Attachement_D_Inventory_Checklist.pdf

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SNAP Retailer On-Site Store Vsits Support Services
Solicitation number
AG-3198-S-15-0027
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Store Visit PWS Attachment D

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ATTACHMENT D OF

TASK ORDER PERFORMANCE WORK

STATEMENT (PWS)

INVENTORY CHECKLIST

SNAP STORE VISIT CONTRACT

Store Name: FNS Number:

Reviewer (Print Name): Signature (Original in ink):

Site Visit or 1st attempt: Date:_ /_ / Arrival Time:_ am / pm (circle one)

(If applicable) Re-Visit or 2nd attempt: Date:_ / /_ Arrival Time:_ am / pm (circle one)

Checklist for FNS or Authorized Agent Use Only U.S. Department of Agriculture - Food and Nutrition Service December 2010 - BRD/SNAP

Dairy Products 1-5 Units

6-20 Units

> 20 Units F/F/R

Butter/ Margarine Cheese (hard/ soft)/ Cottage Ice Cream/ Ice Milk Milk/ Cream Sour Cream/ Yogurt/ Dips Infant Formula (Animal-milk based)

F / V 1-5

Units 6-20 Units

> 20 Units F/F/R

100% Juice (Fruit or Vegetable)

FRUITS

Apples Pears Apricots/ Peaches/ Nectarines Mangoes/ Plums/ Prunes/ Mixed Fruit

Bananas/ Plantains/ Pineapples Papaya/ Guava/ Dates/ Figs Coconut/ Coconut Milk

Berries (Blue/ Black/ Rasp/ Cran/ Straw, etc.)

Cherries/ Grapes/ Kiwi

Melons (Watermelon, Honey Dew, Cantaloupe, etc.)

Citrus (Oranges, Tangerines, Limes, Grapefruit, Lemons, etc.)

VEGETABLES

A sparagus/ Artichokes/ Broccoli Cauliflower/ Brussels Sprouts Cabbage/ Sauerkraut

Beans/ Bean Sprouts/ Tofu/ Peas/ Nuts/ Nut Butters/ Lentils/ Soy Products

Carrots/ Parsnips/ Turnips/ Beets/ Radishes/ Mixed Vegetables

Celery/ Onion/ Leeks/ Mushrooms Corn Greens/ Lettuce (Boston, Collards, Iceberg, Kale, Green/ Red Leaf, Mustard, Romaine, Spinach, Swiss Chard, etc.)

Peppers/ Bell Peppers/ Avocados Potatoes (White/ Sweet/ Yams) Squash (Acorn, Butternut, Eggplant, Spaghetti, Yellow, Zucchini, etc.)/ Okra/ Cucumbers/ Pumpkins

Tomatoes/ Tomato Sauce Soup/ Stew (all types) Infant F& V/ Juices / Soy-based Formula

Breads and Cereals 1-5 Units

6-20 Units

> 20 Units F/F/R

Loaf Bread (sliced, unsliced)/ Rolls/ Buns/ Bagels/ English Muffins/ Biscuits/ Pizza/ Pot Pies/ Tortillas/ Pitas

Cakes/ Muffins/ Pastry/ Pie Crusts/ Pancakes/ Waffles

Breakfast Cereals (hot, cold) Pasta Rice/ Barley/ Millet/ Rye Corn Meal/ Grits Flour/ Cracked Wheat/ Baking Mixes Snacks: Cookies/ Crackers/ Chips/ Pretzels/ Popcorn/ Stuffing Mix/ Croutons/ Bread Crumbs/ Granola Bars/ Rice Cakes

Infant Cereal

Meats, Poultry, Fish 1-5 Units

6-20 Units

> 20 Units F/F/R

Beef/ Veal Lamb/ Mutton/ Goat Pork (Ham, Bacon, Sausage, etc.)

Chicken/ Turkey/ Duck/ Goose Game Birds

Deli/ Lunch Meat/ Hot Dogs

Canned/ Potted Meat (beef/ pork/ poultry)

Eggs Fish, Finned (Catfish, Cod, Flounder, Haddock, Halibut, Herring, Mackerel, Perch, Salmon, Sardines, Scrod, Snapper, Sole, Swordfish, Trout, Tuna, Turbot, Whiting, etc.)

Fish, Shell/ Misc. (Clams, Crabs, Mussels, Oysters, Scallops, Shrimp, Squid, etc.)

Infant Meats Meat Jerky (e.g. beef jerky, pork jerky, etc.)

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