Child And Adult Care Food Program Center Sponsor Claim - Arizona Department Of Education

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ARIZONA DEPARTMENT OF EDUCATION
CHILD AND ADULT CARE FOOD PROGRAM CENTER SPONSOR CLAIM
th
Claims must be received by the 10
of the month following the claim month. Claim(s) are to be submitted
electronically at the CNP Web at https:// Sponsor must retain a copy of claim
for permanent record.
CTD #
Sponsor
Type of Submission:  Original
Claim Month/Year:
 Revision
____________________
Date of Revision: _____________
Income Received During Claim Month
Non-CACFP Income
CACFP Income
Value of Cash/Non-Cash Donations
Value of Excess Personnel Meals
Examples of CACFP Administrative and Operational Costs
Administrative Costs
Operational Costs
Itemized Costs
Overseeing Compliance
Direct Meal Service
(managing CACFP)
(preparation and service of meals)
Labor
Owner, Director, Monitor
Teachers, Cook
Benefits
Owner, Director, Monitor
Teachers, Cook
Staff Training
Labor, travel, materials for training
Food handler/food safety mgr training
Food
N/A
Net food used/delivered
Supplies and Equipment
CACFP office supplies; paper, pens, etc.
Bleach, paper plates/cups, pans, etc.
Rent/Mortgage
Office area
Kitchen, service areas
Contracted Services
Storage facility, computer maintenance
Pest control, refrigerator repair
Communication & Utilities
Phone, internet
Electricity, water
Other Costs
Computer, copy machine
Stove, refrigerator, grocery shopping
Actual CACFP Expenditures During Claim Month
Administrative
Operational
Salaries
$
$
Benefits
$
$
Food
N/A
$
Supplies
$
$
Rent or Mortgage
$
$
Contracted Services
$
$
Communication and Utilities
$
$
I:\Health_and_Nutrition\CACFP\Centers\General Documents\2008\CNP Web & Claiming Info\Sponsor Claim Worksheet.doc

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