Food Provider Application (FPA)

Food Provider Application (FPA)

This application is intended forany entitywho wishes to sell, donate, or providefood and/or beveragesto SFUSD studentsduring the school day on a regular, ongoing basis. School day is defined as the time students arrive in the morning until 30 minutes after the end of the afterschool programs.

This application does not have to be completed for one-time events, such as a student fundraiser, a school celebration, or a classroom party, nor does it have to be completed by parties who have an approved contract for services with SFUSD’s Student Nutrition Services.

Background

In April 2015, the Board of Education approved a new wellness policy that was developed through a collaborative community process. Wellness Policy (P5167) meets all the provisions of the Healthy, Hunger-Free Kids Act of 2010 (HHFKA), and it provides all schools with a framework for promoting healthy eating and physical activity. SFUSD strives to nourish students with quality food that enables them to live healthy lives and thrive both inside and outside the classroom. The goal of this application is to work collaborativelywith all providers to alignnutrition and quality standards for the food and beveragesoffered to students.

Wellness Policy Guidelines

A full copy of the Wellness Policy and the District’s Nutrition Guidelines are available on the web at: The excerpts below highlight the policy guidelines for donating, serving, or selling food and/or beverages to SFUSD students during the school day.

To maximize the District’s ability to provide nutritious meals and snacks, all District schools shall participate in available federal school nutrition programs, including the National School Lunch Program, the School Breakfast Program, the Child and Adult Care Food Program, and the Summer Food Service Program.
Schools shall not invite or contract with any entity and/or individual who wishes to sell, donate, or provide any kind of food or drinks to students, even those meeting the District’s nutrition guidelines, if it is in direct competition with SNS’s or EED’s federally funded school meal programs.
Any entity and/or individual interested in donating, serving, or selling food and/or beverages to students during the school day must be pre-approved in writing by SNS and must keep their own records as proof of compliance.

Application Procedures

This application is to be completed by any entity who wishes to provide food/beverages.
Given the unique nature of each school, if you wish to provide food/beverages to more than one school you must complete an application form for each school.
If you wish to provide food/beverages to support more than one program at a given school, list all of the programs at the school on one application form.

Applications must be completed in full and sent via email to be considered for approval. Completed applications should be emailed to: . Application with missing information will be returned.

The FPA will be reviewed on a rolling basis throughout the year. Within 10 business days of receiving an application, SNS willsend a letter indicating approval or denial.

Once your application is approved by SNS, your programmustcomplete or have an approved Memorandum of Understanding or a Contract, and a Facilities Use Permit.[Anticipate at least 4 weeks after you receive an SNS pre-approval letter.]

Memorandum of Understanding (MOU). Any vendor or organization that wants to provide food and/or beverages to students in any public school free of charge to SFUSD must have an MOU approved by the Board of Education as well as the SFUSD’s program, legal, and contracts departments before you begin working with students! Please note that the process to approve and fully execute an MOU normally takes 3-4 weeks. For more information visit:

Contract. Vendors or Organizations who will be paid by SFUSD must complete a contract, not an MOU. The SFUSD department/school paying for your services will guide you through the process to get an approved contract. Please keep in mind that it can take at least 4-6 weeks to fully execute a contract.

Facilities Use Permit. Anyone using an SFUSD facility outside of the regular school day must have a permit, and must pay permit fees – including nonprofit groups, public agencies, and private or commercial users. If your permit is related to an afterschool program, you can coordinate directly with the afterschool program provider to consider developing a joint facility use permit. Please allow at least three weeks to get a Facilities Use Permit. You can find detailed information about Facilities Use Permits and fees at:

Annual renewal of the FPA is required; per July 1 through June 30. However, programs can be extended a few weeks if needed, but dates must be listed on application.

Prohibited Food/Beverages

FPA

Page 1 of 7

For food standards, please refer totheNutrition Guidelines available at

Beverages are limited to plain water, carbonated water, and low fat or fat-free milk/milk alternatives.

Food Provider Application

You must complete all sections below and sign the application form before submitting it to SNS.

Section 1: Food ProviderInformation

First Name: Last Name:

Name of Organization:

Street Address:

City:State: Zip:

Email: Phone:

Please indicate the type of pre-approval you are requesting. Check all that apply.

Requesting pre-approval to donate food/beverages.

Requesting pre-approval to sell food/beverages.

Requesting pre-approval to provide food/beverages more than once a week at no cost to students, as part of an agreement to provide other services.

Requesting pre-approval to provide food/beverages at no cost to students and we will receive State/Federal school meal reimbursements.

Who will you be providing the food/beverages to: School at large Wellness Center Afterschool Programs Others, please specify:

Will the school be required to cover any of the costs associated with your request?

If YES, describe the costs that will be covered by the school:

Will students/families be required to cover any of the costs?

If YES, describe:

Section 2: School Information

School Name:

Person-in charge of managing the food/beverages provided:

First Name: Last Name:

Title/Role:

Organization:

Email: Phone:

What is the anticipated service startdate (dd/mm/yy):

What is the anticipated service end date (dd/mm/yy)?

Check the time period foods/beverages will be served:

Breakfast Morning snack Lunch Afternoon snack

SupperThroughout the dayOther (describe)

What time will the food/beverages be distributed to the students:

How frequently will the food/beverages be served to the students?

Daily Weekly Monthly Other (describe):

How many students will be served on any given day:

Where will the food be served to students?

Classroom CafeteriaMain Office Other (specify):

What, if any, requirements must the school meet in order to receive food/beverages?

What human resources is the school responsible for providing? Check all that apply.

People to receive the delivery People to prepare food/beverages

People to distribute food/beverages People to help store food/beverages

People to clean up food/beverages after students

Please describe the type of training provided to the school staff prior to the service:

Section 3: Food and Beverages

Will beverages be provided? YesNo

If yes, please describe any beverages:

Describe anyfood that will be provided. Check all that apply.

I. Fruits and Vegetables:

Fresh fruit Fresh vegetables Dried fruit/veg Frozen vegetables Canned beans

II. Grains:

All grain-based products must be at least 50% whole grain.

List all grain-based products provided: .

III. Protein:

Will you be providing or using any raw protein? YesNo

List all protein products (e.g. eggs, chicken, beef):

Describe the lean-to-fat ratio, if using ground meat:

IV. Dairy:

Type of dairy product: Milk Cheese Yogurt Other

Will all the food/beverages provided meet the District’s Nutritional Guidelines as outlined on our web page: Yes No

Please submit menu, list of food items, and nutrition labels for review and verification.

Section 4: Delivery and Distribution

How frequently will the food/beverages be delivered to the school?

Daily Weekly on the following day: Monthly Other (describe):

Note: Friday deliveries to schools are strongly discouraged and can only be considered if the request doesn’t present concerns about food storage or food safety and sanitation.

Describe the process for receiving items at the school.

Provider will handle all elements of the delivery, including receiving and storage.

The school will be responsible for receiving all items.Please indicate staff responsible:

Describe the process for distributing items to the students.

Provider will handle all elements of the distribution.

The school will be responsible for distributing all items.Please indicate staff responsible:

Section 5: Food Storage and Equipment

A critical element of food safety is proper storage and maintaining safe food temperatures. In order to prevent cross contamination with food for school meal programs, providedfood and beverages may not be stored in SNS kitchen space. Therefore, it is the responsibility of the person in charge to ensure proper storage is available for all provided food/beverages at all times.Please indicate how temperatures will be maintained:

Food/beverages will not be stored at the school.

Food/beverages will be refrigerated. Please describe location of refrigerator:

Food/beverages will be frozen. Please describe location of freezer:

Shelf-stable Food/beverages will be kept in dry storage. Please describe location of dry storage:

Section 6: Food Safety and Sanitation

Will any food preparation take place at the school? Yes No

If YES, describe the type of preparation required. Check all that apply.

Assembly Washing Cutting Heating Cooking

Other (describe):

Describe where in the school the food will be prepared. Check all that apply.

SNS kitchen (facility permit required) Teacher’s Lounge

Cafeteria Classroom (insert numbers): Other (describe):

Describe any food safety and sanitation training that will be provided:

Section 7: Waste Management

How will left over food/beverages be managed?

How will waste be disposed?

Describe any impact your services will have on custodial services.

None. We will clean up and dispose of all waste.

Waste removal only. Program will place waste in bins provided by SFUSD and clean surfaces and floors.

Waste removal and cleaning. Custodial services will be needed to clean surfaces and floors.

Other (describe):

Section 8: Food Provider’s Requirements and Responsibilities

Please read each statement below and check the box to indicate you have read the statement.
I have read the application instructions in full. I have completed this application in good faith and understand this application is a request for approval.
I understand that once pre-approval is provided by SNS, all other permits must be in place prior toproviding services to students. Other permits include MOU or Contract and Facilities Use Permit.
I have reviewed the District’s Wellness Policy and Nutrition Guidelines.

I confirm that all food/beverages provided will meet these guidelines. (ref:
I understand that provided food/beverages may not compete with SFUSD’s Federal meal programs.

I understand that we will be responsible for ensuring food safety and sanitation protocols are in place, including training staff on properly managing the program foods.
I agree to provide services as indicated on this application, and that approval may be revoked if program is found to be out of compliance.
Please contact Student Nutrition Services if the following changes occur:

Contact of Person in charge
Types of food/beverages provided
Cancellation of service

Food Provider:
Print Name: Date:
Signature:______
School Site Person in Charge:
Print Name: Date:
Signature:______

Applications must be completed in full and sent via email to to be considered for approval.

FPA