Great Plates Delivered Program - Restaurant Intake Selection Form
Name of Restaurant *
Restaurant Address *
Contact name *
Contact phone number *
Contact email *
What type of food or produce do you serve? *
Business Ownership *
Are you currently participating in a state or federal meal service program? *
Are you able to prepare and provide all three meals (breakfast, lunch and dinner)? *
Are you able to meet the meal nutrition requirements? Breakfast low in sodium, no sugary drinks (24 calories/8 oz. and of fruit juice, must be only 100% fruit juice allowed). Lunch/Dinner must include a piece of fresh fruit or vegetable on each dish, low in sodium, no sugary drinks (24 calories/8 oz. and of fruit juice, must be only 100% fruit juice allowed). *
NOTE: Priority is given to local businesses that can provide three meals daily.
Do you have a current Business License? *
Do you have a current Health Permit? *
What is your limit to capacity the number of meals per day/meal time? *
Can you provide vegan and/or vegetarian meals? *
Are you able to provide beverages? *
Are you able source local produce/meats? *
Can you deliver? *
When will you be ready to begin the program? *
Hours of operation *
If yes, have you completed a background check of your drivers *
Food safety requirements for delivery
Restaurants & Food Providers should continue to follow established food safety protocols and best practices for retail food establishments and important COVID-19 recommendations.
Cost Estimate
Based on your answers above, how much is the cost for all three meals for one person daily? (in order to participate, the cost must be $66 or under). Cost includes all sales tax, delivery, and labor necessary to provide this meal service. *
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