Laserfiche WebLink
<br />" <br /> <br />I <br /> <br />Value of Equipment (Attach completed and signed Form C) <br /> <br />Description of item(s) <br /> <br />Total Yearly <br />Value <br /> <br /> <br />TII VlR.- if' .;2cJ.OO <br /> <br />/3 j. ,;lo <br /> <br />Value of Supplies/Materials (Attach completed and signed Form D) <br /> <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 /> <br /> Total Yearly <br />Description of item(s) Value <br />. <br />I <br />I Total Value lft S$ S-.;2. ~6 <br /> <br />,/ OVERALL TOTAL VALUE <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 /> <br /> <br />~ ;:--C?/'f'/(Vdc//\ Y-2;?~dJ <br /> <br />Signature - Agency Director Title Date <br /> <br />revised 2/03 <br /> <br />C:\wpdocs\forms\conlribsp.03 <br />