Exhibit E Food Distribution Monthly Statistical Report.pdf
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- Attached to
- Master Agreement AZ|CTR078756
- Contract number
- CTR078756
- Issued by
- Arizona
About this file
Exhibit E is a Food Distribution Monthly Statistical Report (Form HRP-1012A) designed for regional food banks operating under Arizona Department of Education Services (ADES) contracts. The form serves as a standardized reporting mechanism for food banks to document their monthly distribution activities across Arizona's counties, including Apache, Cochise, Coconino, Gila, Graham, Greenlee, La Paz, Maricopa, Mohave, Navajo, Pima, Pinal, Santa Cruz, Yavapai, and Yuma.
The report captures comprehensive data on food distribution activities including The Emergency Food Assistance Program (TEFAP) commodities, Commodity Supplemental Food Program (CSFP) commodities, and other food sources such as purchased items, donated goods, and USDA commodities. Reporting categories include the number of unique and duplicated individuals served, households served, food boxes distributed, and meals served across all programs. The form also documents inventory management, tracking ending inventory of TEFAP and CSFP commodities; waste disposal through landfill or compost; statewide transfers and distributions; out-of-state distributions; agency distribution by county; transportation costs including total miles driven for food pickup and delivery; and receipted food in pounds by category (donated, purchased, and USDA sources). The form requires the reporting organization to provide their ADES contract number and reporter name, facilitating accountability and performance monitoring within the state's food assistance network.
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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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