Vendor Interest Form

Contact Name

First NameLast Name

Vendor Business Name

Vendor Website for Facebook page URL

Vendor Email

example@example.com

Vendor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Are you a food truck vendor?

If you indicated no, please specify what type of vendor you are

Fill in your Pima County Health Permit Number, if applicable

Fill in your Town of Marana Business License Number

Arizona Sales Tax ID Number

Indicate which of the following insurances that you have (please check all that apply)

Auto Liability (owned/non-owned) $500,000/$1,000,000 Bodily InjuryCommercial General Liability (CGL) $1,000,000 OccurrenceWorkers Compensation (Statutory Limits)

* Denotes Required Field

*Please note you will need to provide a Certificate of Insurance (COI) listing Saguaro Bloom/CCMC as a certificate holder and listed as "Additional Insured".

Thank you for your interest in becoming a vendor at Saguaro Bloom. In submitting you will be added to your vendor database and will be contacted when opportunities are available. Partially completed forms may be rejected.