Capacity Building Equipment Grant Application – Spring 2015
Second Harvest Food Bank of Northwest NC
Capacity Building Equipment Grant Application
Second Harvest Food Bank of Northwest NC is excited to extend a Request for Application to our partner
agencies to apply for one or more of the following: (1) enclosed trailer; (1) utility trailer or (1) ULINE
industrial platform scale. Each program may apply for one of the trailer options, the platform scales
and/or both via the same application form. However, no program will be awarded more than one item
for the Spring 2015 grant cycle. Therefore, should your program choose to apply for a trailer and a
platform scale, please understand that your program will only be eligible to receive ONE of those items.
We encourage every program in need of greater capacity in these areas to apply, as recipients will be
chosen from across our service area and from all types and sizes of programs.
Applications must be submitted by close of business Friday, May 15th, 2015.
Late applications will not be accepted. No exceptions.
The equipment available through this application process is described below.
TRAILER OPTIONS (CHOOSE ONLY ONE)
ENCLOSED TRAILER – Leonard Cargo Trailer – Item No. TRLC – 0612STD-155VE
G.V.W.R.: 3,500 lbs.; Axle: Single EZ Lube Drop Axles; Side Wall Height: 6’-0”; Tires: ST205
15" Bias Play Tires; Interior Walls: 3/8" plywood; Frame System: 2” x 3" Tube with steel
stress plate; Cross Members: 2” x 3" Tube 24" oc; Wall Pickets: 1.5” x 1" Tube 24" oc;
Tongue: 2” x 4" Tube 3-piece
UTILITY TRAILER – Leonard Tandem Axle High Side Trailer – Item No. TRLU-6416LEO-280
G.V.W.R.: 7,000 lbs. G.V.W.R.; Heavy Duty Frame: 3"x4"x1/4" with 2"x3"x3/16" angle cross
members; Heavy Duty Tongue: 3 Piece Wrap-Around 4" channel 3"x3" square tube;
Removable Floor: Each floor board is screwed down making them easy to replace; High side
walls: 24" side wall with thick gauge metal mesh; Strong 4' Gate with slam latch system and
side handles - allows you to close the gate with one hand.
PLATFORM SCALES – ULINE Deluxe Model No. H-747 –
Platform size 18 x 23”; capacity is 660 lbs., accuracy within 0.1 lb.; unit weighs approximately 52 lbs.;
operates on rechargeable batteries or AC adapter (included); auto zero tracking; stainless steel
platform; recalls last weight; removable 26” tower included; calculates sample weight; counts up to
999,999 pieces.
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Capacity Building Equipment Grant Application – Spring 2015
**Before submitting the application, please ensure that the program is in compliance with Monthly
Service and TEFAP reporting and that the account balance is current.
PLEASE NOTE:
Applications received after 5:00 p.m. on Friday, May 15th will not be considered, so please submit
applications as soon as possible to avoid any last minute complications. Grant recipients will be
announced via email on or before Friday, June 5th. Recipients will be responsible for coordinating
trailer pick up directly from Leonard USA, 580 N. Andy Griffith Parkway, Mt. Airy, NC 27030. Platform
scales will be available for pick-up at Second Harvest Food Bank. Deadlines and detailed pickup
instructions will be provided to grant recipients on Friday, May 15th. Should the program close or stop
providing services to the community for any reason, the recipient program shall return the
enclosed/flatbed trailer or platform scale to Second Harvest Food Bank to be re-granted to an active
food distribution site. If you are not able to fulfill any of these grant requirements, please do not apply.
Program Information
Agency/Program Name: ________________________________________________________________
Program Number: ________________________________________________________________
County: ______________________________________________________________________________
Phone Number: _______________________________________________________________________
Email Address: ________________________________________________________________________
Contact Person: _______________________________________________________________________
Program Type (Please Circle Only One):
Food Pantry
Soup Kitchen
Shelter
Please place a check mark beside the unit(s) for which you are applying.
(Reminder: You may only apply for one type of trailer. Please mark only one.)
( ) ENCLOSED TRAILER – Leonard Cargo Trailer – Item # TRLC – 0612STD-155VE
( ) UTILITY TRAILER – Leonard Tandem Axle High Side Trailer – Item # TRLU-6416LEO-280
( ) PLATFORM SCALES – ULINE Deluxe Model No. H-747
1. What is the program’s current food transportation capacity and/or platform scale capacity (i.e.
none, church van, volunteer-owned vehicle(s), box truck, one platform scale, two table scales
etc.)?
______________________________________________________________________________
______________________________________________________________________________
________________________________________________________________________
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Capacity Building Equipment Grant Application – Spring 2015
2. If awarded, will this equipment replace existing equipment?
Yes
No
3. Circle the products your program regularly accesses from Second Harvest Food Bank:
SAM
PRODUCE
TEFAP
EGGS
FOOD PURCHASE
FOOD DRIVE/SALVAGE
MEATS
TRIAD COMMUNITY KITCHEN
4. Did the program submit all monthly reports by the deadline during April 2014 – March 2015?
(Answering no to this question does not automatically make a program ineligible to apply.)
Yes
No
5.
If no, what are the plans to ensure that the program remains in compliance with MSTR policies?
______________________________________________________________________________
______________________________________________________________________________
6. Did the program experience a suspension of shopping privileges for any reason during April 2014
– March 2015? (Answering yes to this question does not automatically make a program ineligible to
apply.)
Yes
No
7.
If yes, why were shopping privileges for the program suspended? What are the plans to ensure
that the program remains in compliance?
______________________________________________________________________________
______________________________________________________________________________
8. If your program is a food pantry, what is the average number of individuals served by the
program each month?
Total (Duplicated) Individuals_____________ Unduplicated Individuals ____________
9. If your program is an onsite feeding program, what is the average number of meals served by
the program each month?
Total Meals ___________________________
10. How frequently is the program open (i.e. Monday-Friday 8:00 am – 5:00 pm, the 3rd Saturday of
each month 12:00 pm – 3:00 pm etc.)?
______________________________________________________________________________
11. How frequently can the same individual and/or household be served by the program (i.e. once
every 30 days, as needed, once each quarter etc.)?
_____________________________________________________________________________
12. Is the program open to the general public?
Yes
No
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Capacity Building Equipment Grant Application – Spring 2015
Program Description
Please answer each question below. Answers should be as thorough as possible. If additional space is
needed, please attach a separate sheet(s) to the application and make sure to identify the questions to
which additional information is being provided.
13. What are the current needs for food transportation/platform scale capacity at the program
site?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
14. Please describe how the item(s) for which your program is applying will increase your capacity
to serve the community. What will this additional food transportation/platform scale capacity
allow the program to do? In other words, what impact will the item(s) have on the program
and how will that impact be measured? (Please provide specific goals (i.e. will allow the
program to access and provide fresh produce and other fresh products for distribution to clients;
will enable program to open one extra day each week/month; will allow accurate tracking of
fresh produce and other donations etc.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
15. Does your program provide Food and Nutrition Services (formerly known as the Food Stamp
program) outreach? If so, please describe. Do you provide tracking information to Second
Harvest Food Bank each month? If you do not provide tracking information to the Food Bank,
please help us understand why.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
16. Does your program provide Nutrition Education outreach and services? If so, please describe.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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Capacity Building Equipment Grant Application – Spring 2015
17. What do you see as the most valuable aspects of your partnership with Second Harvest Food
Bank?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
__________________________________________________________________________
18. Are there other areas for consideration you would like to bring to the attention of the Second
Harvest Food Bank selection committee that may help clarify the need for additional food
transportation capacity/platform scales at your program location and the anticipated impact
on your program if chosen to receive this grant?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Questions?
Please contact our Agency Relations department (336-784-5770) and ask to speak with the
Agency Outreach Coordinator for your county.
Peggy Robinson
Alamance
Caswell
Guilford
Randolph
Jan Jones
Alexander
Alleghany
Ashe
Caldwell
Davidson
Iredell
Surry
Watauga
Wilkes
Tracy Doss
Davie
Forsyth
Rockingham
Stokes
Yadkin
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