**To keep a copy of this application, use your browser to save this page as a "Complete Webpage."**

USDA -- Food and Nutrition Service

Supplemental Nutrition Assistance Program (SNAP)
Community Partnerships to Increase SNAP Enrollment

This application has two options: 

1. SNAP Outreach partnership with federal, financial reimbursement.
2. SNAP Outreach partnership without financial reimbursement.

The first option includes a thorough verification process of the applicant organization's fiscal health and stability.

The second option is for organizations that would like to enjoy the benefits of the SNAP Outreach Partnership without any financial requirements.

Organizational Info

Organization Description

Please provide a few brief sentences about your organization, including its mission, history, relevant experience or programs, and the funding sources for its SNAP outreach activities. This information will be provided to DES and USDA and may also be published on the Wildfire and DES websites.

Scope of Work 

The goal of the SNAP Partnership is to educate, inform, and assist low-income and likely eligible community members in accessing SNAP benefits to help alleviate hunger and food insecurity in Arizona.

Fill out the form below in concise and clear sentences to outline your organization's goals and innovative outreach/education methods. Be sure to highlight and clearly explain what makes your program effective.

Highlight 5 key aspects of your organization's planned outreach activities:

Scope of Work -- Outreach Goals

Please provide estimates of your organization's goals for promoting SNAP to your community members in the coming federal fiscal year (October through September).

Information Distribution

Self-Service Activity

(Services are available to clients, but organizations do not assist with filling out the application)

Full-Service Activity

(Organizations work with clients to walk through all the steps of the application)

Returning Partners

If your organization is applying as a recurring partner, part of your application evaluation will be based on your organization’s past performance. If your organization faced any extenuating circumstances that you believe hindered your past SNAP partnership performance, please indicate why this occurred and what solutions you will implement for the new fiscal year.

If you are a new applicant, please enter "N/A" in the textbox below.

Financial Documents and Info

**This page can be temporarily skipped if you do not yet have the information and/or documents ready for submission.  The information collected here will be required before you can submit the application.**

You will be required to submit the most recent audit report for your organization. 

If an audit report is not available, you may submit the most recent set of financial statements (statement of financial position/balance sheet, statements of activities, cash flow, and functional expenses).

Submit a W-9 Form

Click Here to download a blank W-9 form.  Submit a completed and signed copy below.

Organizational Budget/Finance Responsibilities

This contact person will be responsible for informing Wildfire of performance concerns of which the organization becomes aware in the performance of its duties and responsibilities. 

This person will also be responsible for providing, in a timely manner, original or copies of required documentation, and for being available to Wildfire and DES for consultation and assistance during the organization's normal business hours and days of operation.

Budgetary/Finance Contact Address:

Sunshine Park Locations

Please enter the contact information for each of your locations where SNAP application assistance activities will take place.  All locations will be listed on Wildfire's searchable map of SNAP Outreach services.  You may opt out of publication for locations that provide domestic violence services.

Sunshine Park Staffing Budget

Projected SNAP Outreach Budget and Justification

In each of the following budget categories that you choose to include in your overall SNAP Outreach budget, you will be required to provide a budget narrative that justifies the expense.

The "Total SNAP Expense" figure in each category represents the cost that your organization will incur to support SNAP outreach and application assistance activities.  You will also be required to explain how the "Total SNAP Expense" figure in each category was determined.  

Personnel & Employee Related Expenses (ERE)

Copying/Printing/Materials

Expenses in this category consist of costs related to the in-house and outsourced production of SNAP informational material such as flyers, newsletters, pamphlets, brochures, and newspaper advertisements.

Internet/Telephone

Expenses in this category consist of costs related to cellular phone monthly charges, desk phone (i.e., landline) monthly charges, and Internet connectivity monthly charges. Internet connectivity can refer to Internet connections delivered through physical means such as cabled networks or through wireless devices such as mobile hotspots.

Smart phones and mobile hotspot devices are capped at a maximum reimbursement of $50.00 per device per month, and mobile phones without smart features or hotspot capability are capped at a maximum of $25.00 per device per month.

Equipment & Other Capital Expenditures

Expenses in this category are only for individual purchases that will exceed $5,000.  Costs for laptops and other computing devices under $5,000 should be included in the next category (Supplies and Non-Capital Expenditures).

Supplies & Non-Capital Expenditures

Expenses in this category consist of costs associated with the purchase of computing devices such as laptops, printers and scanners, as well as supplies used during SNAP access and information operations. All computing device expenditures must be approved and evidenced by a sales receipt before reimbursement will be provided.

Examples of supplies allocated to this line item include pens, pencils, paperclips, files, folders, business cards and notepads. Reinforcement items purchased with program funds must have a direct relationship to program directives and are capped at a maximum value of $5.00 per item. Reinforcements may not be used to incentivize clients to apply for benefits and must be of an educational or informational nature. 

Building/Space

Expenses in this category are based on the percentage of square footage used for SNAP outreach operations. Staff salaries are not factored into the calculations.

When the building or space is rented from another entity, rent is the principle occupancy cost used in the calculation for reimbursement.  When the building or space is owned, building-related costs are the principle occupancy costs used in the calculation for reimbursement (depreciation, maintenance, security, taxes, insurance, utilities, etc.)

You may not apply a use allowance to projections, nor include building/space expenditures as both a direct and indirect cost.

Other Expenses

Expenses in this category consist of costs associated with expenditures that cannot be allocated to a different direct cost category or to indirect costs.

In general, this category can include the allowable, reasonable, and necessary costs of professional memberships, dues and subscriptions and costs associated with outsourced services such as information technology support and accounting. Additional costs beyond these types will be considered if they are determined to be reasonable, allowable and necessary and are not obviously allocable to an alternative direct cost category.

Long-Distance Travel (Out-of-State)

Expenses in this category consist of costs associated with travel to training and conferences outside of Arizona.

Local Travel (In-State)

Expenses in this category consist of costs associated with SNAP Outreach-related travel inside of Arizona and costs related to attending Wildfire's annual conference.

Contractual

Expenses in the category consist of costs associated with outsourced services. In general, costs for accounting services, contract staff, web hosting and information technology are allocated to this category.

Indirect Costs

Organizations that do not allocate indirect costs to the direct cost categories can choose to include this category in their projected budget.

Calculations for indirect costs should only be performed by organizations whose accounting systems are equipped to handle them correctly.

Sunshine Park Line Item Budget

Each partner organization must be able to match at least 50% of its total SNAP Outreach budget with funds that are not derived from federal sources.

Your organization's total, non-federal match requirement from the budget you have proposed above is $90,668.75. 

Please indicate below the total amount of these matching funds that your organization has already secured for the upcoming federal fiscal year (October through September).

Memorandum of Understanding

By signing and submitting this Memorandum of Understanding (MOU), you are certifying that all of the information contained in this application is true and correct.

If your application is approved by Wildfire, DES, and USDA, you will receive a countersigned copy of this MOU.  The approval process takes several months and may require additional information and clarification.

UNITED STATES DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICES

Supplemental Nutrition Assistance Program

Draw-Down Funding for Community Partnerships to Increase SNAP Enrollment

This is a partnership agreement between

Wildfire

and

Sunshine Park (Hereinafter "SCP")

I. PURPOSE AND SCOPE

The purpose of this Memorandum of Understanding (MOU) is to clearly identify the roles and responsibilities of each party. Wildfire is the entity responsible for enrolling and supporting SNAP Community Partners (SCPs) as well as administering the draw-down of USDA funds through the Arizona Department of Economic Security (DES).

This Partnership is intended to help inform potentially eligible households about the availability, eligibility requirements, application procedures and benefits of the Supplemental Nutrition Assistance Program (SNAP), also known as Nutrition Assistance in Arizona. To support this goal, Wildfire and SCP will participate in activities targeting eligible households, providing accurate information, serving as a trusted source of information in the community, and assisting households with completing the application process, preferably through the Health-e-Arizona online application portal.

Both Wildfire and SCP should ensure that program activities are conducted in compliance with all applicable Federal laws, rules, and regulations including Civil Rights and Office of Management and Budget (OMB) circulars governing cost issues.

All applicants and recipients of SNAP benefits are granted civil rights in accordance with Federal laws and US Department of Agriculture, Food and Nutrition Services (USDA) policy that services will be provided without discrimination on the basis of race, color, national origin, age, sex, disability, sexual orientation, political beliefs, or religion.   

II. MOU TERM

The term of this MOU Agreement is the period within which the project responsibilities of this agreement shall be performed. The term begins October 1, 2024, and ends September 30, 2025. 

III. WILDFIRE ROLE AND RESPONSIBILITIES

1. Wildfire shall serve in the following roles and maintain responsibilities stated herein during the duration of the MOU term:
1. Provide guidance and resources to SCP regarding applicable federal and state laws, regulations, and program guidelines.
2. Review and approve all documentation evidencing SCP’s performance of services as set forth in the Scope of Work and monitor SCP’s compliance with the MOU.
3. Provide training and technical assistance to SCP on SNAP, promising practices related to outreach, improving access, increasing program participation, and fiscal and programmatic rules and regulations on an as-needed basis.
4. Promptly process activity reports and invoices submitted by partners on a monthly basis. Invoices and activity reports will be processed by Wildfire no later than the 20th of each month, or the first day of business thereafter, in the event the 20th of the month occurs on a non-business day for Wildfire. Activities must be eligible for USDA draw-down as allowable expenses according to the terms and conditions set forth in this MOU. SCP is responsible up front for all costs incurred, and reimbursement will be provided only for allowable activities as approved by Wildfire, DES, and USDA.
2. Wildfire liability for funds related to this Partnership is limited as follows:
1. SCP acknowledges that all funds to be provided pursuant to this Agreement will be provided by USDA.
2. Wildfire’s obligations under this Agreement are subject to USDA’s provision of funds pursuant to the Program Documents. 

IV. SCP RESPONSIBILITIES

1. SCP shall agree to the following during the duration of the MOU term:
1. Provide SNAP outreach services and application assistance as outlined in the approved Partnership Agreement, Scope of Work, and Program Budget.
2. Follow all relevant laws and regulations regarding documentation, reporting, use, etc. of these federal funds in accordance with OMB circulars A-122 relocated to 2 CFR Part 230; and A-133 (for non-profits) or OMB circulars A-87 relocated to 2 CFR, Part 225 and A-133 (for State, Local, and Indian Tribal Governments) or OMB circulars A-21 (for Educational Institutions). Link to OMB Circulars.
3. Furnish project management, contract administration and fiscal control services, including but not limited to:
1. Adherence to the approved Partnership Agreement, Scope of Work, Assurances, and Program Budget.
2. Preparation and timely submission of complete and accurate monthly expenditure and activity reports. Activity and expenditure reports shall reflect 100% of activities completed and expenses incurred for the program. SCP will be reimbursed for 40 percent of allowable expenses included on the report (invoice) up to and not to exceed the SCP’s approved Program Budget, unless alterations or changes receive prior approval. A monthly report of activities completed and expenses incurred shall be submitted by the 10th day of the month following the month for which draw-down is requested. For example, SCP must submit a report by November 10th to receive a draw-down of funds for October’s expenses.
3. Participation in trainings and meetings as requested by Wildfire, including monthly Partner calls.
4. Participation in evaluation of SNAP Outreach.
5. Retention of all records supporting the funds used for draw-down, as well as any additional expenditures covered by the draw-down funds for five (5) years after the end of the contract term. This requirement applies to fiscal records, reports and client information. Additionally, SCP agrees to make all records relating to draw-down activities and expenses available upon request by Wildfire, DES and/or any Federal entity. Any costs that cannot be substantiated by source documentation may be disallowed.
6. Return of any funds necessary to repay Wildfire for any disallowed expenses in which SCP has not complied with the requirements of this MOU and applicable state and federal regulations. Funds will be returned to Wildfire within 30 days of receipt of written notification. vii. Submission of a copy of audited financial statements to Wildfire nine months after the end of the SCP’s fiscal year during which this Agreement falls. SCP agrees to provide access to auditors to determine compliance with federal regulations. If SCP does not undergo an annual audit process, alternative arrangements may be made upon approval of Wildfire. The CFDA Number for this grant is 10.561.
4. Maintain proper standards of disclosure and confidentiality as set forth by USDA:
1. Case file information on SNAP recipients, including names of recipients, social security numbers, and other sensitive information is considered confidential and may not be released.
2. Disclosure of information obtained from recipients may be made only to persons directly connected with the administration of SNAP or to others provided that the program recipient signs a release form documenting their agreement to the specific release. Such an agreement shall not be a condition of receipt of benefits. (7 CFR Section 272.1(c); and (Section 11(e)(8) of The Food and Nutrition Act of 2008, as amended.)
3. State agencies and their contractors must protect confidential and private information gained from clients during the outreach process. Appropriate physical and computer security policies should be in place to protect sensitive information. 

V. WILDFIRE AND SCP AGREE TO THE FOLLOWING PROVISIONS

1. Documents prepared by organizations using program funding for external release, in print or other media, or via the internet, must undergo appropriate review and receive the necessary departmental approvals from DES prior to publication or distribution. Documents shall be submitted to DES for review and approval before publication. Reviews may take up to ten (10) working days. This MOU identifies the following documents intended for external release as subject to review:
1. Types of documents/communications:
• One-time, periodic, or occasional
• Providing factual information to the public or target audience to increase enrollment in SNAP
• Conveying a specific message to a select, target audience about SNAP Examples:
• Brochure
• Fact sheet
• Media campaigns and advertisements
• Newsletter
• Fotonovela
• Press release or other press materials
• Public Service Announcement
2. Press releases announcing events sponsored by SCP shall not require prior approval unless they include information about the Partnership described herein or SNAP eligibility or rules. Social networking, such as Facebook, Twitter, and blog posts, requires prior approval in cases where the partnership created herein or information regarding eligibility or programmatic rules is included. Wildfire and shall be notified upon release of any press release or social media piece released by SCP, and SCP shall provide copies of all releases to Wildfire at the end of the Term.
3. Materials, whether newly developed or reprinted, may require an appropriate acknowledgement/funding statement in accordance with state and federal agency specifications. SCP shall contact Wildfire for information on approved acknowledgement/funding statements and which types of materials should carry which version of the statement. For materials not listed, contact Wildfire for guidance on which statement is appropriate.
4. Any materials relaying information about SNAP shall contain the following statement (an abbreviated version of the statement is available if space constraints exist): 
• In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity. Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.
• To file a program discrimination complaint, a Complainant should complete Form AD-3027, USDA Program Discrimination Complaint Form, which can be obtained online at: https://www.usda.gov/sites/default/files/ documents/ad-3027.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:
• 1. mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; or
• 2. fax: (833) 256-1665 or (202) 690-7442; or
• 3. email: program.intake@usda.gov
• This institution is an equal opportunity provider.
• To request this document in alternative format or for further information about this policy, contact your local office; TTY/TDD Services: 7-1-1. • Free language assistance for DES services is available upon request. • Disponible en español en línea o en la oficina local. 

2. SCP shall prominently display the USDA nondiscrimination poster “And Justice for All,” provided by DES or Wildfire, at any facility providing services outlined in this Partnership. 

3. Program activities shall not supplant existing SNAP outreach programs, and where operating in conjunction with existing programs, shall enhance and supplement them.  

VI. FUNDING

1. Funding available for this program is on a monthly draw-down basis. Interested Partners must sign this MOU and provide Wildfire with a Partnership Agreement and Scope of Work for activities SCP expects to complete in the Term, as well as a Program Budget, Budget Justification, Assurances, current W-9, and any other requested documentation or information in order to apply to become an SCP. Funding is subject to the following terms:
1. Funding for this Partnership is 100% USDA Federal reimbursement and as such is subject to the availability of Federal funds. USDA may, due to internal budgeting decisions or changes in federal allocation, reduce or eliminate funding for this program at any time, with or without advance notice. Additionally, DES may choose to discontinue this Partnership at any time, with or without advance notice. SCP understands and agrees to hold harmless Wildfire for any funds expended for which SCP is not able to receive reimbursement due to termination of funding.
2. Funding for this Partnership is by reimbursement only. No request can be honored to advance funds or pay costs incurred by the SCP without prior approval by Wildfire and DES. Wildfire makes no guarantee of the reimbursement of federal funds and is not liable for any costs incurred by SCP which are not reimbursed by USDA and/or DES.
3. It is the responsibility of the SCP to monitor all contract expenditures by line item and ensure no overexpenditures occur. If an over-expenditure occurs, Wildfire and DES may disallow any costs exceeding the line item amount approved at the start of the contract year and reimbursement for amounts exceeding the approved budget will not be approved.
2. Funding is subject to approval by Wildfire, DES, and USDA. Wildfire will utilize the available USDA federal draw-down to provide SCP funds in accordance with SCP’s reasonable request, and Wildfire reserves the right to ask SCP to adjust the Partnership Agreement, Scope of Work and/or Budget to fit with the funding available.
1. SCP agrees to submit all reports and documentation required by the 10th day of the month following the month in which work was completed. Wildfire and DES will process the request through the proper channels and SCP will receive a check in the amount approved for matching draw-down, equal to a maximum of 40% of the funds expended by SCP for allowable activities in the month prior.
2. SCP is responsible for submitting an invoice for each month of the contract year. In months where no activity was completed under this Partnership, SCP is responsible for reporting this to Wildfire and submitting an invoice showing that no expenses were incurred for the month.
3. SCP acknowledges and accepts that reimbursement for allowable activities is dependent upon the approval of Wildfire, DES, and USDA. The aforementioned parties may disallow any expense reported which is not in accordance with the Allowable Activities outlined by USDA and/or not in accordance with SCP Partnership Agreement, Scope of Work and/or Budget.
4. SCP acknowledges and agrees that all invoices are subject to approval by DES and USDA, and Wildfire’s approval does not bind DES or USDA, nor constitute a guarantee by Wildfire of payment to SCP.
3. SCP agrees to indemnify, defend and hold Wildfire and its directors, officers, employees and agents harmless for, from and against any tax or other liabilities, losses, costs, expenses (including attorneys’ fees and court costs), penalties, claims, demands resulting from or arising out of a breach of this Agreement by SCP or SCP’s employees or agents, or resulting from or arising out of rendering services under this Agreement by SCP or SCP’s employees or agents or to the extent caused by the negligence or intentional misconduct of SCP or SCP’s employees or agents. Wildfire agrees to indemnify, defend and hold SCP and its directors, officers, employees and agents harmless for, from and against any liabilities, losses, costs, expenses (including attorneys’ fees and court costs), penalties, claims, demands to the extent caused by the negligence or intentional misconduct of Wildfire or Wildfire’s employees or agents. 

VII. MODIFICATION AND TERMINATION

1. This agreement may be cancelled or terminated without cause by either party giving thirty (30) calendar days advance written notice to the other party. Such notification shall state the effective date of termination or cancellation and include any final performance and/or payment invoicing instructions/requirements.
2. Any and all amendments must be made in writing and must be agreed to and executed by Wildfire and SCP before becoming effective.
3. Wildfire intends to Partner with multiple SCPs. This Partnership is non-competitive and can be terminated at any time by Wildfire. Wildfire reserves the right to terminate any Partnership without advance notice for any violation of contract agreement. 

VIII. SCP ASSURANCES

Please use the checkboxes next to each statement below to acknowledge SCP's agreement with each provision.

SCP is responsible for completion of all activities outlined in the Scope of Work and MOU. 

SCP is responsible for securing funds that are not derived from federal sources in the amount of at least 50% of SCP's total costs for its SNAP Outreach program.

The amount requested in SCP’s Program Budget is the maximum allowable reimbursement for the federal fiscal year and may only be payable for allowable expenses. SCP is responsible for timely repayment of any reimbursed costs deemed unallowable by DES or USDA. 

Activities included in the Scope of Work are those deemed allowable as outlined in the USDA guidance provided by DES and Wildfire. 

Volunteers may be utilized to help meet the Scope of Work, but their time cannot be billed to this Partnership. 

Only non-federal funds may be used to draw down a reimbursement. The non-federal funds used in this agreement may not be used for any other federal match. 

Funding for this program may be revoked by USDA at any time without prior notification. SCP is eligible for reimbursement only for allowable activities approved by Wildfire, and it is the sole responsibility of the SCP to pay any related expenses in full regardless of whether the requested reimbursement is provided by USDA. 

Documentation of activities, expenditures, and audits completed must be maintained by SCP for a minimum of 3 years after completion of the Term. It is the sole responsibility of the SCP to maintain all records and provide them to Wildfire, DES, and/or USDA upon request. 

Program activities are conducted in compliance with all federal laws, rules, and regulations including Civil Rights and OMB regulations governing cost issues. 

Program activities are reasonable and necessary to accomplish outreach goals and reach potentially eligible households. 

EFFECTIVE DATE AND SIGNATURE

This MOU shall be effective upon the signature of Wildfire and SCP authorized representatives. Wildfire and SCP indicate agreement with this MOU by their signatures. 

Sunshine Park

Wildfire