Confirmation of Match

AMS Grant Programs

Confirmation of Match 8-17-16

Local Food Promotion Program (State)

OMB: 0581-0240

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OMB No. 0581-0240

[Use Letterhead of Organization Providing the Match]


MATCH VERIFICATION LETTER


[Application Authorized Organizational Representative]

[Applicant Organization Address]


Dear [Application Authorized Organizational Representative]:


We commit to providing the following matching funds to the 2016 [LFPP/FSMIP] application: [Project title]


  1. Cash in the total amount of $XXX, which we will provide during the grant period September 30, [insert year begins] through September 29, [insert year project will terminate].

    1. Funds will be used for [provide particular item(s) corresponding to the budget narrative or describe how the applicant will otherwise use the funds].

    2. We will provide the following amounts per year:

Year:

Amount:

Year 1

$

Year 2

$

Year 3*

$

*Only applicable to LFPP implementation grants. LFPP planning grants are only 18 months and FSMIP projects are only 2 years.


  1. In-kind contributions in the total amount of $XXX, will be contributed as follows:

    1. Salaries and wages of staff time for the following employees:


Employee Name

(add additional lines as needed)

Title

Description of Duties

Base Rate ($)/hr or % FTE

Year 1:

# of Hours or $ equivalent

Year 2:

# of Hours or $ equivalent

Year 3*:

# of Hours or $ equivalent





























*Only applicable to LFPP implementation grants. LFPP planning grants are only 18 months.


    1. The following items/activities with a total fair market value of $XXX:

Item/Activity

(add additional lines as needed)

Fair Market Value per Unit:

How Fair Market Value Determined (must provide documentation):

Amount Donated Year 1:

Amount Donated Year 2:

Amount Donated Year 3*:


$


$

$

$


$


$

$

$


$


$

$

$


$


$

$

$

*Only applicable to LFPP implementation grants. LFPP planning grants are only 18 months.


Sincerely,


[Signature of Matching Organization Representative]

[Printed Name of Matching Organization Representative]

[Title]

[Email, address and phone number if not already included on letterhead.]

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 0581-0240. The time required to complete this information collection is estimated to average 1 hour 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.


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