Tri-State Food Bank, Inc.

BackPack Program Partner

Terms of Participation

The terms of the following Terms of Participation have been agreed upon and understood by Tri-State Food Bank, Inc. (TSFB) and ______(Program Partner). By signing this agreement, both parties acknowledge their respective duties and responsibilities related to the administration of the BackPack Program. The BackPack Program meets the needs of hungry children by providing them with nutritious and easy-to-prepare food to take home on weekends and school vacations when other resources are not available.

The BackPack Program Partner will:

1.  Establish criteria for the children who will receive the weekend BackPacks of food.

2.  Distribute healthy, nutritious food to participating children free of charge.

3.  Provide BackPacks a minimum of once a month during the school year.

4.  Require staff and volunteers with repetitive contact with children pass a National Background Search.

5.  Ensure that the site complies with all applicable federal and local statutes, ordinances and regulations.

6.  Inform TSFB in writing of any significant changes to the BackPack program or distribution site.

7.  Provide necessary information about the school/site when requested.

8.  Place orders, provide payment for, and receive deliveries from TSFB according to the BackPack Program Purchase Procedures (attached).

9.  Maintain records to identify food allergies the child may have (peanuts, milk, etc.) and flag their name so that those items will not be distributed to them.

10.  Be available for at least one annual site visit by TSFB, keeping applicable records (i.e. applications and eligibility verification) on-site and available for audit.

11.  Receive deliveries of, or pick up product on the designated day.

12.  Ensure the program food is stored off of the floor and in a secure place.

13.  Communicate problems and requests to Tri-State Food Bank in a timely manner.

14.  Pay invoices within one month of receipt.

15.  Maintain records of the number of bags distributed and fax or email the Monthly Report Sheet to TSFB by the 5th day of the following month. Example: January report by February 5th.


Tri-State Food Bank, Inc. will:

1.  Appoint a primary contact for the BackPack Program who will be responsive to the Program Partner’s BackPack-related needs.

2.  Ensure that Program Partner meets national and local BackPack Program objectives through annual monitoring inspections and periodic site visits during designated hours of operation. Any issues needing to be addressed will be communicated in writing to the program partner within seven business days.

3.  Identify and procure staple food items and/or supplies necessary for the operation of the BackPack Program.

4.  Provide or coordinate training opportunities for BackPack Program staff and volunteers as appropriate such as program administration, safe food handling and nutrition education.

5.  Schedule BackPack Program meetings to facilitate communication and information sharing between program partners when necessary.


Liability Release:

The Program Partner affirms that the original donor (when applicable), Tri-State Food Bank, and Feeding America:

1.  Are released by the Program Partner from any liabilities resulting from the product.

2.  Are held harmless from any claims or obligations in regard to the Program Partner or the product.

3.  Offer no express warranties in relation to the product.

Either the Program Partner or Tri-State Food Bank may discontinue this program at will. Written notice will be delivered to either party not less than 30 days prior to the desired date.

Upon discontinuation of the program, the Program Partner will return any equipment and/or materials provided by Tri-State Food Bank for the BackPack Program to Tri-State Food Bank within 30 days of program termination.

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Program Partner Executive Director/Principal Signature Date

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Tri-State Food Bank Representative Signature Date

801 E. Michigan Evansville, IN 47711 (812) 425-0775 (812) 425-0776 (fax) www.tristatefoodbank.org