PRODUCER VENDOR CERTIFICATE
St. John's Farmers Market
Producer Vendor Certificate
May 1, 2004
I, ________________ do certify on this date, ________________ 2004 that products described as follows:
_______________________________________________________
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_______________________________________________________
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are grown or produced by me and/or members of my household at my farm, home or garden located at
______________________________________________(Address).
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 and/or your Virginia Department of Agriculture inspection report must accompany this certificate.
I understand that if this statement is false, I will remove the prohibited item(s) or give up my space and forfeit my fee at the St. John's Farmers Market
Signed ____________________________________________________
Address ___________________________________________________
Download Producer Vendor Certificate in PDF format (15 KB)
WANT TO BE A VENDOR?
Return to St. John's Farmers Market introduction
Read the Rules & Regulations
Complete the Vendor Agreement and mail with this Certificate
Contact Martha Frank at 804-443-1003 or
P O Box 523, Tappahannock Virginia 22560
