Laserfiche WebLink
<br />, <br />Value of Eq4ipment (Attach completed and signed Form C) <br />I <br /> <br /> Total Yearly <br />Description of item(s) Value <br />Tables, desks, TVNCR, white board, ete 9.6.1dJ. 00 <br />I Total Value <br /> <br />Value of Supplies/Materials (Attach completed and siQned Form D) <br /> Total Yearly <br />Description of item(s) Value <br />I Total Value <br /> <br />Value of Other Resources (attach completed and siQned Form E) <br /> Total Yearly <br />Description of item(s) Value <br />I Total Value <br /> <br />I OVERALL TOTAL VALUE <br /> <br />I ~ /4 /30. 8 0 I <br /> <br />Madison 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 />Signature - gency Director <br /> <br />_~A'(A1~~ <br />Title <br /> <br />~/2:Z;O .3 <br />/ <br /> <br />Date <br />