Urbanna's Farmers Market Producer Vendor Certificate

If you are selling produce or baked good at home you must fill out the this form and supply either your Virginia Deptartment of Health or Virginia Deptartment of Agriculture inspection report. If you wish to sell shellfish or shell stock we must have a copy of your Shellfish Sanitation Division of Virginia inspection report as well as your Virginia Department of Agriculture inspection report must accompany this certificate..

You can scan or take a picture of your report(s) and email it to urbannafarmersmarket@gmail.com. You can also bring your inspection reports to the Farmers Market the day of the event however if you do not have your reports you will have to remove the items or give up your space and forfeit you space fee.

Please be sure to fill out your Vendor Registration form

Producer Vendor Certificate 2018

First Name*
Last Name*
Business Name (If applicable)

Fill out the address section below if the address the products were grown ore produced is different from the address on your Vendor Registration form

Address
City*
State*
Zip*

I certify that the products described as follows have been grown or produced by me and/or members of my household at my/our farm, home. If the products were grown or produced at a different location that stated on the Vendor Registration form you must fill out the address section above.

*This section is required

For those who wish to sell prepared foods, a copy of your current inspection report from the Virginia Department of Agriculture or the Virginia Health Department must accompany this certificate. For those who wish to sell shellfish or shell stock, a copy of an inspection report from the Shellfish Sanitation Division of the Virginia Health Department as well as your Virginia Department of Agriculture inspection report must accompany this certificate.

By submitting this form I state that I understand that if this statement is false or I do not present my Virginia Department of Health or Virginia Department of Agriculture reports, I will remove the prohibited item(s) or give up my space and forfeit my fee at the Urbanna Farmers Market.

Vendors shall hold the UFM Committee Members, Volunteers, the Urbanna Business Association, the Town of Urbanna, and any businesses or individuals donating space or property to the UFM, harmless from any liability whatsoever resulting from their activities at the UFM.

I agree to abide by all the rules and regulations of the Urbanna Farmers Market as noted on this form.

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