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<br />II. . \, - <br /> <br />Value of Equipment (Attach completed and signed Form C) <br /> <br /> Total Yearly <br />Description of item(s) Value <br />... <br />. , I Total Value <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 />I Total Value' <br /> <br />./ OVERALL TOTAL VALUE <br /> <br />1~~7.:?~ I <br /> <br />rhL fir;p p~u:u L~., <br /> <br />(Name of Agency) .(J , <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/seNices available for <br />matching the Family Nutrition Program and that these funds are not used to match other Federal <br />programs. <br /> <br /> <br />~f'/~. <br /> <br />Sign ure - Agency Director <br /> <br />On behalf of <br /> <br />we agree to <br /> <br />Tl~ j)r~ <br /> <br />'~:;;A h ';; <br />Oat I - <br /> <br />revised 2/03 <br /> <br />C:lwpdocslformslcontribsp.03 <br />