OMB Control No: 0584-0524
Expiration Date: 6/30/2016
Distribution Fees associated with USDA Foods
Region
State
What type of Storage Facility do you have?
State contracted commercial warehouse
District Co-op contracted commercial warehouse
Direct ship to district warehouse
State-Run
Food Bank
Other _____________________________
Number of Distribution facilities
Broken into how many regions?
Distribution Service
Delivery
Frequency/Schedule
Weekly
Monthly
How many months
Month range
Pick up
Distribution Fees
Transportation Fees
SAE funds
Subsidy to reduce fee
Direct payment of fees
Other State funds used
Fee Basis
Units for Charges
Per case
Per pound
Per cwt
Other
Fees by region
Region spaces to report?
Additional Charges?
Contracted guaranteed minimum cases per warehouse for SY
Fuel market clause
Minimum drop quantity for delivery
Dwell Days
Included in initial fee
Storage Fees charged for dwell days included in initial fee
Units for Charges
Admin Fees
Admin Fee Basis
Direct Ship Fees (fees charged to direct ship districts)
Processor Fees
DoD Fresh ‘state’ service fee
Units for charges
Programs
NSLP
CACFP
SFSP
TEFAP
FDPIR
NSIP
CSFP
Number of RA’s
Communication Methods of NOA (how contact RA’s)
Approximate time between DF arrival and RA notification
Immediate
A week
A month
RA’s can track inbound food in real time
Other
Billing Source to RA
Roll down WBSCM to RA
State Ordering System
Contact Information
Name
Title
Agency Name
Dept
Address 1
Address 2
City
State
Zip
Telephone
Fax
Comments
Special circumstances unique for your systems
These questions will be in the comment section for explanation of special circumstances:
Warehousing and Distribution Systems
General Description __________________________________________________
Warehousing and Distribution Costs
General Description__________________________________________________
Warehousing
Warehouse Operating Hours __________________________________________
Pallet Exchange _____________________________________________________
Frequency of Distribution to RA’s and Pick Up by RA’s ______________________
Specifics of State or State Contracted Warehouse Delivery to RA’s_____________
DA Assessment Fees to RA
Fees Charged ________________________________________________________
All RA’s pay the same fee _______________________________________________
Frequency fee is reviewed ______________________________________________
Structure of fee _________________________________________________________
Basis of fee ____________________________________________________________
Breakdown of fee ________________________________________________________
Additional Costs paid directly to Commercial Entities by RA (Non-DA billed costs) ____________
Processed and Fresh Product Costs _________________________________________________
Please provide any additional information ___________________________________________
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0524. The time required to complete this information collection is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Potter, LaNae - FNS |
File Modified | 0000-00-00 |
File Created | 2021-01-27 |