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This document certifies that the institution is not participating or applying to participate under more than one Child and Adult Care Food Program (CACFP) agreement, ensuring the agreement with the
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How to fill out certification of single exclusive
How to fill out Certification of Single Exclusive CACFP Agreement
01
Obtain the Certification of Single Exclusive CACFP Agreement form from the relevant governing body or website.
02
Read the instructions carefully to understand the requirements and necessary documentation.
03
Fill in the organization’s legal name, address, and contact information in the designated fields.
04
Indicate the type of service being provided (e.g., childcare, adult care) in the appropriate section.
05
List the names of authorized representatives who can enter into the agreement on behalf of the organization.
06
Sign and date the form by an authorized official to validate the agreement.
07
Submit the completed form along with any required attachments to the appropriate state agency.
Who needs Certification of Single Exclusive CACFP Agreement?
01
Organizations participating in the Child and Adult Care Food Program (CACFP) that are seeking to establish or maintain exclusive agreements.
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What is Certification of Single Exclusive CACFP Agreement?
The Certification of Single Exclusive CACFP Agreement is a document that certifies that an organization is the sole provider of the Child and Adult Care Food Program (CACFP) services in a given service area.
Who is required to file Certification of Single Exclusive CACFP Agreement?
Organizations that operate as a single provider of CACFP services in their designated area are required to file the Certification of Single Exclusive CACFP Agreement.
How to fill out Certification of Single Exclusive CACFP Agreement?
To fill out the Certification of Single Exclusive CACFP Agreement, organizations must provide their identifying information, confirm their exclusive status in servicing CACFP, and complete any required declarations as outlined in the form instructions.
What is the purpose of Certification of Single Exclusive CACFP Agreement?
The purpose of the Certification of Single Exclusive CACFP Agreement is to ensure that only one entity is accountable for delivering CACFP services within a specific area, thereby streamlining the program and avoiding service overlaps.
What information must be reported on Certification of Single Exclusive CACFP Agreement?
The Certification of Single Exclusive CACFP Agreement must report the organization's name, address, contact information, certification of exclusivity, and any relevant licensing details or operational scope.
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