Dear Emergency Food Provider

Dear Emergency Food Provider

THE FOOD BANK FOR WESTCHESTER AGENCY CONTRACT

SECTION 1

AGENCY RELEASE

Your organization affirms that the Food-Bank, original donor, and Feeding America are released from any liabilities, and furthermore offer no express warranties in relation to the products that you receive as part of this agreement.

Whereas the Food-Bank has offered to solicit, maintain, and provide certain foods and related items as available tothe Agency, the Agency hereby warrants, represents, and guarantees as follows:

  1. All donated product is accepted by the Agency in “as is” condition.
  2. The Agency hereby accepts full responsibility for the purity and fitness for consumption of all donatedproduct accepted.
  3. The Agency will serve or distribute the donated product as soon as possible.
  4. The Agency hereby warrants and guarantees to indemnify, defend and hold the Food-Bank, FeedingAmerica, and the original donor harmless from all liabilities, claims, losses, causes of action, suits at law orin equity or any other obligation whatsoever arising out of, or attributed to, the storage and/or use of the products supplied fromor coordinated by the Food-Bank.

SECTION 2

AGENCY ELIGIBILITY AND COMPLIANCE STANDARDS

  1. The Agency must be a federally tax exempt 501(c)3 organization, wholly-owned by a 501(c)3 organization or a Church. The Agency may be an unincorporated program designated as the agent of a 501(c)3 agency or Church in distributing donated product obtained from the Food-Bank to eligible recipients under the following conditions:
  2. The 501(c)3 organization or Church must affirm such designation in writing, acknowledging the responsibility to enforce all provisions of this agreement with the Food-Bank on the designated Agency;
  3. The 501(c)3 organization or Church must be programmatically, fiscally and legally responsible for the donated product handling/distribution activities of the designated Agency; and
  4. Funds used to pay shared maintenance fees assessed by the Food-Bank must come from the 501(c)3 organization or Church and not from the designated agent and all money received and disbursed in connection with the donated product handling/distribution activity will go through the fiscal books of the 501(c)3 organization or Church.
  5. The Agency must be incorporated for the purpose of serving the ill, needy, or infants (minor children).
  6. The Agency must distribute donated products free of charge for use by the ill, needy, or infants (minor children.) Distribution is limited to use in Westchester County, New York.
  7. The Agency will neither offer for sale, sell, transfer, nor barter the donated product in exchange for money, other properties, or services.
  8. The Agency agrees not to transfer any items acquired from the Food-Bank to any other organization unless first approved by member services at the Food Bank.
  9. The Agency agrees to support the operation of the Food-Bank by contributing to the “shared maintenance fee” of $0.10 per pound of donated product. The shared maintenance fee helps to maintain Food-Bank as a licensed and approved food inspection and warehouse distribution system.
  10. The agency agrees to adhere to any additional donor stipulations that may be required.
  11. The agency must track and maintain records of clients served by household and age of the client. Those numbers must be reported to the Food Bank by the 10th of following month.
  12. Failure to report your monthly statistics will result in immediate suspension of your account and you will not be able to order any food until your statistics have been submitted.
  13. Food Safety Requirements:
  14. The Agency must have a system for securing donated product received and have adequate refrigeration/freezer space and dry storage to ensure the safety and wholesomeness of donated product until used and/or distributed. Measures taken to secure donated product and maintain its integrity must include, but are not limited to:
  15. Keeping donated product distinct from that of other programs, staff and/or personal use;
  16. Restricting access to storage areas with lockup capacity;
  17. Storing food off the ground, in a cool, dry area protected from danger of freezing;
  18. Storing grains, cereals, etc. in such a way as to protect against rodent problems;
  19. Keeping thermometers in everyfreezer/cooler and maintaining temperature logs daily and retaining them for at least two years
  20. Every agency is responsible for ensuring program staff and volunteers are trained properly in hygiene, safe handling of food, and dealing with the public in a professional manner.
  21. On site feeding programs must have at least one staff member or regular volunteer designated as responsible for the safe storage, handling, and preparation of food and certified in food safety by either the Food Bank’s Food Safety Program (ServSafe) or provide proof of certification from a qualified, professional food safety training agency
  22. Service Requirements:
  23. The Agency will treat recipient applications and written records as confidential material, keeping all intake cards and sign-in sheets on-site in a locked and secure area or password protected on a computer.
  24. Eligible staff, volunteers, congregational members, or any other subgroup of recipients shall not be given priority or exclusive rights over the distribution of donated product.
  25. Recipients may not be required to attend a religious or political meeting or to make a statement of faith, non-faith or pledge membership, or to attend any religious or political meeting before, during, after, or in exchange for product.
  26. The Agency agrees to treat recipients with respect and dignity.
  27. The Agency will not engage in discrimination, in the provision of service, against any person because of race, color, citizenship, religion, gender, national origin, ancestry, age, marital status, disability, sexual orientation including gender identity or expression, unfavorable discharge from the military or status as protected veteran.
  28. The Agency will keep posted, both the Client Bill of Rights and Provider Bill of Rights, in a place where all program participants, volunteers and staff may be able to read and understand them.
  29. Inactive Status
  30. If the agency has not placed an order or submitted their statistics in at least 6 months, the agency will placed on suspension and a site visit is required before the agency can order.
  31. If the agency has not placed order in at least 1 year, the agency is made inactive.
  32. If the agency has missed more than 3 deliveries in 6 months, the Food Bank will no longer make deliveries to the agency; pick up at our warehouse will be required from that point moving forward.

SECTION 3

FINANCIAL

  1. Credit Limits are assigned to every agency; your agency will be notified of your credit limit shortly after becoming a member agency.
  2. The Food Bank requires that all invoices be paid within 60 days; failure to do this will result in immediate suspension until payment is received.

SECTION 5

MONITORING

The Agency monitoring process serves to ensure compliance with state and federal law, as well as the Contract. Food-Bank representatives will meet regularly with Agencies to periodically evaluate the Food-Bank and Agency relationship and to promote Agency best practices.

  1. The Agency agrees to a preliminary on-site visit by a Food-Bank representative during the application process.
  2. The Agency agrees to allow the Food-Bank to monitor regularly at least once every eighteen (18) months, or moreoften at the Food-Bank’s discretion.
  3. The Agency will allow the Food-Bank to monitor the Agency at its own discretion, announced orunannounced.

Unannounced monitoring visits will only be conducted during the posted operating hours of the Agency. Food-Bank staff will strive to work with Agency staff or volunteers to arrange an agreed upon appointment to meet.

In witness of their intention to be legally bound by the terms and conditions of this Contract, and to work together toward the common goals, and in accordance with the preamble, the Food-Bank and the Agency have signed this Contract.

Food Bank for Westchester /
Name of Agency

Print Name (Member Services) /
Print Name (Agency Director)

Signature /
Signature

Date /
Date

The Food Bank for Westchester

Member Application

Organization Name (as listed on your 501c3):

ProgramName:

Address:

Organization Director/Head Clergy:

Program Contact:

Email Address:

Program Phone#:Program Fax #:

Federal ID (501c3):

Liability Insurance Carrier:

FEEDING SERVICES

Circle category describing your program:

  1. Food Pantry (choose either option 1 or option 2)
  2. Emergency-Distributions are REGULAR and SCHEDULEDand bags are NUTRITIONALLY BALANCED
  3. Supplemental-Distributes any food available
  4. Soup Kitchen-Cooking and serving meals to walk-in guests; open to public.
  5. Emergency Shelter-Providing emergency shelter and on-site food preparation; open to public.
  6. Residential On-site Program-Cooking and serving meals to a registered clientele:includes day cares, group homes, domestic violence shelters, halfway houses, rehab programs, etc.
  7. Other (please describe)

When did you begin providing services described above?

Other Services provided:

Who is eligible for your services?

What are your eligibilityguidelines?

Geographic area served:

No. of people served by your program:

Days and Hours of Days and Operation:

Sources of food (other than The Food Bank):

What are your funding sources?

STORAGE FACILITIES:

Quantity and Dimensions of the following:

Refrigeration:Total sq. ft.:

Frozen:Total sq. ft.:

Dry:Total sq. ft.:

FOOD PICK-UP:

Do you have the ability to pick up food?

Type of Transportation Available (sedan, SUV, truck, etc.):

BILLING:

Billing Contact:

Email:

Phone:

Please enclose the following:

  1. A photocopy of your IRS/US DEPT. OF TREASURY LETTER OF DETERMINATION (the statement of your 501(c)(3) tax exempt status).
  1. List of your Board of Directors
  1. Brochure or letter describing your program in detail.
  1. Any written guidelines for client eligibility.
  1. Nutritional information describing bags/menus.

When we have received this form and the requested documents, we will be able to determine if your agency/program is eligible for Food Bank membership.

You will be notified and, if eligible, Denise Killeen will contact you to schedule a site visit. Once the site visit is complete and passes inspection, you will be invited to attend agency orientation; at that point, you will officially become a member agency!

Please return this form and requested documents to:

Denise Killeen

Agency Relations and Programs Coordinator

914.909.9615

The Food Bank for Westchester

200 Clearbrook Road

Elmsford, NY 10523

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