Vendor Acknowledgment 2024 - Double Up Food Bucks Oregon

Double Up Food Bucks Oregon

Eligible Vendor Acknowledgment
SIGNED ACKNOWLEDGMENT MUST BE ON FILE WITH MARKET MANAGER PRIOR TO REIMBURSEMENT

IT IS YOUR RESPONSIBILITY TO INFORM YOUR MARKET MANAGER ONCE YOU HAVE FILLED OUT THIS FORM BY SENDING THEM A .PDF FILE OF THE AGREEMENT OR SENDING THEM A COPY OF THE JOTFORM CONFIRMATION EMAIL

**Effective 1/1/2024 through 12/31/2024**
This acknowledgment is for the purpose of authorizing the below-mentioned Vendor to accept Double Up Food Bucks (hereafter referred to as "Matching Currency") at the specified market/s (below) from SNAP participants in exchange for eligible fruits and vegetables only.
- THE CURRENCY IS GOOD FOR: any variety of fresh, dried, or frozen whole or cut fruits and vegetables without added sugars, fats, oils, or salt. Includes mushrooms, fresh herbs, dried beans, and edible plant starts.
- CURRENCY IS NOT GOOD FOR: nuts, grains, meat, eggs, cheese, baked goods, prepared foods, fermented foods, salsa, pickles, jams, jellies, honey, cider, juice, tea, or other foods that do not fit into the above guidelines; nonfood items.
THE MARKET AGREES TO:
1. Collect from the Vendor redeemed Matching Currency and to account for and pay the Vendor for any Bucks received by the last day of this market’s 2024 season.
2. Monitor sales to ensure program guidelines are being followed.
BY SIGNING THIS ACKNOWLEDGMENT, THE VENDOR AGREES TO:
1. Provide only eligible fruit and vegetables in exchange for Matching Currency.
2. Not give cash change for purchases made with Matching Currency.
3. Not provide cash or credit in exchange for Matching Currency.
4. Provide eligible fruits and vegetables at a price no more than the price charged to non-SNAP customers.
5. Not allow the return of fruits and vegetables purchased with Matching Currency in exchange for cash or for non-eligible items.
6. Be monitored by the farmers market or Farmers Market Fund for program compliance.
7. Not redeem Matching Currency for non-food items.
8. Not accept expired Matching Currency from customers, only current 2024 Food Bucks.
9. Educate employees on program guidelines and eligible fruits and vegetables.
10. Turn in all redeemed Matching Currency for reimbursement by the farmers market in accordance with market guidelines. The last day to turn in Matching Currency for reimbursement is the last day of this market’s 2023 season.
11. Only turn in Matching Currency for reimbursement at the market in which they were received.
12. A Vendor and/or employees who violate the provisions above may be financially responsible for the cost of the matching currency redeemed or disqualified from the program and not allowed to participate in future seasons.
Farmers Market Name*
Vendor Business Name *
Your business/farm name
Vendor Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Vendor Phone Number*
Please enter a valid phone number.
Vendor Email*
example@example.com
The Vendor, through signature below, acknowledges and accepts guidelines and agreements listed above.
Vendor Full Name *

First NameLast Name
Vendor Signature*

Clear
Date*

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Date
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