HomeMy WebLinkAbout15-007 Oakdale Farmsi �
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� 2015 Vendor Appiication MAY 14 2�15
(Produce, PIa11tS S�t N011 PCOC@SSeCI FOOCIS 011I � HEALTH DEPT.
Bass River Farm Market
311 Old Main Street, Bass River,MA 02664 ,
2Q15 Market Dates: Thursdays, June 11—Sept. 17 9 AM— 1:30 PM
Saturdays, lune 13—Sept. 19 9 AM —1:30 PM
Rain or Shine �"
Name: �� �t ��t(iF� C�..i,ti� ���%� N1rlr���'1
Farm/Vendor Name �' ��� �C't� il l�
Farm/Business Address I`1� � -.�i��e.r��- �� �� _
Farm/Business Website:
Telephone (Work} (Home} (Cell� � - �Z u-;, -S�ZCj
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Best way to contact you: C-e � �
Name& contact info for individual rnanning your spac�: �.�C�.t �
Produce/Product you will be seliin :
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Check the following that appiy and a#tach copies with apptication:
,�/ Product Liability insurance
SenrSafe Certification(i#providing samples)
G.A.P.Training Certificate
Food Allergy Awareness Training Certificate
The Market accommodates 18-24 vendors. Spaces wi{I be assigned by the Market Manager.
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� Fuil Season Fees '
' Thursdays $200 Both Days $375 �`"�p/ � � � $��S
' Saturdays $200 �{��
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i A 50%non-refundable deposit is due by Apri! 30, 2015. Final payment is due by May 20, 2015.
All fufl-season vendors are expected to attend weekly. If a seasonal vendor does not show up °
at a Market and has not given notice to the Market Manager,that vendor will receive notice
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from the Market Manager that hisjher space is forfeited for the remaining season.There are
no refunds.
Educators, Master Gardeners, No charge.
NON RROFfT and Authon and Sustainable Living
EDU
CATfQNAI GROUPS advocates to share and dispfay
' their knovvledge and work.
Must be appraved by the Market
Manager
Please Note:
By signing this form the vendor acknowledges that he/she has read and wil!
comply with the guidelines for the 2015 Bass River Farm Market which are
availabfe on our website. (hard copies can be sent to you upon request)
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Applicant's Signature � �`�:_.
Date '�-�`��� ��
Make your check payable to the Bass River Farmers Market
and
Return with compteted application to
Bass River Farmers Market
P.O. Box 1374
South Yarmouth, MA 02664
Market Manager: Carlene Veara j774j 217-1Q67
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Oakd,ale Farms
Michael and Laura Smith
1758 Somerset Ave., Dighton, MA 02715
508-336-5525
Oakdalefarms.lauraC«��mail.com
2015 Produce List
,:
Our produce is grown using natural methods in our greenhouses,
� high tunnels, and fields.
�
; Vegetables Fru�t
� Asparagus ApPkes __.._
� Beans Blueberries
Beets Melon—cantaloupe
' Broccoli Melon—red water '
` Brussel sprouts Peaches
Carrots Raspberries
�
Cauliflower Strawberries
� Corn (IPM)
� Cucumbers
Eggplant
i Garlic Herbs
Greens=arugula, bok choy,swiss chard,tatsoi Basil
Cabbage Cilantro
Kale Lavender
Lettuce Mint
� Mesclun Oregano
, Mizuna Parsley
Spinach Rosemary
Leeks Sage
Onions
Peas
Peppers FPeSh EggS
Potatoes-sweet,red, purple,white
Pumpkins
Radishes
Rhubarb
Scallions
� Squashes
Tomatoes
Turnip
I . SNNTti17 OF ED:RGL
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• a�Q��'� CERTlF1CATE C}F LfAB(LITY INSURAPICE o�.r�3r�aa5
+�,....--�.
'THiS CERT{F{CATE IS ISSUED AS A MATTER OF tNFORMATION ONLY AND CONFERS NO RtGHTS UPON THE CERTIFICATE HOLDER. TNIS
CER11FtCATE DOES NOT AFFlRMATIYELY OR NEGAINELY AMEND, EXTEPID OR ALTER THE GOVERAGE AFFORDED BY 1HE POUCIES
BELOW. TFIIS CERTIFICA'iE OF INSURANCE DQES NOT CONS7t7UTE A COtJ'iRACT BE7WEEN THE ISSUING INSURER(Sy, AUTHORlZED
REPRESENTATfVE OR PRODUGER,JWD THE CER7iFICA7E HOLDER.
IMPORTANT: if�e certiticate hoidet is an ADDITlONAL tN3URED,tfie policy(ies) must be endarsed. If SUBROGATtON {S WANED,subjeet to
the terms and conditions of the policy,certain palicies may rcquire an endorsement. A statement on this cenificate does not coMer rights to the
certificate holder in li�u of such endarsemen s• .
PRODUCER NAME
FBinsure,LLC �H o E t. NO-
DBA FBinsure
PO Box 138 aoa�ss
Rehoboth,MA 02765 INSUREAESy AFFORDING GOVERAGE ���
�xsuaER n:Acadia lnsurance 31325
INSURED Michaei J.�Laura Smith INSUftER B:
1758 Somerset Ave INSURER C:
Dightort,MA 02715 �NSU�R D:
INSIlRER E:
INSURER F:
�Q���S CERTiFFGATE NUMBER: REVtSiON NUMBER:
THIS 1S TO CERTlFY THAT THE POLIGES OF INSURANCE USTED BELOW HAvE BEEN ISSUED TO THE INSURED NAMED ASOVE FOR THE PQLICY PERIOD
IIJDICATED_ iJO7WIiHSTANDiNG ANY REQUIi�EfAENT. TEi2f�7 OR CONDlTION OF ANY CONTRACT OR OTHER D�CUPA£NT WiTH RESPEGT TO WNICH THiS
CERTIFICATE MAY BE IS5UED OR �viAY PERTAIN, THE INSURANCE A�FORDED 6Y THE POLICIES JESCRlBEC} HEREIN 1S StiBJECT �O ALL THE TERt1�S.
EXCIUSIONS AND CONDITIONS OF SUCH POLlCI£S.LITd1TS SHQWN MAY HAVE BEEN REDUCED BY PAIU CLAIMS.
TYPE OF IN51lRANCE PO!!CY NUMBER LW�TS
��t 1.QOQ,
COMMERCIAL GENERAL LYl&Lff7 EACI-S OCCURRENCE �
Cl.A7MS-MADE �OCCUR
PR a a urte e � ��'�
p X A gri Liability FM5731}506 12121f2014 12/21t2015 �EQ�P(qRy one pQ�n) s_ 5,
PERSONAL 8 ADV WJURY S 1,000+
GENERAL AGGREGATE 5 2+��+�
C�EN'L AGGREGATE LfM1T RPPLIES PER
R PFtODUC�S-COMPIOP AGG 5
POLICY❑jE� �LOC
5
O?HER: COMSiNED SINGLE LIMIT 5
AUTMAC181LE�Y►H1L�TY ( �cid ntl _,�
60DIlY INJURY(Per persDn) S
AT�FY AUTO
%L OWNED SCHEDULED 60DiLY INJi1RY(Per accident} 5
AUTOS ��Q`��h� PROPERTY DRMAGE c�
Peraccitlent
}iif2ED AtJSOS A,UTOS 5
��-�'�� OCCllR EACH OCCURf2ENCE 5
EXCESS LIAB GLrUtv1S-MADE AGGREGATE 5
S
D'cD RE?EN710N� acR OTH-
WORKER5 COMPENSATION 7AT
AND EMRCOYERS LIA�CfTY y 1 N �.t.�pC#i ACGt�NT 5
ANY�OPRIFfORJPARTNEWEXECUi1VE ❑N!A
OFFtCER/i�1EM8ER EXCLUDED? E.L.DISEASE-EA EMPLOYE S
(Mantiatory in NM)
it Yes.tlescn0e w+der E.L.DISEASE-POLlCY UA41S S
DESCRIPiiOTd OF OPERA71flNS DNow
DESCRIPTION OF OPgtATiONS 1 IUCATIONS 1 VEHICLES�ACORD tdt,Additional Rert�arks S�edWe.may De attacAed if m°re space is requiredl
Farmers'Markets Liability
CERTIFICATE HOLQER CANGELLATiON
SM{THMI SHOULD ANY OF 7HE A�DVE DESGR{BED POLICIES BE CANCELlED BEFORE
THE EXPIRATION DA'T� 7HEREOF, NOTICE NfILL BE DELIVERED IN
ACGORDANCE IMTH THE FOLICY PROVISIONS.
Michael J 8�Laura Smith
1758 Somerset Ave AUTHORiZED REPRESEPIiATIYE
Dighton,MA 02715 ��� ���
O 1988-2014 ACORD CORPOR�►TtON. All�i9hts reseryed�
AGORD 25(201M01) �'t►c AGORD name and lo�o are re9istered marks of ACORO
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THE COMMONWEALTH OF MASSACHUSETTS
i TOWN OF YARMOUTH
; BOARD OF HEALTH
PERMIT NiJMBER: #15-007 _ FEE: None
i This is to Certify that Michael and I,aura Smith d/b/a Oakdale Farms
� 1758 Somer et AvenLe, Dig to ,MA
,'
IS HEREBY GRANTED A LICENSE
� For NAME OF EVENT: Bass River Farmers Market
! _ _ DATE OF EVENT: Thursdays and Saturdays throug to Se�tember 19, 2015.
LOCATION: 311 Old Main Street. South Yarmouth, MA
_ FOOD SERVED: Assorted ve�etables, fruits,herbs; Fresh eggs.
T'his permit is granted in conformity with Article VI of the Sanitary Code of The Commonwealth of Massachusetts,and
expires September 20,2015 unless sooner suspended or revoked.
Mav 15,2015 BOARD OF HEALTH: J��1�C��t¢�rl[�t� �AGl�lttp�fZ
�J`3cu���c�, _.lY�.,1�., `Uice C!Piai�cnuut
�ex�
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Bruce G. Murphy, MP .S., CHO
D.irector of Health
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