Exhibit E Food Distribution Monthly Statistical Report.pdf
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- Attached to
- Master Agreement AZ|CTR078753
- Contract number
- CTR078753
- Issued by
- Arizona
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Exhibit E - Food Distribution Monthly Statistical Report (HRP-1012A)
This document is a monthly statistical reporting form used by Regional Food Banks operating under an Arizona Department of Education Services (ADES) contract to track food distribution activities. The form serves as the primary reporting mechanism for food banks distributing commodities and meals across Arizona counties, including Apache, Cochise, Coconino, Gila, Graham, Greenlee, La Paz, Maricopa, Mohave, Navajo, Pima, Pinal, Santa Cruz, Yavapai, and Yuma.
The report captures data across multiple program areas including TEFAP (The Emergency Food Assistance Program), CSFP (Commodity Supplemental Food Program), and other food assistance initiatives. Required reporting metrics include unique and duplicated individuals served, households served, food boxes distributed, and meals provided, organized by county and program type. The form also tracks receipted commodities by source (donated, purchased, and USDA), statewide transfers and distributions, out-of-state distributions, inventory levels, waste disposal methods, and transportation costs including miles driven for pickups and deliveries. Regional Food Banks must provide the ADES contract number and reporter name, with all monetary amounts and totals calculated and reported monthly to document compliance with contract requirements and service delivery obligations.
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Text version
Regional Food Bank Name:
Reporting Month and Year:
VII: RECEIPTED Donated LBS Purchased LBS USDA LBS TEFAP Unique Duplicated TEFAP # TEFAP Individuals Served Individuals Households Meals CSFP # TEFAP Households Served Apache Non-USDA Produce # TEFAP Food Boxes Distributed Cochise Retail/Wholesale # TEFAP Meals Served Coconino Food Drives CSFP Unique Gila State Funds # CSFP Individuals Served Graham Other # CSFP Households Served Greenlee SUBTOTALS 0 0 0 # CSFP Food Boxes Distributed La Paz TOTAL RECEIPTED 0 Other Programs Duplicated Maricopa Other Food Banks # Other Programs Individuals Served Mohave # Other Programs Households Served Navajo VIII: COMMENTS
Pima Pinal Santa Cruz
Location Name LBS Yavapai Yuma
TOTALS 0 0 0 0 0 0
V. WASTE
SUBTOTALS 0 Category LBS Landfill Compost
USDA Commodities Submitted Approved STATEWIDE DISTRIBUTIONS LBS Non-USDA Produce To Service Area Agencies Other Food RFB Direct Distributions TOTALS 0 0 0
SUBTOTALS 0
Transfers and Distributions TOTAL 0 VI. TRANSPORTATION COSTS
OUT OF STATE DISTRIBUTIONS LBS
Produce to Out-of-State Food Banks 0 Non-Produce to Out-of-State Food Banks
#DIV/0!
III. ENDING INVENTORY LBS
TEFAP Commodities CSFP Commodities
TOTAL 0
USDA Commodity Disposals
TOTAL MILES DRIVEN
Total Transportation Costs Transportation Cost Per Mile
I. SERVICE AREA DISTRIBUTION
County Total
TEFAP LBS
IV. AGENCY DISTRIBUTION PER COUNTY
II: TRANSFERS AND DISTRIBUTIONS
STATEWIDE TRANSFERS
# Miles Driven to Pick Up Food # Miles Driven to Deliver Food
Total Produce LBS
Total Food LBS
TEFAP Commodities
ADES Contract No.:
Reporter Name:
Exhibit E - Food Distribution Monthly Statistical Report (HRP-1012A)
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