Form SFN59989 "Child and Adult Care Food Program Annual Information Certification" - North Dakota

What Is Form SFN59989?

This is a legal form that was released by the North Dakota Department of Public Instruction - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2011;
  • The latest edition provided by the North Dakota Department of Public Instruction;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form SFN59989 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Public Instruction.

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Download Form SFN59989 "Child and Adult Care Food Program Annual Information Certification" - North Dakota

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RETURN TO:
CHILD AND ADULT CARE FOOD PROGRAM ANNUAL
Department of Public Instruction
INFORMATION CERTIFICATION
Child Nutrition and Food Distribution Programs
600 E. Boulevard Avenue, Dept. 201
NORTH DAKOTA DEPARTMENT OF PUBLIC INSTRUCTION
Bismarck, ND 58505-0440
CHILD NUTRITION AND FOOD DISTRIBUTION PROGRAMS
Phone: (701) 328-2294
SFN 59989 (7/2011)
Sponsor of Center
If there have been changes to any of the items below, please contact our office.
This is to certify that the Sponsor of Center(s) named above meets all of the requirements for renewing institutions
contained in 7 CFR 226.6(b)(2). This entity certifies that:
The management plan on file with the State Agency is complete and up to date;
No sponsored facility or principal of a sponsored facility is currently on the CACFP National Disqualified list;
The outside employment policy most recently submitted to the State Agency remains current and in effect;
The names, mailing addresses, and dates of birth of all current Sponsor of Center’s principals have been submitted to
the State Agency;
The Sponsor of Centers itself, and the sponsor’s principals, are not currently on the CACFP National Disqualified list;
The list of any publicly funded programs that Sponsor of Centers and principals have participated in the past seven
year is current;
The Sponsor of Centers itself, and the Sponsor of Center’s principals have not been determined ineligible for any
other publicly funded programs due to violation of that program’s requirements in the past seven years;
No principals of the Sponsor of Center have been convicted of any activity that occurred during the past seven years
and that indicated a lack of business integrity; and
The Sponsor of Centers is currently compliant with the required performance standards of financial viability and
management, administrative capability, and program accountability as described in
7 CFR 226.6(b)(2)(vii):
Compliance with Performance Standards: Each renewing institution must submit information sufficient to
document that is financially viable, is administratively capable of operating the program in accordance with this
part, and has internal controls in effect to ensure accountability. To document this, any renewing institution must
demonstrate in its application that it is capable of operating in conformance with the following performance
standards. The State Agency must only approve the applications of those renewing institutions that meet these
performance standards, and must deny the applications of those that do not meet the standards.
Signature
Title
Date
RETURN TO:
CHILD AND ADULT CARE FOOD PROGRAM ANNUAL
Department of Public Instruction
INFORMATION CERTIFICATION
Child Nutrition and Food Distribution Programs
600 E. Boulevard Avenue, Dept. 201
NORTH DAKOTA DEPARTMENT OF PUBLIC INSTRUCTION
Bismarck, ND 58505-0440
CHILD NUTRITION AND FOOD DISTRIBUTION PROGRAMS
Phone: (701) 328-2294
SFN 59989 (7/2011)
Sponsor of Center
If there have been changes to any of the items below, please contact our office.
This is to certify that the Sponsor of Center(s) named above meets all of the requirements for renewing institutions
contained in 7 CFR 226.6(b)(2). This entity certifies that:
The management plan on file with the State Agency is complete and up to date;
No sponsored facility or principal of a sponsored facility is currently on the CACFP National Disqualified list;
The outside employment policy most recently submitted to the State Agency remains current and in effect;
The names, mailing addresses, and dates of birth of all current Sponsor of Center’s principals have been submitted to
the State Agency;
The Sponsor of Centers itself, and the sponsor’s principals, are not currently on the CACFP National Disqualified list;
The list of any publicly funded programs that Sponsor of Centers and principals have participated in the past seven
year is current;
The Sponsor of Centers itself, and the Sponsor of Center’s principals have not been determined ineligible for any
other publicly funded programs due to violation of that program’s requirements in the past seven years;
No principals of the Sponsor of Center have been convicted of any activity that occurred during the past seven years
and that indicated a lack of business integrity; and
The Sponsor of Centers is currently compliant with the required performance standards of financial viability and
management, administrative capability, and program accountability as described in
7 CFR 226.6(b)(2)(vii):
Compliance with Performance Standards: Each renewing institution must submit information sufficient to
document that is financially viable, is administratively capable of operating the program in accordance with this
part, and has internal controls in effect to ensure accountability. To document this, any renewing institution must
demonstrate in its application that it is capable of operating in conformance with the following performance
standards. The State Agency must only approve the applications of those renewing institutions that meet these
performance standards, and must deny the applications of those that do not meet the standards.
Signature
Title
Date