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<br />, <br />\ NO Family Nutrition Program <br />-r>j <br /> <br />CONTRIBUTOR SUPPORT FORM <br /> <br />October 1, 2006 - September 30, 2007 <br /> <br />Your intention to pledge in-kind value to FNP is considered a local match to the Federal dollars that <br />support the Family Nutrition Program. Though your pledge of time or use of equipment does not represent <br />an actual cash outlay by your organization to the FNP program, it is necessary for us to place a monetary <br />value on that pledge in order to receive an equivalent amount of Federal funding. Please assign dollar <br />values consistent with your agency financial records; when in doubt, please assign a conservative estimate. <br />Thank your very much for your pledge to our program. It is essential for our continuing operation to <br />have this demonstration of local community support. <br /> <br />County/Site Cass <br />Name of Agency Fargo Park District <br />Contact Person Scott Fredrickson <br />Address 701 Main Ave. Fargo <br />Phone 701-241-1350 <br />E-mail <br /> <br />Value of Personnel Services (Salary + Fringe Benefitsl a X b = C <br />Position Title No. of Hourly value Estimated Total Yearly <br /> persons in hours per year Value <br /> this position toFNP <br />Playground Staff 47 7.50 47 352.50 <br />Playground Staff 16 7.50 32 240.00 <br />Administration Staff 2 14.00 20 280.00 <br /> Total Value 872.50 <br />