GEORGIA WIC PROGRAM PROCEDURES MANUAL VM WIC Retailer Agreements Policy No. VM- 100.10 Effective Date: October 1, 2016

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Policy The Georgia WIC Program extends either a 2 or 3 year agreement to retail applicant locations that meet selection criteria at the time of application.

The Program enters into three (3) year agreements with those food retailers, pharmacies or commissaries that meet the Program’s definition of a corporate vendor. The Georgia WIC Program defines a Corporate Vendor as an authorized vendor that is owned by a corporate entity. A corporate vendor can be a publicly or privately owned corporation or a limited liability company. If an incorporated applicant is seeking authorization for two or more stores.

All other entities enter into two (2) year agreements as non-corporate food retailers or pharmacies.

Each authorized store location will be assigned a vendor number and will receive a vendor stamp with that identifying number. Vendors are not permitted to redeem food instruments at any location until each location is authorized. A newly authorized store cannot begin accepting food instruments until it has received a vendor stamp with its assigned vendor number.

Vendor Eligibility and Location:

1. An eligible vendor is a business entity that is 1) licensed by the Georgia Department of Agriculture and, 2) without a debarment or suspension from United States Department of Agriculture. Military commissaries and pharmacies do not have to be licensed by the Georgia Department of Agriculture. 2. An eligible vendor is a business entity that is 1) registered and licensed by the United States Department of Agriculture Food & Nutrition Service as a retail participant in the Supplemental Nutrition Assistance Program or SNAP (formally the Food Stamp Program) and 2) is in good standing without debarment or suspension from the United States Department of Agriculture or the SNAP program. Military commissaries and pharmacies do not have to be SNAP participants. 3. An eligible vendor must have a fixed location with an official physical address. 4. An eligible vendor must meet all requirements as described in the most recent version of the Georgia WIC Program Vendor Handbook and all addendums. 5. The vendor must comply with the selection criteria, including any changes to those criteria, throughout the agreement period. The Georgia WIC Program may reassess any authorized vendor at any time during the vendor agreement period using the current vendor selection criteria, and will terminate the agreement if the vendor fails to meet those criteria. 6. A vendor authorized as a military commissary or pharmacy will be given certain exceptions to the vendor agreement. The exceptions are outlined in the vendor agreement and the Georgia WIC Program Vendor Handbook.

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM WIC Retailer Agreements Policy No. VM- 100.10 Effective Date: October 1, 2016

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Purpose The purpose of a vendor agreement is to establish the terms and conditions for an authorized vendor to sell prescribed supplemental foods under the Georgia WIC Program, in accordance with federal and state laws and regulations. Procedures I. The Georgia WIC Program enters into three (3) year agreements with those food retailers that meet the Program’s definition of a corporate vendor and two (2) year agreements with non-corporate food retailers.

The Georgia WIC Program defines a Corporate Vendor as an authorized vendor that is owned by a corporate entity and seeking authorization for two or more stores. A corporate vendor can be a publicly or privately owned corporation or a limited liability company.

II. Three (3) Year Agreements A. Incorporated applicants must complete and submit a Corporate Information Form along with the vendor authorization application. The Corporate Information Form is available as an electronic document via the program website or a hardcopy of this form may be obtained by calling the Office of Vendor Management, at (404) 657-2900 or toll free within Georgia at (866) 814-5468.

B. If an incorporated applicant is seeking authorization for two (2) or more stores, it must also complete and submit, with its application, a corporate attachment form for each store location. An authorized representative must sign the application and each Corporate Attachment Form.

C. If an entities application packet has been approved, the Georgia WIC Program will extend two original copies of the vendor agreement for signature. Both originals must be returned completed, signed and dated within the designated timeframe. The vendor certifies, through the signature of the owner, or an authorized representative, that he or she understands and accepts all terms of the vendor agreement. The individual signing the vendor agreement certifies that they are authorized to sign the agreement on behalf of the vendor.

D. The designated Georgia WIC Program representative will sign and date both original, returned copies of the vendor agreement. The agreement becomes valid only upon the signature of an authorized representative of the Georgia WIC Program and upon receipt, by the vendor, of an executed copy along with vendor stamps for each authorized store location.

E. A corporate vendor will receive one, fully executed vendor agreement and one will be retained at the State WIC Office. The Corporate Attachment Forms serve as verification of each store location that is authorized under the vendor agreement and, therefore, are addendums to the vendor agreement.

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM WIC Retailer Agreements Policy No. VM- 100.10 Effective Date: October 1, 2016

No. of Pages: 5

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F. Each authorized store location will be assigned a vendor number and will receive a vendor stamp with that identifying number. Vendors are not permitted to redeem food instruments at any location until each location is authorized.

G. A newly authorized store cannot begin accepting food instruments until it has received a vendor stamp with its assigned vendor number.

Note: If a store location, under a corporate vendor, begins transacting and/or redeeming food instruments before it receives its vendor stamp, that store location will be denied authorization for a period of three (3) years. Amending the 3 Year Agreement If a currently authorized corporate vendor wishes to seek authorization for additional stores during the agreement period, it must submit an updated vendor authorization application, a Corporate Information Form, Corporate Vendor Training Checklist and a Corporate Attachment Form for each proposed store. The authorization of additional stores will not require the execution of a new vendor agreement. The Corporate Attachment Form for each newly authorized store will be an additional addendum to the existing corporate vendor agreement. If one store in the chain violates the Georgia WIC Program regulations and is disqualified, the remaining stores are not affected. III. Two (2) Year Agreements

A. If an entities application packet has been approved, the Georgia WIC Program will extend two original copies of the vendor agreement for signature. Both originals must be returned completed, signed and dated within the designated timeframe. The vendor certifies, through the signature of the owner, or an authorized representative, that he or she understands and accepts all terms of the vendor agreement. The individual signing the vendor agreement certifies that they are authorized to sign the agreement on behalf of the vendor.

B. The designated Georgia WIC Program representative will sign and date both original, returned copies of the vendor agreement. The agreement becomes valid only upon the signature of an authorized representative of the Georgia WIC Program and upon receipt, by the vendor, of an executed copy along with vendor stamps for the authorized store location.

C. The vendor will receive one, fully executed vendor agreement and one will be retained at the State WIC Office. The authorized store location will be assigned a vendor number and will receive a vendor stamp with that identifying number. Vendors are not permitted to redeem food instruments at the applying store location until the location is authorized.

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM WIC Retailer Agreements Policy No. VM- 100.10 Effective Date: October 1, 2016

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D. A newly authorized store cannot begin accepting food instruments until it has received a vendor stamp with its assigned vendor number.

Note: If a store location begins transacting and/or redeeming food instruments before it receives its vendor stamp, the store location will be denied authorization for a period of three (3) years. See the Vendor Agreement for a detailed outline of Vendor and Georgia WIC Program responsibilities, termination of the vendor agreement, sanctions, sanctions/violations from previous agreement periods, claims assessed and collected against vendors, criminal penalties, adverse actions and review procedures, severability, renewability, and non-transferability. The vendor agreement does not constitute a license or property interest. If the vendor wishes to continue to be authorized beyond the period of the agreement, the vendor must apply for re- authorization. If the vendor is disqualified, the Georgia WIC Program will terminate the current agreement, and the vendor will have to re-apply to be authorized after the disqualification period is over. The vendor’s new application will be subject to the vendor selection criteria and any vendor limiting criteria in effect at the time of re-application. The Georgia WIC Program Vendor Handbook is part of the vendor agreement, and is incorporated by reference.

Authority 7 C.F.R. § 246.12 (h)

Definitions/Supporting Information VM-100.02 - Vendor Selection and Limiting Criteria VM-140.01 - Vendor Appeals VM-130.03 - Vendor Violations and Sanctions VM-100.07 - Termination of Vendor Agreements VM-130.01 - Establishing and Collecting Vendor Claims VM-100.03 - Above 50 Percent Vendor Assessment VM-130.02 - Vendor Civil Monetary Penalty VM-110.01 - Vendor Training

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM WIC Retailer Agreements Policy No. VM- 100.10 Effective Date: October 1, 2016

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Non-Corporate Vendor Agreement - 2 Year Corporate Vendor Agreement - 3 Year Corporate Attachment Form Vendor Annual Training Checklist

Contact Information Georgia Department of Public Health Georgia WIC Program Office of Vendor Management Vendor Relations and Adm. Unit 2 Peachtree Street, NW, 10th Floor Atlanta, Georgia 30303