HomeMy WebLinkAbout21-Park and Rec
CITY OF SAN BERNOIDINO -
REQUEST ~ COUNCIL ACTION
From: Ann1e F. Ramos, Director
Dept: Parks, Recreation & Community Services
Date: June 19, 1991
Subject: ADOPT A RESOlUTON APPROVING AN AGREEMENT
WITH THE CALIFORNIA STATE DEPARTMENT OF
EDUCATION, FOOD DISTRIBUTION SECTION FOR
COMMODITIES FOR THE SUMMER FOOD SERVICE
PROGRAM FOR CHILDREN - JULY 1, 1991 -
AUGUST 30, 1991.
Synopsis of Previous Council ection:
Council adopted a similar resolution on June 4, 1990.
Recommended motion:
Adopt the resolution.
~ ,.~~
Contact person:
John A. Kramer
Phone: 5031
Supporting deta attached: Staff REoort. Reso 1 ut i on & Aareement Ward: N/ A
FUNDING REQUIREMENTS:
Amount: Nn r.ity Fllnd~ Invnlved.
Source: (Acct. No.!
(Acct. Descriotionl
Finence:
Council Notas:
"7"'_n~t;,?
.6nAn,.ha Itom Mn .J ,
CiTY' OF SAN BERNIQDINO - REQUEST FO COUNCIL ACTION
ADOPT A RESOLUTION APPROVING STAFF REPORT
AN AGREEMENT WITH THE CALIFORNIA
STATE DEPARTMENT OF EDUCATION,
FOOD DISTRIBUTION SECTION FOR
COMMODITIES FOR THE SUMMER FOOD
SERVICE PROGRAM FOR CHILDREN -
JULY 1, 1991 - AUGUST 3D, 1991.
The California Department of Education, Food Distribution
Section administers USDA donated commodities for the Summer
Food Service proqram for Children. Donated commodities are
utilized by the sponsor's vendor for food preparation.
This department's vendor for food preparation is the San
Bernardino City Unified School District. The commodities
will be distributed to the School District for their use in
preparinq the meals for the Summer Lunch Proqram.
6/19/91
75.0264
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
o 0
1 RESOLUTION NO.
RESOLUTION OF THE CITY OF SAN BERNARDINO
AUTHORIZING THE EXECUTION OF AN AGREEMENT WITH THE
CALIFORNIA STATE DEPARTMENT OF EDUCATION, FOOD
DISTRIBUTION SECTION FOR COMMODITIES DONATED BY THE
AGRICULTURE MARKETING SERVICE FOR USE WITH THE CITY'S
SUMMER FOOD SERVICE PROGRAM FOR CHILDREN DURING THE
PERIOD JULY 1, 1991 THROUGH AUGUST 30, 1991.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF
THE CITY OF SAN BERNARDINO AS FOLLOWS:
SECTION 1.
The Mayor of the City of San
Bernardino is hereby authorized and directed to execute
on behalf of said City an agreement with California
State Department of Education, Food Distribution Section
for Commodities donated by the Agriculture Marketing
Service for use with the Summer Food Service Program for
Children during the period July 1, 1991 through August
30, 1991 a copy of which is attached hereto, marked
Exhibit "A" and incorporated herein by reference as
fully as though set forth at length.
SECTION 2.
The authorization granted hereunder
shall expire and be void and of no further effect if the
agreement is not executed by both parties and returned
to the Office of the City Clerk within 60 days following
effective date of the resolution.
I HEREBY CERTIFY that the foregoing resolution
was duly adopted by the Mayor and Common Council of the
City of San Bernardino at a
meeting
thereof, held on the
day of
1991, by the following vote, to wit:
6/19/91
-1-
o
o
1
2
RESOLUTION RE: COMMODITIES DONATED FOR USE BY THE
SUMMER FOOD SERVICE PROGRAM JULY 1, 1991 THROUGH AUGUST
30, 1991.
3 COUNCIL MEMBERS:
4 ESTRADA
5 REILLY
6 HERNANDEZ
7 MAUDSLEY
8 MINOR
9 POPE-LUDLAM
10 MILLER
11
12
13
14
15
AYES
NAYS
ABSTAIN
city Clerk
The foregoing resolution is hereby approved this
day of
, 1991.
16
17
18
19
20
21
22
23
24
25
26
27
28
w. R. Holcomb, Mayor
city of San Bernardino
Approved as to form
and legal content:
James F. Penman
city Attorney
6/19/91
-2-
~
06/12/91 15:20
--."---0
o
(I CAI.'I'ORNIA STATe' DEPARTMENT OF SDUCATION
. 721 Capitol Mill; P.O. Bolt 944272
- SacramenlO. CA 94?44-2720 -
April 26, 1991
..
TO:
All Sponsors Partlclpatlns In The
Summer Food ScIWlc Prosnun for Chllclren
S. M. Delano, Ada!lnlltrator ~ rn I ~
Food Distribution SectIon p'
USDA DONATED FOOD OPPBlUNG FOR nm
SUMMBR FOOD SERVICE PROGRAM FOR CHILDREN
PROM:
SUBJECT:
002
The Food DJsm1lutlon Soctlon bas beoII advIIcd by tIIo UDlted States Depar_tof Apt\l1llturo (USDA) that
)Our agency is a potential sponsor for tIIo Summer Food Se:rvlc:e Propm for CbllclfDll (SPSPC).
The atllld1ed SPSPC offeriD& paclcaJClIs being tbrwardcd to ,vu to c:qodIUl )Our order In adV8llCG of USDA
applOYll of)Our appUClUOn. NOUllbatlllo asr-at &lid food oUcrIng ftnmI aboaId be IllOmploted. alaned,
IlId returned by the aponsoring agency even thougb the food Is prepan:d by apother eligible recipient apC)'.
Tbe offeriDS pllckap include&:
1. AGREEMJ!NT FOR DISTlUBUTlON OP DONA11!D FOOD .
both aJpIca of thIa fonn (ao <<*rbollreqUIred) ahou1d bo retW'lIcd
to the addJas at the top of tho form. PIcaso laIC l1JlftrI=
or press firmly with pen to complCUl thIa form.
2. CBRTIfJCAll0N OF NONPARllCJPATlON IN THB SUMMBk
CAMP J>ROORAM FORM . compIctcJ..... rotlUll thIa furm to tho address
or lbe: J)1~lrlbUlkm CaIIter shown It the top of the ~tIon form.
3. FOOD OPPBIUNO FORM - aJmploUl apd aeud 10 tho address
oC \he DlsuibulIon OOlllel' a, ,he lOp ot tho tonn.
4. INSTRUcnONS:
.~
How to Older CollllllOdllles
S1IIpplnllnfonnatlon
l!IldIn& IltveDlOty Repon and RetllJ'D of Unuacd Commodities
:>. BNDING INVBNTORY RBPOR.T FOR SUMMBR FOOD
SERVICE PROGRAM. aJlDplele within 5 days oC the close of the prosram and
_d- to-lI4d-._ da&-top-of. da&.!mm,
lOITer I
.
06/12/91 <<::)5:24
o
008
.
Plge 2
Summer Food ~ Program Sponsors
April 26, 1991
WhOll tho PQQd Distribution Section ~ uotlflcatloll from USDA tbat your application Iw been approved
and his your CXllUplctcd . AgroemeIIt (or Distribution of DoDated Pood" 0lI. 0l6, the Distribution Center wIl1
be notified. The Dl5Utbutlou CCIlter wI1I then prepare and ship your oommodItlea In accordance with the
iIlstnlCtiolll you iJldlc:ate on tho food offering.
If wu plan to niek "0 vour commodities at the Distribution l"..f!nter. three-davs notfoo mUlt be ,Wen. There
will be nO nJckqp of cmnmodttles on . drot).o.ln bills.
Note tbe (oUowiJI, regulations reprdiDg me reccslpl of dOPlltcd COIIIIIllIdItleI:
1. Scbools C8D recelvll mmmocutle$, and one Kbool SID. prepare Illeals for
nother scbooL
2. A private nonprofit sponsor II eligible to reocIve commodities provided the
sponsor his n lm:Ii!A eooldng program or contracts witb a Kbool or school
d1sulc:t to prepare III meals.
3. t!sI. sponsor Is eI1&Ible to receive CIOIl&tcd llOIIUDOd\t1ea If the sponsor intends
to mutraet with a private vendor or lXlmpany to !me Its meals prepared.
If you should have any questions, please mutaet Myrl Pardee, Program Management Unit, al (916) 323.7192.
SMD:SR:cw
attadlmenll
DSPSPC
OFD/C-F-032
i
- 2 -
-
'.
06/12/91 c::>15:21
o
003
CaUComla Department of Education
CbDd Nuutdon and Food DIstribution Division
Pomona Distribution Center
2SSO FullOD Road
Pomona, CA 91767.2176
CERTIFICATION OF NONPARTlCIPATlON
IN TIm SUMMER CAMP PROGRAM
TIilS CERTIF1CATION FORM MUST BE COMPLETBD AND RETURNED WITH
YOUR SUMMER I"OOD SERVICE PROGRAM I"OR CHILDREN OFFERING.
ORD8RS WILL NOT BE FILLED wrmOUT nus CERTIFICATION.
CERTIFICATION OF COMPLIANCE
1 am aware that my organization Is prohlblted from panldpatlng In both the Summer Food Service Program
for Chlldren (SFSPC) and the: Summer Camp Program al the same time.
Tills is to eenlIY that City of.s;.n R%n"~ri;nn
(KecljlIIIll caO)'
In the 1991 Summer Camp Program.
will not panic:ipate as a sponAnr
Nom. al Au'_ RcprcoelI....... (prial or 'I'1\lC) llde
Director of Parks, Rec.
Annie F. Ramos R. ;+v ,,,rv;,.,,.
Sl'..'.... Veadar NumW
07-06-63127-00-9
Date Tdepbanc
714/384-5233
- .. -
l.
1216/12/91
65:21
o
1211214
CalIfornia Department of Bducation
QIld Nutrition and Food Distribution Dlvlslon
Pomollll DIstribution Center
2SSO PaltoD Road
PODOIIlI, CA 511767-2176
(714) 5~7777
HOW TO ORDRR COMMODITIR'l
The quantity of fooa you wlU be eligible for wlU be bued on the number of approvod meals &eIVed dUMg the
&UIllIIl\:l' of 1m. as reported by USDA. If you cIld DOt participate In tbe 1990 Summer Pood Service Pro....m
tor CIluorcn, you 5110uld c:alClllate the amount uC wmmuoliLic.s roq.ucsted as lDstnlClccl balow.
PIClI5C make sure that you have completed the foUowIng Ilems on the atl8Cbed offering form before returning
your order:
A. A'YWlIgc number of cbf1dren taking meals dally.
B. Are one, two, three or four meablalUlc:b scnecI each day?
C. Number of clays Summ\:l' pooa ScMIlO Program for QIldrcn will opC:r&tC.
D. Opc:niDg date oC Summer Program.
The commOOlty raaor on tbo anached offering incllaltcs the rate of dJstribullon for your lotal meals for your
enllre Summer Prolfllm. For OXDmple, B cae of bolter prIIIu Is aUowed Cor each /1:10 meals.
To delermlne the llIlIount of a commocllty your Summer Program Is eUglblo to recclve, muhlnl.. Iho oYOJ1lg.
number of cbf14rcn taking tucals dally (Item A a~) by the Dumbc:r of meals &ef\'cd dally (ItemS above)
by tho nUJQbc:r of da)'S your Summer Prognun will operate (Item C above) and di\'ide by Ihe oommodlty lactor
indicated OD the Offering fonn (Column 1). Enter this Jlgure foc your Summer Program In Column 2 on the
olrerlng form. A Summc:r Pro....m ba\'inS 350 children taIdDg tbrcc meals daUy for tbirty days would be
eligible for 126 cases of butter prints (3SO x 3 x 30 .. 31,500 dMde4 by 650 .. 48). Fractions of ono-half (112)
Or mure JOllY be .....ried Oul 10 the DCoIt whole Dumber. A Summer Prol!l'8m feedlno fewer meals then
Indicated bv the fimJfe in the commodity f~or mlumn maY nnt~r R mmmum of one ease ot the comlD.usIJ1!a
It Is nOlncccssary to order the tllUimum antO\lDL Order only wIlat can be ",''''' without wasle during your
Summer Program poriocI (Column 3).
NOm: ALL COMMODrrms LEFI' AT 1HE END OP nIB SUMMBR
PROORAM ARE TO BE RBTURNED TO OUR DlSTRIBUTlON
CBNlER, OR TRANSFERRED TO AN01HBR BLlOmLE AGENCY
AT YOUR EXPENSR wmIIN l'U'll2oN DAYS J\FI'BR TIm CLOSE
OFYOUR PROGRAM. CAU... (916) 324-!1882 TO OBTAIN ASSISTANCE
IN TRANSFERRING ANY USDA COMMOD1TIBS.
-4-
06/12/91
d5:25
o
009
~HIf.llNG lNFO.B.MATION
We are requesting that you inform us of the opening date of your Summer Food Service Program
for awdren in order that commodities may be sbtppcd at the proper time. Deliveries will not hr.
1llllde c:arlicr than three weeks before the openins date.
The Distribution Center will deliver commodities only to the city in which the administrative
headyuaners for the DTOlJTllm ore located. In designating the shippiJlg address, consideration should
be gtvCn to the personnel facilities Which can be made available for accepting delivery of
commodities and arrangement for adequate storage including refrigeration and freezer space. BE
SURE TO HA VB ~MEONa A VAn..ABLB TO ACCEPT DELIVERY.
Hyou prefer, YOU MAY PICK 'Qr.your order. The recommended time for pickup of your food
order at the Distribution Center is Monday through Prillay, between 7:30 a.m. and 2:00 p.m.
Frozen storage hours arc 7:30 a.m. to 11:00 a.m. and 12 noon to 2:30 p.m. Please call
(714) 596-7777 for an appointment. Commodities are stored at various sites so it is highly
recommended that you pick up the food order as early as possible to allow for driving time between
sites. If you plan to pick up yuur ordct, please indicote this information on the offering form
in the space pi'ovidcd for shipping address.
~ING INVENTORY REPO~T AND RETURN OF UNUSED COMMODl'MES
EQIJ.OWING TIfE CLOSE OF YOUR ~ FOOD PROGRAM 5>R CHII..PREN
An Ending Inventory Repon must be forwarded to the Distn"bution Center, whose address is shown
at the top of the fonn, within five d~ after the close of your Summer Program. All commodities
left must be returned to the Distribution Center, or transferred to another eligible agency, at vour
exoense. within fifteen days following close of your Summer Program.
Care should he taken for pJOper handling of commodities. You must provide proper storage,
including freezer storage if necessary, for the food dpring its return to the Distribution Center.
.
Please be sure that all personnel involved with the storage and handling of donated commodities
are aware of these requirements. Any food losses that are caused by improper handling on your
part will have to be paid for at full (air market value.
-~-
\:oJu- ....;..'......
o
II ..." Cl)l
" -
"r ...
c=:s II - t
, ,
! Utili
... " 1
i I ~i
~n_1
H .\:1
H .
B I
= i
B '
II I,
1I
"
U
"
"
~
"
"
1I
"
"
"
"
U
tl
tl
tl
tl
tl
"
"
H
tl
U
tl
"
"
il I I
II _____1
11-"'1 .....
II':::! EI c ~I
i!~ r'., I
n..... -I ~
1I ,... I
=w I ~ t
H~ . 0 I:
ill . ~
n;::; I" t
H~ I g i
II . c.. I
II . I
tl I" ,
tl I
H '~I
1--1" I
Dc.. ~!~ g. I
_e: I '
"::J .
!1m t I
n , ,
" , ,
..- I I
ij:" i I'
u_ ,
~ I :
, ,
1- I I
nil
P ! i
II , I
" I '
" ,
" I
1I I I
U ' ,
.. 1 I
II t :
II , I
.. I ,
al I ::
=\ 10 n n
Jg I- n
2.1 I I"" I If
~~f~i~~ r-~-I---~
." !I"i i- I: i ~ 11 l:j I III'
....\...-... I'"
c: I.. o. rn I II
1r r:~i lllil ;. ~ I U
~'5C 2111.1 j;g I 9
Ii.... I'" Ir I I~ u
I,l! ~.i.3: I~, p II
"I~ I....... I IV'll R "
i 't!i 1:& ? f, 1\:" I ~ II
1 g.~!! :01" "
I _I:.. N I'" "
~,:-.... :z t B.. ::
,......... 'I "
I In tfJ ... II II I. ;: i1
I ~8 0 l.l "'- 1 I ~ "
I o<'lf l.!t I I~. Ch Ii
rt ~ I I - tt
I If~!. n =, ' ! r: !i
. 11 i ~ ~I I i L,'
t, II ....!I I f iI
= .. .,. s 1"1 t I II
oS-I rt I' 1'1'
_'""1.0 I . 1
---01' ,
""1i~." " II
r .... 0 ~ Ifl I~ I 1'1
. ft .....'=i -I ...... I .,
n _ "".- a I......... I U
l--- " If
== ;:r--:--i-.-n
_ _ "".a I I I I II
II D to: I , I I "
_ ... --I 1 '"I" II
::......s:z 1'1"'10 "
_ ..::t "'-I ~ w 1- II
.,. _ Ii ~ ....1 I~.- II
50 it if!l IS: ;;15 .n
- .. i s: I , I" ,- II
-I. M ~I I , t I:
r~i1;Sl ILL n
; .. tL fi II-r-.\ - 1 Ii
n ..~~o I c:: t II
_ .. B .... 1-:1 I II
i:is'a.i i~ a;g'ls a
o _tf_1 1 1~I,j' II
,,:1- ~I I -.- 1m"
iB I 'S INlI;;: ii
~: l!'il1, !n a. '~I~ h
n ... K t'" I . II
z.. i i I: ;;11 -r-r~ II! H
1'"..... -;:" : I :1'
I: 5._" :" I I 10 In - I
ire.;;; I 10 l.s2.~11
. ~ ::1"" I 1- -'S 5 II
o;":;!.... I I ~;-ls...'I'1
~ ..,.., I. II
n III I I ~ I
i51-.. I In I ,.!
::;-If g &. L_I'" _L_LL !1
.. ""'- c:I --------"
~ e M -, . I ' II
~ ~ _ en t' ,n
::!l-g~ I' I "'0 1 glll
~~i!' Iw l!!ll'!-ll'
- is. ... I I..... S llii:g ,
;; II! s. g- I.... - "Iif is" n
00C is. - f I" G If
- ..", I L I II
""If"t-8 I- I- It
II ~~ ~ i -I -r-b:re III
iiC ~ I II~" li:li
I ~ le_I__"
I" ID _ _ ft II
, 10 I-"~. "
t 10 t... at U
It' t"'J:t It
I 1 I Z'D.t1
I I 1 I :1
o
(I) \II-\1I;Q no
~.,...,..m,,"",,""'"
z..........n-c
-<0
",zz)> C/'
mooZO
~;Q7IJo-nU'
Z-I-I ...,
~xxn(.n"'-
:;J> O)>N
OU)(I),.S.z......
.............3:
;.zmm 0:0
~O:;J>:;J>lnmo
~ :;g;g m:;g
t. ,..J>:;J>Z<D
'n <J>
;,.x:x;....:;o
;.~~)>>no
~N -< -< m ...
rso","' en Z
'.0 0
f ~
~~.
Iii'
-
-
'"
()l
~
t ~ II K!1 ~I ~ n, ~
I '10:> ";-1--.0 :::1'" I U I:
en'" ;...... ,,5-.....i _tW "If'
1 ..~u-il......JlI::Ja.r:
I Ii B'- ...;'1 ~I'~ r B I
I Iii' 1'''' 8:1 ..., - II a
I =l'i~ H~'II~~ p~
,Il"i:fi~ "lit I~:~~
I~ ~k \1'" ~!I~
j.... ij:il I~ II!
2~ l~ JIe' I f< J~
o)C 10 11. II J~ u_
~co I ih ~ E:'
!j!" I .iC.! '-.9i:
!<:' r-a; i~' I ro. a ~
la ; C.ft~r I Iv, L,,~
-t~I.'"ttl tn
~: I ~.I~ ' ;;r liS
!Ii ~ ! !.:" L I" IS I U
~= I ft~lN 1 r III
co I :r......I'~ I Ie 'II'" '''''''
!~ i f~ F .-.".. I!
;j!i I ....-ii I ~. ii!~ g
Q -I" I t= .1 I If ''''' "'-
c;; 1_ C. II I U ~ - n
!!!;cn....j' v/n I H"~ III ~!.
_ I 'l'::. HI,. I... .. .
: s I i g In NI ~ ~! 12 fa i
"'_~ I Hit ~ :Zi"~ I _'Ut AI
_ , I Ii.:::~ ~;~~
:! l!...-~ 'nil JR' ~i Iii ~~~~ii
e~ I ~I ~. ~,,! I~ ~~~i~i
g: I f;'~ ,IS IS "'~li'ii
~. I glii'U I 'If Ii .. !ire.
!e I:;: ~H I I.. 1= oS
-<_1"11 U8: 3:
:;l:1 ill I "n"al'" i
Ui _ I · U I :' .2
-4' II I t_
~CI) I I. I 11.r-
!i i fl I ~ I~
....;.... I II I I I,
~' ti~ I II
I 1-:; i'-~-~~~ I
~ ~ I~ f. t ' ~rJ ~
r ; ~ ii
l.o~f ~ ~
l.D ,P "
,- 1: t' u
I .. II I n
I ;; I U
a 'U
I II' I II
t u I II
I 1'1 I U
I I ."
I n I II
I
I: =:
1 tot 50
'.... ;:a
l~ i
l~ :l!!
I. iil
...1
I~ i
. ,
I ,
I ,
, I
I I
~
...
.
a.
-
-
06/12/91
05:23
S;;: I I
~I = I i 0: , g:
+1 ~ , !I:;ll .
0...--_____..-.-___...-_______
:,,' g ,'la.1
iJl, i i I =3'1 Ii
al NO t'l I 'CIl, ~.
... ~ I' I iI
I :, I~I r :l~'
'!!l ill! pll ~ u
~ ~I I~ i I
:; i i~ i n
m I I I ~ =
~ I I ~ ~ i
. ~ I I en II
I !Ii: I I =
'R; It!!
: - I I "
:: \/I I. I;: I H
: @ I ;:: I ,.... I II
I ;; ,0 I ,.... 'L "
1 NO "'" I'" U
r-: g ~-rl -~-~-, -~-=
. . "'". I" I If
. . 2' I , 'II
! i ! J... I I Q\ i~ Ilg U
I : $ ""!~81 11i:lll I&' II
I . S I I ',c ~ _5 II
: : e J I :z - :I
L-! i L_L-L_L_I _I _fil'
: : I' : 1 I r rl II
j I I i~ll I\J~r~_gl
I I ==1 t I I I _Ii ~ fl
: : 5:, : J I I I~. 5 ,... n
~: t' I : 1-- ~~
" ,I.,. I ' i ["",
:: ,'II>>, In z.. Q Ii
:: tOO I IfA L far'1.
i-i-~-i-'-l- -~-, -I ~II
: : I : I I I' liI U
I , C . J . I II
, , I I 10 f I I .... ')
: I:,' 111oN.Pef/:..,.
fl' . I I;; DI_1e "
: I : , : I I 1::- :; & cr II
, , , , ,I ,.. .. 51w "
, C , I I It... ..
, I , . I I. I"" II
: : ; I Icr I I I II
: : ,I : t.!; "III I : I I:
I' t. '_ I . , I ..
------'"""""'-----------11
-----------------_u
; : : I I I I I I I:
: : : ~ . ( I (... =
, . , I I VI I 'l.ol l~ "'Iif gl "
: : : . I..... J WI i -.0' ::
I . , . '_I '.Ie ~W.
If' " . 'Do _. II
, I I . . . . ,- ..... D t&
. t , I , I ' .. I to II
, f . .. I I II
I I . r . L 'I'
t I . . I I 'I
------_-~_ -too---t---....._ II
: : I J I 1 : I h.: 5' u.
J : 'I I I I I.. ' lit ::
,. . I. I lL I'
I I I . IN' I.... e:.. _ _ t
I f I I I I ....... ::a .,_ n II
I , I , f , I. -... 51! CD II
: : : : 1'01 . o,rt ;'-1.::
I . t t '0' '0' In It
: ~ : : I : 1 1 Ii" ::
I , I I I . . , . II
o
, ~:; g'!' ~: ~ n -.:I
I. (X) -J.......-. VII II Sf!
. .1....... ~........=:11I ..;
J f ~ a - sr...... I::J ~ " .
I <c l!l lit... ID'.., I'" = lii
a.:: H' r::I' r:: lD if II .
i ~i rl'~ r~fl'~i r: I-
I ~ 2" ., tn" .,. U
. ;; .IRl I'll 1c.."":I_
. II" lD I-~ II_
Iou'" ... "... II .
"'" -.. U I a!; II ..
1~1!I' !n~ns:
"'" - 'I '-"-S:
>< ~ II i~ II or
il" I ~u 't'"
f;:M I:;; jj 13' rio.'
'" <<0 ~ = :-. n cr
~ ~ ~-- q l ~ n ~
... II I ~ Ii I~ II'"
!ClI &,~li j",:li:
-c~ ~. n :n:lft
S,... < ,. ,~o 110
: . - II , , If
"'a I Dr.'" II I '0 " J
...1; I II ~- It
........... . :' ~ .. I . ~
~ (") t S-.,-, = I Ie ,,;;'
SG; I' I ,-. .,...
)Iio Ii' 0 ,: f 'll) ;1.
....... '<...,' I."' '10
11:- ~ I , I' ,~
- 0 .... I I II eo
:i! 8: ~ ;I In j: Ii
@.... ~:: I It"t .1_
~"I ... II 1 IUS;:
~ U : I 11 ·
& .. -n,-c:; It I:!
'"::; ft !i (lJr:.,(IJ~ H 5..
~-c lrr: 11I..cIDJ!S~;r
~.". II ::J::Jt: .. _
- f>' II 'U c:
Ii.... ~__ II CD tl CD N::
o f 0. ft CD I'll "
i: I . J ~:~::"E:
I i ~ ~ H ~ J~ u!
eg I -I-U c.. i~ =~
f-~ a ::J'::J::
. '1 ,,,_
- IOU 0.0 II 0
B7 1 z~'" c , ~ :1 Do
- - I ft E>> ft I . " R"'
=~ .-c~ I I II;
DEC, uD : 111
....... I ~~II : l :It.
5C .~t8" . 1 'J~
!!= riff l ; k!
"'::; I U ~ U
5Jl M II I U
~ ~: n ~:t
"""'M' 'I . 11
~ I :: ::;
o I U I.'
... I II . It
- J! I II
Q~ H . II
; I ',--; ::"'-(=;1....;:;:...--:; =
a ' . fI -,.....-, ,."
: :1lJ ~IN'D :.......~ u
~ I '- c I,::J '-=-~'-t II
-...,. I c: 1! I 1- I~ "
..... 1 s II'" '0 I If
"< - II~ :-.. u
~ 1l::J .,.. II
n f~"
J;'::~ :~ II
:i: lie. :. n
\0 11_. 1_ II
\0 2. Ug J N U
110 to"
~ II ~.......::
~ " f II
... II I n
I: :: :::
II I II
f1 'II
" "1
II I It
II I"
" 'll
:1 I U
" "1
It "1
"'11
006
-::;1"'ll\1"D9~
::: ~ ==
~ .....
"",. ~ z 2
tA -oct;
'l'~B";;-q.
:: :::::G
--....--4
-::a: Z!!l ~
..Go.. f
Z 81
-
... n.....,.
.. Silo
...K...
~ ",Ill
, ~f
:!...
n'
i
'"
:c
0;-
S
,...
'8
I...
I~
I.....
,...
.'"
Ii
,
';;l
1:6
:;
I",
I""
Is
'...
,
,...
''''
Ill!
,-
I~
.
it
!i
.
ta
I;
im
i
~
~ ~
o
"
,
o
0\
,
0\
W
....
I\)
"
,
o
o
I
'"
<>
-
-
..
..
i
1
,
'" ,~
Q\ .-
I'"
,
...'
oDl
oDl
...:
,
,
,
,
,
>
og
...
....
....
.
;:
~
..
...
o
-
~
06/12/91
05:24
.
.
;1 J I VI 'I ~ n n
~: i .. f ~ I 8 i J. !i
4.: ; I 1 I ; p:'J . t::r;t . II
.. . . . I , t - I tt
O~-------~-I-r-----H
=! I I,' I = I> I n
i:' I: c : "'d I II
<::I! I! 1= I~ 1 Ii
~ 1 Inl I 1~ltul "
Dt I a 1 I I. I CI) I ,n
1 t ~. I : I> iJ
. I 6. , 'C')' c::: I II
I 1 In: J f 2: ) (') I 'I"
'I i g! II II:' I~ , I'
I C;;;, ." I ,I
I -" I' "
. !:! I I I.n I ~ II
I H! t I i tJ:t 'I ~ I::; H
, - I . 10 . 1-: u
1 en t : :z:. . ~ H
t ,I d I 1 H
I ~ I I ~ I f ~ f
I. I I e.-
'I: t:
- . "
.. , I I
ClI I f I I
t'l"lI. I I I
~: C : I
f rn tIt I
. mI. . I
I CII , 'I
I ~ I : I U
l.:c : i 1 II
: ~ : I; n
t ~ ; 1 10\ I n','
t ~ I I (7\1""'" .
f.... I; ,-- I
I 1 ~ I i ~I 0 J HI
~_: ~ ~_~_~_L_~___u
. , _. I , . . I II
I I _ I I , I I I I:
I ~ ~: Ii....: I [I II
t : al: I I.: I.....:~ Ii
: I ;v; t :\081~'I:!; Ie II
i 1 '=' I I : I VI ~ ~.;5 ~I
I II ~. I : t I ~I- =
I I : 1 I I U
, . I " I I , H"
. I ,.,., I .
r-! _ r---r-r-r-rl-J
If.... ,I' t it
I I rn I i ~ i= I~ ~~~~'I~i I
I. I I f-D I~ 115.... H'
., . ",-""
I! I I 1 Ii rf~'
I, I I n I n ill I!:,! n
L-L---r: -+-_t.!_~-,--:-!jEi Ii
: : 'I I I :. I
It' ,.. I .
J t: 100 I : I.... I
: : : -'='" 10 Ii' el:;'I'~ ~
I 'I I I~ ::11,__ II
I I': I I:;-;;-IC co
, , 'ICD ~Ig._
I ., 'IC':L. I
, " "'WI
J ;: J 'I I,
. I : ; n: n 'I 'I
, , , , en, 1ft I
---------------------
.-I-~-I-t-~-r-t-.-
I I : I I : I I :
I I : : : : I __ I;: ..1:11: g!
I I I , I . I....... 0,. -
I : : II ; ; :.....: 'i~~ It
. 'I I' I .... IS 6..,,, _ =
J I : : : I ; .::; "':.... a ::
: : I I I ! " I : U
, . I I . t I I II
~-~-~-~-~-~-~-r-r-u
I . . . I I . I .:Z: ~ H
J : :; I:: I! -N II,
. . I I , I I ..., .0. :l
, I 1 . 1 I . .." Ie: ,,_ _ II
, . I , I I , -- .~ .. ... n ..
I I I I fit. 1_' '::I .. If
: 1 : : : I : 0 11"9 ~ II
I I , . . , I _ I .n t ::
. I I . I f I _ I l:r 0.. II
: : ; ; : I I ; F t
'^
;:-
.
I
I
.
I
I
,
,
I
I
.
,
I
,
I
,
,
!i!>< I
!~ r ~;
l:i ~ I i;'
GO IU I f'I'l_~
,...... I ,.,-
~fi I G-~
..." I C>
c;I!::4 GIS:
:II; - , ~
-Ii! .
= I
~;; I
51 1
..._ I
... I
2-c' I
...... ,
- >- .
'"'" ,
mti .-(;
-4 JV I .
ili.... '
i5~ I ;~
8~ I ~!
8~ I 0:-
<tI C""T&,
!i l;j
!!. ii
'^ -
litCil
;;a:
~~
"'...
""
!s
ei
-
-""
. ~
.
0..
~><
~...
o
.0.:
011:
QC
QC
~ II g!1~: ~
= co .a-I........::;' Vl:
n........ 'V .........-1..
11_ ....~:l0
II,-ti: :-
IL )lII1 71t.: :::
II ~I ~I.,~
I!~ =1~Ei~=-
=., ..., ;.,;:11
U et 1(1) r CL"
II(D .et .-.~
",;- ',;- ':l1IQ
r. i lo!!:
g; a I I n~
_ . ,-.
!it" I I,..,.
I'D 1 1<
::0 ..
I 1<:
i 1=.
I.....
.-.
1(1)
. a.
,
I",
U Ig.
II ~o
It :0 U
r. 1- g
~ ;0 II
= 1-' =
II I~ I:
.. .., II
... P. '-."
~ It 'n:1
:. D I rot II
WI " I II
...... I' I II
I. , , II
It .n,oll
:Vl~:Vlg U
ij, 'QI -< 1(1):r II
II ;~ ;:1':< II
II I I ,.
I' 'm 'm II
:: 1(1) ~ (I) U
II ..,.., II
= 1:1 t~ U
., ,01 ,01 II
If I., '., II
= ICL :'CL =
It ,-. -. I'
II ':I ':I II
= :0 10 U S'
Ell n
t . It R"
, , II <
:I ; : 11:
" It"
= I ; :l ~
It . . ,,~
* ! i i! i
= I : II In
= I ~ U
" 1 . It
" , , II
II I t fI
II , , U
I' . , II
II . I II
11 1 ; ::
n I : ::
II . 14
U -<=;;-";::;:::-=1 ::
" _I _.1 <<I' II
I'" ~I\D'U......... - II
II '< N ,_tD II
Ite 1:::~i-'='"t il
Om 10 ~.. II
I,et , 1 II
"., I I II
51 =:1 I :w :1
~ ".,01 " ',lXl ',',
. II" , ,- II
IICL t , I II
o 11_. 1 1_ II
- II=' :N I:
::0 ~:I
:: ;:1
II I II
It I II
" I"
" I"
II ."
II I II
II I tl
.. '"
" . fI
" '"
II I tt
" I II
II I It
II f It
r!O
.. ..
< ..
.. ..
Q,C>
..
Iii'.,
:::i
"If
..
..
-
....
U"I
U"I
o
,--0
, .
.
I
1<-
I c
,
1-<
I
,
,
,
,
II.D
. I.D
.
,
,
,
I
,
,
.
,
,
.
I
I
,
,
'"
...
=
-
"
~
...
..
..
...
;:
.
u ~
II Z
n ~
l'li
Ii ..
H~
n I
" ..
" -
" ~
l' ~
.I ~
,
...
3-
:>
,..
-
..
...
i
...
~
~
..
n
!
..
"
..
..
..
Q,
..
..
-
..
..
.
..
"
...
..
..
~
'"
..
:>
os:
il
...
"
-
..
0137
~..i~i~~
_ 808 e;:::
It' ~., 0
~. ~O'21J
=n__"-
'~80"'1'"
:: ~;:e
:: S I: f il
~ iil
_ n........
.. lla.
..
-s ~f
3...
l!'-
..9
-
g
,..,
:8
.""
.
l~
....
,~
''''
.-
Iifi
!~
I""
II!:!
'!IE
I~
....
.
I~
!'"
,...
I:::i!
,-
,n
,...
,
,,,
l~
IE
,
lel
I'"
Iii!
,-
.....
'~
I~
Ia.
<:
!
...
..
..
...
..
o
.....
,
o
'"
,
'"
w
....
'"
.....
, I
'0
10
, I
I'"
I
.
,
""
-
<
-
...
i
Iii'
~
.
,
I
'>
....
1"1
, ...
I....
,
,
.,...
1(1\
I-
!...
1.0
, .0
I...
I
I
I
,
.
I:l
~
'"
-
-
..
..
~
,
,
I",
18
,-
,...
I
I
,
,
I
.
,
,
,
,
,
I
"
..
..
..
-
..
-
...
-
CALIFORNIA STATE DEPARTMENT OF EDUCATION
CHILD NUTRITION - FOOD DISTAIIlJ110N DMSDN
o
o
AGREEMENT FOR DISTRIBUTION OF
DONATED FOOD - INSTITUTION
OFD - 1038 (8188)
Raturn 10: CAUFORNIA STATE DEPARTMENT OF EDUCA1lON
Food DiI1ribulion Seclion
P.O. Box 844272
Sacr8menID, CA 94244-2720
The eppIlcant agency ldentKied below, hereinafter called the rwdlllllnt.,.,.", hereby makes application for commodities
donated by the Agricu.ure Marketing Service, U.S. Department of Agricu.ure, to the California State Department of
Education, hereinafter called the .,. Apm:y, for U89 and diapos.ion in aocordance wfth the Terms and Condftions
appearing on the reverse side hereof, which by reference are iNIDrporated-herain.
RJll .....E OF RECIPIENT N3D/Cf
Cit of San Bernardino Park
MAILING ADDRESS ,...,,...balr,.,,,..,,
CITY
ZIP
COUNTY
547 N. Sierra Way
San Bernardino, CA
92410
San Bernardino
1. Has recipient agency appIiad lor donelad food undar enolhar.......1 ~ Yes
Recipient has received donated food since 1980
I::!I A tax-supporlad agency
o No
IN ')N", p/Nss ptOMdBon '_Ie _ oM ""';fI/IfIl
tr/otmallon tegllfd/ng pricK app/I<8l1onl, _lion" '10.)
2a. Racipient agency is:
o A privalll, nonprofitagancy and Is operating a ncnprofit feeding program
2b. Type of Institution operating Iha ncn-profitl8eding program: IChsck" appn>prialll ra.ponlll)
I') TW- i TW- I') TW-
(l)_pItaI .~ ~ (5) AdlAI Rohoblll_ (8) Home lor lI10 .-y aged
f<:.
(2) Nolllllident chid CIn . S"'CCh,lcdcn_lnslt- (7) Nu1ritian _em for IIlo
-I--) ....... ~
(3) AdlAldruv__1 a CI1yIcOunly jllil (8) _ or Idu:hon for
___r -ing.-y-
(4) .lJvenle_ a_- X (Il) s..""",,,Food_
...... IlIIfwey - PragrIm lor children
(.J)
Type
~\ti
(10) Summer camp lor childre" high
sc:hooI age and undor (May
IIltough s.prombor), Ioc:aled at:
(11) llornalorllloDovelopmentslly
DIsebIed
(12) 0IIl0r (1ipBd1y)
- AGREEMENT CERllFlCAllON -
I, the agent authorized by the I/O",,",ing -.Jofthe racipient agancy lor
by the chief adminislr8li.. officer of a radpienr agancy which has no
go",,",ing boen1) '" .",., inlO Ihis agraament certify fhal the infomlllfion
pt8SlIIlled Is aocuralfl_.... 10 lire Temrs _ CondilIotI. of this
egraemenr. as Ihey ara pnlsanlfld on the ra...... side of this form.
- STATE AGENCY APPROVAL -
ThiS eppllcation when IIfJPfOved by rhe Slalfl Agency shall con.#/U/e an
.-nr which .haII ramain in fulf force and effecl un#! wrill8n nodes
10 the conrrery is g10en a. ptOllided in Paragraph 8 of lire Term. and
CondIIion. on lire ra....e side of lIri. form.
.....E OF RECIPIENT NJE.I/t'f
City of San Bernardino
PAlNlED OR TVPEO.....E OF AU1HORlZEO RECPENT AOEI/t'f REPRESENTATIVE
Annie F" Ramos
SIGNATURE OF AUlHORIZED RECIPIENT NJ/il/t'f REPRESENTATIVE
FOR OFFICE USE OM. Y
.
Al'PROVED - The Recipient Agency Is ap- I
proved to order commodities tor Iha following
maalIl per WII8k:
.
T~ Director of Parks, Recreation and
COl1lllunitv Servi""c n..n:
TELEPHONE NO. DATE
( 714) 384-5233 "/~
alllNATURE OF AU1HORIZEO STATE NJE.I/t'f
REPRESENTATIVE
DATE
_llJlhttlflltl.11'liI11'lt"lillllilllltlrI1111111111111111Iii: