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Value of Equipment (Attach completed and signed Form C) .. <br /> <br /> Description of item(s) <br /> <br />Tables, Refigerator, Stove, TV etc. <br /> <br />Total Yearly <br />Value <br /> <br />$138.20 <br /> <br />Total Value <br /> <br />Value of Supplies/Materials (Attach completed and signed Form D) <br /> <br />Description of item(s) <br /> <br />Total Yearly <br />Value <br /> <br />Total Value <br /> <br />Value of Other Resources (attach completed and signed Form E) <br /> <br />Description of item(s) <br /> <br />Total Yearly <br />Value <br /> <br />Total Value <br /> <br />OVERALL TOTAL VALUE <br /> <br />58254.40 <br /> <br /> On behalf of 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, 2005. 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 />Signature - Agency Director Title Date <br /> <br /> <br />