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CERTIFICATION REGARDING PARTICIPATION ELIGIBILITY IN CHILD NUTRITION PROGRAMS I certify that print provider s name 1 I have not been disqualified from participation in any Child Nutrition Program for violating the program s requirements or and Adult Care Food Program. signature of provider date 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...
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