Great Start Readinesss Program Preschool Food Service Monthly Invoice 
     ISD Name:
     Subrecipient Name:
     Month and Year
     This template is for internal billing purposes for subrecipients (LEAs and/or CBOs) seeking reimbursement from ISDs for meals/snacks.  The reimbursement process between 
     subrecipients and ISDs should not be prohibitive to the SNP and CACFP federal programs that expect children to be provided healthy meal and snack options.  CBOs unable to 
     participate with CACFP seeking ISD reimbursement for GSRP meals/snacks are highly encouraged to complete the third section of this template with their monthly submission to 
     the ISD.  Subrecipients seeking reimbursement are not required to use this template but are expected to keep comparable records for monitoring and auditing purposes.  All 
     subrecipients should maintain records of children's meal attendance and eligiblity for the program, center attendance, and monthly menus regardless of the reimbursment 
     method utilized. 
                     Complete this section for subrecipients participating in NSLP (optional):
                     To receive reimbursement from GSRP funds, subrecipients must provide the ISD with the School Food Authority (SFA) prices for breakfast and lunch as specified in the annual SNP 
                     contract.  The cost after reimbursement is billed to the GSRP program as it cannot be charged to children/families.  The cost of snacks should be established annually by the SFA with 
                     approval by the ISD; this cost should reflect a reasonable average cost of providing a nutritious snack that meets food program guidelines.  Adult meal costs reimbursed by GSRP 
                     should not exceed the adult meal price established by the SFA.  Material costs and other equipment not included in meal costs required for providing food service specific to GSRP 
                     and kept in the GSRP classroom may be itemized below and reimbursed by GSRP funds.
                                                                                                                                                                                                                 Number of Number of Number of Number of  Total Number of 
                                                                                                          SFA Price For Meals                          Less Federal                                                  Meals                Meals                Meals                Meals               Meals/Snacks 
                                                    Description                                                (Total Revenue)                      Reimbursement                        Difference                Claimed              Claimed              Claimed              Claimed                    Claimed                          Total
                                                                                                                                                                                                                      Insert               Insert              Insert               Insert 
                                                                                                                                                                                                                   Name of              Name of              Name of              Name of 
                                                                                                                                                                                                                    School/              School/              School/              School/ 
                                                                                                                                                                                                                   Program              Program              Program              Program
                     Breakfast (SBP)
                     Paid                                                                                                                                                                            $0.00                                                                                                                         -               $0.00 
                     Reduced                                                                                                                                                                         $0.00                                                                                                                         -               $0.00 
                     Free                                                                                                                                                                            $0.00                                                                                                                         -               $0.00 
                     Total Breakfast                                                                                                                                                                                                                                                                                               -               $0.00 
                     Lunch (NSLP)
                     Paid                                                                                                                                                                            $0.00                                                                                                                         -               $0.00 
                     Reduced                                                                                                                                                                         $0.00                                                                                                                         -               $0.00 
                     Free                                                                                                                                                                            $0.00                                                                                                                         -               $0.00 
                     Total Lunch                                                                                                                                                                                                                                                                                                   -               $0.00 
                     Snacks
                     Cost of providing snacks                                                                                                                                                        $0.00                                                                                                                         -               $0.00 
                     Total Snacks                                                                                                                                                                                                                                                                                                                  $0.00 
                     Adult Meal Price
                     Breakfast                                                                                                                                                                       $0.00                                                                                                                         -               $0.00 
                     Lunch                                                                                                                                                                           $0.00                                                                                                                         -               $0.00 
                     Snack                                                                                                                                                                           $0.00                                                                                                                         -               $0.00 
                     Total Adult Meals                                                                                                                                                                                                                                                                                             -               $0.00 
                     Other Costs - Itemize Below (e.g. serving containers, utensils, additional supplies kept in GSRP classroom, delivery charges)                                                                                                                                                                                            Total
                     Description                                                                                                                                                                                                                                                                    Amount
                                                                                                                                                                                                                                                                                                                                                    $0.00
                                                                                                                                                                                                                                                                                                                                                    $0.00
                                                                                                                                                                                                                                                                                                                                                    $0.00
                     Total Other Costs                                                                                                                                                                                                                                                                                                              $0.00
                     Total Amount Charged to GSRP                                                                                                                                                                                                                                                                                                   $0.00
                     Complete this section for subrecipients participating in CACFP (optional):
                     To receive reimbursement from GSRP funds, subrecipients must provide the ISD with the Reasonable Average Meal/Snack Cost prices as determined annually for 
                     breakfast/lunch/snack for children and adults.  The cost after reimbursement is billed to the GSRP program as it cannot be charged to children/families.  Material costs and other 
                     equipment not included in meal costs, required for providing food service specific to GSRP and kept in the GSRP classroom, may be itemized below and reimbursed by GSRP funds. 
                     Subrecipients contracting for meals/snacks from an outside vendor may charge the full cost of meals/snacks ordered in advance of known attendance if a child's absence prohibits claiming reimbursement for the meal/snack.
                                                                                                                                                                                                                 Number of Number of Number of Number of  Total Number of 
                                                                                                          Reasonable Average                           Less Federal                                                  Meals                Meals                Meals                Meals               Meals/Snacks 
                                                    Description                                              Meal/Snack Cost                        Reimbursement                        Difference                Claimed              Claimed              Claimed              Claimed                    Claimed                          Total
                                                                                                                                                                                                                      Insert               Insert              Insert               Insert 
                                                                                                                                                                                                                   Name of              Name of              Name of              Name of 
                                                                                                                                                                                                                    School/              School/              School/              School/ 
                                                                                                                                                                                                                   Program              Program              Program              Program
                     Breakfast
                     Paid                                                                                                                                                                            $0.00                                                                                                                         -               $0.00 
                     Reduced                                                                                                                                                                         $0.00                                                                                                                         -               $0.00 
                     Free                                                                                                                                                                            $0.00                                                                                                                         -               $0.00 
                     Total Breakfast                                                                                                                                                                                                                                                                                               -               $0.00 
                     Lunch* Reimbursement rates should include cash-in-lieu of commodities
                     Paid                                                                                                                                                                            $0.00                                                                                                                         -               $0.00 
                     Reduced                                                                                                                                                                         $0.00                                                                                                                         -               $0.00 
                     Free                                                                                                                                                                            $0.00                                                                                                                         -               $0.00 
                     Total Lunch                                                                                                                                                                                                                                                                                                   -               $0.00 
                     Snacks
                     Paid                                                                                                                                                                            $0.00                                                                                                                         -               $0.00 
                     Reduced                                                                                                                                                                         $0.00                                                                                                                         -               $0.00 
                     Free                                                                                                                                                                            $0.00                                                                                                                         -               $0.00 
                     Total Snacks                                                                                                                                                                                                                                                                                                                  $0.00 
                     Adult Meal Price
                     Breakfast                                                                                                                                                                       $0.00                                                                                                                         -               $0.00 
                     Lunch                                                                                                                                                                           $0.00                                                                                                                         -               $0.00 
                     Snack                                                                                                                                                                           $0.00                                                                                                                         -               $0.00 
                     Total Adult Meals                                                                                                                                                                                                                                                                                             -               $0.00 
                     Unclaimed Breakfast                                                                                                                                                                                                                                                                                           -               $0.00 
                     Unclaimed Lunch                                                                                                                                                                                                                                                                                               -               $0.00 
                     Unclaimed Snack                                                                                                                                                                                                                                                                                               -               $0.00 
                     Total Unclaimed Meals/Snacks                                                                                                                                                                                                                                                                                                  $0.00 
                     Other Costs - Itemize Below (e.g. serving containers, utensils, additional supplies kept in GSRP classroom, delivery charges)                                                                                                                                                                                            Total
                     Description                                                                                                                                                                                                                                                                    Amount
                                                                                                                                                                                                                                                                                                                                                    $0.00
                     Total Other Costs                                                                                                                                                                                                                                                                                                              $0.00
                     Total Amount Charged to GSRP                                                                                                                                                                                                                                                                                                   $0.00
                     Complete this section for CBOs NOT eligible for CACFP (optional):
                     To receive reimbursement from GSRP funds, CBOs NOT eligible to participate in CACFP may use a similar method of billing as that established for CACFP by annually determining  
                     Reasonable Average Meal/Snack Cost prices for breakfast/lunch/snack. The full Reasonable Average Meal/Snack Cost will be charged to GSRP.  Monthly invoicing for meals/snacks 
                     may be submitted utlizing the form below. Subrecipients contracting for meals/snacks from an outside vendor may charge the full cost of meals/snacks ordered in advance of 
                     known attendance if a child's absence prohibits claiming reimbursement for the meal/snack.
                     **Alternately, actual costs may be submitted for reimbursement. If utilizing the actual costs method instead of Reasonable Average Meal/Snack Cost prices, documentation is submitted to the ISD for the full cost of providing 
                     meals/snacks that can be attributed to the GSRP program, including: menus for foods served for all GSRP enrolled children; meal attendance for all meals/snack served to GSRP enrolled children; center attendance for GSRP 
                     participants (may differ from meal attendance); enrollment forms for GSRP children; receipts for monthly food and non-food expenditures; prorated portion of labor for direct labor costs related to preparing and serving 
                     meals.
                                                                                                                                                                                                                 Number of Number of Number of Number of  Total Number of 
                                                                                                          Reasonable Average                                                                                         Meals                Meals                Meals                Meals               Meals/Snacks 
                                                    Description                                              Meal/Snack Cost                                                                                        Served               Served               Served               Served                    Claimed                          Total
                                                                                                                                                                                                                      Insert               Insert              Insert               Insert 
                                                                                                                                                                                                                   Name of              Name of              Name of              Name of 
                                                                                                                                                                                                                    School/              School/              School/              School/ 
                                                                                                                                                                                                                   Program              Program              Program              Program
                     Breakfast Price
                     Cost of providing breakfast                                                                                                                                                     $0.00                                                                                                                         -               $0.00 
                     Total Breakfast                                                                                                                                                                                                                                                                                                               $0.00 
                     Lunch Price
                     Cost of providing lunch                                                                                                                                                         $0.00                                                                                                                         -               $0.00 
                     Total Lunch                                                                                                                                                                                                                                                                                                                   $0.00 
                     Snacks
                     Cost of providing snacks                                                                                                                                                        $0.00                                                                                                                         -               $0.00 
                     Total Snacks                                                                                                                                                                                                                                                                                                                  $0.00 
                     Adult Meal Price
                     Breakfast                                                                                                                                                                       $0.00                                                                                                                         -               $0.00 
                     Lunch                                                                                                                                                                           $0.00                                                                                                                         -               $0.00 
                     Snack                                                                                                                                                                           $0.00                                                                                                                         -               $0.00 
                     Total Adult Meals                                                                                                                                                                                                                                                                                             -               $0.00 
                     Unclaimed Breakfast                                                                                                                                                                                                                                                                                           -               $0.00 
                     Unclaimed Lunch                                                                                                                                                                                                                                                                                               -               $0.00 
                     Unclaimed Snack                                                                                                                                                                                                                                                                                               -               $0.00 
                     Total Unclaimed Meals/Snacks                                                                                                                                                                                                                                                                                                  $0.00 
                                                    Description                                                                                                                                                                                                                                                                               Total
                     Other Costs - Itemize Below (e.g. serving containers, utensils, additional supplies kept in GSRP classroom, delivery charges)
                     Description                                                                                                                                                                                                                                                                    Amount
                                                                                                                                                                                                                                                                                                                                   -               $0.00 
                     Total Other Costs                                                                                                                                                                                                                                                                                                             $0.00