Organic Program 2017 Farm Crop Full Application

Transcription

1 Organic Program 2017 Farm Crop Full Application Farm or Business Name: Applicant Name: Title: Phone: Preferred Contact: Phone Contact Name: Title: Phone: Preferred Contact: Phone Additional Contact: Title: Phone: Preferred Contact: Phone Mailing Address: City: County: State: Zip Code: Preferred method of correspondence including certification and notices: Mail Please provide the physical address/location of the farm, with detailed directions from Albuquerque, NM to the site: Business Information: Please provide information detailing the structure of your business (ownership, legal entity status, etc.): What is your estimated 2017 income from organic sales? $ Page 1 of 21

2 Affirmation of Organic Applicant I,, as an authorized representative of [Business Name], depose and say that I will: 1. Fully comply with all applicable organic production and handling regulations in accordance with Title 7 CFR Part 205 National Organic Program Rule. 2. Establish, implement and update annually an organic production or handling system plan that will be submitted to the New Mexico Department of Agriculture (NMDA). 3. Supply NMDA with all information required to verify compliance with the National Organic Program Rule. 4. Permit onsite inspections with complete access to the production or handling operation, including non-certified production and handling areas, structures, and offices by NMDA inspectors. These inspections may be announced or unannounced at the discretion of NMDA or as required by the Administrator of the National Organic Program. 5. Maintain all records applicable to the organic operation for not less than five (5) years beyond their creation. 6. Allow authorized representatives of NMDA, or the US Secretary of Agriculture access to these records during normal business hours for review and copying to determine compliance with the National Organic Program Rule. 7. Submit to NMDA the applicable fees as described on the fee schedule which is current at the time of payment (see page 20). 8. Immediately notify NMDA about any application, including drift, of a prohibited substance to any field, production unit, site, facility, livestock, or part of an operation. 9. Immediately notify NMDA of any change in our certified operation or portion of it that may affect its compliance with the National Organic Program Rule, including: additions or deletions of crops & fields; new inputs (fertilizers, pest control processing aids, etc.); facilities; ingredients & products; changes to managers; responsible parties; contact information or address. 10. Understand that willful violation of organic rules and regulations may result in revoking of organic certification, and in extreme cases may lead to state and federal fines and penalties. 11. Understand that submitting this application in no way implies granting of certification by NMDA. 12. Understand that this form becomes a legally binding document upon submission to NMDA. Print Name: Title: Signature of Authorized Representative: Date: Page 2 of 21

3 Section 1. General Information 7 C.F.R , Have you ever been denied certification or had your certification suspended or revoked? 1a. If Yes, please describe circumstances, including year, certifier and issue: 2. List previous or current organic certification and /or applications for certification, by certification agencies and year: 3. Describe the corrective action you took in response to any noncompliance notices or conditions for continued certification: 4. Submit a Map that: Map Attached o Matches your Field History. o Includes every organic farm/field. o Shows farm name, field name and acreage of each field. o Shows borders & shape of each field. o Identifies location of crops and fallow land. o Accurately shows land boundaries and organic buffer zones. o Identifies all adjacent land use, such as other farms, roads, ditches, open range, etc. o Accurately identifies all buildings and structures present. o Indicates NORTH. 5. Adjoining Land Use 5a. Describe your farm borders and adjacent land use (organic farms, fallow fields, CRP land, wild lands, non-organic crop or livestock production, residential use, etc.): 5b. Describe the measures you take (management practices, communications and/or physical barriers) to prevent contamination by prohibited materials that are or may be applied to adjacent or nearby land (neighboring parcels or fields in split operations), or attach an Adjoining Land Use Statement: Adjoining Land Use Statement Attached Page 3 of 21

4 5c. Describe buffer zone for each field/pasture that you maintain on your organic land to protect crops from contamination. Please specify whether the buffer is left fallow or if crops are grown there, and whether you plan to sell or represent them as organic. Please include information as an attachment. Description of Buffer Attached 6. Field History: Please complete a field history form for all fields requested for certification. Fields must have had no input of prohibited materials for at least three years. Field History Form Attached 6a. Have you managed all fields for 3 years or more? 6b. If No, please submit a Previous Land Use Verification Form Previous Land Use Form Attached 6c. To the best of your knowledge, what was the date of the last use of prohibited materials? (synthetic inputs including but limited to fertilizers, pest, weed and disease control, etc.) If N/A, move to question 8. Not applicable, no prohibited applied 6d. To what field was the prohibited material applied? 6e. What was the prohibited material? 7. Crops Requested for Certification in 2017: Please provide a complete list of crops you want to certify in 2017 (submit electronic or paper attachment). This will be used to prepare your Organic Product List. Please list generic crops and NOT variety (examples: wheat, tomato, basil, apples, etc.). You may not sell new products (products not certified organic in 2017) as organic until they appear on your 2017 Organic Product List Crop List Attached 8. Do you hire or contract custom services during production, handling, or storage of organic crops? (i.e. tractor work, laser leveling, harvest, transportation, cleaning etc.) 9a. If Yes, submit a completed Custom Service Compliance Statement for each Service Provider. Custom Service Compliance Statement Attached Page 4 of 21

5 9. Do you label any products? 9a. If Yes, please submit label proofs to NMDA for approval before printing. (NMDA is NOT responsible for non-compliant or incorrect labels.) All Proposed Labels Attached Section 2. Material Inventory 7 C.F.R NOP requires that the organic system plan include a list of each substance to be used as a production or handling input. Materials must be approved by the certifier prior to use/application. Please include a complete list of products that includes brand name of the product. Please note: seed, seed inoculants, seed coating, etc. will be requested in the Seed section of the application and should not be placed in this section. If more space is needed to detail Materials please submit a separate attachment (electronic or paper). Additional Material Inventory Attached Material & Brand Name (please be specific) Purpose You must provide updates to NMDA by , letter, or fax before you apply a material NOT already on this inventory. Use of unreported materials may jeopardize your organic certification. 1. Micronutrients: The use of Micronutrients must be justified by soil or tissue testing or other analysis. 1a. Do you apply micronutrients to manage for deficiencies? (Iron, Zinc, etc.) o If Yes, please maintain justifiable micronutrient deficiency analysis in your records. Page 5 of 21

6 Section 3. Seeds, Annual Transplants, & Seedlings 7 C.F.R NOP requires that producers use organically grown seed, annual seedlings and planting stock (even when these are provided from a contracted-buyer). Annual transplants must be certified organic to produce an organic crop. Non-organically produced untreated seeds & planting stock (potatoes, garlic, perennials, etc.) may be used only if organic forms are not commercially available. N/A: No seeds, planting stock, or annual or perennial transplants are used. Move to Section 4. Check all boxes that describe what you use or plan to use: 1. Seeds and Annual Planting Stock not applicable; no seeds or annual planting stock used or planned for use certified organic seed, purchased certified organic seed, saved on farm (requires additional records) certified organic planting stock (e.g., seed potatoes, sweet potato slips, garlic, strawberry crowns) non-organic, untreated seed non-organic, untreated planting stock for annual crops 2. Seed or Planting Stock Treatments And Inoculants not applicable; none used inoculant coating pelletization priming fungicide or insecticide disinfection other (describe): planting lubricant Please list specific treatments and inoculants: 3. Annual Seedlings not applicable; no annual seedlings grown or purchased seedlings or transplants grown on farm. purchased certified organic seedlings. other (describe): 4. Perennial Planting Stock (for crops grown as perennials, e.g.,herbs, trees, shrubs, vines) not applicable; no perennial planting stock is used Page 6 of 21

7 certified organic perennial planting stock is: produced/propagated on farm purchased non-organic stock (describe, include date planted or anticipated planting): other (describe): 5. Commercial Availability Note Commercially availability is defined as the ability to obtain a production input in an appropriate form, quality, or quantity to fulfill an essential function in a system of organic production or handling, as determined by the certifying agent in the course of reviewing the organic plan. If you use seed or planting stock (annual and/or perennial) that is not certified organic, submit a completed Organic Seed/Planting Stock Search Log or equivalent. not applicable; all seed and planting stock is certified organic Organic Seed/Planting Stock Search Log Attached Section 4. Greenhouse Crop Production 7 C.F.R , (a)(5), (c) 1. Do you produce organic seedlings, transplants or crops in a greenhouse or hoophouse? 1a. If Yes, complete questions 2 5 of this section. 1b. If No, move to Section Please describe your greenhouse structure type(s). Check all that apply. Hoop house(s) Cold frame(s) Hydroponic Greenhouse(s) Other (describe): 3. Please describe your greenhouse crops. (Check all that apply.) Annual transplants or starts Perennials (planting or sale of whole plants as organic) Harvested crops (e.g., fruits, vegetables, cut flowers, herbs) Other (describe): 4. Are greenhouse crops grown in the ground? Page 7 of 21

8 5. Are crops grown in containers and planting medium? 5a. If Yes, include all components of the potting soil or planting medium mixture on your Materials List. Section 5. Soil Fertility & Crop Nutrient Management 7 C.F.R , NOP requires producers to manage crop nutrients and soil fertility through crop rotations, cover crops and applications of plant and animal material. Additionally, you must manage plant and animal materials to maintain or improve soil organic matter while minimizing contamination of crops, soil and water. 1. What are the major practice components of your soil-building/crop nutrient management plan? crop rotation incorporation of crop residue green manures cover crops compost manure mined minerals mulch soil inoculants bio-dynamic preparations fertilizer materials or blends other (specify): 2. List all materials used or planned for use on your Materials List. All materials used or planned for use are listed on my Materials List. No materials are used. 3. How do you determine the effectiveness of your soil fertility practices? 4. Can your material application records track all fertility inputs applied to organic fields? Section 6. Crop Rotation 7 C.F.R In an attachment, describe your crop rotation plan(s), in general terms, including its main goals (soil organic matter; weed and pest management, nutrient management; erosion; biological diversity). List the sequence and frequency of crops/plant families, cover crops, green manures or sod. If you use more than one basic rotation sequence, please describe each rotation you use. For perennial crops, describe management of ground cover, alley cropping, intercropping or hedgerows. Page 8 of 21

9 Crop Rotation Plan Attached Section 7. Manure & Compost 7 C.F.R NOP (manure & compost) (c) The producer must manage plant and animal materials to maintain or improve soil organic matter content in a manner that does not contribute to contamination of crops, soil, or water by plant nutrients, pathogenic organisms, heavy metals, or residues of prohibited substances. Animal and plant materials include: (1) Raw animal manure, which must be composted unless it is: (i) Applied to land used for a crop not intended for human consumption; (ii) Incorporated into the soil not less than 120 days prior to the harvest of a product whose edible portion has direct contact with the soil surface or soil particles; or (iii) Incorporated into the soil not less than 90 days prior to the harvest of a product whose edible portion does not have direct contact with the soil surface or soil particles; (2) Composted plant and animal materials produced though a process that: (i) Established an initial C:N ratio of between 25:1 and 40:1; and (ii) Maintained a temperature of between 131 F and 170 F for 3 days using an in-vessel or static aerated pile system; or (iii) Maintained a temperature of between 131 F and 170 F for 15 days using a windrow composting system, during which period, the materials must be turned a minimum of five times. 1. Manure: Do you use un-composted, raw or aged manure? 1a. If No, move to question If Yes, select how your use of raw manure complies with the USDA organic standards. Manure is: Applied to land producing a crop not intended for human consumption (e.g., pasture, hay, cover crops, etc.). Incorporated at least 120 days before harvest of a crop whose edible portion may contact the soil surface or soil particles. Incorporated at least 90 days before harvest of a crop whose edible portion does not directly contact the soil surface or soil particles. A pelletized manure product listed or documented to meet NOP requirements of heating at 150 F for one hour or 165 F with <12% moisture content, or other procedure compliant with NOP 5006 Guidance on Processed Animal Manures in Organic Crop Production. Please be prepared to show records of manure use (locations used, crops grown, application and harvest dates). 3. Compost: Do you purchase compost? 3a. If Yes, please include all composts on your Material Inventory. 4. Do you produce compost? 4a. If Yes, please list all compost ingredients (including feedstocks, minerals, and inoculants, if applicable): Page 9 of 21

10 4b. If Yes, please describe your composting methods including temperatures reached, timelines for production, whether in-vessel, static pile, or windrow, and aeration methods: 4c. If Yes, do you maintain records for your compost production? If Yes, please have records available at the time of inspection. If No, please note: If records are not available detailing the compliance of compost production practices with respect to (c)(2), the product must be considered raw manure and applied accordingly (see #2 above). Application dates must also be maintained in records. Section 8. Natural Resources: Soil, Water, Woodlands, Wetlands, & Wildlife 7 C.F.R Check the relevant plans you maintain to assist you in managing on-farm natural resources: Farm Plan or Resource Management Plan Conservation District Farm Plan NRCS Farm Plan Other (specify): 2. What conservation practices are used? conservation tillage contour farming firebreaks retention ponds riparian management strip cropping permanent waterways maintain wildlife habitat terraces tree lines interplanting/undersowing windbreaks winter cover crops other (specify): 3. Do you experience any soil erosion problems? 3a. If Yes, please describe the problem and any action you have taken to minimize its affects: 4. How often do you conduct conservation monitoring? weekly monthly annually as needed Page 10 of 21

11 other (specify): Organic System Plan Farm Crop Producer Section 9. Water 7 C.F.R Water Sources: Check all that apply. on-site well river/creek/pond spring acequia irrigation district N/A, no irrigation 2. What type of irrigation system do you use? drip flood center pivot N/A, none other (specify): 3. Fertigation: Do you apply fertilizers using an irrigation system? 3a. If Yes, what input products are applied through the irrigation system? 3b. If Yes, what, if any, products are used to clean irrigation lines/nozzles? Section 10. Weed Management Practices 7 C.F.R , , What weed control methods do you use? crop rotation hand weeding mechanical cultivation non-synthetic mulch livestock grazing flame weeding cover crops synthetic mulch planting time mowing other(specify): 2. Do you keep a record of how often you utilize these weed control methods? 3. What are you weed problems? 4. How do you monitor the effectiveness of your weed management program? observation of weed types weed counts comparison of crop yields records kept of observations/counts other (specify): 5. How often do you monitor for weeds? daily weekly monthly as needed other (specify): Page 11 of 21

12 Section 11. Pest Management 7 C.F.R , , What methods do you use to manage pest damage to crops? traps lures crop rotation timing of planting repellents monitor release of beneficial insects physical removal beneficial habitat other (specify): 2. Do you keep a record of how often you utilize these insect pest control methods? 3. What are your problem pests? rodents gophers birds nematodes no pest problems insects (specify): other animals (specify): 4. How do you monitor the effectiveness of your insect pest management program? soil testing observation of crop health comparison of crop yields microbial testing observation of soil monitoring records kept other (specify): 5. How often do you conduct pest monitoring? daily weekly monthly as needed other (specify): Section 12. Disease Management 7 C.F.R , , What disease prevention methods do you use? crop rotation companion planting timing of planting cultivation compost/tea plant spacing resistant varieties field sanitation other (specify): 2. Do you have a recurring disease problem? 2a. If Yes, please describe in detail: Page 12 of 21

13 3. How do you monitor the effectiveness of your disease management program? soil testing observation of crop health comparison of crop yields microbial testing observation of soil monitoring records kept other (specify): 4. How often do you conduct disease monitoring? daily weekly monthly as needed other (specify): 5. Are all weed, insect pest and disease inputs applied to fields reported in your Material Inventory? 6. Input Records: Can your material application records track all inputs applied to certified organic fields? (Including all inputs for weed, insect pest and disease management?) Section 13. Maintenance of Organic Integrity 7 C.F.R , (a)(5) Split production: Part of your farm business (the entity for which you seek certification) is managed to meet certification requirements for organic production, and you also produce non-organic crops. Parallel Production: A crop variety is managed to meet requirements for organic production, and you also produce the same crop variety non-organically. Procedures must be in place to prevent contamination and commingling of crops. Records verifying that steps have been taken to prevent contamination of organic crops and prevent commingling of organic & non-organic crops must be available during inspection. 1. Split & Parallel Production: Does your farm business (the entity for which you seek certification) produce non-organic crops? 1a. If No, move to question 4. 1b. If Yes, do you use the same equipment on organic and non-organic crops? 1c. If Yes, is the equipment cleaned before use on organic crops and do you document these steps? Page 13 of 21

14 2. List each non-organic crop grown (including crops harvested from buffer zones). Non-organic Crop Total Acres Field ID 3. What procedures will you use to prevent the commingling of conventional and organic crops? This includes mixing of the two crops, contamination by material inputs, and in storage. 4. Please list all equipment used for planting, tillage, spraying, weed management, harvesting, packing, or any other production function: Equipment Name Owned, Rented, or Custom Used on Organic Used on Conventional Storage Location 5. Please detail the cleaning procedure for each piece of equipment listed in Question 4, above. Page 14 of 21

15 Section 14. Harvest, Packing, Storage, & Transportation 7 C.F.R requires that handling practices and procedures present no contamination risk to organic products from commingling with non-organic products or contact with prohibited substances. Packaging materials, bins, and storage containers must not contain synthetic fungicides, preservatives or fumigants. Reusable bags or containers that have been in contact with any substance in such a manner as to compromise the organic integrity cannot be used unless the bag or container has been thoroughly cleaned. Procedures used to maintain the organic integrity of ingredients or products (cleaning or lining) must be documented. 1. Harvest: Organic crops are harvested: mechanically by hand by farm employees by custom harvester by other (specify): 2. What containers are used for harvesting? cardboard/ wax boxes plastic containers wooden totes truck boxes other (specify): 3. Are harvest containers: new dedicated organic cleaned prior to use lined prior to use other (specify): 4. What steps are taken to protect organic crops form commingling and contamination during harvest? 5. How do you identify harvest containers as organic? 6. Post-Harvest: Describe your post-harvest processes, procedures and equipment: 6a. Where do these procedures take place? Page 15 of 21

16 7. Describe how you clean and control pests in your post-harvest handling area, including any food contact surfaces, and materials used: 8. Do you use water to clean crops or food contact surfaces? 8a. Do you add chlorine to wash water, dump tank, flume or other water that has direct food contact? 8b. If Yes, how do you provide for a potable water rinse after the agricultural crop has been in contact with water with added chlorine? 8c. If Yes, please describe what rate or concentration you use, your rinse procedures, and any testing or monitoring you do. 9. List any other materials added to water: 10. Crop Storage: For on-farm storage, provide details of your storage area: Storage Name Crops Stored Type of Storage (bin, cold room etc.) Length of Storage (overnight, long term, etc.) Dedicated Organic? 11. Describe how you ensure organic crops are not contaminated with prohibited materials during storage. Page 16 of 21

17 12. For storage area where both organic and non-organic crops are stored, how do you ensure organic crops are not commingled during storage? 13. How do you clean storage units prior to storage of organic crops? 14. How do you prevent and control insect pests and rodents in crop storage area? 15. For each offsite storage location, please complete and attach an Offsite Storage Verification Form with your application. Offsite Storage Verification Form Attached 16. Transportation: Are you responsible for the transportation of organic crops or finished product leaving your farm? 17. How are organic crops transported? 18. How do your ensure organic crops or products are not contaminated during transport? equipment is used for organic crops only equipment is cleaned prior to organic use organic products are transported in sealed packages or containers other (specify): 19. What type of cleaning documentation is maintained? clean truck/affidavit clean out records other (specify): 20. When do organic crops leave your custody? at point of sale at harvest other (specify): 21. When do organic crops leave your ownership? at point of sale at harvest other (specify): Page 17 of 21

18 Section 15. Recordkeeping 7 C.F.R , , RECORDS KEPT Please note that if you produce both organic and non-organic crops, then you have a split operation. If you grow the same crops as both organic and non-organic, then you also have a parallel production. If you are a split operation of any type, please be prepared to show all production and sales records at your inspection that allow for tracking and production verification of both organic and non-organic crops (e.g., crop lists and acreages, input application records, equipment use and cleaning, harvest and sales records). Such records are necessary to facilitate production verification audits, and are especially important if the crops are visually indistinguishable, as in a parallel production. 1. What types of records do you keep? Indicate all that apply. In order to document practices described in your OSP, you will need all records available for inspection. Some records must be documents from other businesses (such as seed and input purchase receipts, suppliers organic certificates, and soil or tissue test results). Others will be your own records of onfarm activities. You may design your own forms, or use/adapt templates or sample documentation forms available from the NOP, or other sources, provided they include information needed to document compliant practices. Purchase or acquisition records for all inputs (e.g., receipts, delivery tags, custom applicator invoices) Input application records that show all materials applied to soil, water and crops (e.g., fertilizer and soil inputs, pest management materials and post-harvest handling), including product name/formulation and manufacturer, application date, rate or quantity, crop and location Seed, seedling, and planting stock, inoculant or seed treatments; seed-saving/propagation records; documentation of commercial non-availability of organic seed/non-gmo status of seed Copies of organic certificates from suppliers (i.e., organic seedling or transplant producers) Planting and/or field activity records that show crop rotation, including cover crops/green manures Activity and/or observation records (i.e., field log, notes on calendar or maps) Manure use records showing interval between date of application and harvest date of crops grown for human consumption Compost production records (e.g., composting system, ingredients, C: N ratio, temperature, turnings) Monitoring records (e.g., soil or tissue tests, water tests, pest observation logs) Cleaning records (required if application or harvest equipment is not dedicated to organic) Harvest records (e.g., records showing location, crop, date harvested and transported from the field) Post-harvest activities (i.e., washing and grading product, bagging or boxing, etc.) Page 18 of 21

19 Storage records (e.g., delivery/receiving tags showing facility location, crops, quantities, postharvest activities and pest control) Shipping records (e.g., packing facility tags, delivery receipts, receiving documents, bills of lading) Sales records (e.g., invoices, purchase orders, grower statements, inventory lists) The USDA organic regulations require that your recordkeeping system be adapted to your business, and fully disclose all activities and transactions of your operation. 3. Do you keep production, harvesting and handling records pertaining to organic agricultural products for at least five years after their creation? 4. Can your recordkeeping system balance crops harvested with crops sold? 2016 Sales Information Please provide detailed information for sales of organic crops and products in Please be as thorough as possible as this information will be verified at the time of your next inspection. Organic Crop/Product Yield (pounds, tons, bushels, etc.) Wholesale Sales (round to the nearest dollar) Direct to Consumer Sales Farmers On-farm Sales Markets CSA Sales Total Certified Organic Sales 2016 Page 19 of 21

20 Fee Schedule NMDA Organic Program Fee Schedule The Assessment Fee is three-fourths one percent (3/4 percent or.0075) of the first million dollars of gross organic sales, plus seventy-five one thousandths of one percent (.00075) of the gross organic sales over one million dollars. Assessment Fee Total Gross Certified Organic Sales for the 2016 Calendar Year (Jan. 1, 2016 Dec. 31, 2016, Please round figure to the nearest dollar) Sales between $0 - $1,000,000 $ $ Example= $1,200,000 Multiply by =$ Sales above $1,000,000 $ Ex. = $1,000,000 Ex. = 1,000,000 x Multiply by Ex. = $7,500 =$ Ex. = $200,000 Ex. = $200,000 x Ex. = $160 Total Assessment Fee = $ Ex. = $7,650 Application Fee NEW Applicant Fee RENEWAL Applicant Fee Not Certified Organic by NMDA in 2016 Previously Certified Organic by NMDA in 2016 Application Fee = $ Renewal Fee = $ Application Fee = $ Late Fee (for RENEWAL applications postmarked after April 1, 2017) Renewals received after April 1, 2017 Late Fee: $75.00 Renewals received after May 1, 2017 Late Fee: $ Renewals received after June 1, 2017 Late Fee: $ Renewals received after July 1, 2017 Late Fee: $ Late Fee = $ (Total Assessment Fee + Application Fee + Late Fee) = Total Fees = $ Business Name: Authorized Representative Signature: Date: Page 20 of 21

21 Fee Policy NMDA Organic Program Fee Schedule 1). Fees are NOT REFUNDABLE 2). Make checks Payable to NMDA 3). If new or additional fields or products are added after the annual inspection is complete, additional costs will be incurred. A cost estimate will be provided. o If a second inspection is necessary you will be billed for the actual cost of the inspection and the actual cost of the office audit ($40/hr) to complete the addition. o In cases where no second inspection is required, you will be billed for the actual cost of the desk audit ($40/hr). o Payment must be received before the new or additional fields/products are certified organic and added to the Organic Product List and the Organic System Plan. Mailing Procedure Please mail Application, Payment and Cost Share documents to: NMDA Organic Program 2604 Aztec Rd NE Albuquerque NM Or application to certifier@nmda.nmsu.edu Cost Share Please complete the following section in order to receive Cost Share Reimbursement. Page 21 of 21

22 Application for Cost-Share Reimbursement 2017 Name of Certified Organic Business: Your Name: Type of Certification (crop, livestock, processor): Address: City: State: Zip: Phone: Fax: Name of your certifier (NMDA, etc.): Allowed reimbursement costs for certification include: application fees, inspection fees, user fees, postage and assessments. Late fees and charges relating to violations of the organic standards are not eligible expenses. If you have questions about a particular expense, please call (575) If you are certified by NMDA you do not need to attach receipts unless you are claiming postage. If you are claiming postage or are not certified by NMDA you must attach receipts. Everyone must attach an itemized list of items to be reimbursed. A) During the year10/1/16-9/30/17 I spent (the following amount) $ on organic certification expenses. B) Multiply the amount above x.75. $ C) If the number on line B is larger than $750 you are eligible for a reimbursement of $750. If the number on line B is less than $750, that amount will be the amount of your reimbursement. D) If you were first certified in 2017, or are certified by a body other than NMDA, please attach a copy of your certificate. This is REQUIRED! TOTAL REIMBURSMENT: I, understand that under the NOP cost-share program I am eligible to apply for 75% of my annual certification costs up to $750/year for Federal FY 2017, and nothing more. Awards of funds will be made on a first-come first-served basis (of the complete application); funds may not be available to reimburse every certified business. Date: (sign here) Please follow the instructions on the next page.

23 Please follow these instructions. 1. The Organic Cost-Share Program is a federal program, funded by the 2014 Farm Bill, to reimburse producers and processors for 75% of the cost of organic certification, up to $750. You must apply to receive reimbursement. If you have more than one certification (e.g. crop and processor) you may apply for EACH current certificate, but you must complete a separate application for each certified operation. 2. In New Mexico, the New Mexico Department of Agriculture is the agency responsible for distributing the federal funds. All certified organic New Mexico businesses are eligible for reimbursement as long as they have successfully completed the certification process and have a current certificate from a USDA-accredited certifier. 3. You must fill out the forms completely and include the required attachments to be reimbursed. 4. Requests for reimbursement must be received no later than 10/31/ There is no guarantee that funds will be available. Reimbursements will be issued on a first-come-first served basis until the money runs out. 6. What is important in figuring your certification costs for a particular year is the date that you wrote the check to cover those costs. Checks you wrote from 10/1/16-9/30/17 would be eligible for cost share reimbursement this year. Your certification year, (the date on your certificate or renewal) is irrelevant to this program. Eligible expenses generally are ones for which you paid your certifier. Application fees and assessments are eligible. Late fees charged for late application submission are not eligible. 7. Please don t hesitate to call Elaine Padilla at (575) if you have any questions about this program. We want you to get your reimbursement. What you have to do Guided by the information above: 1) Fill out the cost-share application and sign it. 2) Fill out the NMSU Vendor Questionnaire form. Section 1, Are you currently working with a department on a purchase-although you are NOT actually working on a purchase, Check Yes, and write in "NMDA". Section 2, Check your Business Type. Section 3, Do Not select "One-Time Payment", as this will remove you from the system as soon as payment is made to you. If you file as an individual, sole proprietor or any type of LLC, you MUST complete Section 5: Independent Contractor Determination. For Question 2 of this section, please write the following: I am not providing a service to NMSU but am being reimbursed for fees paid to NMDA. Print, Sign and Date the form on page 4. 3) Include a copy of your current organic certificate if you were first certified in 2017, or are not certified by NMDA. 4) Include an itemized statement of certification expenses; and, if not certified by NMDA or you are claiming postage, please attach receipts. 5) Please confirm that the Vendor Questionnaire is complete and all questions answered. 6) Do NOT Send the VQ (Or any other documents) to NMSU. Send ALL the above items to: Julia Conlogue NMDA Organic Program 2604 Aztec NE Albuquerque, NM Vendor-Questionnai