2001-173S \Our Documents\Ordmances\01\summer food service doc
ORDINANCE NO J" 79'
AN ORDINANCE OF THE CITY OF DENTON, TEXAS, AUTHORIZING THE CITY
MANAGER TO SUBMIT AN APPLICATION UNDER THE NATIONAL SCHOOL LUNCH
ACT TO OBTAIN FUNDING FOR THE 2001 SUMMER FOOD SERVICE PROGRAM, IF
SUCH FUNDING IS GRANTED, THE CITY MANAGER IS AUTHORIZED TO EXECUTE
THE SUMMER FOOD SERVICE PROGRAM AGREEMENT WITH THE TEXAS
DEPARTMENT OF HUMAN SERVICES AND EXECUTE A CONTRACT WITH THE
DENTON INDEPENDENT SCHOOL DISTRICT AND ALL ADDITIONAL DOCUMENTS
AND AGREEMENTS, AS REQUIRED, AUTHORIZING THE EXPENDITURE OF FUNDS TO
ADMINISTER THE PROGRAM, AND PROVIDING AN EFFECTIVE DATE
WHEREAS, the City of Denton, Texas will submit an application for funding under the
National School Lunch Act, to the Texas Department of Human Services for the purpose of making
meals available to eligible children at the City's Summer Action Site programs, and
WHEREAS, pursuant to the grant, if received, the City will contract with the Denton
Independent School District to provide the meals at the various sites, NOW, THEREFORE,
THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS
SECTION 1 The City Manager is hereby authorized to execute, on behalf of the City, an
application for funding under the National School Lunch Act, and if funded, the Summer Food
Service Program Agreement with the Texas Department of Human Services, a copy of which is
attached hereto and incorporated by reference herein, along with any other documents and
certificates necessary to obtain such funding
ACTION 2 The City Manager is hereby authorized to execute a contract with the Denton
Independent School District, substantially in the form of the contract which is attached to and made
a part of this ordinance for all purposes, to provide meals for eligible individuals at the various sites,
and such other documents and certifications as are necessary to carry out the 2001 Summer Food
Service Program, if such program is fimded per the terms set forth in Section I above, and to handle
all fiscal and administrative matters relating to the application and the program
SECTION 3 The expenditure of funds necessary to administer the 2001 Summer Food
Service Program is hereby authorized
SECTION 4 This ordinance shall become effective immediately upon its passage and
approval r~/z
PASSED AND APPROVED this the / day of 2001
EULINE BROCK, MAYOR
Z
S wur Documenbwed~ngouegAlVUmma food gav~ge doq
ATTEST
JENNIFER WALTERS, CITY SECRETARY
BY
APPROVED AS TO LEGAL FORM
HERBERT L PROUTY,C ATTORNEY
BY
PAGE 2
State of Texas
County of Denton
AGREEMENT TO FURNISH FOOD SERVICE
CITY OF DENTON
and
DENTON INDEPENDENT SCHOOL DISTRICT FOOD
SERVICES
THIS AGREEMENT is made and entered into by and between the Denton Independent School
District and the City of Denton both of whom are local governmental entities authorized to enter
into mterlocal agreements under Chapter 791 of the Texas Government Code (Vernon 1994)
Whereas, the interlocal agreement contemplates the performance of function or services that
each party to this contract is authorized to perform individually
Whereas, that the City of Denton is making payment under this agreement which It is funding
from payments from current revenue, whereas, the payments provided by the City of Denton are
in an amount that fairly compensates the Denton Independent School District for the services that
it is performing
Witnesseth
I Provision of Meals
Denton Independent School Distnct agrees to supply unitized meals inclusive of milk and juice
to the City of Denton Parks and Recreation Department, at the MLK Recreation Center, Phoenix
Park, Denis, Park, Civic Center, Owsley Neighborhood, North Lakes Recreation Center, TWU
Playhouse Program, Village East Apartments, Fred Moore Learning Center, Rivera Elementary
School , Houston Elementary School and one additional elementary site to be determined by
Denton Independent School District
Breakfast $ 0 00 each Lunches $ 1 80 each
Snacks $ 0 00 each Supper $ 0 00 each
II Menu Records
it is further agreed that the Denton Independent School District pursuant to the provisions of the
Summer Food Service Program Regulations, a copy of which is attached as Exhibit "A" and is
part of this agreement, will assume that said meals meet the minimum requirements as to
nutritive value and content as outlined in the U S D A's sponsor Meal Preparation Handbook,
and will maintain full and accurate recordings of such, including the following
1 Menu Records, including amount of food prepared
2 Meals, including daily number of meals delivered by type
III Retention of Records
These records must be reported to the institution promptly at the end of each week Denton
Independent School District agrees also to retain records required under the preceding clause for
a period of three years and 90 days after the end of the contract period If audits, claims or
litigation have not been resolved, all records must retain beyond the required time period until all
issues are resolved in accordance with the Summer Food Service Program Agreement between
The City of Denton and The Texas Department of Human Services
IV Compliance With Immigration Laws
The Denton Independent School District agrees to comply with the requirements of the
Immigration Reform Control Act of 1986 regarding employment venfication and retention of
verification forms for any individuals hired after November 6, 1986 who will perform labor or
services under this contract
V Audit
The Deliton Independent School District agrees to allow for purposes of audit, examination,
excerpt, and transcription the USDA, the Comptroller of the United States, D S and any of
their authorized representatives to have access to any of the contractor's books, documents,
papers, and records that are pertinent to the contract
VI Energy Efficiency
The Denton Independent School District agrees to comply with the required mandatory
standards and policies concerning energy efficiency contained in the Texas Energy Conservation
Plan issued in compliance with the Energy Policy and Conservation Act (P L 94-163)
VII Remedies For Breach of Contract
The Denton Independent School District agrees that except for small purchase contracts, it will
comply with and enforce provisions that allow for administrative, contractual, or legal remedies
if contractors violate or breach contract terms, and any appropriate sanctions and penalties
VIII Comphance With Labor Regulations
The Denton Independent School District agrees to be in compliance with Section 103 of the
contract Work Hours and Safety Standards Act (40 USC 327-330) as supplemented by the
Department of Labor regulations (29 CFR, Part 5) Under this Act, contractors must compute the
wages of mechanics and laborers on the basis of standard workday of eight hours and a standard
workweek of 40 hours Work that exceeds the standards must be compensated at least 1'h times
the basic pay rate for overtime hours worked These requirements do not apply to the purchase
of supplies or materials ordinarily available on the open market or contracts for transportation
IX Equal Employment Opportunity
The Denton Independent School District agrees to comply with Executive Order 11246 entitled
"Equal Employment Opportunity" as amended by Executive Order 11375 and as supplemented
in Department of Labor regulations (41CFR, Part 60)
X Compliance With Laws
The Denton Independent School District agrees to comply with all other applicable laws,
including without limitation, any additional applicable Federal Laws or regulations contained in
the Summer Food Program Agreement between the City of Denton and the Texas Department of
Human Services
XI Remedy For Breach
If the Denton Independent School District falls to provide services in accordance with the
provisions of this contract, the City of Denton may, upon written notice of default to the
contractor, immediately terminate the whole or part of this contract
XII Consideration
The City of Denton agrees to pay Denton Independent School District for all meals ordered on
daily basis at the rate agreed upon in this contract
XIII Term
The agreement shall be effective as of May 29, 2001 and shall have the same term as the
Summer Food Program Agreement between the City of Denton and the Texas Department of
Human Services It may be terminated by notice in writing given by any party hereto to the
other parties at least 30 days prior to the date of termination
XIV Venue
This agreement shall be interpreted in accordance with the laws of the State of Texas Any
litigation filed with regard to this contract shall be tried in a court of competent jurisdiction
setting in Denton County, Texas
IN WITNESS WHEREOF, the parties hereto have executed this agreement as of the dates
indicted below
1-0 Agreed to this date 3 13-0
Agreed to this date
Sponsor Official M-fl School Sponsor
CITY OF DENTON DISD
Title interim city manager Title School Board President
The location of the food preparation site will be
Rivera Elementary School
701 Newton
Denton, Texas 76205
APPROVED A TO LEG Utuvi
HERBERT gROUTY I Y ATTORNEY
BY
TEXAS DEPARTMENT OF HUMAN SERVICES
SPECIAL NUTRITION PROGRAMS
AGREEMENT
STATE OF TEXAS
COUNTY OF TRAVIS §
The Texas Department of Human Services, hereinafter referred to as TDHS,
AND
City of Denton, Texas, A Texas Municipal Corporation
at 215 E. McKinney, Denton, Texas 76201
hereinafter referred to as the Contractor, do hereby make and enter into this contract, as required by the National School Lunch
Act and the Child Nutrition Act, as anieaded , and the following program-mWations the National School Lunch Program (NSLP),
7 Code of Federal Regulations (CFR) Part 210, the Special Milk Program (SW), 7 CFR Part 215, the School Breakfast Program
(SBP), 7 7 ~ CFR Put 2Part 202the Summer Food Service Program (SFSPJ 7 CFR Part 225, and the Child and Adult Care Food Program
This one or agreement of the aerehnameedd program ass stipulated herem. By s gnmg this agreement, both p pa arUes acre bound by its stemmas
in
and conditions from it beginning effective date until terminated in accordance with this agreement.
I.
MUTUAL AGREEMENTS
The Parties mutually agree
A if the Contractor fads to provide services in accordance with the provisions of this contract, TDHS may, upon written notice
of defnuh to the Contractor, immediately terminate the whole or any part of this contract, including refusal to pay claims for
rwmbmsement, and such termination shall not be an exclusive remedy but shall be in addition to any other right and remedies
provided by law or under this contrecK.
B If federal or state laws or other regnrement are amended or judicially interpreted so that the contm»ed fulfillment of this
contract, on the part of other party, u substantially unreasonable or impossible, or if the parties are unable to agree upon any
amendment which would therefore be needed to enable the substantial continuation of the services contemplated by this
contract then, the parties shall be discharged from any further obligations created under the terms of this contract, except for
the equitable settlement of the respective accrued interest or obligations, including audit findings, incurred up to the date of
termination.
C This contract may be caihoeled by mutual coherent However, if such mutual consent cannot be attained, then and in that writing to the other
either party to this r - ' may d to be cameled without cause arty and this contract shall thereupon be canceled upon the expiration of such dirty (30 danotice y penod. naNothing in this
p
paragraph shall be construed to prohibit immediate cancellation pursuant to above paragraphs A and/or B
IL
CONTRACTOR PROGRAM ADMIIVISTRATION AND FINANCIAL MANAGEMENT
A The Contractor wi71 comply with the applicable regulations for its designated program, as well as 7 CFR Parts 245 and 250,
as amended, the Uniform Federal Assistance Regulation (7 CFR, Part 3015, as amended), Audits of State, Local
Governments, and Non-Profit Organizations (7 CPR 3052, as amended)and state policies and procedures as issued and
amended by TDHS The Contractor finther agrees to perform as described in it application (mcludng its Policy statement
and supporting document, and approved amendment to the application) for participation in the designated program.
11
CONTRACTOR PROGRAM ADMINISTRATION AND FINANCIAL MANAGEMENT
B The Contractor accepts final admrmstrative and financial responsibility for food service operations in each school, operated or sponsored summer feed site, and c child ~ ~ ant care facility, eor payment aym referred
ent deficiency isite n the program cov veered by this the
Contractor The onslty any audit exceptions TDHS or USDA and will be
contract, and all subcontracts haeunda, which are found after monitoring or auditing by
responsible for the collections and payback of any amount paid in excess of the proper claim amount. the authority for the
C The Contractorl submits; for TDHS administration of food service operations to the Contractor lorawhich have executed subagreem~ with the Contractor for
the admrmstradon of food services operations
D Contractors participating in the NSLP agree
1 that the offictal signing the Claim for Reimbursement will be responsible for reviewing and aralyang meal
counts to ensure accuracy and compliance with federal regulations regulations, and
2 to enter into an agreement to receive donated foods as required by federal
3 to price lunch as a unit
E Contractors participating in the CACFP provide or accept responsibility for the provision of organized, non-residential
child day care and will immediately report to The Texas Department of Protective and Regulatory emas (TDPRS)
Licensing or Child Protective Services staff, any suspected vtolati ms of TDPRS Licensing standards or suspected abuse
of children in sponsored centers or day homes
III.
RECORD KEEPING
A The Contractor will keel financial and suQporang documents, statistical records, and any other records Perimeat to the
services for which a claret was submitted in the manner and detail prescribed by TDHS The records and documents will for
evant be kept for a mmunum of 3 years and 90 days after the termination federal of the such e ical the Contactor wID lixp~
any litigation, claim, or audit involving these records begins
records and documents for not less than 3 years and 90 days and until all litigation, chinos or audit findings am a written
agreement is
into The case is -chat resolved whim there is s order issued ds of nonce er-expendable property acquired under the
between TDI S and the Contractor The Contraactor ctor will keep p
wntract for 3 years and 90 days aft final disposition of the property
B The Contractor and its subcontractors will allow TDHS and USDA officials and other appropriate officials determined by
TDHS to inspoet facilities and records and to audit, examine, and copy records at any reasonable me This includes
access to all records of costa paid, even in part, by TDHS
IV.
C M RIGHTS POLICY COMPLIANCE
A The Contractor agrees to comply with Title VI of the Civil Rights Act of 1964 (Publics of Jasax and Call F Prirr mea42ts
imposed by the reoubuons of the Department of Agriculture (7 CFR Part 15) Dep
and 50) and FNS dtectrves or re$ulatioas issued ptssuant to that act and the regulations Section 504 of the
Rehabilltaaon Ad of 1973 (Public Law 93-112), the Amencars with Disabilities Act o~990 0( fublrc T~~1bc 9~4-1975 Title IX of the Education Amendments of 1972 (7 CFR Part 15a), the Age Disaim natito these acts
135), and all amendments to each, and all reVirements unposed by the regulations issued pursuant
addition the contractor agrees to comply with Title 40, Chapter 73, of the Texas Administrative Code These provide m
part that no person in the United States shall, on the ground of race, color, national ongin, sex, ago, dusabty, hacal
by federal
beliefs. or religion be excluded from participation in, or denied any aid, care, savmoe or other opts p ov~
and/or state fimdmg, or otherwise be subjected discrimination. ty gcontractor mor °~AIDS and with
Safety Code Section 85 113 (relating to workp
The contractor hereby gives assurance that it will immediately take any measures necessary to effectuate this agreenrent
IV
CIVIL RIGHTS POLICY COMPLIANCE
(Continued)
13 This assurance is given in consideration of and for the purpose of obtaining any and all federal financial assistance, grants
and loans of federal funds, reimbursable expenditures, grant or donation of federal property and interest in property, the
detail of federal personnel, the sale and lease of, and the permission to use, federal property or interest in such property or
the furnishing of ervices without consideration or at a nominal consideration, or at a consideration which is reduced for
the purpose of assisting the recipient, or m recognition of the public interest to be served by such sale, lease or furnishing
of services to 4he recipient, or any improvements made with federal financial assistance extended to the program applicant
by the TDHS This includes any federal agreement, arrangement, or other contract which has as one of its purposes the
provision of cash assistance for the purchase of food, and cash assistance for purchase or rental of food service equipment
or any other financial assistance extended in reliance on the representation and agreements made in this assurance
C The Contractor agrees to compile data, mamtam records, and submit reports as required, to pernut effective enforcement
of the above Acts and permit authorized TDHS, USDA and FCS personnel during normal working hours to review such
records, books, sad accotmts as needed to ascertain comphaax with the above Acts If there aro any violations of this
, TDHS, USDA and FCS have the tight to seek judicial enforcement of this assurance Thu assurenx is binding
o
aN=a
oof the Contractor
D A religious or charitable organization is eligible to be a contractor on the same bases as any other private organization.
The contractor retains its mdependence from State and local governments, including the contractor's control over the
definition, development, practice, and expression of its charitable or religious behefs Except as provided by federal law,
TDHS shall not interpret this contract to require a charitable or religious organization to alter its form of internal
governance or remove religious an, icons, scripture, or other symbols Furthermore, if a religious or charitable
organization segregates the government fiords provided under the contract, then only the financial assistance provided by
these fiords well be subject to audit However, neither TDHS's selection of a charitable or faith-based contractor of
services nor the expenditure of funds under this contract as an endorsement of the contractors charitable or rehgious
character, practices, or expression. The purpose of this contract is the provision of services, no State expenditures have
as their objective the fimdmg of sectarian worship, instructions, or prosehytizabon.
of~~f the
A charitable or faith-based provider of services under this contract shall reasonably apprise all assisted individuals
following "Neither THDS's selection of a charitable or faith-based provider of services nor the expenditure
under this contract is an endorsement of the provider's charitable or religious character, practices, or expression. No
provider of services discriminate against you on the basis of religion, a religious belief, or your refusal to participate
in a rchgious practice If you object to a particular provider because of its religious character, you may request assignment
to a different provider If you believe that your rights have been violated, please discuss the complaint with your provider
or notify your local TDHS Special Nutrition Programs office 604a, sets
Swbou 104
certain of Tha Personal Responstbthty and Won charitable and far Reconciliation
providers of semces,cells t addditional
forth rth additional tights and respons
rights of assisted individuals, and certain sddttional responsibilities of TDHS to these providers and assisted individuals
This contract is subject to those additional rights and responsibilities
V
TDHS CLAIMS PAYMENT
A TDHS will, subject to the federal appropriation and availability to TDHS of sufficient fiords for the applicable program, bursemen make program payment to the Contractor in accordance i the beginning his agreement. No
date of this agreements ntt shh)alll i em cede
for performance under this agreement occurring; prior date established by TDHS based on the date of receipt of a fully executed copy of this agreement.
8 In accordance with Section 403 OSS(h) of the Government Code, the contractor agrees that any payments due to the
contractor under this contract will be first applied to any debt and/or back taxes the contractor owes the State of Texas
Payments will be so applied until such debts and back taxes are paid in full This clause does not apply if federal law
requires pa cat to be made to the contractor for goods and services provided in support of of the USDA child and
adudultn}m
alt nuts programs, and may not apply if federal law conditions the receipt of the money or these goods or services
to the state on the basis of payment being made to the contractor
VI.
IMMIGRATION
The Contractor agrees to comply with the regwrements of the lmmtfration Reform and Control Act of 1986 regarding
employment verification and retention of verification forms for any mduviduals hired after November 6, 1986, who will
perform any labor or services under this contact.
VII
CERTIFICATION
A. Rcipirdlinq Dcbwnmw , Suspension. lneltgibility, or Voluntary Exclusion For Covered Contracts - The contactor testifies,
exa mm of thus agreement, that nether it n" its principals is presently debarred, suspended, proposed for debarment,
d~erdared meligible, or voluntarily excluded kom'partreipstrngaa **oonuset by may federal department or agency or by
the State of Texas By making thus certification the contractor agrees to the following terms
1 The above certification is a material representation of fact upon which reliance was based when this contract was
entered into If it is later determined that the contractor kmowml rendered an erroneous certification, in addition to other
remedies available to the federal government, the Department (if Health and Human Services, United S~Department of
pursue available
Agriculture or other federal e agency, or the Texas Department of Human Services may
remedies, including suspension en Persoll to winch this certificabon is submitted if at y
when submitted or has become erroneous reason of immediate written notice to changed circumstanoes
2 The the contractor shall learns tthvuatttthe certification was erroneous the
time
3 The words "covered contract," "debarred," suspended," ..ineligible," "participant," "person." "prmcipal," "proposal,,,
and voluntarily excluded," as used in this certification have meanings based upon materials m the Defimbons and
Coverage sections of federal rules implementing Executive Order 12549 Usage is defined in the attachmem.
4 The contractor agrees by submitting this certification that, should the proposed covered contact be entered into, it shall
not kmowmgly enter into any subcontract with a person who is debarred, suspended, declared mchghble, or vol ntar*
excluded from participation in this covered transaction, unless authorized by the Department of Health and Human
Semis, United States Department of Agriculture or other federal department or agency, and/or the Texas Department of
Human Services, as applicable
5 The contractor fitrther agrees by submitting this certficaton that it will include TDHS Form 2046 tided "C rthficauon
Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion for Covered Contracts" without nmodificauon, in
all covered subcontracts and in all solicitation for all covered subcontracts
6 A contractor may rely upon a certification of a subcontractor that it is not debarred, suspended, mehgible, or
voluntarily excluded from the covered contract, unless it mows that the certificatm is erroneous A contactor must, at a
nu mum, obtain certificates from its covered subcontractor upon each suboontiactr's initiation and upon each renewal
7 Nothing contained in all the foregoing shall be construed to require establishment of a system of records in order to
render in good froth the certification required by this certification document. The kmowlalge and information of a
contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of
business dealings
h 4 of these terms, of a contractor in a covered contract knowingly enters
8 Except for contracts authorized wrierwhoho is sp deb ineligible, or voluntarily excluded from participation
into covered subcontract with a person w a suspended, erred, Department of Health and Human
in the transaction. in addition to other remedies available to the federal government, hcable, aad/r the Texas
Department Services, of United Human States Services Department may pursue available or other remedies iinncluding suspension and/or debarment.
VII
CERTIFICATION
(Continued)
B Regarding Federal Lobbying - This certification applies only to thts contract and is a material representation of fact upon
Code Any person who fails to fie the
for making or entering into thiis transaction imposed by section 1352, tinto itle 31, U S Submission
wr certification shall be subject to a civil penalty of not less than $10,000 and not more than S 100,000 for each such
MThe contractor certifies, to the best of lus or her knowledge and belief. that
No federally 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 o any f wider, or contract,
the making of any federal grant, the mating of any federal loan, the entering into of any cooperative agreeme, the
extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative
agreement.
If any funds other than federally 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 ntran officer or ac subcontract, employee of Co gress
or an employee of a member of Congress in connection with this federally fund
cooperative Agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions
The contractor shall require that the language of this certification be included in the award documents for all cover ed
subawards at all hers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements)
and that all covered subrecipients shall certify and disclose accordingly
delinquent in its francluse
of franchise tares
otherwise nott that
C ttaaxpayments to the ttateof Texas, or is pa non-profit corporation for-profit
to the State of Texas
D unThe contractor certifies that all information derstands that the deliberate misrepresentation oor~withpursuant to this holding of information i a violation of this contract and mray correct. The result in prosecution under applicable state and federal statutes
E Under Section 231006, Family Code, the vendor or applicant certifies that the individual or business entity named in this
contract, bid, or application is not ineligible to receive the specified grant, loan, or payment and acknowledges that this
contract may be terminated and payment may be withheld if this certification is inaccurate
VIII
EFFECTIVE DATE AND SIGNATURES
The parties hereto in their capacities stated, affix their signatures and bind themselves for the futhful performance of the
terms of this contract pursuant to participation in the following program or programs
National School Lunch Program
School Brealdast Program
Special Milk Program
Name of Contr tmf Orgamzanon
(Please print or type)
Child and Adult Care Food Program
RX Summer Food Service ogram
Vooffilcial f chairman of board of duectors
who has been authorized to sign
contracts on behalf of the contracting organization
Howard Martin
Name of Official tgamg
(Please print or type)
Interim Citv Manazer
Title of Official
(Please print or t)pe)
TEXAS DEPARTMENT OF HUMAN SERVICES
Effective from until wrrmnatc&
Date
TDHS Representative Approved for Form by OGC
APPROVED AS TO
CITY Al tORN
CITY OFD
EXHIBIT C, FMay 2200000
Texas Department
of Human Services
SPECIAL NUTRITION PROGRAM
CERTIFICATE OF AUTHORITY
This is to certify that the following person(s)
Howard Martin
Citv of Denton
im City Manager
321 E McKinney St. llenton rexa eac
The e ontracU gdorganizatiogn to make written agreements with the Texas Department of Hum nuServices to operate a
th
food program, to sign documents or reports about the agreement and to present claims for reimbursement, when
appropriate, to the department
By signing this document we certify individually and collectively that to the best of our knowledge and beliantef,
documents submitted physically or electronically on behalf of the above named Contracting Organization
our correct In all tirespects, that they are/will be completed according tolthe Nutrition terns and conditions Hof existing agreements
Including (exrr uding amendedlad)uad claims) for goods available to for which we have already received will not submit
claims payment We
recognize that we are fully responsible for any excess amounts which may result from errors made in relation to the
completion and submission of claims We are also aware that deliberate misrepresentation or withholding of
information may result in prosecution under applicable state and federal statutes
Howard Mart
Interim Ci
DELETED AUTHORIZED REPRESENTATIVES A contracting organization may not have more than three (3)
Authorized Representatives, including the Official of the Contracting Agency R you are replacing or deleting an
of Delete Representas) below
Authorized Representative, list the name(s) of a the In sled uapse to reu removed as Authorized
Name o elated Representadve
Michael Jez
FOR OHS USE ONLY Oate Received
Correct No Reserved By
15~
Form 4508
May 2000
Texas Department
of Human SeNIC68
SPECIAL NUTRITION PROGRAM
CERTIFICATE OF AUTHORITY
This is to certify that the following pereon(s)
Howard Martin
Is
3ZI h. The representative(s) designated above, and myself, acknowledge that each is
of Human Services to operate a
the contracting organization to make written agreements with the Texas Department
food program, to sign documents or reports about the agreement, and to present claims for reimbursement, when
appropriate, to the department
By signing this document, we certify Individually and collectively that to the best of our knowledge and belief, a
ledge
and
documents submitted physically or electronically on behalf of the above namn Programs, TDHS,sare/tion be true pursuant to
our participation In any and all programs administered by Special
correct in all respects, that they arelwill be completed according to the terms and conditions of existing agreements
claims l (excluding amendedladj sted claims) for goods available ces for which we have already received payment. We
recognize that we are fully responsible for any excess amounts which may result from errors made in relation to the
completion and submission of claims We are also aware that deliberate misrepresentation or withholding of
information may result in prosecution under applicable state and federal statutes
interim City Manager three DELETED AUTHORIZED REPRESENTATIVES A contracting organization may nnotaha rep acing or de e 9 an
Authorized Representatives, Including the O(ficlai of the Contracting Agency you
Authorized Representative, list the name(s) of the Individual(s) to be removed as Auiiiiii; 61: thorized eprRepro entas) below
ame o Deleted Repreaentadve
Name of eletad Repreaentadve
Michael Jez
fOR DHS US ONLY Date RecaNed
1 Conirad No Received By
75•
SFSP COMMODITY PROGRAM Form 4808
r_.. n.,,unmwnt May 2000
0t Human Services
SPECIAL NUTRITION PROGRAM
CERTIFICATE OF AUTHORITY
This is to certify that the following person(s) 11 Name of AuthonzIad RBpreeentst a lease type or pnnt) tle
Howard Martin
ignature-Authonzad Re resentat
ame of Authorized Representat va (please IYPe or pdnq Title
v
n
Signature-Authonzed Representative
is are deal ated as an Authorized Re resentaUve of
Nameo Contracting rgan at on
Cit of Denton
A dress( treat, V, State, I )
321 E McKinney St. Denton, Texas 76201
The representative(s) designated above, and myself, acknowledge that each is individually authorized on behalf of
the contracting organization to make written agreements with the Texas Department of Human Services to operate a
food progreml to sign documents or reports about the agreement, and to present claims for reimbursement, when
appropriate, to the department.
sy signing this document, we certify Individually and collectively that to the best of our knowledge and belief, all
documents submitted physically or electronically on behalf of the above named Contracting Organization pursuant to
our participation in any and all programs administered by Special Nutrition Programs, TDHS, arelvvtil be true and
correct 'In all respects, that they arelwill be completed according to the terms and conditions of existing agreements
Including amendments, that records arelwill be available to support any and all claims, and that we will not submit
claims (excluding amended/adjusted claims) for goods or services for which we have already received payment We
recognize that we are fully responsible for any excess amounts which may result from errors made In relation to the
completion and submission of claims We am also Swam that Information may result In prosecution under applicable state and federal statutes isrepresentstion or withholding of
Name c Oftid I o ontred ng Agency (p ease type or pnnq Itle
Howard Martin Cit Mana er
ignatu Intel of on ading envy
DELETED AUTHORIZED REPRESENTATIVES A contracting organization may not have more than three (3)
Authorized Representatives, Including the Official of the Contracting Agency If you are replacing or deleting an
Authorized Representative, list the name(s) of the Individual(s) to be removed as Authorized Representative(s) below
Nameo Delete Representat/ve ame o Delafed Representative Name of Deleted Representative
Michael e7z
FOR DNS USE 01 LY Received By Data Recervad
Contract No
75-
SFSP COMMODITY PROGRAM Form 4508
May 2000
16x86 .epiiiii
of Human Sarvioea
SPECIAL NUTRITION PROGRAM
CERTIFICATE OF AUTHORITY
This is to certify that the following person(s)
Name of AuthoriRed Representative (please type or p nq Title
Howard Martin Interim city Manager
ignsture- uthornzed presentative
ame of Authorised Represenlelrve (please type or pdnp isle
X Signature-Authorsed Representative
Is are deal ated as an Authorized Re resentative of
Name o contract ng roan at on
City of Denton
A dress( treat, City, late, P)
321 E McKinney St Denton, Texas 76201
designated above, and myself, acknowledge that each Is individually authorized on behalf of
The the contracting representative(s) organization to make written agreements with the Texas Department la Human n Services to operate n
food program, to sign documents or reports about the agreement, and to present claims for reimbursement when
appropriate, to the department.
By signing this document, we certify individually and collectively that to the best of our knowledge and belief, all
documents submitted physically or electronically on behalf of the above named Contracting Organization pursuant to
our participation in any and all programs administered by Special Nutrition Programs, TDHS, arelwill be true and
correct in all respects, that they arelvvi(I be completed according to the terms and conditions of existing agreements
Including amendments, that records aretwill be available to support any and all claims, and that we will not submit
claims (excluding amendedlladjusted claims) for goods or services for which we have already received payment. We
recognize that we are fully responsible for any excess amounts which may result from errors made in relation to the
under applicable state and federal Serrate s misrepresentation or withholding of
compilation
etlon may resultissIn prosecution sion of claims
Name o O i al of ontrecting gancy (pease type or pnno Is
Howard Martin Interim City Manager
Sign lure-0 al of ntr ding Ag ncy
''DELETED AUTHORIZED REPRESENTATIVES A contracting organization may not have more than three (3)
Authorized Representatives, Including the Official of the Contracting Agency If you are replacing or deleting an
Authorized Representative, list the name(s) of the Individual(s) to be removed as Authorized Representative(s) below
Name of Deleted epresentattve
ame o Delete Representative Name of Deleted Representative
Michael Jez
FOR DHS USE ONLY Received By F7 =
Contract No
75-