California Department of EducationAugust 28, 2017

Nutrition Services

Application
2017 National School Lunch Equipment Assistance Grant
California Department of Education (CDE) Nutrition Services Division (NSD)
This Application allows school food authorities (SFA) to apply for the 2017 National School Lunch Program (NSLP) Equipment Assistance Grant (EAG). Explanations for each field in this application are available on the CDE NSLP EAG Request for Applications Web page at and by clicking the question mark symbol located to the right of each question.
Once you begin the application, you can save and return to it at any time by selecting the Save Responses button at the bottom of each page. You will be provided a unique URL for entrance back into the application. All fields in the application must be completed unless noted otherwise.
For questions regarding this grant, you cane-mail .
SFAs must complete the application online and submit it no later than midnight Thursday, October 19, 2017. The NSD will not accept fax, e-mail, or U.S./Priority mail submissions.
Public school districts, county offices of education, directly funded charter schools, private schools, and residential child care institutions that participate in the NSLP are eligible to apply for this grant.
Application: Section 1
This SFA received funds from the 2009 American Recovery and Reinvestment Act (ARRA) or funds from the 2010, 2013, 2014, 2015, or 2016 NSLP EAGs?
 / Yes
 / No
Warning: Sites/central kitchens that were previously awarded an EAG are eligible to receive funds for the 2017 EAG, but priority will be given to eligible SFAs who have not receive funds from past EAG grants
Provide the name of the SFA applying for the grant below:
______
Provide the address of SFA below:
Street: / ______
City: / ______
State: / ______
ZIP Code: / ______
Please provide the required SFA identification information below:
SFA Child Nutrition Information and Payment System (CNIPS) ID: / ______
(5 digits, example 01234)
SFA Vendor Number: / ______
(4 digits, example 0123 )
Please select your county from the following list:
 / 01 Alameda /  / 18 Lassen
 / 02 Alpine /  / 19 Los Angeles
 / 03 Amador /  / 20 Madera
 / 04 Butte /  / 21 Marin
 / 05 Calaveras /  / 22 Mariposa
 / 06 Colusa /  / 23 Mendocino
 / 07 Contra Costa /  / 24 Merced
 / 08 Del Norte /  / 25 Modoc
 / 09 El Dorado /  / 26 Mono
 / 10 Fresno /  / 27 Monterey
 / 11 Glenn /  / 28 Napa
 / 12 Humboldt /  / 29 Nevada
 / 13 Imperial /  / 30 Orange
 / 14 Inyo /  / 31 Placer
 / 15 Kern /  / 32 Plumas
 / 16 Kings /  / 33 Riverside
 / 17 Lake /  / 34 Sacramento
 / 35 San Benito /  / 47 Siskiyou
 / 36 San Bernardino /  / 48 Solano
 / 37 San Diego /  / 49 Sonoma
 / 38 San Francisco /  / 50 Stanislaus
 / 39 San Joaquin /  / 51 Sutter
 / 40 San Luis Obispo /  / 52 Tehama
 / 41 San Mateo /  / 53 Trinity
 / 42 Santa Barbara /  / 54 Tulare
 / 43 Santa Clara /  / 55 Tuolumne
 / 44 Santa Cruz /  / 56 Ventura
 / 45 Shasta /  / 57 Yolo
 / 46 Sierra /  / 58 Yuba
SFA Total amount of grant funds requested?
Warning: An SFA can request up to a maximum of $100,000. Please decrease the total request in the response above.
Total number of sites for which the SFA is applying for grant funds (no more than five)?
 / 1 /  / 2 /  / 3 /  / 4 /  / 5
Contact Information for Grant
Food Service Director:
Name: / ______
Title: / ______
Phone (example: xxx-xxx-xxxx): / ______
E-mail: / ______
Superintendent/Director/Administrator:
First Name: / ______
Last Name: / ______
Title: / ______
Phone (example: xxx-xxx-xxxx): / ______
E-mail: / ______
Capitalization Threshold and Cafeteria Fund Balance
Does the SFA have a capitalization threshold for equipment?
 / No. (If no, the CDE must assign the federal capitalization threshold of $5,000.)
 / Yes. (If yes, provide documentation of your board's approval of the lower capitalization threshold to the equipment grants
e-mail box at .)
Note: Each piece of equipment that an SFA purchases with grant funds must meet or exceed the SFA's capitalization threshold. Any piece of equipment that costs less than the SFA's capitalization threshold will not be funded with this grant. If your capitalization threshold is below $5,000, send documentation of your SFA’s board approval of a lower capitalization threshold Policy to .
Cafeteria Fund Balance
Please enter your SFA cafeteria fund balance as of
July 1, 2017: ?______
Please enter your SFA’s one month's average food service operating expense: ?______
Excess net cash resources = {ENCR}*?(EAG Note: This is an auto populated calculation)
*Cafeteria fund balance – (one month average food service operating expense x 3) = Excess net cash resources
SFAs with net cash resources (NCR) must explain why their excess NCRs cannot be used in lieu of grant funds. Please note that SFAs with excess NCRs may be ineligible for a grant. ?
______
Four Focus Areas
This equipment will support efforts to (check all that apply):
Improve nutritional quality, serve healthier meals, and meet nutritional standards: ?
 / Provides fresh fruit and/or vegetables at lunch/breakfast
 / Increases the variety of entree choices
 / Increases SFA’s ability to prepare foods in a healthy manner such as steaming, baking, or grilling
 / Enables scratch cooking
 / Other
Explain:
Improve food safety: ?
 / Decreases cross-contamination risks
 / Improves sanitation
 / Maintains proper temperature
 / Replaces outdated/worn equipment
 / Other
Explain:
Improve energy efficiency: ?
 / Increases storage and decreases frequency of deliveries
 / Replaces outdated/worn equipment
 / Other
Explain:
Expand participation: ?
 / Enables preparation and service of additional meals
 / Increases the variety of entree choices
 / Adds additional points of service
 / Provides meals to more sites
 / Implements strategies for adopting smarter lunchrooms (appeals to student population, promotes healthier choices, faster/additional lunch lines, etc.)
 / Other
Explain:______
In the space below, explain why the equipment requested is necessary to support participation in the efforts selected above emphasizing how the equipment will help improve nutritional quality, serve healthier meals, and meet nutritional standards. Provide a detailed written explanation based on each item you will be requesting. See Section C of the scoring criteria for examples and additional information.
______
Application: Section 2 Site 1
This site/central kitchen received funds from the 2009 ARRA or funds from the 2010, 2013, 2014, 2015, or 2016 NSLP EAGs?
 / Yes
 / No
Warning: Sites/central kitchens that previously received funds from the 2009 ARRA or 2010, 2013, 2014, or 2015 NSLP EAGs are not given priority to receive funds in the 2016 NSLP EAGs.
Name of the site/central kitchen applying for the grant:
______
CNIPS Site Number: ?______
School Address:
Street: / ______
City: / ______
State: / ______
ZIP Code: / ______
Site/central kitchen participates in (check all that apply): ?
 / NSLP
 / School Breakfast Program (SBP)
Warning: No boxes were checked on the question above, "Site/central kitchen participates in". If the applicant does not participate in either program they will be ineligible for this grant.?
Total number of students enrolled at this site or total number of students served by this central kitchen on October 31, 2016.? ______
Total number of students at this site or served by this central kitchen approved for free and reduced-price (F/RP) meals as of October 31, 2016.?______
Enter the number of operating days in October 2016.?______
Enter the total number oflunchesserved at this site or by this central kitchen during October 2016 to students in the following meal eligibility categories:?
Free / ______
Reduced-price / ______
Paid / ______
Application: Section 2 Site 1: Eligibility Calculations
F/RP Percentage = {SiteoneFRP}%*?
*Students approvedfor F/RP/total number of students x 100 = F/RP Percentage
Total Meal Count (TMC) for the month of October 2016 = {SiteoneTMC}*
*Lunches free + Lunches reduced-price + Lunches paid = Total Meal Count
Percentage of F/RP lunches served = {siteonePFRPM}%* ?
*(Lunches free + Lunches reduced-price)/(Lunches free + Lunches reduced-price + Lunches paid) x 100 = Percentage of F/RP lunches served
Total possible meals = {TotalLunchServ}*
*Total number of students x Operating days in October 2016 = Total possible meals
Expansion potential for meals served = {siteoneEPFMS}*?
*TMC - Total possible meals = Expansion potential
Application: Section 6:Equipment 1
Equipment One
Equipment Name / ______
Per unit cost of the item / ______
Quantity of equipment at site 1: / ______
Quantity of equipment at site 2: / ______
Quantity of equipment at site 3: / ______
Quantity of equipment at site 4: / ______
Quantity of equipment at site 5: / ______
Name of vendor #1 contacted for price quotes: / ______
Name of vendor #2 contacted for price quotes: / ______
Name of vendor #3 contacted for price quotes: / ______
Use this space to describe the site/central kitchen's need for the equipment requested as it relates to anticipated increased participation at the sites it is requested for. / ______
Equipment requested is: New UsedRenovated/Repaired
If this piece of equipment is a vending machine, check yes to acknowledge that grant funds may only be used to purchase a vending machine if it is used to distribute reimbursable meals. / Yes
Will this equipment be housed at a central kitchen or site that prepares for multiple sites? / Yes
Do you have more pieces of equipment to enter on the next page?
 / Yes
 / No
Warning:Equipment One"Per unit cost of the item" on the previous page is listed at less than $5,000. On Section 1 of this application the capitalization threshold is listed at the federal $5,000 minimum. In this case, all equipment under this grant must cost at least $5,000. Please press the back button and change your response(s).
Note: The price of each piece of equipment must meet or exceed the federal capitalization threshold of $5,000 or provide documentation of the SFA's board approved capitalization threshold at the time of application. Without board approval, the CDE must apply the federal capitalization threshold of $5,000 and any piece of equipment below the capitalization threshold will not be funded by this grant.
Warning:The total grant requested on Section 1 of this Application was {auto populated number based on their response} and the total of equipment requested in Section 3 of this application was {auto populated based on the amount of grant funding the LEA has applied for}. Please press the Back button at the bottom of this page and modify the requested total dollars to match the total equipment dollars.
I hereby certify that, to the best of my knowledge, the information contained in this application is correct and complete; and that the completed application is accepted as the basic conditions in the operation of the 2017 EAG application process. I further certify that we will not commingle the 2017 Agriculture Appropriations Act funds with other program funds, and will separately track and report all grant income and expenditures timely. I am responsible for understanding and observing all applicable state and federal procurement laws and regulations, and submitting all required reports by the specified due date(s).
Please type your name below that will serve as a signature and certify agreement with the above terms.
You have now completed the 2017 EAG application. Please select the Submit button. The CDE will contact you within two business days to confirm receipt of your application. If you have any questions regarding the Equipment Grant Application process, please send an e-mail to the EAG team at .
Nondiscrimination Statement:
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.
Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at 800-877-8339. Additionally, program information may be made available in languages other than English.
To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call866-632-9992. Submit your completed form or letter to USDA by:
(1) Mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
400 Independence Avenue, SW
Washington, D.C. 20250-9410;
(2) Fax: 202-690-7442; or
(3) E-mail:
This institution is an equal opportunity provider.
Once you select the Submit button below, your survey responses will be sent to the CDE and you will be redirected to the EAG Request for Application page.