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DOH Amendment GVL24912-2 Page 1 of 5
Revision 04/2020
CONTRACT AMENDMENT
1. NAME OF CONTRACTOR
City of Renton - Farmers Market
dba Renton Farmers Market
2. CONTRACT NUMBER
GVL24912
ADDRESS OF CONTRACTOR (STREET)
1055 South Grady Way
2a. AMENDMENT NUMBER
CITY, STATE, ZIP CODE
Renton, WA 98057
2
3. THIS ITEM APPLIES ONLY TO BILATERAL AMENDMENTS.
The Contract identified herein, including any previous amendments thereto, is hereby amended as set forth in Item 5
below by mutual consent of all parties hereto.
4. THIS ITEM APPLIES ONLY TO UNILATERAL AMENDMENTS.
The Contract identified herein, including any previous amendments thereto, is hereby unilaterally amended as set forth
in Item 5 below pursuant to that changes and modifications clause as contained therein.
5. DESCRIPTION OF AMENDMENT: The purpose of this amendment is to add federal funds, extend the period
of performance to December 31, 2021, and add special requirements for participation in the Gus Schumacher Nutrition
Incentive Program (GusNIP) grant from the U.S. Department of Agriculture (USDA).
5.a Statement of Work: Exhibit A-1 is revised in accordance with Exhibit A-2, attached hereto and incorporated
herein.
5.b Consideration: This amendment increases the Contract Consideration by $22,000; therefore, the revised
maximum consideration of this contract and all amendments shall not exceed $34,500.
Source of Funds for this Amendment: (FED) $22,000; (ST) $0; (Other) $0; Total $22,000
Contractor agrees to comply with applicable rules and regulations associated with these funds.
5.c Period of Performance: remains is extended through December 31, 2021.
5.d The Effective Date of this Amendment: is effective Upon written notification from DOH that the Contractor has
been approved by the USDA to participate in the GusNIP grant (approval from USDA can take up to 30 days after
both parties have signed this contract .
6. All other terms and conditions of the original contract and any subsequent amendments thereto remain in full force and
effect.
7. This is a unilateral amendment. Signature of contractor is not required below.
Contractor hereby acknowledges and accepts the terms and conditions of this amendment. Signature is required below.
8. CONTRACTOR SIGNATURE (also, please print/type your name)
{{Sig_es_:signer1:signature}}
DATE
{{Dte_es_:signer1:date}}
9. DOH CONTRACTING OFFICER SIGNATURE
{{Sig_es_:signer2:signature}}_ }}
DATE
{{Dte_es_:signer2:date}}
This document has been approved as to form only by the Assistant Attorney General.
CAG-02-079, Adden #2-21
EXHIBIT A-2
STATEMENT OF WORK
DOH Contract GVL24912-2
DOH Amendment GVL24912-2 Page 2 of 5
Revision 04/2020
SNAP Market Match
PURPOSE: Washington State’s Fruit and Vegetable Incentive Program (FVIP) provides point of sale incentives
to Supplemental Nutrition Assistance Program (SNAP) clients. One part of the FVIP is SNAP Market Match at
farmers markets. Farmers markets will implement SNAP Market Match to increase the purchasing power of SNAP
clients to purchase fruits and vegetables. SNAP Market Match is supported in part by a GusNIP grant.
Scope of Work:
1. Implement the SNAP Market Match program, which includes but is not limited to:
a. Providing $1 of fruit and vegetable “incentives” for $1 every SNAP clients use to purchase SNAP eligible
items, up to $40 per day (daily customer “cap”). Incentives can only be used for fresh fruits, vegetables,
mushrooms, fresh herbs, and edible plant starts.
Using standard currency and promotional material as provided by DOH.
2. Report SNAP transaction data, which includes:
a. SNAP and incentive distribution for each SNAP/EBT transaction each month – including transaction
date, market name, SNAP sale amount, incentive distribution amount, last 8 digits of EBT card, and zip
code. Reporting will be through the tablet/app provided by DOH. Farmers markets can use paper tracking
during the market day, but need to transfer this data to the table/app.
b. Farmers markets must return DOH issued tablet to DOH at the conclusion of contract period.
c. SNAP and incentive redemption each month – including SNAP and incentive amount redeemed by
vendors. Reporting will be to the designated Technical Assistance Provider, unless otherwise directed by
DOH.
3. Market will provide courtesy notification to DOH when planning to use SNAP Market Match logo for
promotional materials with a wide reach (i.e., videos, websites). Market will include the following funding
statement on promotional materials: “SNAP Market Match is made possible and administered by Washington
State Department of Health.” Market will also include a link to the SNAP Market Match website and the
statement “find more information at www.doh.wa.gov/SNAPMarketMatch.”
4. Farmers markets must notify DOH when 75% of annual budget for SNAP Market Match incentives has been
redeemed based on the 2021 budget detailed on page 4. This notification will allow DOH and the market time
to amend this agreement as necessary.
5. Farmers markets must maintain copies of EBT batch settlement tape, EBT account records, and/or bank
account information affiliated with EBT transactions. DOH may ask to see this information to verify payment
to vendors for EBT currency. Farmers markets must make this information available to DOH upon request.
See General Conditions 14. RECORDS, DOCUMENTS, AND REPORTS for DOH’s full record retention
requirement.
6. Train staff, volunteers, and vendors on the statewide SNAP/EBT Match Program, with the assistance of the
Washington State Farmers Market Association and a Technical Assistance Provider (designated by region by
DOH).
7. Promote the SNAP/EBT Match program to SNAP clients at your farmers market.
8. Invoice Department of Health on a monthly basis (see Payment and Deliverable sections below).
9. Work with the region’s Technical Assistant Provider to troubleshoot issues related to the SNAP/EBT Match
Program and reporting.
Payment:
Payment will come from two different funding sources, with different payment periods and allowable
reimbursements. See table on page 4 for a breakdown.
1. State funding must be used by June 30, 2021 and allowable reimbursement is for incentives redeemed
only. State funding reimbursement cannot exceed $10,000. State funding must be spent down before
contractor can bill to federal funding.
EXHIBIT A-2
STATEMENT OF WORK
DOH Contract GVL24912-2
DOH Amendment GVL24912-2 Page 3 of 5
Revision 04/2020
2. NEW for 2021: Federal funding must be used by December 31, 2021 and allowable reimbursements are
for incentives and administrative costs (calculated at 10% of incentives). Federal funding reimbursement
cannot exceed $22,000.
The contractor will invoice monthly on A-19 invoice form provided by DOH and send the invoice to a DOH
designated email for timely processing and reimbursement.
Payment will only be dispersed if Deliverable #1 and #2 is up to date for the respective month.
Funding Source Payment Period Amount DOH will reimburse Allowable
reimbursements
State July 1, 2020 – June
30, 2021
$10,000 Incentives
Federal January 1, 2021 –
December 31, 2021
$22,000, which includes:
Incentives: $20,000
Administrative Costs: $2,000
Total Federal: $22,000
Incentives and
Administrative
Costs (calculated at
10% of Incentives)
Deliverables:
1. SNAP and incentive distribution for each SNAP/EBT transaction each month– including transaction date,
market name, SNAP sale amount, incentive distribution amount, last 8 digits of EBT card, and zip code.
2. SNAP and incentive amounts redeemed by vendors each month.
Special Requirements:
Gus Schumacher Nutrition Incentive Program (GusNIP) Grant Project Participation
1. Firm Contact Information
Street: 233 Burnett Avenue South, Renton, WA 98057
Mailing: 1055 South Grady Way, 6th Floor, Renton, WA 98057
FNS#: 049-9053
Operates: Tuesdays 3pm - 7pm, June-September
2. GusNIP Grant Project Participation
a. Time Period: The Firm’s participation in DOH’s GusNIP grant project will occur during a time period
defined as beginning January 1, 2021 and ending on August 30, 2023.
b. Incentives offered at firm: customer of the Firm who participate in the federal Supplemental Nutrition
Assistance Program (SNAP) will be eligible to use SNAP to purchase any SNAP eligible item and
receive an incentive of $1 to spend on fresh vegetables, fresh fruits, mushrooms, fresh herbs, seeds, and
plants that produce food up to $40 per day.
3. Data Collection: the Firm will provide the Grantee with all incentive transaction-related data necessary for a
robust evaluation of the GusNIP grant project with the mutual understanding that this data will be furnished
by USDA NIFA, FNS, and GusNIP evaluators. These data include:
a. Site and Project Information
i. Management or organizational structure of the program
ii. Financial instrument used for SNAP and incentive purchases (tokens, scrip, electronic, etc.)
iii. Retail locations, mobile routes, or other pertinent information to understand how the project improves
access to healthy food for underserved, low-income consumers
iv. Months of operation and operating days and hours
EXHIBIT A-2
STATEMENT OF WORK
DOH Contract GVL24912-2
DOH Amendment GVL24912-2 Page 4 of 5
Revision 04/2020
v. Whether it is a new SNAP incentive program or the continuation, expansion, or modification of an
existing program
vi. Whether program sites accept other nutrition assistance program benefits
vii. Whether program sites collaborate with nutrition education programs or offer other experiential
nutrition education activities
viii. Expenses associated with establishment and operations of the program
b. Incentive Program Information
i. Fruit and vegetable products eligible for incentives
ii. Incentive level (ratio and maximum)
iii. Incentive delivery mechanism
iv. Dollar value of SNAP purchases (per site/per year)
v. Number of SNAP transactions (per site/per year)
vi. Dollar value of incentives issued (per site/per year)
vii. Dollar value of incentives redeemed (per site/per year)
viii. Average incentive value redeemed per recipient (weekly/monthly/annually)
c. Firm Regulations: the Firm will follow all relevant GusNIP and SNAP rules including, but not limited to,
the following:
i. The Firm will only accept incentives for GusNIP qualifying fruits or vegetables;
ii. The Firm will never accept incentives for ineligible products (i.e., non-food, alcohol, tobacco, or hot
food products);
iii. The Firm will never exchange incentives for cash (i.e., trafficking);
iv. The Firm will never provide cash or SNAP EBT change for incentives;
v. The Firm will never provide cash or SNAP EBT refunds for incentives;
vi. The Firm will never accept incentives from individuals known not to be legally entitled to possess
incentives;
vii. The Firm will never accept incentives to pay credit accounts; and,
viii. The Firm will never knowingly provide false information of a substantive nature regarding their
participation in the grant project.
The Firm acknowledges that failure to abide by GusNIP and SNAP rules, at any firm location, may result in
SNAP disqualification, civil money penalties, and/or criminal penalties.
d. Grantee Regulations: The Grantee acknowledges that failure of the Grantee to abide by GusNIP grant
program rules may result in rescission, in whole or in part, of grant funds.
e. Grantee Responsibility for Firm: The Grantee acknowledges that they are responsible for overseeing
firms participating in their grant project to ensure that SNAP and GusNIP rules are followed; and that
they will be held responsible for instances of noncompliance that occur at any of their participating firms.
The Grantee and the Firm hereby acknowledge the above regulations and agreements and commit to uphold them
throughout the duration of the GusNIP grant program, or until this agreement is superseded by a future
memorandum of understanding to ensure continued compliance with USDA FNS guidelines.
EXHIBIT A-2
STATEMENT OF WORK
DOH Contract GVL24912-2
DOH Amendment GVL24912-2 Page 5 of 5
Revision 04/2020
Sanctions:
Sanction Table
Violation Actions
#1 Failure to comply or respond to Technical
Assistant Provider inquiries
If Technical Assistance Provider does not receive a
response from market within 10 business days of
original email, they will send follow-up email
#2 Failure to comply or respond to Technical
Assistant Provider inquiries
If Technical Assistance Provider does not receive a
response from market to follow-up email within 5
business days, they will send a second follow-up email
and phone call
#3 Failure to comply or respond to Department of
Health inquiries
If Technical Assistance Provider does not receive a
response from market within another 5 business days
they will escalate to Department of Health staff. DOH
staff will call market and send a follow-up email with
cc to TA.
#4 Failure to comply or respond to Department of
Health inquiries
If DOH staff does not receive a response from market
within 10 business days of email and call, DOH will
terminate contract due to non-compliance effective 30
days from the last date of attempted contact.
Both the Technical Assistance Provider and Department of Health staff will take into account the documented
preferred communication method of the farmers market and attempt to contact them using that method when
possible. Email and phone calls may be substituted for other means of communication per the markets
documented preference (i.e. text messaging).
GVL24912-2 City of Renton Farmers Market
Final Audit Report 2021-04-14
Created:2021-03-18
By:WA Department of Health Contracts Office (dohcon.mgmt@doh.wa.gov)
Status:Signed
Transaction ID:CBJCHBCAABAAaBLQ71h3J6I9hYYYt49ofg02QRW5r0Ox
"GVL24912-2 City of Renton Farmers Market" History
Document created by WA Department of Health Contracts Office (dohcon.mgmt@doh.wa.gov)
2021-03-18 - 4:56:05 PM GMT- IP address: 192.230.13.106
Document emailed to Carrie Olson (clolson@rentonwa.gov) for signature
2021-03-18 - 4:56:43 PM GMT
Email viewed by Carrie Olson (clolson@rentonwa.gov)
2021-03-18 - 5:01:00 PM GMT- IP address: 146.129.251.56
Document e-signed by Carrie Olson (clolson@rentonwa.gov)
Signature Date: 2021-04-13 - 7:13:28 PM GMT - Time Source: server- IP address: 146.129.251.56
Document emailed to WA Department of Health Contracts Office (dohcon.mgmt@doh.wa.gov) for signature
2021-04-13 - 7:13:30 PM GMT
Email viewed by WA Department of Health Contracts Office (dohcon.mgmt@doh.wa.gov)
2021-04-14 - 3:32:03 PM GMT- IP address: 192.230.13.106
Document e-signed by WA Department of Health Contracts Office (dohcon.mgmt@doh.wa.gov)
Signature Date: 2021-04-14 - 3:34:44 PM GMT - Time Source: server- IP address: 192.230.13.106
Agreement completed.
2021-04-14 - 3:34:44 PM GMT