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<br />Vcllue of Equipmer)t (Attach completed and signed Form C) <br /> <br /> Total Yearly <br />Description of item(s) Value <br />Tables, desks, TVNCR, white board, ete 1j/60,oo <br />I Total Value <br /> <br />Value of SUDDlies/Materials (Attach completed and signed Form D) <br /> Total Yearly <br />Description of item(s) Value <br />I Total Value <br /> <br />Value of Other Resources (attach completed and signed Form E) <br /> Total Yearly <br />Description of item(s) Value <br /> . <br />.- I Total Value <br /> <br />I OVERALL TOTAL VALUE <br /> <br />I. / I, Lj~-- Lj~ <br /> <br />Jefferson School <br /> <br />On behalf of <br /> <br />we agree to <br /> <br />(Name of Agency) <br />contribute the above in-kind resources to support the Family Nutrition Program during the project year <br />through September 30, 2004. We certify that we have public, non-federal funds/services available for <br />matching the Family Nutrition Program and that these funds are not used to match other Federal <br />programs. <br /> <br /> <br />~A~ <br /> <br />Title <br /> <br />torl:r~/()~ <br /> <br />Date <br />