NO. gia001-2017 School Food Authority



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AGREEMENT


Offeror certifies that the FSMC shall operate in accordance with all applicable state and federal regulations.

Offeror certifies that all terms and conditions within the Proposal shall be considered a part of this Contract as if incorporated therein.

This Contract shall be in effect for one year and may be renewed by mutual agreement for four additional one-year periods.

IN WITNESS WHEREOF, the parties hereto have caused this Contract to be signed by their duly authorized representatives.


ATTEST: SCHOOL FOOD AUTHORITY:
____________________________________

Name of SFA


____________________________________

Signature of Authorized Representative


____________________________________

Typed Name of Authorized Representative


____________________________________

Title


____________________________________

Date Signed


ATTEST: FOOD SERVICE MANAGEMENT

COMPANY:
__________________________________ ____________________________________

Name of FSMC
____________________________________

Signature of Authorized Representative


____________________________________

Typed Name of Authorized Representative


____________________________________

Title


____________________________________

Date Signed


Exhibit A

SCHEDULE OF FOOD SERVICE LOCATIONS AND SERVICES PROVIDED

(To be completed by SFA)

Genesis Innovation Academy

1049 Custer Avenue, SE

Atlanta, GA 30316



Exhibit B
PROGRAM MENU CYCLES

MENU CYCLE FOR

NATIONAL SCHOOL LUNCH PROGRAM

Attach a sample 21-day cycle lunch menu prepared by the FSMC.

This menu must be used for the first 21-day cycle of the new school year.
2017-18 School Year
Campus Level: Elementary/Middle School (K-6)


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Exhibit B


MENU CYCLE FOR

A LA CARTE PROGRAM

Attach a sample 21-day cycle a la Carte menu prepared by the FSMC.

This menu must be used for the first 21-day cycle of the new school year.
2017- 2018 School Year
Campus Level: Elementary/Middle School (K-6)


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Exhibit B

MENU CYCLE FOR

SCHOOL BREAKFAST PROGRAM

Attach a sample 21-day cycle breakfast menu prepared by the FSMC.

This menu must be used for the first 21-day cycle of the new school year.
2017-2018 School Year
Campus Level: Elementary/Middle School (K-6)


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Exhibit B

MENU CYCLE FOR

AFTER SCHOOL CARE PROGRAM

Attach a sample 21-day cycle after school care menu prepared by the FSMC.

This menu must be used for the first 21-day cycle of the new school year.
2017-18 School Year
Campus Level: Elementary/Middle School (K-6)


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Exhibit C
FOOD SERVICE DRAFT BUDGET – FIXED-MEAL RATE

(To be completed by SFA)

School Year 2017 – 2018 (ESTIMATED -1st year)
Revenues:

Cash Sales:

Student Breakfast Sales $ 40,000

Student Lunch Sales $139,000

Student Snack Sales ________

Student a la carte Sales $ 2,500

Adult Sales $ 1,300

Catering Sales ________

Interest Income ________

Concession Sales ________

Vended Meal Sales ________

Vending Machine Sales ________


Total Cash $182,800
State and Federal Reimbursement/Funding

NSLP $155,000

SBP $ 43,000

ASCP ________

SSO ________

SFSP ________

State Matching Fund ________

Commodities Received ________

Other Funding ________
Total Reimbursements $198,000
Total Revenues: = All Cash Sales + All

Reimbursements ________


(School) SFA

Food Service Budget (cont.)



Expenses:

Reimbursable Breakfast Meal Rate Fee $1.58

Reimbursable Lunch Meal Rate Fee $2.93

Management Fee _______

A la Carte Equivalent Meal Rate Fee _______

A la Carte management Meal Rate Fee _______

SFA Direct Expense _______
Total Expenses _______

Commodities

Commodities Used (SFA may

call GADOE for amount _______

Commodity Division for annual

Usage amount for the SFA)
Commodity Delivery _______

Commodity Processing _______



Surplus / Subsidy =

Total Revenues – Total Expenses _______



FSMC Guaranteed Return _______

FSMC Guaranteed Break Even _______

FSMC Guaranteed Subsidy _______


SFA Employee responsible for submission of this budget data:
Name: ___________________________________

Telephone: ___________________________________
FSMC Employee responsible for submission for this budget data:
Name: ___________________________________

Telephone: ___________________________________



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