ALTADENA FARMERS’ MARKET

APPLICATION FOR CERTIFIED PRODUCER OR PRODUCER

LOCATION: Loma Alta Park: 3330 Lincoln Avenue, Altadena, CA 91001

MARKET OPERATOR: STACEY WHITNEY

PHONE: (626) 733-6818 email: [email protected]

MARKET SPONSOR: ALTADENA COMMUNITY GARDEN

3330 N. LINCOLN AVE., ALTADENA, CA. 91001

PRODUCER’S NAME:
BUSINESS NAME:
CELL PHONE/TEXT:
MAILING ADDRESS: CITY: ,
ZIP CODE:
E-MAIL:
DO YOU NEED A WEBSITE?
FARM SIZE/TOTAL ACRES: ACRES: (ORGANIC) (CONVENTIONAL)
LOCATION OF FARM:
(COUNTY ROAD INTERSECTIONS – if applicable):
COUNTY OF PRODUCTION:

FAMILY MEMBER(S) AND EMPLOYEE(S) WHO MAY SELL:

NAME /RELATIONSHIP:
NAME /RELATIONSHIP:
NAME /RELATIONSHIP:

DO YOU HAVE COLD STORAGE? *
IF YES, GIVE LOCATION ADDRESS:
DIMENSIONS OF TRUCK OR VAN: (WIDTH X LENGTH)
LIST ALL THE MARKETS YOU PARTICIPATE IN:

PLEASE SIGN AND DATE BELOW:

I REQUEST PERMISSION TO SELL AT THE ALTADENA FARMERS’ MARKET. I HAVE READ THE MARKET RULES. I AGREE TO ABIDE BY THESE RULES AND ALL OTHER LAWS, CODES, AND REGULATIONS, AS AMENDED, TO COOPERATE WITH MARKET MANAGEMENT, AND TO PAY ALL REQUIRED FEES.
PRODUCER:'S SIGNATURE:
DATE:
MARKET MANAGER (Market Manger will Initial Later):

PRODUCE WORKSHEET - ALTADENA FARMERS’ MARKET

Please list the items you would like to sell at the Market and when they will be available. Failure to list any crop may result in your not being allowed to bring it to the Market. Complete an additional copy of this form if you want to sell on a second certificate. List additional crops on reverse side. Crops not specified by this agreement can be added at a later date with Manager’s approval and signed by Manager and
FARM NAME:

List Products for Approval that You Would Like to Sell

CROP

JAN - MAR

APR - JUN

JUL - SEP

OCT - DEC

{example] tomatoes, onions, peppers
YES
YES

HOW DOES YOUR SERVICE ELEVATE OUR ALTADENA FARMERS' MARKET?

ALTADENA FARMERS’ MARKET

APPLICATIONS USE FORM

LOCATION: Loma Alta Park: 3330 Lincoln Avenue, Altadena, CA 91001

MARKET OPERATOR: STACEY WHITNEY

PHONE: (626) 733-6818 email: [email protected]

MARKET SPONSOR: ALTADENA COMMUNITY GARDEN

3330 N. LINCOLN AVE., ALTADENA, CA. 91001

FARM NAME:
DATE:
NEAREST TOWN: COUNTY:
CERTIFIED ORGANIC BY A THIRD PARTY CERTIFIER: *
IF YES - NAME OF CERTIFIER:
REGISTERED ORGANIC WITH STATE OF CALIFORNIA:
TO CONTROL PESTS WE USE: (Please list all materials which may be applied and all mechanical techniques used.)
TO CONTROL WEEDS WE USE: (Please list all materials which may be applied and all mechanical techniques used.)
TO CONTROL ROT, FUNGUS, AND/OR SPOILAGE, WE USE: (Please list all materials which may be applied and all mechanical techniques used.)
TO ENHANCE AND/OR CONTROL SIZE, FLAVOR, RIPENESS OR APPEARANCE, WE USE: (Please list all materials which may be applied and all mechanical techniques used.)
TO INCREASE SOIL FERTILITY AND CONSERVE WATER, WE USE THE FOLLOWING COVER CROPS:
(Please list all materials which may be applied and all mechanical techniques used.)
PLEASE SIGN AND DATE BELOW:
PRODUCER:
DATE:

ALTADENA FARMERS’ MARKET

EMPLOYMENT AGREEMENT

LOCATION: Loma Alta Park: 3330 Lincoln Avenue, Altadena, CA 91001

MARKET OPERATOR: STACEY WHITNEY

PHONE: (626) 733-6818 email: [email protected]

MARKET SPONSOR: ALTADENA COMMUNITY GARDEN

3330 N. LINCOLN AVE., ALTADENA, CA. 91001

I, a Certified Producer under Title 3, Article 6.5 of the California Code of Regulations, do currently employ as authorized under Section 1392.2 to sell certifiable agricultural products of my own production for me at a Certified Farmers’ Market. I attest that the above named employee is a legal employee and that all compensation to this employee is based on a fixed salary and not on a commission or on a resale basis and agree that I will provide documentation for verification of this employment upon request. This agreement will be available for review at any operating certified farmers’ market.

I will immediately notify the endorsing Agricultural Commissioner/Sealer upon termination or change in status of my employee.

I am aware that any violation of the Direct Marketing Regulations (Title 3, Article 6.5) by me or by my employees may result in a civil administrative penalty and/or revocation of my Certified Producer’s Certificate by the Issuing County and/or my privilege to participate in a Certified Farmer’s Market.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Executed this DAY of MONTH , YEAR in COUNTY OF , CA.

Renewal of this employment agreement is required upon expiration of Certified Producer’s Certificate.

CERTIFIED PRODUCER:

CERTIFICATE NO.:

CERTIFICATE EXPIRATION DATE:

CERTIFIED PRODUCER'S SIGNATURE:

ALTADENA FARMERS’ MARKET

HOLD HARMLESS AGREEMENT

LOCATION: Loma Alta Park: 3330 Lincoln Avenue, Altadena, CA 91001

MARKET OPERATOR: STACEY WHITNEY

PHONE: (626) 733-6818 email: [email protected]

MARKET SPONSOR: ALTADENA COMMUNITY GARDEN

3330 N. LINCOLN AVE., ALTADENA, CA. 91001

I, OWNER OF
WHOSE ADDRESS IS:
(hereinafter “Seller”), in consideration of being provided selling space at the Altadena Farmers’ Market agree to the following terms and conditions:
  1. Seller shall indemnify, defend, and hold harmless the Altadena Farmers’ Market, Stacey Whitney, Altadena Community Garden, The Los Angeles County Department of Parks and Recreation, their agents, servants, employees, and volunteers
from and against any and all loss, damages, liability, claims, suits, costs and expenses, whatsoever, including reasonable attorneys’ fees arising from or in any manner connected to the willful misconduct or to the passively or actively negligent
acts, errors, or omissions of Seller, its agents and employees, in connection with Seller’s participation in the Altadena Farmers’ Market and in the performance of services, work or activities under this agreement and the Altadena Farmers’ Market Rules & Regulations.
  1. Seller acknowledges receipt of and agrees to comply with each and every rule, regulation, procedure, term and condition set forth in the Altadena Farmers’ Market Rules and Regulations.
IN WITNESS WHEREOF, THIS AGREEMENT IS EXECUTED THIS DAY OF
OWNER’S NAME (PRINT):
OWNER’S SIGNATURE:
PHONE:
EMAIL: