Name of Producer      

Company / Sole Trader Name  

Trading Name for Sole Trader    

Full Address

(Click in here to fill in)

VAT Number

Tel Number

Fax Number

Mobile Telephone

e-mail address

Website Address

CPH Number (County/Parish Holding Number)

SBI Number (Single Business Identifier)

NB - If applicable to your business - above required to comply with Devon Renaissance Grant

Are you a registered food business for all the food products you wish to sell?   

Yes  □             N□  □

If yes, name of Local Authority with whom registered

If meat □r meat products are the premises licenced   

Yes    □            N□   □

If yes, name of Local Authority with whom registered

If you are selling meat, fish or cheese, is it all pre-packed?

Yes   □           N□  □

If No, please detail how product is displayed

Will you require electricity?

Yes  □              N□  □

If yes, list appliances & wattage required and attach a copy of test certificate for each one you wish to use

Do you have protective clothing ?

Yes   □         N□  □      N/A  □

Food handlers trained in hygiene regulations?

Yes   □               N□  □

Food handlers trained in food hazard awareness ?

Yes   □               N□  □

Do you have a name board or □other visible means of identification

Yes    □              N□  □

Please give details of your current insurance for public liability, product liability (relating to the products you wish to sell) and if an employee will attend the market your employer’s liability insurance (please attach a copy of your insurances).

Insurance company name:

Policy number:

Amount insured:

Expiry date:

Please list all the food or craft products you would like to sell:

Who will be selling the produce? (Wherever possible this should be you or someone who is involved with growing or producing the goods.)

List of Names

I have received and read the constitution and general regulations and agree to comply with their conditions.  I attach copies of all the certificates required.

Sign

Date