Exhibit E Food Distribution Monthly Statistical Report.pdf
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- Attached to
- Master Agreement AZ|CTR078755
- Contract number
- CTR078755
- Issued by
- Arizona
About this file
Exhibit E is a Food Distribution Monthly Statistical Report (Form HRP-1012A) used by Regional Food Banks in Arizona to report to the Arizona Department of Education and Services (ADES). The form serves as a standardized reporting document for food distribution activities across Arizona's 15 counties: 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 receipts of donated pounds, purchased pounds, and USDA commodity pounds. It tracks service metrics across multiple programs: TEFAP (The Emergency Food Assistance Program) and CSFP (Commodity Supplemental Food Program), reporting unique and duplicated individuals served, households served, food boxes distributed, and meals served. The form documents statewide distributions and transfers to service area agencies and direct distributions, as well as out-of-state distributions. Additional sections record ending inventory of TEFAP and CSFP commodities, waste categorization by type and disposal method (landfill or compost), and transportation costs including miles driven for pickup and delivery operations. Regional Food Banks submit monthly data with their ADES Contract Number and reporter name for contract performance monitoring and accountability.
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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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