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<br />6 .... <br /> <br />CONT~BUTORSUPPORTFORM <br />NO Family Nutrition Program <br />October 1, 2007 - September 30, 2008 <br /> <br />Your intention to pledge in-kind value to FNP is considered a local match to the Federal dollars that support the <br />Family Nutrition Program. Though your pledge of time or use of equipment does not represent an actual cash outlay by <br />your organization to the FNP program, it is necessary for us to place a monetary value on that pledge in order to receive <br />an equivalent amount of Federal funding. Please assign dollar values consistent with your agency financial records; <br />when in doubt, please assign a conservative estimate. <br />Thank you very much for your pledge to our program. It is essential for our continuing operation to have this <br />demonstration of local community support. <br /> <br />County Cass <br />Contact Person Mike Montplaisir <br />Phone <br /> <br />Name of Agency I Cass County <br />E-mail <br /> <br />Value of Personnel Services (Salary + Fringe Benefits) <br /> <br />a <br /> <br />x <br /> <br />b <br /> <br />= <br /> <br />c <br /> <br />Position Title No. of persons Hourly value Estimated hours Total Yearly <br /> in this Dosition per year to FNP Value <br />County Auditor 1 $52.56 1 $52.56 <br />Auditor Assistant 1 $27.15 1 $27.15 <br />IT Staff 3 $24.13 20 $482.60 <br />Comm. Secretary 1 $23.85 1 $23.85 <br /> Total Value $586.16 <br /> <br /> Total Yearly <br /> Value <br />Value of Physical Space (Attach Schedule A AND documentation) <br />. Name of facility: Cass County Annex $4096.00 <br />Value of Equipment (Attach Schedule B) <br />Value of Supplies/Materials (Attach Schedule C) <br />Value of Other Resources (Attach Schedule D) <br /> <br />OVERALL TOTAL VALUE I <br /> <br />$4682.16 <br /> <br />On behalf of Cass County <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 3D, 2008 . We certify that we have put;>lic. 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 />~atu~ - ~ency Di~ <br /> <br /> <br />6&""'4'-' <br />Title <br /> <br /> <br /> <br />Revised 1/07 <br />