"Agreement to Furnish Meals for the Child and Adult Care Food Program" - Georgia (United States)

This "Agreement to Furnish Meals for the Child and Adult Care Food Program" is a part of the paperwork released by the Georgia Department of Early Care and Learning specifically for Georgia residents.

The latest fillable version of the document was released on June 1, 2018 and can be downloaded through the link below or found through the department's forms library.

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Download "Agreement to Furnish Meals for the Child and Adult Care Food Program" - Georgia (United States)

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Agreement to Furnish Meals for the Child and Adult Care Food Program
This agreement is made and entered into between _______________________________ and
FSMC
__________________________. WHEREAS the ______________________________ agrees to provide daily
CACFP Institution
FSMC
unitized meals (inclusive/exclusive) of milk to ________________________ for the rates herein listed:
Circle one option
CACFP Institution
# Meals Needed
# of Operating Days for
Estimated Total Cost of
Price Per Meal
Meal Type
X
Per Day
X
Contract Period *
=
Food Service Contract
$
Breakfast
X
X
=
$
$
AM Snack
X
X
=
$
$
Lunch
X
X
=
$
$
PM Snack
X
X
=
$
$
Supper
X
X
=
$
Evening
$
X
X
=
$
Snack
Total Estimated Cost of Food
$
Service for Contract Period
*The contract period should not extend beyond one year. Therefore, the number of operating days should equal the total number of days the
center will be open and provide food service for the year.
It is further agreed that __________________________, pursuant to the provisions of the Child and Adult Care Food
FSMC
Program regulations, 7 CFR Part 226**, attached copy of which is part of this agreement, will assure that said
meals/snacks meet the minimum meal pattern requirements, including creditable components and accurate portion sizes,
and will maintain complete and accurate records that at a minimum include details regarding the preparation and delivery
of meals/snacks ordered. Said records will be provided to ___________________________ promptly by the last calendar
CACFP Institution
day of each month to meet its responsibility. It is further understood that the Institution and Vendor or FSMC are
responsible for meeting accurate recordkeeping requirements; agrees to maintain all required records for three years, plus
the current year, or longer until all reviews and/or audits are closed, and submission of all monthly claims for
reimbursement in accordance with7 CFR 226.
____________________________acknowledges its responsibility to pay for all meals/snacks delivered in accordance
CACFP Institution
with this Agreement and federal regulations. _________________________________understands that neither USDA, nor
FSMC
Bright from the Start assumes any liability for payment of meals/snacks delivered, or the differences between the number
of meals/snacks delivered and the number of meals/snacks served or claimed for reimbursement; nor does Bright from the
Start or USDA assume liability for the Institution’s non-payment for meals.
This agreement shall be effective as of ____________ through ____________. It may be terminated by notice in writing
Date: MM/DD/YY
Date: MM/DD/YY
given by any party to the other party, at least 10 days prior to the date of termination.
IN WITNESS THEREOF, the parties hereto have executed this agreement as of the dates indicated below:
_______________________________
__________________________________
Signature and Title of FSMC
Signature and Title of CACFP Institution
_______________________________
__________________________________
Date: MM/DD/YY
Date: MM/DD/YY
**A copy of the CACFP regulations and CACFP Food Crediting Guide should be provided to vendor along with agreement.
USDA and Bright from the Start are equal opportunity providers and employers.
Agreement to Furnish Food Revised 06/2018
Agreement to Furnish Meals for the Child and Adult Care Food Program
This agreement is made and entered into between _______________________________ and
FSMC
__________________________. WHEREAS the ______________________________ agrees to provide daily
CACFP Institution
FSMC
unitized meals (inclusive/exclusive) of milk to ________________________ for the rates herein listed:
Circle one option
CACFP Institution
# Meals Needed
# of Operating Days for
Estimated Total Cost of
Price Per Meal
Meal Type
X
Per Day
X
Contract Period *
=
Food Service Contract
$
Breakfast
X
X
=
$
$
AM Snack
X
X
=
$
$
Lunch
X
X
=
$
$
PM Snack
X
X
=
$
$
Supper
X
X
=
$
Evening
$
X
X
=
$
Snack
Total Estimated Cost of Food
$
Service for Contract Period
*The contract period should not extend beyond one year. Therefore, the number of operating days should equal the total number of days the
center will be open and provide food service for the year.
It is further agreed that __________________________, pursuant to the provisions of the Child and Adult Care Food
FSMC
Program regulations, 7 CFR Part 226**, attached copy of which is part of this agreement, will assure that said
meals/snacks meet the minimum meal pattern requirements, including creditable components and accurate portion sizes,
and will maintain complete and accurate records that at a minimum include details regarding the preparation and delivery
of meals/snacks ordered. Said records will be provided to ___________________________ promptly by the last calendar
CACFP Institution
day of each month to meet its responsibility. It is further understood that the Institution and Vendor or FSMC are
responsible for meeting accurate recordkeeping requirements; agrees to maintain all required records for three years, plus
the current year, or longer until all reviews and/or audits are closed, and submission of all monthly claims for
reimbursement in accordance with7 CFR 226.
____________________________acknowledges its responsibility to pay for all meals/snacks delivered in accordance
CACFP Institution
with this Agreement and federal regulations. _________________________________understands that neither USDA, nor
FSMC
Bright from the Start assumes any liability for payment of meals/snacks delivered, or the differences between the number
of meals/snacks delivered and the number of meals/snacks served or claimed for reimbursement; nor does Bright from the
Start or USDA assume liability for the Institution’s non-payment for meals.
This agreement shall be effective as of ____________ through ____________. It may be terminated by notice in writing
Date: MM/DD/YY
Date: MM/DD/YY
given by any party to the other party, at least 10 days prior to the date of termination.
IN WITNESS THEREOF, the parties hereto have executed this agreement as of the dates indicated below:
_______________________________
__________________________________
Signature and Title of FSMC
Signature and Title of CACFP Institution
_______________________________
__________________________________
Date: MM/DD/YY
Date: MM/DD/YY
**A copy of the CACFP regulations and CACFP Food Crediting Guide should be provided to vendor along with agreement.
USDA and Bright from the Start are equal opportunity providers and employers.
Agreement to Furnish Food Revised 06/2018
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