MAC GOODS Program Recipient Application

MAC GOODS Program Recipient Application

This is an application for groups to apply for donations from the Greater Good GOODS Program, through the Ambassador McKamey Animal Center. Donors provide wholesome, nutritious food on an as-available basis only. Recipient organizations are not able to request specific food types (e.g., grain-free) or brands. Food and supplies (the "Donated Goods") are for distribution to pet owners in need or for the Recipient Group’s use only. They may not be sold, rented, or exchanged for other goods or services nor presented for refund. Each Recipient Organization must complete its own application. MAC may collect a handling fee from Recipient of no more than $0.15/pound for food/litter or $25/pallet for goods. Submitting this form does not guarantee approval to receive products, nor does acceptance guarantee specific types, schedules or amounts of distribution.
Organization Name*
Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Non-profit tax ID/EIN (if applicable)
Please attach a copy of your organization's IRS 501(c)(3) determination letter (if applicable)

Cancelof
Contact Name*

First NameLast Name
Contact Phone Number*
Please enter a valid phone number.
Contact Email*
example@example.com
Organization Website*
What is your organization's primary function:*

Animal Welfare Group (e.g. animal shelter/rescue group/animal control)Human Services Organization (e.g. food bank, advocacy group)

By submitting this application you agree and acknowledge the following terms and conditions:
1. You are authorized to sign this agreement on behalf of this organization and certify that the information set forth in this application and supporting documentation is correct
2. You have read and understood the criteria that apply to this application and certify that the group meets each one.
3. The IRS determination letter (if applicable) has not been revoked, canceled or modified.
4. That MAC may collect a handling fee from Recipient of no more than $0.15/pound for food/litter or $25/pallet for goods for each distribution made.
5. That food shall be protected against dampness, deterioration, and mold or from contamination by insects, birds, rodents or other animals
6. That food spoiled or otherwise contaminated shall not be served.
7. To abide by restrictions or conditions of distribution, if any, imposed by the source of Donation and communicated to Recipient by Donor.
8. Any raw meat provided is not fit for human consumption and shall be used solely for feeding animals.
9. That feeding pet food to ruminant animals is prohibited.
10. To not sell, transfer, trade or barter any Donation or portion thereof in exchange for money, property or services or otherwise allow the items to enter commercial channels.
11. To release both Donor and Donor’s source(s) from any liability arising from the condition of Donation and further agrees to indemnify and hold harmless Donor and its source(s) against any and all damages, losses, claims, causes of action and suits of law or in equity or any obligation whatsoever arising out of or attributed to any action of in connection with Recipients receipt, handling or distribution of Donation.
12. That Greater Good and MAC may list your organization as a participant in its publications, website or other informational materials but will not sell or disclose non-contact information for any commercial purpose.
13. That goods or services are provided on an "as is" and "as available" basis. Greater Good and MAC expressly disclaim all warranties of any kind, whether express or implied, including, but not limited to the implied warranties of merchantability or fitness for a particular use or purpose.
14. Your organization grants to Greater Good and MAC the following: 1) the right to include on its website a link to your organization’s website(s), 2) the right to use any image(s) that you submit to Greater Good and/or MAC or that may be recorded by Greater Good or MAC during or in connection with events that involve both organizations.
15. Permit monitoring, including a site visit if requested, by a Donor representative, as reasonable and necessary to verify that compliance with criteria, receipt, handling and use of Donation conform to this Agreement.
16. Applicant grants permission to Greater Good, MAC and pet products donors to use information contained in this application for their internal evaluation and response procedures.
17. All Handling Fee payments are to be made payable to the MAC as requestedand prior to receipt of product, and in no event made to any individual or other organization.
18. I have read and agree to the terms and conditions described in this application.*
Signature*

Clear
Should be Empty: