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Page 11 – Alabama WIC Vendor Agreement FY 2027-2029 The undersigned represents acknowledgement that he/she has read the entire agreement and fully understands and accepts the requirements herein on behalf of the Vendor. The undersigned agrees to process food instruments and cash value vouchers (eWIC) in accordance with the terms in the agreement, state and federal WIC program rules, regulations, policies and applicable law without exception. Signature further indicates an agreement on behalf of the Vendor to train all store personnel and cashiers in program rules and requirements and accept full responsibility for any intentional or unintentional violations of this agreement. The undersigned, as Vendor Representative, represents that he/she has the authority to execute this Agreement on behalf of the Vendor. Vendor Representative Signature:

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Vendor Representative Printed Name:

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DO NOT WRITE BELOW THIS LINE – FOR ALABAMA WIC PROGRAM AGENCY USE ONLY The Department agrees to the terms and conditions stated herein and authorizes Vendor’s participation in the Alabama WIC Program. The undersigned Alabama WIC Program Representative has authority to execute this Agreement on behalf of the Department. WIC Representative Signature:

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WIC Representative Printed Name:

WIC Representative Title:

Alabama Department of Public Health State Agency By:

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