Mississippi Local Food Purchase Assistance Program (LFPA) Producer Questionnaire Overview The Mississippi Department of Agriculture was awarded a cooperative agreement from USDA for the Mississippi Local Food Purchase Assistance Program (LFPA) for the following purposes: To increase the distribution of locally-produced food to underserved communities by utilizing the distribution network of Mississippi’s Feeding America Food Banks; and To increase economic opportunities of local, regional farmers/producers and socially disadvantaged farmers/producers by purchasing locally produced food products by creating connections/introductions between the producers and food distributors. To be considered as a producer for the Mississippi Local Food Purchase Assistance Program, complete this questionnaire in full. By completing this questionnaire, you agree to allow MDAC to share your information with potential purchasing and distribution agencies. Submission of this questionnaire does not guarantee an award or contract for purchase. This questionnaire is for a producer of locally and regionally produced food; meaning the food is raised, produced, aggregated, stored, processed, and distributed in Mississippi or within 400 miles of the point of distribution in Mississippi. Examples include fresh fruits and vegetables, and processed foods and beverages including milk, beef, poultry, pork and rice. Complete all sections that apply and provide as many details as possible. Producer Contact Organization Name (if producer is a group or co-operative) First Name Last Name Producer Phone Producer Email Producer Mailing Address Producer Zip Producer City Producer State County (Farm location or location of production) Farm Address Farm Zip Farm City Farm State Are there multiple farm locations? Yes No Do you qualify as a socially disadvantaged farmer as defined by the USDA? Yes No (For the purpose of this program, “socially disadvantaged” is a farmer or rancher who is a member of a Socially Disadvantaged Group. A Socially Disadvantaged Group is a group whose members have been subject to discrimination on the basis of race, color, national origin, age, disability, and, where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or a part of an individual's income is derived from any public assistance program.) Add Products When submitting product information, be sure to click 'Add Product' to ensure this information has been saved. Product Unit Package Descriptionex. bag, box, bin, individual Weight Per Unitex. 32 oz, 1 lbs, 20 lbs Total Units Availableex. # of bags, # of boxes, # of bins Minimum Units Available per Order Maximum Units Available per Order Months Availableex. All, Sept - Oct Est. FOB Unit Priceex. $ per unit Add Product ProductDesc UnitSize WeightPerUnit TotalAvailUnits OrderMinimum OrderMaximum MonthsAvailable EstFOBUnitPriceRows per page: 0-0 of 0 Do you have packaging capabilities? (i.e. boxes, individual packaging, ability to break down to individual-sized packages, pallets, etc.) https://www.ams.usda.gov/grades-standards Yes No If yes, explain how items will be packaged. Although not required, does your farm or cooperative have a food safety certification (example: GAP/GHP)? Yes No If so, describe the certification. Have you ever participated or taken food safety handling training classes? Yes No If no, would you be willing to participate in a free Produce Safety Alliance food safety training in order to participate in the LFPCA program? Yes No Do you have the capability to deliver products following proper food safety guidelines? Yes No If so, please describe your delivery capabilities (how far, delivery costs, etc.) If product is only available for pick-up, describe the capacity for pick-up of product at your location (for example, ramp and dock available, or load only from field) In 250 words or less, describe your operation, any past distribution or direct retail activities and how it might fit into the LFPA program. Be sure to include how you would continue these activities beyond the end of this program. Before clicking 'Submit', please review form and make sure all information has been completed. Submit Reset