School-Age Certification Statements for CACFP during COVID 19

School-Age Certification Statements for CACFP during COVID 19
During the COVID-19 pandemic, centers and/or homes are permitted to claim reimbursement for meals served to school-age children who are enrolled for care. This option does not apply to school-age children over 12 years of age.
Name of Center*
Program Contact *

First NameLast Name
The undersigned delegated Principal/Program Contact certifies to the following with respect to monthly claims And program operation. Please maintain a copy of this form on file with your CACFP records. This institution, its Principals(s), Responsible Individual(s) and/or Authorized Representatives(s) certify that:
Certifications*

I will adhere to all program requirements outlined in the policy memo Guidance for Claiming School- Age Children in CACFP during COVID-19Program accountability will be maintained and the maximum number of meal(s) and/or snack(s) claimed for reimbursement will not exceed two (2) meals and one (1) snack or one (1) meal and two (2) snacks per child, per day for the School Breakfast Program (SBP), National School Lunch Program (NSLP) and Child and Adult Care Food Program (CACFP)If meal(s) and/or snack(s) are provided by a third party such as a parent/guardian or a School Food Authority (SFA), I will not claim these meals for reimbursement under the CACFP.
Signature of Principal Program Contact*

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