2-Appendix A SFA Certification of Acknowledgement.pdf

Appendix A

SFA Certification of Acknowledgement

Initial below next to each statement certifying that you have read and fully understand the contents of this contract.

A. I certify that I, ____________________ SFA Authorized Representative, on behalf of the SFA, have read and fully understand the contents of this contract. I understand that the SFA must maintain oversight of the food service operations and that these responsibilities will not be delegated to the FSMC. I also understand that the SFA is responsible for closely monitoring the FSMC contract and the FSMC’s daily activities.

Initial Here: __________

B. I certify the SFA is securing a Fixed Price contract for a Food Service Management Company and will follow the respective procedures.

Initial Here: __________

C. I certify that I will not enter into a contract with an FSMC that has a real or apparent conflict of interest. This includes FSMCs that provide recommendations, develop or draft specifications, requirements, statements of work, requests for proposals, contract terms and conditions, or other documents for use in conducting procurement.

Initial Here: __________

D. I certify that I, nor any employees (including School Board Members) of the SFA, will not solicit or accept donations, gratuities, nor favors from current or potential FSMCs (i.e., gifts, golf outings, meals, etc.).

Initial Here: __________

E. I certify that I will appropriately and in a timely manner respond to all bid protests and concerns raised by potential FSMCs.

Initial Here: __________

F. I certify that the SFA will have a written Code of Conduct that addresses conflicts of interest and governing the performance of its employees engaged in the selection, award, and administration of contracts, and will make sure all employees are aware of said standards.

Initial Here: __________

G. I have read and understand what the allowable costs are for all of the applicable CN programs.

1 Revised: 04/24/2026

Initial Here: __________

H. I certify that the SFA will be legally responsible for the conduct of the non-profit school food service program and shall supervise the food service operations in such manner as will ensure compliance with the rules and regulations of PDE and the USDA regarding each of the CN programs covered by this contract.

Initial Here: __________

I. I certify that this SFA position ____________________________ will fulfill the SNP director's responsibilities. The SNP director must meet the minimum Professional Standards hiring and annual training requirements and provide program oversight, including but not limited to, ensuring that the FSMC’s food service director and all food service staff also meet the Professional

Standards requirements (Title 7 CFR §210.30). Directors must complete an eight-hour food safety course upon hire. The training must not be more than 5 years prior to their starting date or completed within 30 days of the employee’s start date and every five years thereafter.

Initial Here: __________

J. I certify that the SFA shall retain control of the CN programs’ non-profit school food service account, signature authority, and overall financial responsibility for the CN programs. This includes access to the State Agency application and claiming system(s).

Initial Here: __________

K. I certify that the CN programs are the responsibility of the SFA and the SFA is responsible for all contractual agreements entered into in connection with the CN programs.

Initial Here: __________

L. I certify that the SFA will be responsible for determining student eligibility for all applicable programs and that the FSMC will have no involvement in the process.

Initial Here: __________

M. I certify that the SFA will retain all records for the current year plus the three from the end of the contract including any renewals.

Initial Here: __________

N. I certify that all food will be in compliance with the current meal standards and Local Wellness Policy.

2 Revised: 04/24/2026

O. I certify that the SFA will monitor the FSMC in order to ensure compliance with USDA regulations.

Initial Here: __________

P. I certify that the SFA will create an advisory board composed of students, teachers, and parents to assist in menu planning.

Initial Here: __________

Q. I certify that the SFA will not delegate any of the above responsibilities to the FSMC.

Initial Here: __________

R. I hereby certify that neither the SFA nor its principals/authorized representatives are presently debarred, suspended, proposed for debarment, declared ineligible, disqualified, or voluntarily excluded from participation in this transaction by any Federal/State department or agency.

Initial Here: __________

S. I further certify that neither the SFA nor any of its principals/authorized representatives has a reported criminal background that would affect the receipt of Federal funds.

Initial Here: __________

T. I certify that the FSMC is not a paid consultant or contractor with the SFA in any other capacity than for this contract.

3 Revised: 04/24/2026

I certify under penalty of perjury that the information on these forms is true and correct, and that I will immediately report to the state agency any changes that occur to the information submitted. I understand that this information is being given in connection with receipt of federal funds. The state agency may verify information; and the deliberate misrepresentation of information will subject me to prosecution under applicable federal and state criminal statutes.

On behalf of the SFA I hereby agree to comply with all state and federal laws and regulations governing the CN programs administered by the state agency. In accordance with Federal law and USDA policy, the SFA does not discriminate on the bases of race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by the USDA. I will ensure that all monthly claims for reimbursement are true and correct and that records are available to support these claims.

Printed Name of SFA Authorized Representative

SFA Authorized Representative Title

SFA Authorized Representative Signature

4 Revised: 04/24/2026

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