UM Health-West Farm Market Application | Metro Health Farm Market

University of Michigan Health-West Farm Market

I want to be considered for a seasonal vendor spot (at the market every Thursday for the entire or majority of the season)
I want to be considered for a daily vendor spot (at the market when daily spot is available or for a portion of the season)

Product Category (Check all that apply)

Other - Please Specify

Vendor Category (Check all that apply)

Farmer (100% grower)
Farmer with locally purchased supplement (grows minimum of 51% of own products)
Artisan
Other

Other Vendor - Please Specify

Type of Business

Type of Business Other

Name of Farm/Business

Address of Primary Contact or Business

Street Address Address Line 2 City State ZIP Code

Primary Contact Name

Primary Contact Phone Number

Primary Contact Email Address

Alternate Contact Name

Emergency Contact Name & Phone Number

Website of Farm/Business

Insurance Agent (General Liability) Name:

First Last

Phone Number

Type of Insurance

Please list ALL individuals who will be your onsite manager (include yourself) and provide phone numbers for each:

First	Last	Phone Number

Products to be sold

Please list all products sold and their sources (own farm, purchased from local farm) Attach additional sheet if necessary.

Product	Source

Please list license and inspection numbers required for operation of your business and/or sale of your products, and any other license, registration, certification, or permit required by local, state, or federal law. You must provide copies of all current and valid licenses, registrations, certifications or permits with your registration. Copies can be scanned and emailed to Farm_Market@umhwest.org

Michigan sales tax license number

Nursery dealer license number

Plant dealer license number

Plant or nursery inspection number

Organic certification license number

Other relevant license number

Other relevant inspection numbers

Provide copies of all current and valid licenses, registrations, certifications, or permits with your registration.

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 MB.

University of Michigan Health-West Village Stall Assignments

University of Michigan Health-West Village provides an excellent location to host the farm market. There is plenty of community attendance and employees from the hospital and surrounding businesses that visit each week. As a hospital, our first priority is to care for our patients and their families. We ask that farm market vendors acknowledge the steady and urgent flow of traffic through the village. At no time should patient traffic be interrupted. The Market Manger or hospital security may request that you move your stall or vehicle at any time during the market. The University of Michigan Health-West Farm Market will take place in the Metro Health Village at 5900 Byron Center Avenue SW. Wyoming, MI 49519. The 2022 stall fee will be $150 per 10’X10’ space for the season or $25 per day per 10’X10’ space. This should provide adequate room for the display space and potential a vehicle, per the Farm Market Managers discretion. The 2023 season is Thursdays, May 11, 2023 through October 12, 2023 from 9 am to 2 pm. Seasonal vendors will be provided the same space at each weekly market; daily vendors will be assigned spaces as available. Space location will be based upon seniority and all assignments will be at the discretion of the Farm Market Manager.

Notice for All Farm Market Vendors

You must notify the market manager at least 48 hours in advance if you will not be attending the market. Vendors who do not provide notice that they will be missing a market will be written up as “no show”. After three (3) no show write-ups, the vendor will be subject to losing their assigned market space. This courtesy allows your stall to be used by a vendor on the waiting list to maintain market “fullness” and appeal.

Please Note: while participating in the University of Michigan Health-West Farm Market, you may be photographed or videotaped for educational, public relations and promotional services.

Signature

Vendor’s signature verifies that the above information is complete and correct. The vendor has read, understands and agrees to all provisions in the market rules of operation including all Michigan Food & Safety guidelines & laws. The market rules can be accessed in the market office or online. Inspection of Vendor’s farm/place of business by market management may occur as a condition of selling at the market.

Signature

Date

Print Name

First Last

Date

Approximate Date I can start

Approximate Date I can end

Stall Name

Please do not submit vendor fees until contacted and your application is confirmed by the Farm Market Manager. Once confirmed, booth fees can be paid by check or cash. If sending a check, please make the check payable to University of Michigan Health-West Hospital and send to Attn: Eva VanWyck, University of Michigan Health-West 5900 Byron Center Ave. SW Wyoming, MI 49519. Seasonal fees must be turned in on the first day you set up your booth at the market. All payments will be verified with a receipt. Please contact the Farm Market Manager Eva VanWyck at (616) 252-5031 or Farm_Market@umhwest.org with any questions or concerns.