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<br />"\. <br /> <br />'''-r <br /> <br />Value of Equipment (Attach completed and signed Form C) <br /> <br />Description of item(s) <br /> <br /> <br />ves ~ <br /> <br /> <br />Total Yearly <br />Value <br /> <br />KiD <br /> <br />Total Value '15'. / 1) <br /> <br />Value of Supplies/Materials (Attach completed and signed Form D) <br /> <br />.', Total Yearly, <br />Description of item(s) , Value <br />. <br />r 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 />I Total Value <br /> <br />OVERALL TOTAL VALUE <br /> <br />I/ot l{j I <br /> <br />On behalf of ~/F4'Gf) ~C/C( I ro Iv b we agree to <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 />~ /{~1/U,-h4 . <br /> <br />Si nature - Agency Director <br /> <br />/J~, <br /> <br />Title <br /> <br />. ~11o "3 <br />a / <br /> <br />revised 2103 <br /> <br />C:\wpdocs\forms\contribsp,Q3 <br />