ST MARYS PARTNERSHIP FOR FOOD BOXES.PDF

Food Bank
A I. A PARTNER AGENCY INFORMATION
CONTACT INFORMATION
MCDPH-OFH- South Phoenix Healthy Start 0 bouo 4 7 2_
(9
PROGRAM NAME AGENCY EN
IF AFFILIATED, NAME OF UMBRELLA/PARENT ORGANIZATION PARENT FIN, IF DIFFERENT
7202 S. 48th St. Tempe AZ 85282
PRIMARY SITE ADDRESS (WHERE FOOD IS DISTRIBUTED) CITY STATE ZIP
SECONDARY SITE ADDRESS (WHERE FOOD IS DISTRIBUTED) CITY STATE ZIP
ADDITIONAL SITE ADDRESS (WHERE FOOD IS DISTRIBUTED) CITY STATE ZIP
SITE PHONE NUMBER (PUBLIC) FAX NUMBER WEBS ITE ADDRESS (IF ANY)
2737 W. Southern Ave Suite 8 Tempe AZ 85282
MAILING ADDRESS (IF DIFFERENT THAN SITE ADDRESS) CITY STATE Zfl3
BILLING ADDRESS (IF DIFFERENT) CITY STATE ZIP
EA‘r(LA A0c, 1q00 bsor-L__.
ADMINISTRATIVEADDRESS (OE7EXECU1 IVE DIRECTOR/HEAD CLERGY) STATE ZIP
IL\O ast&cl P
meloneybaty@mail maricopa gov
PRINT EXECUTIVE DIR ri:oITHEA CLERGY • E-MAIL ADDRESS
Program Supervisor
TITLE DAYTIME PHONE NUMBER
Meloney Baty meloneybaty@mail.maricopa.gov
PRINT PRIMARY PROGRAM CONTACT (SMFBA PRIMARY CONTACT) E-MAIL ADDRESS
Program Supervisor 602-304-1166
TITLE DAYTIME PHONE NUMBER
IVIoinnpy RAty rnpInneyhaty0mail mnrir:npa gnv
PRINT BILLING CONTACT E-MAIL ADDRESS
Program Supervisor 602-304-1166
TITLE DAYTIME PHONE NUMBER

St. Wry's
Food Bank
L PARTNER AGENCY INFORMATION
PROGRAM DESCRIPTION
WHAT TYPE(S) OF FOOD ASSISTANCE DOES YOUR PROGRAM PROVIDE?
EMERGENCY: OPEN TO PUBLIC NON-EMERGENCY: SPECIAL POPULATIONS
PANTRY El PANTRY I BACKPACK (E.G. FOR SENIORS STUDENTS ONLY)
El SOUP KITCHEN El ON-SITE MEALS & SNACKS (E.G. GROUP HOME, SUMMER CAMP)
111 SHELTER 111 ON-SITE SNACKS ONLY (E.G. AFTER-SCHOOL PROGRAM)
WHAT OTHER SERVICES DOES THE PROGRAM PROVIDE?
El DAYCARE El YOUTH SERVICES E SENIOR SERVICES E HOUSING 0 ENERGY ASSISTANCE
El SUBSTANCE USE El DOMESTIC VIOLENCE 0 HIV-AIDS 0 MENTAL HEALTH N CASE MANAGEMENT
111 MINISTRY 0 OTHER:
IF SERVICE IS LIMITED TO INDIVIDUALS LIVING WITHIN A SPECIFIC GEOGRAPHIC AREA (TOWN OR NEIGHBORHOOD), DESCRIBE: N/A
IF SERVICE IS LIMITED TO A SPECIFIC POPULATION, DESCRIBE: N N/A
. .
WHAT MEASURE(S): DO VOU USE TO DETERMINE CLIENT NEED . LI N/A
El MUST BE A-PROGRAM PARTICIPANT •111 CURRENT:ENROLLMENT IN TOWN; STATE OR FEDERAL NEED-BASED PROGRAM
0 REFERRAL BY SOCIAL-SERVICE AGENCY El ANNUAL HOUSEHOLD INCOME AT REQUIRED °/.0 OF FEDERAL POVERTY LEVEL
El OTHER:
DO YOU REQUIRE PROOF OF: E INCOME El ENROLLMENT IN NEED-BASED PROGRAM, OR E CLIENT IDENTIFICATION? 2 No
WHAT APPROXIMATE PERCENTAGE OF THE INDIVIDUALS SERVED ARE LOW INCOME? 100%
DO CLIENTS PAY A FEE (FOR ROOM AND/OR BOARD, MEMBERSHIP, ETC) IN ORDER TO RECEIVE SERVICES? El YES IM No
DO CLIENTS NEED TO WORK AND/OR VOLUNTEER IN ORDER TO RECEIVE SERVICES? El YES El Na
IF YES, DESCRIBE THE FEE OR WORK/VOLUNTEER REQUIREMENTS:

St. maryis ,
Food 1
PARTNER AGENCY INFORMATION
DISTRIBUTION I SERVING TIMES
1st of the month
PANTRY OR
BACKPACK
7am
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY
MEALS
24/7
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY
SNACKS
LI 24/7
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY
PANTRY/BACKPACK: AVERAGE NUMBER OF CLIENTS SERVED PER MONTH: 350
MEALS/SNACKS: AAVERAGE NUMBER OF MEALS SERVED PER MONTH:
FACTS St FIGURES
How MANY STAFF AND/OR VOLUNTEERS ARE INVOLVED IN THE FOOD ASPECT OF THE PROGRAO 20
VOLUNTEERS
WHAT IS THE OVERALL ANNUAL BUDGET FOR THE PROGRAM?
WHAT IS THE AVERAGE MONTHLY FOOD BUDGET FOR THE PROGRAM? N/A
WHAT PERCENTAGE OF FOOD IS ACQUIRED THROUGH PURCHASING I DONATIONS? N/A N/A
PURCHASED DONATED
OF ALL PRODUCT DISTRIBUTED, WHAT PERCENTAGE COMES FROM ST. MARY'S? 100%
HOW MANY BOXES OF FOOD OR BACKPACKS ARE DISTRIBUTED IN A TYPICAL MONTH? LI N/A 150 N/A
BOXES BACKPACKS
How MANY MEALS AND/OR SNACKS ARE PROVIDED IN A TYPICAL MONTH? E N/A
MEALS SNACKS
How MANY UNDUPLICATED(UNIQUE) INDIVIDUALS DO YOU SERVE IN A TYPICAL MONTH? 150
AN INDIVIDUALIHOUSEHOLD CAN RECEIVE FOOD UP TO 1 TIME(S) A D DAY LII WEEK MONTH

(T miro
. Food Bank
PARTNER AGENCY INFORMATION
FOOD SAFETY St TRANSPORT
HAS AT LEAST ONE PERSON ASSOCIATED WITH OVERSEEING FOOD PREPARATION AND/OR DISTRIBUTION El YES lil No
SUCCESSFULLY COMPLETED A SERVSAFE COURSE IN THE PAST YEAR? (REQUIRED FOR DAIRY AND/OR MEAT)
IF YES, PERSONS NAME: A7TACH A COPY OF CERTIFICATE/CARD DATE OF EXPIRATION
ARE STAFF AND VOLUNTEERS EDUCATED ON A REGULAR BASIS ABOUT SAFE FOOD HANDLING TECHNIQUES? YES El No
HAS AT LEAST ONE PERSON INVOLVED IN PROGRAM OVERSIGHT CERTIFIED IN FOOD HANDLERS? El YES
No
Tatjana Loncar, Deanna Montano 05/23/2019
IF YES, PERSONS NAME: ATTACH A COPY OF CERTIFICATE/CARD DATE OF EXPIRATION
IF FOOD IS PREPARED, ISTHE PROGRAM LICENSED BY THE LOCAL HEALTH DEPARTMENT? * El YES E No
Al/A
IF YES, LICENSE CLASS OR LEVEL EXPIRATION DATE LAST INSPECTION DATE LAST INSPECTION SCORE
IF YES, ATTACH A COPY OF THE LICENSE
IF FOOD IS PREPARED, ARE MEALS OR SNACKS DELIVERED TO INDIVIDUALS OR TO OTHER PROGRAMS? NM E YES El No
IF YES, DESCRIBE THE TRANSPORT PROCESS, INCLUDING HOW FOOD TEMPERATURES ARE MAINTAINED AT APPROPRIATE LEVELS:
ARE PANTRY GOODS DELIVERED TO HOMEBOUND INDIVIDUALS? El YES la No
DESCRIBE HOW COLD-STORAGE PRODUCT IS SAFELY TRANSPORTED FROM THE AGENCY TO THE PROGRAM SITE ADDRESS:
1\1 IA
STORAGE
IS ALL AGENCY PRODUCT STORED AT THE PRIMARY SITE ADDRESS PREVIOUSLY INDICATED? YES E No
IF NO, IDENTIFY ALL ADDITIONAL ADDRESS(ES) WHERE AGENCY PRODUCT IS STORED:
STREET ADDRESS CITY STATE ZIP
(IF MORE THAN TWO ADDRESSES, ATTACH A LIST) CITY STATE ZIP

Si. MareS
Food Bank
s PARTNER AGENCY INFORMATION
ARE ANY OF THE LOCATIONS WHERE PRODUCT IS STORED A PRIVATE RESIDENCE? EYES 111 No
ARE ANY OF THE STORAGE AREAS (INCLUDING COLD STORAGE UNITS) SHARED WITH ANOTHER PROGRAM? E YES M No
ARE ANY OF THE STORAGE AREAS USED BY PROGRAM STAFF (FOR STORING PERSONAL MEALS, ETC.)? ▪ YES la No
IS ACCESS TO STORAGE AREAS LIMITED TO AUTHORIZED STAFF AND VOLUNTEERS? El YES ENo
How IS IT ENSURED THAT AGENCY PRODUCT IS NOT USED BY OTHER PROGRAMS OR UNAUTHORIZED INDIVIDUALS?
South Phoenix Healthy Start staff is present at all times during distribution.
DESCRIBE THE PROGRAM'S DRY STORAGE AREA(S). INDICATE WHERE THEY ARE LOCATED WITHIN THE FACILITY, THE TYPE OF
SHELVING USED, AND ANY USE OF CABINETS AND/OR PALLETIZED AREAS:
N/A
DESCRIBE THE SYSTEM USED TO ENSURE THAT OLDER PRODUCT IS USED BEFORE NEWER PRODUCT:
All the product is distributed during the pantry date and time.
DOES THE PROGRAM HAVE A CONTFiACT WITH A:PES1 .00N1ROL.SERVICE?
IF YES, NAME OF COMPANY FREQUENCY OF SERVICE
IF No, DESCRIBE THE METHODS USED TO DOCUMENT AND CONTROL PEST PROBLEMS:
The distribution site does their own pest control services.
OR CHURCH AFFILIATED PROGRAMS ONLY
ARE RELIGIOUS SERVICES HELD DIRECTLY BEFORE OR AFTER FOOD ASSISTANCE IS PROVIDED? YES ENo
IS ATTENDANCE OF RELIGIOUS SERVICES REQUIRED IN ORDER TO RECEIVE FOOD ASSISTANCE? YES El No
IS RELIGIOUS LITERATURE INCLUDED WITH FOOD PROVIDED? EYES LNo
OF THOSE RECEIVING FOOD ASSISTANCE, WHAT PERCENTAGE ARE MEMBERS OF THE CHURCH CONGREGATION? 3

st, miro
Food Bank
PARTNER AGENCY INFORMATION
001) BANK SATISFACTION SURVEY
PLEASE INDICATE YOUR LEVEL OF SATISFACTION VERY MOSTLY NEUTRAL MOSTLY VERY
WITH ST. MARY'S FOOD BANK ALLIANCE: SATISFIED UNSATISFIED
PRODUCT VARIETY: O N/A
PRODUCT QUALITY: O N/A
PRODUCT QUANTITY: O N/A
ONLINE ORDERING SYSTEM: E N/A
SHOPPING EXPERIENCE: El N/A
PICKUP PROCESS: ▪ N/A
DELIVERY PROCESS: LII N/A
BILLING: N/A
AVAILABILITY OF STAFF: 111 N/A
_HELPFULNESS OF STAFF: El N/A
PROFESSIONALISM OF STAFF: 0 N/A
TRAINING/DEVELOPMENT FROM STAFF: Ed N/A
N/A
OVERALL EXPERIENCE OF PARTNERSHiP: LI N/A
COMMENTS:

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St. Mary's Food Bank Alliance Partner Agency Agreement
This document Is an agreement made between ST. MARY'S FOOD BANK ALLIANCE ("SMFBA") located at 2831 N. 31't Ave,
Phoenix, AZ 85009 and Maricopa County (AGENCY NAME)
Located at 4041 N Central Ave Ste 1400, Pliotnix_AZ 85012 (AGENCY ADDRESS) ("Agency").
The Agency agrees to all of the following terms and conditions of this agreement, and agrees that its compliance with these
terms and conditions are a material inducement for SMFBA to distribute product to the Agency. If any of these terms or
conditions are violated, then SMFBA has the right, without further investigation, to stop distributing product to the agency
and/or follow processes as outlined in the Probation, Termination, and Grievance Policies document until the term(s) or
condition(s) can be met.
Terms of the Agreement are as follows:
1) The Agency agrees that it meets the IRS eligibility requirements for the receipt, transfer, and use of donated
products (food and non-food) under section 170(e)(3) of the IRS code, as stated below:
(A) The Agency agrees that it is incorporated as a 501(c)3 Non-profit corporation or is considered a "church" as
defined by the IRS and meets all of the criteria below for each type of eligible organization.
Check the type of organization that the agency will qualify as;
501(c)3 Non-Profit Corporation- If this box is selected, the Agency is required to submit, prior to Agency
approval:
A current 601(c)3 determination letter from the IRS verifying its non-profit corporate status and
verifying that it is not a private foundation. The Corporation name must match the name that
the Agency is known by the community.
If the Agency name does not match the corporation name listed on the 501(c)3 determination
letter, the Agency is required to submit current (less than 1 years old) official and verifiable
documentation regarding the Agency's ability to use the 501(c)3 verification letter proving their
non-profit status.
If the Agency does not have its own 501(c)3 and is utilizing the 501(c)3 status of another
organization, then the Agency and its sponsor are required to complete and sign the Agency
Sponsorship Agreement every year.
Church (as defined by theiRS)/Religious Organization — If this box is selected, the Agency is required
to complete and submit the Church/Religious Organization 14 Point Self Certification form prior to
agency approval
(B) The Agency agrees that it is incorporated to serve the ill, needy and/or infants (minor children newborn -18
years old).
(C) The Agency agrees that is will not engage in discrimination, in the provision of service, against any person
because of race, color, citizenship, religion, sex, national origin, ancestry, age, marital status, disability,
sexual orientation including gender identity, unfavorable discharge from the military or status as a protected
veteran, or as otherwise prohibited by federal, state, or local law.
(D) The Agency agrees that it will distribute the products obtained from SMFBA "FREE OF CHARGE" (i.e. free
of any return obligation form the recipient, wherever monetary, volunteer hours, services or otherwise).
(E) The Agency agrees that it will not BARTER, SELL, TRADE OR USE FOR FUNDRAISING PURPOSES OR
EVENTS any product obtained from SMFBA.
(F) The Agency agrees that it will store, handle and distribute all products, and maintain its current licenses as
required by all local, state, and federal regulations.
(G) The agency agrees it will accept all products received from SMFBA in "AS IS" condition in accordance with
the Release and indemnification, which is incorporated herein..
(H) The Agency agrees that it will adhere to any donor stipulations placed on donated product.
(I) The Agency agrees it will abide by the policies, procedures, record keeping, and meeting requirements of
SMFBA. The Agency agrees that it is solely responsible for obtaining copies of SMFBA policies,
procedures, record-keeping guidelines, and meeting requirements, including any updates thereto.
The Agency agrees to notify SMFBA of any change in the program's name, location, forms of
communication, contact person, type of service or stated purpose, or desire to terminate this agreement
within thirty (30) days of the change or termination.
(K) The Agency understands that any changes in paragraph (J) may result in a termination of partnership with
SMFBA.
(L) The Agency agrees to allow representatives of SMFBA, donors and government agencies to inspect and
audit all facilities and vehicles where products received from SMFBA are received, stored, and distributed,
Partner Agency Agreement
SMFBA FY 2013-2014 Page 1

St, Mary's Food Bank Alliance Partner Agency Agreement
with or without notice, and the failure to permit inspect or audit may result in an immediate termination of
partnership with SMFBA.
(M) The Agency agrees to pay any applicable Shared Maintenance and/or handling fees (Value Added
Processing, Delivery Charges, Transportation fees) for products received from SMFBA.
(N) The Agency agrees that it will only receive and store product from SMFBA at multiple locations if: (1) all
locations individually meet the requirements of this agreement, (2) have been inspected and, (3) are
approved by SMFBA prior to receiving and distributing food. The Agency is not allowed to sub-distribute
donated product to any organization, agency, partner, or entity other than a qualifying client.
(0) The Agency agrees to execute and submit to SMFBA the "Release and indemnification"form (attached),
and any other liability release forms that SMFBA may require at any time. The Agency agrees that the
terms of the Release and Indemnification are incorporated herein, and by signing this Agreement, the
Agency agrees to the terms of the Release and Indemnification even if the Agency fails to execute and
return the Release and Indemnification.
(P) The Agency agrees to execute and submit to SMFBA the "Corrective Action, Suspension, Termination, &
Grievance Policy" document that is attached to this agreement. The Agency agrees that the terms of the
"Corrective Action, Suspension, Termination, & Grievance Policy" are incorporated herein, and by signing
this Agreement, the Agency agrees to the terms of the "Corrective Action, Suspension, Termination, &
Grievance Policy", even if the Agency fails to execute and return the "Corrective Action, Suspension,
Termination, & Grievance Policy".
(0) The Agency agrees that it is solely responsible for the selection, training, and monitoring of its Volunteers,
and that is solely responsible for ensuring its Volunteers are qualified to perform assigned activities, comply
with all Agency policies, SMFBA policies, federal, state and local law, and any relevant safety regulations,
and that Volunteers have executed an Individual Release releasing SMFBA from liability in connection with
SMFBA or Agency activities. The Agency shall indemnify and hold SMFBA from harmless for any claims or
charges by Agency volunteers. SMFBA retains the right to refuse entry onto SMFBA property or to refuse
services to any volunteer or representative of the Agency at any time at SMFBA's discretion.
(R) SMFBA can terminate this agreement, with or without notice, at anytime upon receipt of evidence that the
Agency has not complied with the terms.
(5) The Agency agrees that SMFBA should not be viewed as your only source for resources, but more as a
supplemental source to your program.
(T) The Agency expressly waives and releases any claims against SMFBA arising from or related to this
Agreement, as described in the Release and Indemnification.
The Agency's authorized pantry representative's signature below confirms that the Agency is accepting and agrees to
abide by all terms of this agreement.
Agency Signature:
See attached signature block
Authorized Pantry Representative's Signature Executive Officer (if other than Authorized Pantry Representative)
Title of Pantry Representative Executive Officer Signature
Date Date
St. Mary's Food Bank Alliance Signature:
Signature of St. Mary's Food Bank Alliance Date
President and CEO
Title of St. Mary's Food Bank Alliance Signature
St. Mary's Food Bank Alliance, 2831 N. 31 st Aye, Phoenix, AZ 85003. Phone: (602) 343-5643
Partner Agency Agreement
SMFBA FY 2013-2014 Page 2

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St. Mary's Partner Agency Probation, Termination, & Grievance Policy
A. PROBATION POLICY AND PROCEDURE
The Agency may be placed on probation for a period not to exceed three months if found to be in
violation of the Contract or state or federal law. Notification of probation will be in writing. Only the
Agency Services Manager, President/CEO, or Chief Programs and Logistics Officer of SMFBA, have
the authority to place member agencies on probation.
The purpose of this probationary period is to place an Agency on notice to bring its program into
compliance, or face suspension. During the probationary period, the Agency retains all the rights
and privileges of its membership. If the violation is not rectified by the end of the probationary
period, the Agency Services Manager, the President/CEO, or Chief Programs and Logistics Officer
has authority to extend the probationary period or to recommend suspension of the Agency. The
Agency's probationary status terminates when the Agency rectifies the violation to the satisfaction
of the Agency Services Manager, the President/CEO, or Chief Programs and Logistics Officer.
The Agency may be put on Probation for the following reasons:
1. The Agency is persistently delinquent in payment of shared maintenance fee/service charge.
2. There is improper storage, refrigeration, or transportation of product.
3. There is inadequate recordkeeping as required by the Contract.
4, The Agency is in violation of any applicable state or local statute, ordinance, code or regulation,
5. The Agency is not open to the public and is found distributing donated product to unqualified
recipients or exclusive groups such as a clubs, sports teams or church congregations.
6. The Agency refuses to collaborate with other agencies in the Service Area.
7. There is no screening process to determine recipients are needy, ill or children.
8, The Agency Services team is unable to monitor the Agency because the Agency is not open or
does not respond promptly to attempts to schedule an appointment.
9, There is no visual accountability to indicate to Food Bank personnel how the Agency operates
in serving the ill, needy, or infants (minor children.)
10. Agency director or staff fails to communicate or respond to the Food Bank in a timely manner.
11. Agency relocates, changes days/hours of service without informing Food Bank,
12. Any other reason found by the Agency Services team that violates the spirit of the Contract and
agreements.
B. SUSPENSION POLICY AND PROCEDURE
A member agency may be suspended without first being placed on probation if it is found to have
one or more violations. A member agency also may be placed on suspension if probation violations
are not rectified by the end of the probationary period or if another violation has emerged during
the same probationary period. Finally, member agency will be suspended if placed on probation
more than twice during any twelve month period. Suspension notification will be in writing.
Upon suspension, an agency loses all rights and privileges, including access to donated product. The
agency's suspension terminates when the Agency rectifies the violation(s) to the satisfaction of the
Agency Services Manager, the President/CEO, or Chief Programs and Logistics Officer. This may
include a monitoring visit from a Food Bank representative prior to any reinstatement decision.
The final decision regarding reinstatement will be that of the Agency Services Manager, the
President/CEO, or the Chief Programs and Logistics Officer and will be in writing.
Probation, Suspension, Termination, Grievance Policy
SMFBA FY 2013-2014 Page 1

St. Mary's Partner Agency Probation, Termination, & Grievance Policy
Member agencies may be suspended for any of the following violations:
1. Exchanging donated product for money, property or services.
2. Removal of donated product from Agency for private use.
3. Using donated product in a manner that is not related to the exempt purposes described in
section 170(e)3 of the Internal Revenue Code and violating the Food-Bank's and Agency's
501(c)3 status.
4. Failure to make good any insufficient funds along with the payment of any additional food bank
fees.
5. Disregard of warehouse use and policies, e.g., opening packages, disregarding quantity
limitations.
6. Staff or volunteers of the Agency display blatant disregard or disrespect for Food Bank policies,
and/or Food Bank staff, other Agencies, recipients, and/or donors.
7. Violations of food safety standards.
B. Any other gross violations of the Contract or state or federal law.
C. TERMINATION POLICY AND PROCEDURE
This Contract may be terminated as follows:
1. The Food Bank may terminate this contract without notice or the Agency may terminate this
Contract by providing written notice of such a decision by its Board of Directors at least thirty
calendar days prior to the effective date of such termination.
2. The Food Bank may terminate this Contract if, after the Agency has been placed on probation or
suspension as defined above, and the violations leading to probation or suspension have not
been rectified. Termination will be provided by written notice through certified mail.
3. Changes to the law, or Feeding America or Food Bank policy eliminate the eligibility of the
Agency.
SMFBA reserves the right to alter or change the Non-Compliance Policies as it deems necessary and
has the obligation to notify agencies of those changes. Publication in the Agency Newsletter, email,
phone calls and/or written letters will be considered sufficient notice.
D. GRIEVANCE PROCEDURE
Agencies may voice concerns or appeal any decisions made by Food Bank personnel. Place your
concerns in writing and send to the Agency Services Manager, and/or the President/CEO, and/or
Chief Programs and Logistics Officer: St. Mary's Food Bank Alliance, 2831 N. 31st Ave, Phoenix,
AZ 85009. Appeals will be heard by either the President & CEO or SMFBA Board of Directors.
Partner Agency hereby acknowledges that it understands and agrees to the terms of these
procedures.
Director or Authorized Representative (Print Name): See attached signature block
Director or Authorized Representative's Signature:
Date:
Probation, Suspension, Termination, Grievance Policy
SMFBA FY 2013-2014 Page 2

C - 8 6-
ATTACHED TO AND A PART OF:
AGREEMENT C-86-16-XXX-X-XX
St Mary's Food Bank and MARICOPA County, Department of Public Health, Office of Family Health
IN WITNESS WHEREOF, the parties agree to enter into this Agreement and its Amendments:
FOR AND ON BEHALF FOR AND ON BEHALF OF
OF MARICOPA COUNTY ST. MARY'S FOOD BANK
By By
Clint Hickman, Chairman, Board of Supervisors
Date Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM: APPROVED AS TO FORM:
Attorney for Maricopa County Signature
Date Date