Waste Not SD Donor Liability Form
The Good Samaritan Law
This national law offers uniform protection to citizens, businesses and nonprofit organizations that proceed in good faith to donate, recover and distribute excess food. It promotes food recovery by limiting liability to acts of gross negligence or intentional misconduct such as donating food from which others have already become ill-and absent these, donors and others shall not be subject to “civil or criminal liability arising from the nature, age, packaging, or condition of apparently wholesome food or apparently fit grocery products received as donations.”
Hold Harmless and Indemnification Agreement
In addition to The Good Samaritan Law all participating agencies have signed the following hold harmless and indemnification agreement:
In consideration for receiving prepared food through donations from the Jacobs & Cushman San Diego Food Bank’s (Food Bank) Food Rescue Program, the (recipient) acknowledges its awareness of the “Good Samaritan” laws. (Recipient) hereby releases the Food Bank and its (Donors) from any liability, loss, damage or claim of any kind, whether at law or in equity, resulting from, or based upon the condition or quality of any item of donated food. (Recipient) agrees to indemnify and hold harmless the Food Bank, its (Donors) and any of it’s employees from and against any liability, damage, loss claim, or cause of action, whether at law or in equity, arising out of an act of (Recipient), its agents, employees, maintenance, transportation, use or distribution of any item of food received from or through the Food Bank or its (Donors) and claims arising from my participation.
I agree that I, (the recipient) will never prosecute or in any way aid in the prosecuting of any demand, claim or suit against the Food Bank or its (Donors), and any agency or employee acting officially or otherwise, for the loss, damage or injury to clients that may occur from their negligence.
Type "I AGREE" in all caps *
As a donor agency, you are promising that you will:
1. Examine the overall condition of the items under consideration and discard anything that is possibly unsafe to eat.
2. Follow temperature guidelines (see below).
3. Examine packaging for tears, holes, dents, and broken seals.
4. Check expiration dates.
5. Label and date all containers so that their contents can be identified and used or destroyed within a safe period of time.
6. Keep donated food products separate to avoid cross contamination.
7. Discard any food items that have been handled by anyone except kitchen staff.

Before the initial donation is made, the Donor should contact its local health department and find out what laws exist that govern donated prepared-and-perishable foods, and then operators should make sure they are in compliance. At the same time, the restaurant should find out if the hunger programs under consideration have also met all health and safety regulations.
Temperature Guidelines
1. Keep refrigerated items cold (41°F or below) at all times.
2. Keep hot dishes to be consumed immediately at 140°F or above.
3. Discard any cut items that have not been kept refrigerated.
4. Never donate items that have been cooked, cooled, and reheated.
5. Discard items that have been thawed and refrozen.
6. Refrigerate or freeze cold items that will not be immediately consumed.
7. Never add warm leftovers to a container of chilled or frozen food.
8. Not keep prepared food in the “danger zone” (between 41°F and 140°F) for more than four hours.

Another important step for Donors involves documenting its efforts to ensure that the items they donate are safe. This step often is taken care of quickly and easily when prepared food is picked up by or delivered to a program. The Food Bank will provide a document titled “Food Rescue Program Donation Report.” At the time of transfer, the Donor should record the food being donated, the quantity and temperature at the time of pick up by the Agency. This document should be signed by the Agency and Donor representatives before the donation leaves the premises. A copy of this document should be faxed or mailed to the Food Bank as it will be needed to record the donation and provide you a receipt for your tax records.
Restaurant Name *
Restaurant Address *
Name *
Phone Number *
Email Address *
What is your position in the company? *
We have found that implementing this program goes more smoothly if one person in the kitchen takes ownership of the donation process, whom we call the "Waste Not SD Ambassador". Please select one chef in your kitchen to be responsible for overseeing your donations. This person is required to meet with our Waste Not SD representative for a ten minute training before starting the program.

A Waste Not SD representative will be contacting you to schedule training and discuss who would best fill the roll of Waste Not SD Ambassador at your restaurant. If you have questions please feel free to email wastenotsd@specialtyproduce.com
WHERE DO YOU WANT YOUR TAX RECEIPTS TO BE SENT? You will get receipts from The San Diego Food Bank for the total pounds of your donations. It is your tax advisor who will help you determine what you can write off.
Name *
Company Name & Position *
Phone Number *
Email Address *
Physical Address - where should we mail them? *
By submitting this Form, you, the applicant, represent and warrant that your own information is provided herein or that you are authorized to submit this application on another’s behalf. You, individually and on behalf of the applicant have read, understand and acknowledge the contents thereof, and are authorized to enter into this agreement and be bound by its terms. You are aware that the provisions of this agreement shall control in the event of any dispute, claim, action or legal matter.

In no event will WasteNotSD or any of affiliates or suppliers participating in the program or any of its officers, agents, employees, representatives, contractors, or volunteers be liable for any damages, whether they be direct, indirect, general, special, consequential, incidental or exemplary damages, including but not limited to damages for personal injury, property damage, for loss of profits, goodwill, use, data or other intangible losses (even if WasteNotSD or any of affiliates or suppliers participating in the program has been advised of the possibility of such damages) resulting from the use of or inability to use this Form or participation in the WasteNotSD program.

By clicking submit, you attest under the laws of the State of California that the above is true and correct, and further expressly approve of and agree to be bound by the provisions of the agreement and the restrictions thereon.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy