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CHILD NUTRITION PROGRAMS SUMMER FOOD SERVICE PROGRAM

FOOD SERVICE MANAGEMENT COMPANY

REQUEST FOR PROPOSAL/INVITATION

FOR BID and CONTRACT

Sponsor: ____________________________________________________

County/District Code/Agreement Number: ________________

OKLAHOMA STATE DEPARTMENT OF EDUCATION

Fiscal Year ____________

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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: http://www.ascr.usda.gov/complaint_filing_cust.html, 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, call (866) 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 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov. This institution is an equal opportunity provider.

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GENERAL INFORMATION

A. Intent

This solicitation is for the purpose of entering into a contract to provide appealing, nutritionally sound, reimbursable meals for the Summer Food Service Program (SFSP). This contract will be between __________________________________________(Sponsor) and the food service management company (FSMC). Signatures between______________________________ (Sponsor) and the FSMC will be submitted when the contract is issued.

B. Performance Requirements

1. During the SFSP, the _____________________________ (Sponsor) provides breakfast, lunch, snack, and supper as needed for the different organizations that it serves. This contract will be for the following sites:

Site Name # of Meals to be Served Rate ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ The Sponsor will notify the FSMC of all sites that have been approved, cancelled, or terminated subsequent to the submission of the initial approved site list and any changes in the approved meals. Such notification will be provided within the time limits mutually agreed upon.

2. The FSMC can bid on any or all of the sites: Yes No

3. All meals prepared will be unitized with or without milk or juice unless the State agency has approved a request for exceptions to the unitizing requirement for certain components of a meal. The site(s) will require breakfast_____, lunch_____, a.m. snack____, p.m. snack_____, and/or supper_____ (See Attachments A, A-1, A-2, and/or A-3 for meal requirements) at a unitized price to be delivered.

4. The FSMC shall make substitutions in the food components of the meal pattern for participants with disabilities or food

allergies when their disabilities or food allergies restrict their diet. Substitutions will be made on a case-by-case basis when supported by documentation from a medical doctor or medical authority. The ___________________________ (Sponsor) shall make this documentation available to the FSMC. This documentation must include recommended alternative foods that comply with the State Department of Education (the State Agency) appropriate meal pattern. (See Attachments A, A-1, A-2, and A-3.)

5. The meals served under the contract must conform to the cycle menus and meal quality standards and food

specifications approved by the state agency and upon which the bid was based. All meals served under the SFSP must meet the requirement of 7 CFR § 225.16 and comply with the 5-day menu cycle provided in Attachments A-1, A-2 and/or A-3, when applicable.

6. Meals must be delivered according to the following delivery schedule:

1. Delivery will be made with the contractor to the facility(ies) in accordance with the order from each facility. 2. Meals will be delivered daily, unloaded, and placed in the facility by the contractor’s personnel at the

location and time listed in schedule A. 3. Meals will be delivered/picked up/served at the time(s) indicated. (Check the applicable meal(s), and indicate

time of service.) Delivered/Picked Up Served Breakfast ________a.m. _________a.m. A.M. Snack ________a.m. _________a.m. Lunch ________a.m./p.m. _________a.m./p.m. P.M. Snack ________p.m. _________p.m. Supper ________p.m. _________p.m.

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7. The FSMC selected shall not subcontract for the total meals or for the assembly of the meals.

8. Food service for any/all of the sites will operate___________________, 20_____ (beginning date) through__________________, 20_____ (ending date) for__________________(number of days). There will be an option to renew for four additional one-year periods. Renewal is contingent upon the needs of ______________________________ (Sponsor) and the performance of the FSMC. The option to renew is at the sole discretion of _______________________________ (Sponsor).

Mealtimes for each program are listed below. (See Attachment B)

Breakfast _______________ PM Snack _______________ AM Snack _______________ Dinner _______________ Lunch _______________

9. Increases and decreases in the number of meals ordered shall be made by ________________________________

(Sponsor), as needed, by ___________ a.m., to the FSMC each day.

10. The FSMC is responsible for all purchases related to the SFSP. This cost will be included within the fixed rate per meal proposed. There will be no reimbursement to the FSMC other than the rate per meal. (See Attachment C for projected revenues/expenditures)

11. The FSMC shall be paid by the sponsor for all meals delivered in accordance with the contract. However, neither the

State Agency or the United States Department of Agriculture (USDA) assumes any liability for payment of differences between the number of meals delivered by the FSMC and the number of meals served by __________________________________(Sponsor) that are eligible for reimbursement.

12. During the SFSP, the FSMC shall operate in conformance with the _______________________________________

(Sponsor) agreement with the State Agency.

13. The FSMC shall be an independent contractor and not an employee of _______________________________________ (Sponsor). The employees of the FSMC are not employees of _____________________________________________. No FSMC salaries shall be charged to SFSP.

14. __________________________ (Sponsor) shall be legally responsible for the conduct of the SFSP and shall supervise

the FSMC in such manner that will ensure compliance with the rules and regulations of the State Agency and USDA.

15. __________________________ (Sponsor) will will not require security checks on all FSMC employees. (Sponsor must check one choice.)

16. The FSMC shall comply with any applicable rules, regulations, policies, and instructions of the State Agency and

USDA and any additions or amendments thereto, including USDA Regulation 2 CFR Part 180 as adopted and modified by USDA regulations 2 CFR Part 417.

17. The FSMC and _______________________________ (Sponsor) shall operate in accordance with current SFSP

regulations (7 CFR § 225).

18. This solicitation and any resulting contract is governed in all respects by the applicable laws of the state of Oklahoma. The contractor shall comply with applicable federal, state, and local laws and regulations. Any claim or action arising under this proposal/contract shall have a venue in _________________ County, Oklahoma.

19. The FSMC must have state or local health certification for the facility or facilities in which it proposes to prepare meals

for use under the SFSP and will provide _____________________________________________ (Sponsor) with a copy of the most current certificate.

20. The FSMC shall adhere to a food safety program, using the HACCP system that is required under Public Law 108-265.

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21. The books and records for the FSMC pertaining to the sponsor’s food service program must be available for inspection and audit by representatives of the state agency, USDA, and the U. S. General Accounting Office (GAO) at any reasonable time and place for a period of three years from the date of receipt of final payment under the contract, except that, if audit or investigation findings have not been resolved, such records must be retained until all issues raised by the audit or investigation have been resolved.

22. The FSMC shall maintain records needed by the sponsor to meet its Program responsibilities under the SFSP USDA

Regulation 7 CFR § 225.6(h)(2)(iv) and shall submit all required reports to the sponsor promptly at the end of each month, unless more frequent reports are required by the sponsor.

23. The FSMC shall ensure that health and sanitation requirements are met at all times. In addition, the FSMC shall ensure

that meals are inspected periodically to determine bacterial levels present in the meals and that the bacterial levels found conform to local health authority standards. The results of the inspections must be submitted promptly to the sponsor and state agency.

24. The FSMC shall maintain records of all costs incurred in the sponsor’s food service operation.

25. In cases of nonperformance or noncompliance on the part of the FSMC, the FSMC shall pay the sponsor for any excess

costs which _____________________________ (Sponsor) may incur by obtaining meals from another source. C. Procurement

Contract is under $150,000 and therefore will use the small purchase procedures. In this case, Attachment D is not considered a part of this RFP/Contract.

Contract is $150,000 or more and therefore will use competitive proposal. (See Attachment D)

All procurement transactions must be conducted in a manner that provides maximum open and free competition consistent with 7 CFR 3016. Mail, phone, or faxed quotes must be obtained from each vendor on the following date: ______________________________________________.

D. Proposal Conference Call

A conference call with any/all interested FSMCs to review the specifications and to clarify any questions will be held on _______________________ (month), _______________ (date), 20_____, at ____________ (time). To participate during the conference call, dial ( ) ______-___________. Participation is optional.

The FSMC may fax any technical issues and specification questions pertaining to the proposal to ( ) ______-_________ (fax number), Attention :_________________________________ (contact person), or you may e-mail them to ______________________________ (e-Mail address). All questions must be submitted in writing no later than __________________ (month), ______________(date), 20_____, and follow these guidelines:

1. Specifically reference the section of the proposal in question. These questions will be addressed during the conference

call and then distributed in the form of an addendum.

2. Prior to and after the initial conference call, no oral interpretation will be made to any company as to the meaning of the specification. Every interpretation will be in the form of a written addendum to the specification issued by the ____________________________________ (Sponsor) and mailed to each interested FSMC of record.

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E. Location

A listing of site addresses and physical locations: ____________________________________________________________________________________________________

____________________________________________________________________________________________________

F. Site Tour

A site tour will be arranged at the request of the FSMC and at the convenience of both the _______________________ (Sponsor) and the FSMC by _______________________________ (date). The FSMC may fax or e-mail any questions that arise as a result of the site tour within a two-day period following the tour to:______________________________(contact person) at ( ) ______-________(telephone number) or by e-mail to _______________________________(e-Mail address).

G. Proposal Submission

Return the original and two copies of the RFP/quote with all attachments completed, including the Certification of Independent Price Determination, as required and signed, along with the following items: 1. Letter of Transmittal: Include an introduction to the FSMC with the name, address, phone number, and e-mail address

for the contact person. 2. Service Capability Assurance: Briefly explain the experience the FSMC would bring to the SFSP and the capability to

provide ____________________ (Sponsor) with all meal services required. 3. Financial Stability: Provide data to indicate the financial condition of the company.

H. Quote/RFP Return Address:

Please return completed RFP/Quote to: Mailing address: ___________________________________ ___________________________________ ___________________________________ ___________________________________ Fax: ___________________________________ Contact Person: ___________________________________ Fax Number: ___________________________________ Deadline: ___________________________________ The vendor selected will be contacted within two working days of the deadline.

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Proposal/Bid/Contract Timeline

ACTIVITY DATE Specifications Issued Questions Submitted

Conference Call Vendor’s Response Due End of Evaluation Period

Contract Award

• Any late proposals will not be considered • ______________________ (Sponsor) reserves the right to reject any or all proposals if deemed to

be in the best interest of the SFSP.

Payment Terms/Method

The charge to ________________________________(Sponsor) at the fixed rate per meal, which shall include all expenses of the FSMC and shall be clearly identified in the proposal (to be completed by the FSMC).

MEAL PRICE

Breakfast Lunch

A.M. Snack P.M. Snack

Supper

The FSMC shall invoice ________________________ (Sponsor) at the end of each month for the amount due based upon site records. This invoice shall include:

1. Name and address of FSMC 2. Invoice date 3. Period covered by the invoice 4. Detail of the services provided 5. Attachment E

The invoice must be in accordance with the terms and conditions of the contract and shall be submitted to:

____________________________________________

____________________________________________

____________________________________________

Upon verification of the invoice, the expected payment date will be 14 working days of receipt of the invoice.

I. Evaluation Criteria for small purchase procedures (See Attachment D for competitive proposals).

The proposals will be evaluated by __________________________ (Sponsor) and awarded points on a comparative formula weighting detailed below.

All quotes will be reviewed and awarded up to a maximum of 100 points based on the following criteria (listed in order of their weight):

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1. Cost: 50 points

The lowest bid received from an accepted proposal will be assigned the maximum points. The remaining proposals will receive assigned points based on the following formula: Maximum Points x Lowest Bid/Bid Price = Assigned Points.

2. Proposal: 25 points

This is the capability of the proposal from the FSMC to meet the needs of the SFSP. This includes services such as provisions to deliver appealing, nutritionally sound meals (or have them picked up locally) at the time specified and at a temperature consistent with the meal type.

3. Qualifications: 25 points

Qualifications will be reviewed to determine the capability of the FSMC to support and maintain the proposal. This will include the ability of the FSMC to make changes, which may be dictated by the SFSP or USDA during the tenure of the contract.

J. Monitoring

____________________________ (Sponsor) shall monitor the food service operation of the FSMC through periodic onsite visits as necessary to ensure conformance with State Agency and USDA program regulations.

K. Nondiscrimination

Both ________________________(Sponsor) and the FSMC agree that no child who participates in the SFSP will be discriminated against on the basis of race, color, national origin, age, sex, or disability.

L. Termination

____________________________ (Sponsor) or the FSMC may terminate the contract for cause by giving 30 days written notice.

M. Insurance

The FSMC shall maintain the Insurance coverage set forth below for each accident provided by insurance companies authorized to do business in the state of Oklahoma. A Certificate of Insurance of the FSMC’s insurance coverage indicating these amounts must be submitted at the time of this award. This must be completed by the _____________________________ (Sponsor).

1. Comprehensive General Liability to include coverage for:

a. Premises – Operations b. Products – Completed Operations c. Contractual Insurance d. Broad Form Property Damage e. Interdependent Contractors f. Personal Injury

• $__________________________Combined Single Limit

2. Automobile Liability: • $__________________________Combined Single Limit

3. Worker’s Compensation – Statutory:

• $__________________________Employer’s Liability

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4. Excess Umbrella Liability: • $__________________________Combined Single Unit

N. Non-proposal Notice If a FSMC chooses not to submit a proposal, please fax a Non-proposal Notice to ( ) _____-_________ (telephone number) to the attention of __________________________ (contact person). (See Page 10) O. Bid Guarantee/Bonding Requirements

(for contracts exceeding $150,000 only) Bonding Requirements

1. Each FSMC which submits a bid over $150,000 shall obtain a bid bond in an amount not less than five (5) percent nor more than ten (10) percent, as determined by the sponsor, of the value of the contract for which the bid is made. A copy of the bid bond must accompany each bid. No sponsor or state agency shall allow FSMCs to post any alternative forms of bid bonds, including but not limited to, cash, certified checks, letters of credit, or escrow accounts.

2. Each FSMC which enters into a food service contract for over $150,000 with a sponsor shall obtain a

performance bond in an amount not less than ten (10) percent nor more than twenty-five (25) percent of the value of the contract, as determined by the state agency, of the value of the contract for which the bid is made. Any FSMC which enters into more than one contract with any one sponsor shall obtain a performance bond covering all contracts if the aggregate amount of the contracts exceeds $150,000. Sponsors shall require the FSMC to furnish a copy of the performance bond within ten days of the awarding of the contract. No sponsor or state agency shall allow FSMCs to post any alternative forms of performance bonds, including but not limited to, cash, certified checks, letters of credit, or escrow accounts. Performance bonds for the successful offeror shall be held for the duration of the contract.

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FOOD SERVICE MANAGEMENT COMPANY PROPOSAL STATEMENT

_______________________________________________________ (Name of FSMC)

Has chosen not to submit a 20_____ Summer Food Service Program proposal

for the

_____________________________________. (Name of Sponsor)

Signed: _________________________________________________

Date:___________________________________________________

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ATTACHMENT A

MINIMUM FOOD SPECIFICATIONS

Meat/Seafood—All meats, meat products, poultry, poultry products, and fish must be government-inspected.

• Beef, lamb and veal must be USDA Grade Choice or better • Pork must be U.S. No. 1 or U.S. No. 2 • Poultry must be U.S. Government Grade A • Seafood to be top grade, frozen fish—must be a nationally distributed brand, packed under

continuous inspection of the USDA Dairy Products—All dairy products must be government-inspected. • Fresh eggs, USDA Grade A or equivalent, 100 percent candled • Frozen eggs, USDA-inspected • Milk, pasteurized Grade A Fruits and Vegetables— • Fresh fruits and vegetables selected according to written specifications for freshness, quality,

and color—U.S. Grade A Fancy • Canned fruits and vegetables selected to requirements—U.S. Grade A Choice or Fancy (fruit

to be packed in light syrup or natural juices) • Frozen fruits and vegetables shall be U.S. Grade A Choice or better Baked Products— • Bread, rolls, cookies, pies, cakes, and puddings either prepared or baked on premises or

purchased on a quality level commensurate with meeting USDA breakfast and lunch requirements, as applicable

Staple Groceries— • Staple groceries to be a quality level commensurate with previously listed standards

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ATTACHMENT A-1 SUMMER FOOD SERVICE PROGRAM (SFSP)

Menu Plan for Breakfast

Sponsoring Organization: _______________________________ Week of: _________________________________________________________

DAY DATE DAY DATE DAY DATE

FOOD COMPONENT1

ITEM SERVING SIZE ITEM SERVING SIZE ITEM SERVING SIZE

MILK, FLUID

VEGETABLES/FRUITS OR JUICE

GRAINS/BREADS2

ADDITIONAL3

DAY DATE DAY DATE

FOOD COMPONENT1

ITEM SERVING SIZE ITEM SERVING SIZE

MILK, FLUID

VEGETABLES/FRUITS OR JUICE

GRAINS/BREADS2

ADDITIONAL3

The minimum amount of food to be served at breakfast is as follows:1

MILK,FLUID 1 cup

VEGETABLES/FRUITS/JUICE ½ cup

GRAINS/BREADS 1 slice or equivalent2

1 The information presented here represents

general guidelines. For specific information, consult the Sponsor Handbook, or program regulations.

2 For equivalents, consult the Sponsor Meal Preparation Handbook.

3 Food items that are not required components or which are served in excess of the required amounts.

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ATTACHMENT A-2 SUMMER FOOD SERVICE PROGRAM (SFSP)

Menu Plan for Lunch or Supper Sponsoring Organization: _________________________________Week of: ___________________________________

THESE ARE FOR: LUNCH SUPPER If the sponsor participates in Nutrient Standard Menu Planning, attach a meal analysis with menu cycle.

DAY DATE DAY DATE DAY DATE

FOOD COMPONENT1

ITEM SERVING SIZE ITEM SERVING SIZE ITEM SERVING SIZE

MILK, FLUID

VEGETABLES/FRUITS OR JUICE2

VEGETABLES/FRUITS OR JUICE2

GRAINS/BREADS3

MEAT/MEAT ALTERNATE3

ADDITIONAL4

DAY DATE DAY DATE FOOD

COMPONENT1 ITEM SERVING

SIZE ITEM SERVING

SIZE MILK, FLUID VEGETABLES/FRUITS OR JUICE2

VEGETABLES/FRUITS OR JUICE2

GRAINS/BREADS3 MEAT/MEAT ALTERNATE3

ADDITIONAL4

The minimum amount of food to be served at breakfast is as follows:1

MILK,FLUID 1 cup VEGETABLES/FRUITS/JUICE ¾ cup2

GRAINS/BREADS 1 slice or equivalent3

MEAT/MEAT ALTERNATE 2 oz. or equivalent3

1. The information presented here represents general guidelines. For specific information, consult the Sponsor Handbook, or program regulations.

2. Serve two or more kinds of fruit(s) and/or vegetable(s) or a combination of both.

3. For alternates and equivalents, consult the Sponsor Meal Preparation Handbook.

4. Food items that are not required components or which are served in excess of the required amounts.

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ATTACHMENT A-3

SUMMER FOOD SERVICE PROGRAM (SFSP) Menu Plan for Snack

If sponsor participates in Nutrient Standard Menu Planning, attach a meal analysis with menu cycle.

DAY DATE DAY DATE

FOOD COMPONENT1 ITEM SERVING SIZE ITEM SERVING SIZE

MILK, FLUID

VEGETABLES/FRUITS OR JUICE

VEGETABLES/FRUITS OR JUICE

GRAINS/BREADS2

MEAT/MEAT ALTERNATE3

DAY DATE DAY DATE DAY DATE

FOOD COMPONENT1 ITEM SERVING SIZE ITEM SERVING SIZE ITEM SERVING SIZE

MILK, FLUID VEGETABLES/FRUITS OR JUICE

VEGETABLES/FRUITS OR JUICE

GRAINS/BREADS2

MEAT/MEAT ALTERNATE2

The minimum amount of food to be served at snack is two of the four components listed below:

MILK,FLUID 1 cup

VEGETABLES/FRUITS/JUICE 3/4cup

GRAINS/BREADS 1 slice or equivalent2

MEAT/MEAT ALTERNATE 1 oz. or equivalent2

7 The information presented here represents

general guidelines. For specific information, consult the Sponsor Handbook, or program regulations.

8 For alternates and equivalents, consult the Sponsor Meal Preparation Handbook.

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ATTACHMENT B SFA SPECIFICATION WORKSHEET ON AVERAGE DAILY PARTICIPATION (ADP)

(Total number of meals by meal type served in the previous summer divided by the total operating days for the summer)*

SUMMER FOOD SERVICE PROGRAM (To be completed by Sponsor)

SITE APPROVED LEVEL REIMBURSABLE

BREAKFASTS/DAY

APPROVED LEVEL REIMBURSABLE LUNCHES/DAY

APPROVED LEVEL REIMBURSABLE

SNACKS/DAY

APPROVED LEVEL REIMBURSABLE SUPPERS/DAY

TOTALS

*If this is a new site, use projected numbers.

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ATTACHMENT C

REVENUE/EXPENDITURES FOR SUMMER FOOD SERVICE PROGRAM (SFSP)

(To Be Completed by Sponsor) REVENUES (FEDERAL REIMBURSEMENT): Meals Rate Total Operating Breakfast #_______________ x ______________ = $_______________ Lunch/Supper #_______________ x ______________ = $_______________ Snack #_______________ x ______________ = $_______________ Total Revenue (SFSP) $_____________ EXPENDITURES: Operating: Cost of Food and Milk $ _____________________ Food Service Labor, Payroll Taxes, and Benefits _____________________ Nonfood Supplies _____________________ Utilities _____________________ Rental of Facility _____________________ Rental of Equipment _____________________ Use Allowance of Equipment _____________________ Transportation of Children/Meals (Rural Sponsors Only) _____________________ Other (Specify) ________________________________

Total Operating $______________

Administrative: Administrative Salaries $ _____________________ Payroll Taxes and Benefits _____________________ Office (Maintenance, Rental, Supplies) _____________________ Utilities _____________________ Mileage (Administrative Purposes Only) _____________________ Audit/Legal Fees _____________________ Communications (Telephone, Postage, Outreach) _____________________ Publication Fee _____________________ Other (Specify) ______________________________

Total Administrative $___________________ Total Expenditures (SFSP) $___________________ SUMMARY: Total Revenue $__________________ Total Expenditures $__________________ Profit or (Loss) $__________________

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ATTACHMENT D

COMPETITIVE PROPOSAL – FIXED-PRICE BID

The FSMC will be paid at a fixed rate per meal/lunch equivalent. The fixed price must include all labor (including bonuses, if any) and expenses as shown below. They may not be charged back to the SFA in any other manner.

a. Menu development specific to the operation b. Nutrition education materials and program expense c. Design services specific to the operation d. Education programs e. Personal representation, visitation, and coverage on a regular basis by a principle of FSMC f. All accounting g. All payroll costs and documentation h. Administrative dietetic, nutritional, sanitation, and personnel advice i. All costs incurred in hiring and relocating, if necessary, the FSMC management team j. All training costs for training for FSMC employees k. All travel costs for training for FSMC employees l. All miscellaneous costs to operate the program m. One-time performance bond

Award Criteria: Proposals will be evaluated by a committee against the following criteria with assigned weights in the following categories. Each area of the award criteria must be addressed in detail in the proposal. (Note: Price is the primary factor in the award of a contract when using competitive proposals. Reference: §3016.36[d][3][iv].) Weight Criteria (_____) points Service Capability Plan (_____) points Experience, References (_____) points Financial Condition/Stability, Business Practices (_____) points Accounting and Reporting Systems (_____) points Personnel Management (_____) points Innovation (_____) points Promotion of the School Food Service Program (_____) points Involvement of Students, Staff, and Patrons (_____) points Cost and Performance Bond (_____) points Program Financial Profile 100 points TOTAL The fixed price per meal/lunch equivalent will be subject to an annual escalator provision, made at the time of contract renewal, based on the CPI for Food Away From Home. The specific CPI used will be: CPI for All Urban Consumers.

To be completed by the FSMC: Fixed Price Per Meal/Lunch Equivalent: $__________________________________

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ATTACHMENT E FOOD SERVICE MANAGEMENT COMPANY

MONTHLY LUNCH EQUIVALENCY WORKSHEET Month/Year: ____________________________ Once the contract has been awarded, this form is to be used by the food service management company (FSMC) to show the sponsor the calculations for determining the lunch equivalencies for each month.

1. Actual Meal Counts: To make the meal count computation, include all SFSP meals that are a part of the contract. The number of lunches, breakfasts, (2 breakfasts equal 1 lunch), and snacks (4 snacks equal 1 lunch) served to children will be determined by actual count.

Based on ________________Days of Services

__________________ ÷ 2 = __________________ Total Breakfasts Lunch Equivalent

(Do Not Round)

_________________ = _________________ Total Lunches Lunch Equivalent

_________________ ÷ 4 = _________________ Total Snacks Lunch Equivalent

Lunch Equivalents Based on Meal Counts = _______________________

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Certificate of Independent Price Determination

Both the SPONSOR and CONTRACTOR (i.e. the “offeror”) shall execute this Certificate of Independent Price Determination.

A. By submission of the offer, the offeror certifies and in the case of a joint offer, each party thereto certifies as to its own organization, that in connection with this procurement: 1. The prices in this offer have been arrived at independently, without consultation, communication or

agreement for the purpose of restricting competition, as to any matter relating to such prices with any other offeror or with any competitor;

2. Unless otherwise required by law, the prices which have been quoted in this offer have not been knowingly disclosed by the offeror and will not knowingly be disclosed by the offeror prior to opening in the case of an advertised procurement or prior to award in the case of a negotiated procurement, directly or indirectly, to any other offeror or to any competitor; and

3. No attempt has been made or will be made by the offeror to induce any person or firm to submit or not to submit an offer for the purpose of restricting competition.

B. Each person signing this offer on behalf of the Food Service Management Company certifies that: 1. He or she is the person in the offeror’s organization responsible within the organization for the decision as to

the prices being offered herein and has not participated, and will not participate, in any action contrary to A.1. through A.3. above or

2. He or she is not the person in the offeror’s organization responsible with the organization for the decision as to the prices being offered herein, but that he or she has been authorized in writing to act as agent for the persons responsible for such decision in certifying that such persons have not participated, and will not participate, in any action contrary to A.1. through A.3. above and as its agent does hereby so certify; and he or she has not participated, and will not participate, in any action contrary to A.1. through A.3. above.

To the best of my knowledge, this food service management company, its affiliates, subsidiaries, officers, directors and employees are not currently under investigation by any governmental agency and have not in the last three years been convicted or found liable for any act prohibited by state or federal law in any jurisdiction, involving conspiracy or collusion with respect to bidding on any public contract, except as described on the attached sheet (if applicable): _________________________________________________________________________________________________ Name of Food Service Management Company ___________________________________________________________________________________________________ Signature of Food Service Management Company’s Authorized Representative _______________________________________ _________________________________________________ Title Date In accepting this offer, the sponsor certifies that no representative of the sponsor has taken any action which may have jeopardized the independence of the offer referred to above. ___________________________________________________________________________________________________ Name of Sponsor ____________________________________________________________________________________________________ Signature of Sponsor’s Authorized Representative _______________________________________ __________________________________________________ Title Date

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ATTACHMENT F LOBBYING CERTIFICATION

Applicable to Grants, Subgrants, Cooperative Agreements, and Contracts exceeding $150,000 in federal funds.

Submission of this certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, U.S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $150,000 for each such failure. The undersigned certifies, to the best of his or her knowledge and belief, that: 1. No federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any person

for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of a federal contract, the making of a federal grant, the making of a federal loan, the entering into a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, or cooperative agreement.

2. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing

or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, Disclosure Form to Report Lobbying, in accordance with its instructions.

3. The undersigned shall require that the language of this certification be included in the award documents for all

covered subawards exceeding $150,000 in federal funds at all appropriate tiers and that all subrecipients shall certify and disclose accordingly.

______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ Name/Address of Organization _____________________________________________________________________________________________ Name/Title of Submitting Official ______________________________________________________ ____________________________ Signature Date

DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB

Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046

(See reverse for public burden disclosure.)1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:

a. contract a. bid/offer/application a. initial filingb. grant b. initial award b. material changec. cooperative agreement c. post-award For Material Change Only:d. loan year _________ quarter _________e. loan guarantee date of last report ______________f. loan insurance

4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Nameand Address of Prime:

Tier ______, if known :

Congressional District, if known : Congressional District, if known :6. Federal Department/Agency: 7. Federal Program Name/Description:

CFDA Number, if applicable: _____________

8. Federal Action Number, if known : 9. Award Amount, if known :

$

10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (if individual, last name, first name, MI): different from No. 10a )

(last name, first name, MI ):

(attach Continuation Sheet(s) SF-LLLA, if necessary)

11. Amount of Payment (check all that apply): 13. Type of Payment (check all that apply):

$ ___________

12. Form of Payment (check all that apply):

nature __________value __________

14. Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s),employee(s), or Member(s) contacted, for Payment Indicated in Item 11:

(attach Continuation Sheet(s) SF-LLLA, if necessary)

15. Continuation Sheet(s) SF-LLLA attached:

16. Signature:

Print Name:

Title:

Telephone No.: _______________________ Date:

Authorized for Local Reproduction

Standard Form LLL (Rev. 7-97)

Information requested through this form is authorized by title 31 U.S.C. section1352. This disclosure of lobbying activities is a material representation of factupon which reliance was placed by the tier above when this transaction was madeor entered into. This disclosure is required pursuant to 31 U.S.C. 1352. Thisinformation will be reported to the Congress semi-annually and will be available forpublic inspection. Any person who fails to file the required disclosure shall besubject to a civil penalty of not less that $10,000 and not more than $100,000 foreach such failure.

Prime Subawardee

actual planned a. retainer

b. one-time fee

c. commission

d. contingent fee

e. deferred

f. other; specify: _________________________

Yes No

a. cash

b. in-kind; specify:

Federal Use Only:

ATTACHMENT G

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INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES

1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.

2. Identify the status of the covered Federal action.

3.

4.

5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, State and zip code of the prime Federal

recipient. Include Congressional District, if known.

6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizationallevel below agency name, if known. For

example, Department of Transportation, United States Coast Guard.

7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance

(CFDA) number for grants, cooperative agreements, loans, and loan commitments.

8.

9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan

commitment for the prime entity identified in item 4 or 5.

10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action.

(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI).

11.

12. Check the appropriatebox(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind

payment.

13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.

14.

15. Check whether or not a SF-LLLA Continuation Sheet(s) is attached.

16. The certifying official shall sign and date the form, print his/her name, title, and telephone number.

This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federalaction, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to makepayment to any lobbying entity for influencing or attempting to influence an officer or employeeof any agency, a Member of Congress, an officer or employeeofCongress, or an employeeof a Member of Congress in connectionwith a coveredFederalaction. Use the SF-LLLA ContinuationSheet for additional information ifthe space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidancepublished by the Office of Management and Budget for additional information.

Identify the appropriateclassification of this report. If this is a followup report caused by a material change to the information previously reported, enterthe year and quarter in which the change occurred. Enter the date of the last previouslysubmitted report by this reporting entity for this covered Federalaction.

Enter the full name, address, city, State and zip code of the reporting entity. Include CongressionalDistrict, if known. Check the appropriateclassificationof the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee,e.g., the first subawardeeof the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number;Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control numberassigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001."

Enter the amount of compensationpaid or reasonablyexpectedto be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whetherthe payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulativeamount of payment made or planned to be made.

Providea specific and detaileddescription of the services that the lobbyist has performed, or will be expected to perform, and the date(s) of any servicesrendered. Include all preparatory and related activity, not just time spent in actual contact with Federal officials. Identify the Federal official(s) oremployee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that were contacted.

According to the PaperworkReduction Act, as amended,no persons are required to respond to a collection of information unless it displays a valid OMB ControlNumber. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information isestimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the dataneeded, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection ofinformation, including suggestions for reducing this burden, to the Office of Managementand Budget, Paperwork Reduction Project (0348-0046), Washington,DC 20503.

22

23

ATTACHMENT H

UNITED STATES DEPARTMENT OF AGRICULTURE (USDA) SUSPENSION AND DEBARMENT CERTIFICATION

Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusions—

Lower-Tier Covered Transactions

This certification is required by the regulations implementing Executive Orders 12549 and 12689, Debarment and Suspension, Title 2 CFR, §180, as adopted and modified by USDA regulation at 2CFR §417, Responsibilities of Participants Regarding Transactions. (Before completing certification, read instructions on reverse.) 1. The prospective lower-tier participant certifies, by submission of this proposal, that neither it nor its principals

are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

2. Where the prospective lower-tier participant is unable to certify to any of the statements in this certification,

such prospective participant shall attach an explanation to this proposal. __________________________________________ ___________________________________________ Organization Name PR/Award Number or Project Name _____________________________________________________________________________________________ Name(s) and Title(s) of Authorized Representative(s) __________________________________________ ___________________________________________ Signature(s) Date

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Instructions for Suspension and Debarment Certification

1. By signing and submitting this form, the prospective lower-tier participant is providing the certification set out

on the reverse side in accordance with these instructions. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this

transaction was entered into. If it is later determined that the prospective lower-tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the department or agency with which this transition originated may pursue available remedies, including suspension and/or debarment.

3. The prospective lower-tier participant shall provide immediate written notice to the person to which this

proposal is submitted if at any time the prospective lower-tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

4. The terms covered transaction, debarred, suspended, ineligible, lower-tier covered transaction, participant,

person, primary-covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations.

5. The prospective lower-tier participant agrees by submitting this form that, should the proposed covered

transaction be entered into, it shall not knowingly enter into any lower-tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated.

6. The prospective lower-tier participant further agrees by submitting this form that he or she will include this

clause titled Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion—Lower-Tier Covered Transactions, without modification, in all lower-tier covered transactions and in all solicitations for lower-tier covered transactions.

7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower-tier

covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principles. Each participant may, but is not required to, check the Nonprocurement List.

8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to

render in good faith the certification required by this clause. The knowledge and information of a participant are not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered

transaction knowingly enters into a lower-tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

25

AGREEMENT

The offeror certifies that the FSMC shall operate in accordance with all applicable state and federal regulations. The offeror certifies that all terms and conditions within the Quote/RFP will be considered a part of the contract as if

incorporated therein. This Agreement will be in effect for one summer. (Note: Contract could be renewed each year for four (4) additional

years if agreed by both parties.) IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be signed by their duly authorized

representatives. ATTEST: SFSP SPONSOR: ________________________________ ________________________________________ Name of Sponsor ________________________________________

Signature of Authorized Representative ________________________________________ Typed Name of Authorized Representative ________________________________________ Title ________________________________________ Date Signed ATTEST: FOOD SERVICE MANAGEMENT COMPANY: _______________________________ ________________________________________ Name of FSMC ________________________________________ Signature of Authorized Representative ________________________________________ Typed Name of Authorized Representative ________________________________________ Title ________________________________________

Date Signed