Fruit and Vegetable Incentive Pilot Program

Request for Proposals

Food Retailer Application

Instructions: To be considered for the Fruit and Vegetable Incentive Pilot Program, food retailers must complete the Food Retailer Application below (pages 1-4) and the retailer’s point-of-sales system vendor must complete the POS Vendor Information Form on page 5. The food retailer must submit both forms to be considered for the award.

Store Information (determines eligibility)

  1. Store Name: ______
  2. Store Address: ______
  3. Store Zip Code: ______
  4. Borough: ☐Bronx ☐Brooklyn ☐Manhattan ☐Queens ☐Staten Island
  5. Store Hours: ______
  6. Contact Person Name: ______
  7. Contact Person Title: ______
  8. Contact Person Phone Number: ______
  9. Contact Person Email Address: ______
  10. Store Owner Name(s): ______
  11. What is the store’s approximate size (by square feet)? ______
  12. Is the store authorized to accept SNAP benefits? ☐ Yes ☐ No
  13. What was the store’s approximate SNAP sales total in 2016? ______
  14. Is at least 50% of the store’s retail space for products intended for home preparation (e.g. cereal, soup, produce)? ☐ Yes ☐ No
  15. Does the store sell at least 7 varieties of produce such as: ☐ Yes ☐ No
  16. Fresh fruits and vegetables
  17. Frozen fruits and vegetables without added sugars, fats, oils, or salt
  18. Canned fruits and vegetables without added sugars, fats, oils, or salt
  19. Dried legumes without added sugars, fats, oils, or salt
  20. Does the store sell or market tobacco products? ☐ Yes ☐ No
  21. If the store is awarded the contract, will DOHMH be allowed to briefly survey SNAP customers three times during the first year to evaluate the program? ☐ Yes ☐ No
  22. Are you willing to consider opportunities to procure and sell locally grown produce? ☐ Yes ☐ No

Selection of Fruits and Vegetables (20 points maximum)

  1. How many types of fresh fruits and vegetables does the store sell?

☐1-2☐3-5☐6-9☐10+

  1. How many types of frozen fruits and vegetables without added sugars, fats, oils, or salt does the store sell?

☐1-2☐3-5☐6-9☐10+

  1. How many types of canned fruits and vegetables without added sugars, fats, oils, or salt does the store sell?

☐1-2☐3-5☐6-9☐10+

  1. How many types of dried legumes (e.g. beans, lentils) does the store sell?

☐1-2☐3-5☐6-9☐10+

Tracking, Reporting and Evaluation (35 points maximum)

  1. What is the name of the store’s Point of Sale (POS) system vendor? ______
  2. The purpose of this funding, which comes from the USDA, is to provide financial incentives to SNAP participants for produce. DOHMH is required by the USDA to track spending and the number of people reached. Please complete the table below indicating if your POS system can be configured to track and report on the following:

POS system can track and report this data / POS system cannot track and report this data / I don’t know
Number of transactions and total dollar amount spent on fruits and vegetables using SNAP per month
Dollar value of incentives issued per month
Dollar value of incentives redeemed per month
Number of SNAP participants that accrued incentives per month
Number of SNAP participants that spent incentives per month
Average incentive value redeemed per recipient weekly, monthly and annually
Transaction history showing items purchased as part of the fruit and vegetable incentive pilot program

Incentive Distribution (35 points maximum)

  1. Does the store have an existing electronic customer loyalty card program? ☐ Yes ☐ No (skip to question 27)
  2. Can the electronic customer loyalty card program be used to distribute and redeem incentives to SNAP customers whenever they purchase fruits and vegetables? ☐ Yes ☐ No

If yes, please briefly describe: ______

  1. Does the store have the capacity to distribute, redeem, and track paper coupons whenever SNAP customers purchase fruits and vegetables? ☐ Yes ☐ No

If yes, please briefly describe: ______

Additional Store Attributes (10 points maximum)

  1. Please indicate the types of alcohol products sold at your store:

☐ Beer

☐ Cider

☐ Wine product (less than 6% alcohol)

☐ Wine

☐ Hard liquor (stores that sell hard liquor are not eligible for the award)

☐ Other Please specify: ______

  1. Does the store accept Women Infants and Children (WIC) checks? ☐ Yes ☐ No
  2. Do you manage or own other food stores? ☐ Yes ☐ No

If yes, please list the address of the other store(s): ______

______

  1. Does the store promote healthy eating in any ways?

☐ Yes - Please briefly describe, including any community organizations your store partners with on programming, marketing or other strategies: ______

☐ No

Certification

I certify that all information provided in this application is correct and accurate to the best of my knowledge.

______

Name (print)SignatureDate

*** Please have your POS system vendor complete the POS Vendor Information Form below confirming their ability to develop and implement an electronic incentive program. Please provide your vendor with sufficient time to complete the form as retailerapplications must be accompanied by a completed POS Vendor Information Form to be considered.

Fruit and Vegetable Incentive Pilot Program

Request for Proposals

POS System Vendor Information Form

Instructions: The form below is to be completed and signed by the food retailer’s point-of-sales (POS) system vendor and submitted with the food retailer’s application.

POS Vendor Information

  1. POS Vendor Name: ______
  2. POS Vendor Address: ______
  3. Contact Person Name: ______
  4. Contact Person Title: ______
  5. Contact Person Phone Number: ______
  6. Contact Person Email Address: ______

POS System Requirements

The purpose of the Fruit and Vegetable Incentive Pilot Program, which is funded by the USDA, is to provide financial incentives to Supplemental Nutrition Assistance Program (SNAP) participants for fruits and vegetables at point of purchase. SNAP customers could receive $0.40 to buy eligible fruits and vegetables for every $1 spent on eligible fruits and vegetables using SNAP benefits.

The incentives will be distributed and redeemed through the retailer’s electronic point-of-sales (POS) system. Please answer the questions below indicating if the food retailer’s POS system can be configured to issue and redeem incentives and to meet program tracking and reporting requirements.

  1. Can the food retailer’s POS system be configured to identify all fruits and vegetables eligible for incentives as determined by the New York City Health Department? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to display on customer receipts the total dollar amount spent on eligible items using SNAP? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to issue SNAP customers incentives on eligible fruit and vegetable purchasesand to accrue incentives in a customer loyalty account to be spent on subsequent purchases? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to apply previously accrued incentives stored in a customer loyalty account toward purchase of eligible fruits and vegetables? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to display on customer receipts the: 1) Total dollar amount of incentives issued on eligible fruit and vegetable purchases using SNAP; 2) Total dollar amount spent on eligible fruits and vegetables using incentives; and 3) Total amount of incentives available in a customer’s loyalty account? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to track the number of transactions and total dollar amount spent on eligible fruits and vegetables using SNAP benefits each month? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to track the number of SNAP participants that accrued incentives per month? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to track the number of SNAP participants that redeemed incentives per month? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to track the amount of incentives issued per month at the store level? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to track the dollar value of incentives redeemed per month at the store level? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to track the average incentive value redeemed per recipient weekly, monthly and annually? ☐ Yes No ☐
  1. Can the food retailer’s POS system be configured to track all items purchased as part of the fruit and vegetable incentive pilot program each month at the store level? ☐ Yes No ☐

Project Timeline and Cost

  1. What is your projected timeline for developing and implementing an electronic fruit and vegetable incentive program including researching and scoping out the project, developing program code, internal and external system testing and store training? ______weeks

2. How much do you estimate it will cost to develop and implement an electronic fruit and vegetable incentive program utilizing the food retailer’s POS system? Please note up to $10,000 will be allocated to support development and implementation of an electronic incentive program that will enable the store to fulfill the activities outlined in the request for proposals scope of work. $______

Certification

I certify that all information provided above is correct and accurate to the best of my knowledge.

______

Name (print)SignatureDate

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