WVDA: Farm & Food Business Mini Grants
Purchasing Request Form
Reasons to complete this form:
This form is to be completed when either seeking approval for making an equipment purchase (for one item of value $5,000+) or for selecting a contractor's/consultant's bid for grant funded activities (valued at a contract of $10,000+) or when making a request of the West Virginia Food & Farm Coalition (WVFFC) to make such large, SINGLE item purchases or payments on your behalf as making the purchase would be prohibitive. The questions below are to ensure that federal requirements for compliance are being followed by all parties as agreed upon. If you have questions about the information and documentation required below to make a request please reach out to our office at 304-926-0567 and ask to speak with Bethany Lewis. Approvals for purchase/payment requests made should be confirmed within 10 business days to be sent via the email provided below. Follow up/questions regarding purchasing made by WVFFC will occur within 30 business days after the request has been reviewed for purchasing to be completed.
Grantee Contact Information
Business or Applicant Name Provided:
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Questions to be completed by those Grantees requesting that WVFFC make the purchase on your behalf
This is a request of WVFFC to make a purchase or contractor payment on my behalf. Check here:
Yes
If this is a request for WVFFC to make a purchase of equipment or of a large amount of materials and supplies/equipment from a SINGLE vendor please provide information below. We will need one or more separate links for the item(s) to be purchased from the dealer's website. After each link please include details such as specs for the sizing/detail of the item. Also, if various quantities can be selected or color, etc. please detail which you prefer.
(i.e., some websites will include items in various sizes or quantities found to be similar at one link the desired size/quantity of the item to be purchased is needed)
Address: If a purchasing request is made, please include the proper mailing or physical address where the goods/item can be received from a shipping company (please take into consideration the size of the delivery and whether or not lift gate may be required)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is freight shipping with a lift gate required? Check here:
Yes
I acknowledge that this is my one allowable large single-item purchase to be processed directly by the West Virginia Food and Farm Coalition (WVFFC) on my behalf. I understand that all other purchases must be made by me and submitted for reimbursement. (Note: WVFFC is here to support you, so if you have any questions or need help navigating this process, please don’t hesitate to reach out to mmartin@wvfoodandfarm.org.) Check here:
Yes
For those Grantees who are making a request of equipment or contractor that will cost a grand total of $5,000/$10,000+ upload the required bids from three suppliers or contractors below
It is then also required of you to complete the last question below providing for your justification of the supplier/contractor you are choosing to receive payment from this grant award
File Upload: MUST upload three separate quotes/bids selected from below
Browse Files
Drag and drop files here
Choose a file
Cancel
of
File Upload:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
File Upload:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Which of the three quotes/bids included above have you chosen to use?
Provide a statement explaining why you selected the one from above. The reason does not have to be that it was the cheapest of the options, but if it is not make sure you provide information as to why you did not choose that one. Examples of rationale could include quality, materials used in production, location, known manufacturer, etc.
Submit
Should be Empty: