market manager. Efforts will be made to retain the same space from day to day, but no guarantees are made. Decisions made by the market manager will be in the best interest of the market. MONTHLY VENDOR $35.00/Month Space will be assigned at the beginning of each month and efforts will be made to retain the same space from month to month, but no guarantees are made. Market Manager retains the right to move monthly vendors from one space to another if necessary. Decisions made by the market manager will be in the best interest of the market. YEARLY VENDOR $200.00/Year Space will be assigned at the beginning of each year and efforts will be made to retain the same space from month to month, but no guarantees are made. Market Manager retains the right to move monthly vendors from one space to another if necessary. Decisions made by the market manager will be in the best interest of the market. All fees include vendor advertising on the market s website and social media

4 Vendor Product List Vendor or Business Name Contact Name (if different) Phone #_ Please provide an itemized list of products you plan to bring to market produce, meats, cheeses, baked goods, herbs, flowers, etc. Items not listed at time of market season opening MUST be approved and application amended by Market Manager BEFORE being displayed or vended at market. Please request an additional form if you need more space. CHECK ( ) CATEGORY FOR EACH PRODUCT LISTED PRODUCT NAME PRODUCE FLORAL/ PLANTS OTHER FARM/ AGRICULTURE MISC PRODUCTS

5 Media Release Form Vendor or Business Name Contact Name (if different)_ Address City State Zip Code Phone # _ I hereby give permission to Wayne County Farmers Market (WCFM) to interview, photograph and/or videotape me and/or my business for promotion of Wayne County Farmers Market. It is my understanding that any photographs, interviews or portions thereof may be used for public view on WCFM s website, social media sites and/or any other promotion/ advertising materials. Further, I agree to participate with no expectations of financial remuneration. I also hereby release WCFM from any claims, demands, and liabilities whatsoever, now or in the future, arising from the use of said products. Signature Printed Name Date