HomeMy WebLinkAboutapplication for participationRAM orI¢trr.I Ioc
tlsi fa QaparLyrrop et EduuNen
roaug.si Wicio+tiO.! rtni
w Wm** sr,.r$l, Shwa tell
1400404-11100
Haut Year; 2 00 5
FLORIDA DEPARTMENT OF EDUCATION
Fr1n1-1 AN" NI riFtriirlikt MANAcir_MEni.i
SUMMER FOOD SERVICE PROGRAM FOR CHILDREN
APPLICATION FOR PARTICIPATION
Aprtamaat Number 04-- 0 89 9
Tormtin/A.d eats:
MO Number;
i. Name and gelling Address of Sponsor
Nernst; City. of Miami
Address: 444 S_ W 2 Altr F i J
city: Miami Zip: 1 33130
P hone: 416--13 0 E
Ext:
Fax: (305) 416-1308
stre+tAkinm : 1444 S.W
County: Dade J SONCOM;
Errsali: gkitchen@ci _miamif l: ,
z T of Sponsor
Q Public $Shoo{ Food Auth,
Q Nonprofit Private 3c/root
Governnterlt
0 Pub Residential Cramp
Q Pvi Realdentlat Camp
O Nonprofit Pal OM
Q Pub NYSP
Pet NYSP
3. Admin. Personnel:
a. sponsor Administrator
Ell -nest Burkee
Then — ec tar -i
b, Program Director:
Gwen Kitchen'
Title;
D. Administrative Coat
a, MgrTlt. Satan,' 3
b, Monitor Salaries 7
c. Clerical Salaries 2
d. Trenspodatian
e. Gommunicettan
f. Rental € tt. Space
S. Operational Cost
a. Food
b. tabor
e. Transportation
e. Nonfood Supplies
t. Other
[Speeity) L
TOTAL
g_ Office Supplies
h.Audit Fees
I, Legal Fees
J•Other
{5peclfyy f
TOTAL
5Z,020_0
9,000
0-
0
a
61000
10. Administrative Reimbursement Ohm, Rale)
To Maxi* Rate
4, Average Neunber. of.
Mtrets Sated fraalfyj
a.. Breakfast
b,:.* Supplement
'c. Lunch
d. PM Supplernant ..t .i.(
or, Supper [QJ
t. - Operational Reimbursement (Max. Rafe)
Total Total Meats Rate Total
'
5, Number of OperatingI
Days
[ 34
6, Number o(Sires
�29
00
b. Lunch is [ 2 7 5 " 35 2
c, Spiron111
d. Supper
T. Darvs of Summer
Food Operrdon
From ; f"s—(}+51
17722 7.0
a. Bsfcfasl x �0 _ 0
3 b. LunchI 55,9
c. Spirant , 58,1
610.2158 t 33,t529
S8,100x _s 6 ; 7,1f ., 6 (o" �
0 f z t 0 1.,- O d. Supper �0 ._ x 1 .. r (. ..
TOTAL 2 s7 2..
12. R rnbursernent Projected
a. Operational
t�. Administrative 42 225
TOTAL - 473,89
13. Describe plans t visit, review
and monitor sites' .PAll` sites wil
be visited. by. the grog_
supervisors . and monitor
TOTAL 4-2 2�.5 ..
14: Docwnertt action taken -to utilize
--dXstrict school food 5ervJcs for meals
Dade County are intere t
in the food service meil _
15 Sponsor Tra Training for Personnel
Dates dumber Attending
5-19-0. 33
5--27-0
16- Request for 4rlvence Funds
June Advance Ragusa(
IR July Advance Request
64 c. Self-Prep/Rural
IS. Sponsor Handbook has been
received and reed
[ia} Yes ® No
t f. ALL. .51res are
a. Solt -Preparation
b. Rand
® Yes No
C Yes . 011 No
• Yes
EJ No
f9, Do you expend aver $.WQ,000 In funds from ail 20Program Dfrector:
federal sources ertrnonly
t�i Yes i No
SFSP-F1
ESE 196
GWENDOLYN KITCHEN pats P. 371/61
DOE Page 1 of 2
Print Date:
Rwturn original to:
Rave D•plirtroont of EdotMkoer
Food and NU con Wninit
7'altxhs#+M, + Filortdi 32133.0404
i440-5O44*O11
Fiscal Year; 2005
FLORIDA DEPARTMENT OF EDUCATION
FOOD AND NUTRITION MANAGEMENT
SUMMER FOOD SERVICE PROGRAM FOR CHILDREN
APPLICATION FOR PARTICIPATION
Agreement Number: 04--0899
Terminated Date:
FEIO Number:
Instructions: List, by position, all administrative personnel. If volunteer or paid from other sources, insert 0 in column C. Combine Like positions on
one line. Positions will include site monitors, clerks, and the administrator. To calcuiate(f), multiply (b)' (c) * (d) • (e).
21. List By Position Ail Administrative Personnel
Tate of
Position
(at
NO: in
Position
}
Wage 1 Hit
salary and FrhWa
(c)
j Hogs Worked
Per Day
id)
Total NO.
17aye Worked
ta,<
Gross Wages
Salaries and Fringe
(il
Supervisor.
1
$12_50
7
37
$3,237_50
Monitors
4
$10.50 5
34
$7,140.00:
Clerk
2
$8.50 5
34-
$2,890_00.
Total Wsgas
$13_, 2 6 7_ 5 0
instructions: List, by position, all operational persvnnelif volunteer or paid from other sources, insert 0 in column C. Combine like positions on one
line. Positions will include site. supervisors, delivery men, and kitchen production workers. To calculate(f), multiply (b)* (c) ` (d) ' (e).
22. List By Position All Operational Personnel
Tilia of
Position
ta)
NO. in
Position
lbw
Wage 1 FIR
Salaries sled Fringe
Hours Worked
Per Day
tdL.
Total NO.
Days Worked
Grose Wages
Salaries and Fringe
_I
Site Monitors
60
$8.50
3
..)_...
34
$ 52,020_00
Total Wearm
$52, 020 _ 00
SFSP-F1 ESE 196
DUE Page 2 of 2
Print Date: