BOLO Organization Annual Application & Agreement

Organization Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Email

Website

Lead Pastor/Director

In order to utilize the services provided by the Bread of Life Outreach, please agree to the following criteria:

Our organization is a Non-profit 501(c) (3) (Please email your organization’s most recent IRS or state tax exempt aﬃrmation letter AND your program’s 501(c) (3) documents to bolo.newport@gmail.com)

Your response

We will not sell, barter, exchange, trade or transfer any food or products received from Bread of Life Outreach in exchange for money, services, or other products or use food items in any fashion other than to serve clientele.

Your response

We will notify the Bread of Life Outreach if program changes location and/or director.

Your response

Any event or program using product from BOLO will not engage in discrimination, in the provision of service, against any person because of race, color, citizenship, religion, sex, national origin, ancestry, age, marital status, disability, sexual orientation including gender identity, unfavorable discharge from the military or status as a protected veteran.

Your response

We will provide transportation to pick up food at the BOLO warehouse in a clean vehicle with a means of protecting the load and using proper temperature control devices.

Your response

We will ensure that all food storage and handling will conform to state and local regulations including timely distribution to clients.

Your response

BOLO, or any BOLO donors are released by the feeding program from any liabilities resulting from the donated food, are held harmless from any claims or obligations concerning the agency or the donated goods and have no express warranties in relation to the gift of goods.

Your response

We will abide by specific donor requests as indicated by BOLO.

Your response

We will prayerfully consider financial support with a monthly donation & understand there is no minimum amount. If we can give, we agree to send our donation no later than 14 days after product is received.

Your response

All items are accepted in “as is” condition. We assume responsibility for product and will not use products from BOLO in a way that would tarnish BOLO’s good reputation.

Your response

When we get food from BOLO, the primary use will be:

Using food for church ministry/outreach

Food distribution (pantry, backpacks, etc.)

Soup kitchen/dinner

Other (describe below)

Other description:

Approximately what percentage of the food you distribute comes from BOLO?

How many individuals does your organization serve each month?

If you are serving meals, how many meals are you serving each month?

BOLO is grateful to partner with you! How can you support?
We respectfully ask that ALL organizations prayerfully consider financially supporting BOLO with a monthly donation. The products received are at no cost to your organization, but the monthly operational costs to BOLO are significant and are made possible through generous contributions by our donors. There is no minimum, but we do ask that each organization faithfully contribute.

In faith, our organization agrees to donate the amount below, per month toward the operating costs of BOLO. We agree to send donations no later than 14 days after product is received.

Ways to Donate: Check payable to Newport Assembly of God
(Memo: BOLO) & mail to Newport Assembly of God 253 North 6th Street Newport, PA 17074.

Give online at https://newportassembly.org/give
(Under Fund choose Bread of Life Outreach)

If you received product, please share a story about how BOLO enhanced your ministry/event. Share stories and photos that we have permission to share on social media or with our partner organizations donating products. Email stories and photos to:
mark@newportassembly.org

I hereby declare that I have read this letter of agreement in its entirety and fully understand and agree to the rules and regulations. It is agreeable that this feeding program will abide by this letter of agreement in order to be in compliance and remain in good standing as a member of the Bread of Life Outreach’s network. Bread of Life Outreach can terminate this agreement with or without notice.

By signing below, we agree to abide by all policies and procedures.

Signature

Todays date