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Vendor Packet - Ventura County Star

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INSURANCE OPTION #1<br />

Deadline: Friday, October 26, 2012<br />

Questions? Julie Lopez, 805-437-0446 or jlopez@vcstar.com<br />

INSURANCE IS MANDATORY FOR ALL WOMEN TODAY EXHIBITORS<br />

When you purchase this option, the California Fair Services Authority provides exhibitor<br />

insurance as part of a pooled risk program. This program meets the insurance requirements<br />

for Women Today detailed in the Official Terms & Conditions on your Women Today contract,<br />

item #11. This option is provided as a courtesy to those exhibitors that do not otherwise have<br />

insurance coverage.<br />

Check One:<br />

Commercial <strong>Vendor</strong> Event Insurance $50<br />

Food <strong>Vendor</strong> Event Insurance $60<br />

Exhibitor Name: ___________________________________________________Contact Name: ____________________________<br />

Address: ___________________________________________________________________________________________________<br />

City: _____________________________________________________________ State: ______________ Zip: _________________<br />

Telephone #: ________________________ E-mail Address: _________________________________________________________<br />

Payment Method (check one): Check Cash MC/Visa Amex DC Bill my VCS account<br />

Card #: ___________________________________________________________ Exp. Date: _______________________________<br />

Name on card (please print): __________________________________________________________________________________<br />

Signature: __________________________________________________________________________________________________<br />

Fax your request to 805-437-0465 or email it to jlopez@vcstar.com by Friday, October 26, 2012. Please make checks payable<br />

to <strong>Ventura</strong> <strong>County</strong> <strong>Star</strong> - Women Today and mail to <strong>Ventura</strong> <strong>County</strong> <strong>Star</strong> - Women Today, P.O. Box 6006, Camarillo, CA 93011.<br />

WT2012_Insurance Request Form Option #1 8/2/2012 Page 1 of 1

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