FMCB Vendor Application - The 712 InitiativeThe 712 Initiative

This serves as an application for booth space at Farmers Market Council Bluffs, held Thursdays May through September, 4:30 to 7:30 pm.

See more about Farmers Market Council Bluffs

Farmers Market Council Bluffs Vendor Application

Contact Information
Business Name*
Contact Name*

First

Last
Mailing Address*

Street Address

Address Line 2

City

State

ZIP Code
Business Email*
Secondary Email
Mobile Number*
Secondary Number
Booth Information
I would like to be a..*
- Season Long Vendor
- Occasional Vendor
Please check all that apply*
- Single Season Long Booth ($200)
- Season Long Additional Booth ($100)
- Season Long Additional Booth ($100)
- Season Long Additional Booth ($100)
- Season Long Electricity ($50)
(You will be invoiced upon vendor acceptance)
Please check which applies*
- Occasional Booth ($20)
- Occasional Booth with Electricity ($25)
(You will be invoiced upon vendor acceptance)
Which week/s would you like to be at the market?

hold CTRL or Command while clicking to select multiple dates
Vendor Category*
Please elaborate on "other"*
Product Description*
Please describe the products you will be selling.
Photos
Please upload up to 4 photos for FMCB promotion. Examples may include you logo, product photos or a photo of your booth set up
Drop files here or

Accepted file types: jpg, png.
Tax Information
Sales Tax Permit/Tax ID Number - Please check the tax documentation that you have obtained.*
- Iowa Sales Tax Permit
- Federal Tax ID Number
- In process of filing for Sales Tax Permit or Tax ID Number
A copy of your Iowa Sales Tax Permit or Tax ID Number MUST be provided/on file with The 712 Initiative. Please email your documentation to Jeff Snow (jsnow@the712initiative.org) or mail copies to the following:
The 712 Initiative
1228 S. Main Street
Council Bluffs, IA 51503
Tax ID Number*
Please upload documentation of your Tax ID Number*
Iowa State Sales Tax Permit Number*
Please upload documentation of your State Sales Tax Permit*
Explain where you are in the process of aquiring your Tax ID Number of Iowa State Sales Tax Permit
Additional Information
Are you a Certified Organic Producer?*
Do you participate in the Wireless EBT project?*
Do you participate in the Farmers Market Nutrition Program (FMNP)? This is formerly called WIC and Senior Checks program.*
Responsibility Waiver*
Checking 'YES' below is representative of my signature and states that I have read and completely understand the Responsibility Waiver found under Terms & Conditions on this page.

YES, I have read & understand the Waiver of Responsibilities
Contamination Affidavit*
Checking 'YES' below is representative of my signature and states that I have read and completely understand the Contamination Affidavit found under Terms & Conditions on this page.

YES, I have read & understand the Contamination Affidavit
Hold Harmless Agreement*
Checking 'YES' below is representative of my signature and states that I have read and completely understand the Hold Harmless Agreement found under Terms & Conditions on this page.

YES, I have read & understand the Hold Harmless Agreement
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TERMS & CONDITIONS

Season Long Vendor Applications for the 2020 Farmers Market Council Bluffs season are due no later than February 5.

Occasional Vendor Applications will be ongoing.

The 2020 Season Long Vendors have ‘first right of refusal and any available Season Long Vendor stalls are reserved on a first-come first-served basis.

The market will be held ‘Rain or Shine’; however, The 712 Initiative does reserve the right to cancel the market due to inclement weather. We do not issue refunds for these market days.

Responsibility Waiver

For any illness, injury, property damage, or loss suffered or sustained by me which is in any way associated with my participation in, travel to and from, or other activities associated with Farmers Market Council Bluffs, I do hereby, for myself, my heirs, and my administrators and executors, forever waive, release and discharge any and all rights and claims for expenses, damages, or other losses which I may have or which may hereafter accrue, against The 712 Initiative, their sponsors, officers, directors, employees, agents, successors, and assigns.

Contamination Affidavit

The undersigned vendor states that all products offered for sale by this vendor at Farmers Market Council Bluffs are free of contamination from chemical residues and bacterial sources. The undersigned vendor further states that all pesticides and herbicides used in the production of items offered for sale by this vendor have been applied in accordance with current rules of the US Environmental Protection Agency, US Food and Drug Administration, and the Iowa Department of Agriculture.

Hold Harmless Agreement

Vendor agrees to indemnify and hold harmless The 712 Initiative and its employees, volunteers and sponsors from any and all liabilities and causes of action which may arise by virtue of vendor’s participation in Farmers Market Council Bluffs.

Farmers Market Council Bluff Vendor Application

Farmers Market Council Bluffs Vendor Application

Contact Information

Booth Information

Tax Information

Additional Information

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