Food Hub Directory Form OMB NO. 0581-NEW
[current year] USDA NATIONAL FOOD HUB DIRECTORY
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DIRECTORY
SECTION
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Questions
1 – 6 are designed to appear in subsequent years of the
Directory and will be visible only to those who filled the Directory
form in the previous year or information is already available from
another source.
These questions are included for the OMB
approval.
(Only managers/ representatives from previous year’s Directory see this question)
[Q1]
Will your
[name of the food hub from previous year’s Directory]
be open for business on
or adjacent to your farm
anytime in
[current year]?
O
1- Yes => Go to Q2 (Still manager/ rep)
O 2- No
=>
Skip to Q3 (Manager/ rep of another on-FM)
O 3- Do not know
=> Go to Q2 (Still manager/
rep)
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[Q2]
According to the USDA National food hub Directory, you were either
the manager or a representative of [name
of the food hub from previous year’s Directory]
in previous Directory. Are you still the manager or a representative
of this food hub in [current
year]?
O
1- Yes
=> If Yes (open) in Q1 and Yes (manager/ rep)
in Q2 => Skip to Q6 (Correct on-FM name?)
=> If Don’t
know (if open) in Q1 and Yes (manager/ rep) in Q2 => Go to
additional message below
O 2- No => Go to Q3
(Manager/ rep of another
on-FM)
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ADDITIONAL
MESSAGE
Only respondents who “Don’t know”(if
market open) in Q1 and Yes (are managers/representatives) in Q2 will
see the below message
Based
on your response, we see that you are still the manager or the
representative of
[name of the food hub from previous year’s Directory],
but you do not know if it is going to operate anytime in [current
year].
This Directory will be available for online updating throughout the
year, so please update the information for this market if it opens
sometime in [current
year].
=>
Exit the current year USDA Directory
update
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[Q3]
Are you a manager or a representative of another food hub in
[current
year]?
O
1- Yes => Go to Q4 (Willing to provide info on another
on-FM)
O 2- No
=>
Exit the current year USDA Directory
update
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[Q4]
Are you willing to provide information about the food hub that you
manage or represent in [current
year]?
O
1- Yes => Go to Q5 (Search engine)
O 2- No
=>
Exit the current year USDA Directory
update
=========================================================================================
(Question
visible only to those who came through the public web site or who
came through the link but manage different market)
SEARCH
ENGINE
[Q5] Please type in the correct official
name of the food hub that you manage or represent.
As
you start typing, food hubs with the same or similar name(s) may
appear and you may choose the proper market name by clicking on the
“update” link in the right column.
Should
there be a spelling mistake in the name of the market listed, but
you are sure (by checking the location address) that this is the
market you manage or represent, you will have an opportunity to
correct the spelling of the official market name.
For
your convenience, you may also search the list by typing in the zip
code of the physical LOCATION of the food hub (not the zip code for
the mailing address, as it might be different).
On-farm
market name or location zipcode:……………………
Displayed food hub names |
Location street |
City |
State |
Zip code |
Update |
Xa |
|
Ka |
AZ |
|
Update => Go to Q6 (Is the name correct?) |
Xb |
|
Le |
OK |
|
Update => Go to Q6 (Is the name correct?) |
Xc |
|
Mw |
RI |
|
Update => Go to Q6 (Is the name correct?) |
aXa |
|
Kl |
AZ |
|
Update => Go to Q6 (Is the name correct?) |
bXb |
|
Lm |
OK |
|
Update => Go to Q6 (Is the name correct?) |
cXc |
|
Mg |
RI |
|
Update => Go to Q6 (Is the name correct?) |
If
the name of the food hub that you manage or represent is not listed,
please click
here
to continue. =>
Skip to Q7 (Type correct
name)
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(Question
visible only to those who came through the public web site AND
clicked on “update” in the table in Q6)
[NameCheck]
Is “[name
of the food hub from previous year’s Directory]”
the correct official
name of your food hub?
O
1- Yes. If yes, this information will appear in the [current
year]
USDA National On-Farm Market Directory.
=> Skip to Q8
(on-FM definition)
O 2- No => Go to Q7 (Provide
correct
name)
=========================================================================================
(New-comers and “No” [i.e., incorrect name] in Q5 or in Q6 see this question)
[CorrectedName]
Please type in the correct official
name of the food hub that you manage or represent. The name that you
provide here will appear in the [current
year]
USDA National On-Farm Market
Directory.
…………………………………………………………
------------------------------------------------------------------------------------------------------------------------------------------------------------
Please
type in the correct official
name of the food hub that you manage or represent. The name that you
provide here will appear in the [current
year] USDA
National Food Hub Directory.
Food
hub name:
……………………
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(Everyone
sees this question)
For
the purposes of this Directory, a “food hub” is “a
business or organization that actively manages the aggregation,
distribution, and marketing of source-identified food products to
multiple buyers from multiple producers, primarily local and
regional producers, to strengthen the ability of these producers to
satisfy wholesale, retail, and institutional demand.”
Does
this operation qualify as a food hub as defined above?
O
1- Yes=> Go to Q9 (Person’s contact info)
O 2- No
=> Exit the [current
year]
USDA Directory
update
============================================================================================
INFORMATION
LISTED IN THIS SECTION WILL NOT
BE PUBLISHED IN THE [current
year]
USDA NATIONAL FOOD HUB DIRECTORY. THIS IS FOR INTERNAL PURPOSES
ONLY. THIS INFORMATION WILL BE KEPT CONFIDENTIAL.
Please
provide contact information of the person completing this
form:
Name:
……………………
Email
address: ……………………
Contact
(phone) number: ……………………
What
is your primary
relationship with this food hub?
O
1- Food hub director
O 2- Food hub manager
O 3-
Contact person/ public liaison for the food hub
O 4- Food hub
supplier
O 5- Food hub customer
O 6- Other, please
specify:
……………………
============================================================================================
ALL
INFORMATION IN THE FOLLOWING SECTION WILL
BE PUBLISHED
IN THE [current
year]
USDA NATIONAL FOOD HUB DIRECTORY.
Mailing
address for this food hub:
Street
name and number or P.O. Box number: ……………………
City:
……………………
State:
………………
5-digit ZIP
Code: ……………………
Please
provide the official contact information for this food hub:
Name
of primary contact for food hub: ……………………
Primary
contact’s official title: ……………………
Primary
contact’s email address: ……………………
Primary
contact’s phone number: ……………………
Food
hub website address: ……………………
Food
hub Facebook page: ……………………
Food
hub Twitter address: ……………………
Food
hub contact information on other social media: ……………………
Please
provide information about the physical location (actual place) where
this food hub operates (i.e., location of food hub
facility/warehouse). If there is not a street address, number or zip
code for this location, or you do not know it, please provide the
state, city/ town and a description of the location with the nearest
road intersection listed (e.g., Main St. x Tree St.). The Directory
will include this description to assist customers in locating the
food hub.
After you enter the information, click on the box
below and an arrow will appear pointing to the location of the food
hub. If it is not the correct location of the food hub in [current
year],
please drag the arrow to the correct location. If you lose sight of
the arrow (by zooming in, for example), you can click anywhere on
the map and a new arrow will appear.
Food
hub location – state: ……………………(a
drop-down menu)
(required)
Food
hub location – county (or parish, if located in Louisiana; or
borough, if located in Alaska): …………..
Physical
street name and number where food hub located: …………
Food
hub location – city: ……………………(required)
Food
hub location – 5-digit ZIP Code: ……………………(only
5 digits allowed)
Description of location: ……………………
Example:
on High Road near Anytown, 3 miles west of the intersection with
state hwy 300.
In
what year was this food hub established?
Year:
……………………
What
is the legal status of this food hub?
O
Non-Profit
O Producer Cooperative
O Consumer
Cooperative
O Producer-Consumer Cooperative
O S Corp
O
C Corp
O B Corp
O LLC
O L3C
O Publicly
owned
O No formal legal structure
O Other, please
specify: ……………………
Does
this food hub operate year round or part of the year?
O
Year round (12 months) => Skip to Q18 (Products sold)
O
Part of the year => Go to Q17 (Indicate months)
Please
indicate in which months this food hub will be in operation in
[current
year].
Please select all that apply.
[_]
January
[_] February
[_] March
[_] April
[_]
May
[_] June
[_] July
[_] August
[_]
September
[_] October
[_] November
[_]
December
[_] Not applicable, please explain: ………………
Which
farm products and other items do you expect to be sold at this food
hub in [current
year]?
Please select all that apply.
[_]
Baked goods: breads, pies, etc.
[_] Canned or preserved
fruits/ vegetables: jams, jellies, preserves, salsas, pickles,
dried fruit, etc.
[_] Coffee and/or tea
[_] Cut
flowers
[_] Dairy products: milk, cheese, etc.
[_]
Dry beans
[_] Eggs
[_] Fish and/or seafood
[_]
Fresh and/or dried herbs
[_] Fresh fruits
[_] Fresh
vegetables
[_] Grains and/or flour
[_] Green
household products: bio-degradable detergent, products made from
100% recycled materials, etc.
[_] Honey
[_] Juices
and/or non-alcoholic ciders
[_] Maple syrup and/or maple
products
[_] Mushrooms
[_] Nuts
[_] Pet
food
[_] Poultry/ fowl meat and products
[_] Red and
other non-poultry meat and products
[_] Soap and/or body
care products
[_] Tofu and/or non-animal protein
[_]
Wild harvested forest products: mushrooms, medicinal herbs, edible
fruits and nuts, etc.
[_] Wine, spirits, beer, hard
cider
[_] Other, please specify: ……………………
19.
Local food is defined as a food product that is
raised, produced, aggregated, stored, processed, and
distributed in the locality or region in which the final product is marketed, so that the total distance
the product is transported is less than 400 miles from the origin of the product, or the State in which
the product is produced.
Based on the definition above does your food hub sell local products?
Yes
No
O
Yes
O No
(If
definition of “local” provided in Q19)
Based
on the hub’s definition of “local”, please
indicate if you expect this food hub will sell exclusively local;
only local when available; both local and non-local; or exclusively
non-local products in [current
year].
Q14
B (If NO definition of “local” provided in Q19)
Using
400-mile radius from the hub as a definition of “local”,
please indicate if you expect this food hub will sell exclusively
local; only local when available; both local and non-local; or
exclusively non-local products in [current
year].
In
the table, display only the food categories selected in Q18
(Products sold)
Food products |
Exclusively local |
Only local when available |
Both local and non-local |
Exclusively |
Baked goods: breads, pies, etc. |
O |
O |
O |
O |
Canned or preserved fruits/ vegetables: jams, jellies, preserves, salsas, pickles, dried fruit, etc. |
O |
O |
O |
O |
Coffee and/or tea |
O |
O |
O |
O |
Cut flowers |
O |
O |
O |
O |
Dairy products: milk, cheese, etc. |
O |
O |
O |
O |
Dry beans |
O |
O |
O |
O |
Eggs |
O |
O |
O |
O |
Fish and/or seafood |
O |
O |
O |
O |
Fresh and/or dried herbs |
O |
O |
O |
O |
Fresh fruits |
O |
O |
O |
O |
Fresh vegetables |
O |
O |
O |
O |
Grains and/or flour |
O |
O |
O |
O |
Green household products: bio-degradable detergent, products made from 100% recycled materials, etc. |
O |
O |
O |
O |
Honey |
O |
O |
O |
O |
Juices and/or non-alcoholic ciders |
O |
O |
O |
O |
Maple syrup and/or maple products |
O |
O |
O |
O |
Mushrooms |
O |
O |
O |
O |
Nuts |
O |
O |
O |
O |
Pet food |
O |
O |
O |
O |
Poultry/ fowl meat and products |
O |
O |
O |
O |
Red and other non-poultry meat and products |
O |
O |
O |
O |
Soap and/or body care products |
O |
O |
O |
O |
Tofu and/or non-animal protein |
O |
O |
O |
O |
Wild harvested forest products: mushrooms, medicinal herbs, edible fruits and nuts, etc. |
O |
O |
O |
O |
Wine, spirits, beer, hard cider |
O |
O |
O |
O |
Other |
O |
O |
O |
O |
Which,
if any, of the following practices does this food hub require that
producers/suppliers utilize? Please select all that apply.
[_]
USDA Certified Organic
[_] Certified Naturally Grown
[_]
Integrated pest management
[_] Non-Certified, but
Practicing Organic
[_] Free Range/Pasture Raised
[_]
Grass Fed
[_] Antibiotic Free
[_] Marine Stewardship
Council Certified
[_] Chemical Free
[_] Good
Agricultural Practices (GAP)-certified => Go to Q22
(GAP-certifying entity)
[_] Good Handling Practices
(GHP)-certified
[_] Certified Humane
[_] Animal
Welfare Approved
[_] Fair Trade
[_] Other,
please specify: ……………………
[_]
Other,
please specify: ……………………
[_]
Other,
please specify: ……………………
[_]
None, this hub does not require any of these practices
Only
those that selected GAP-certified in Q21.
Please
specify by which GAP-certifying entity/ entities these practices
must be certified to be accepted by this food hub.
O
USDA
O USDA and other certifying entity/ entities
O
Other (non-USDA) certifying entity/ entities
Do
you expect this food hub will sell
products to wholesale buyers
in [current
year]?
O
Yes => Go to Q 24 (What channels for selling to wholesale
buyers)
O No, our food hub only sells directly to consumers
=> Skip to Q25 (Will sell directly to consumers?)
Through
what market channels do you expect this food hub will sell
products to wholesale buyers
in [current
year]?
[_]
Large supermarkets or supercenters
[_] Small independent
grocery stores
[_] Corner stores, bodegas
[_] Food
retail cooperatives
[_] Restaurants
[_] Caterers,
bakeries
[_] Distributors
[_] Food processors
[_]
Pre-K food service
[_] K-12 school food service
[_]
Colleges/Universities
[_] Hospitals
[_] Senior care
facilities
[_] Government or corporate cafeterias
[_]
Other, please specify: ……………………
[_]
Other, please specify: ……………………
[_]
Other, please specify: ……………………
Do
you expect this food hub will sell
products directly to consumers
in [current
year]?
O
Yes => Go to Q 26 (What channels for selling directly to
consumers)
O No, our food hub only sells to wholesale buyers
=> Skip to Q27 (Procurement agreement)
Through
what market channels do you expect this food hub will sell
products directly to consumers
in [current
year]?
[_]
Buying clubs
[_] On-line store
[_] Your own retail
storefront
[_] Community-supported agriculture (CSA)
shares
[_] Farmers markets
[_] Mobile retail
units/food trucks
[_] Farm stands
[_] Other, please
specify: ……………………
[_]
Other, please specify: ……………………
[_]
Other, please specify: ……………………
Please
indicate this food hub’s procurement arrangement with its
suppliers.
[_]
We take ownership of the product by buying from suppliers and
then reselling the products to our customers.
[_] We sell on
a consignment basis, i.e., we do not take ownership of the product
- we sell the supplier’s products to our customers and take a
commission on products sold.
[_] We do both – in some
cases we take ownership and resell the product and, in other cases
we sell on a consignment basis.
[_] Other procurement
arrangements, please explain: ……………………
Please
indicate which of the following operational
services or activities
you expect this hub to offer in [current
year].
Please select all that apply.
[_]
Aggregation
[_] Production such as operating a farm or
ranch (including incubator or demonstration farms)
[_]
Distribution services
[_] Brokering services
[_]
Shared use kitchen
[_] Packaging/Repackaging
[_]
Product storage
[_] Canning
[_] Freezing
[_]
Cutting
[_] Other, please specify: ……………………
[_]
Other, please specify: ……………………
[_]
Other, please specify: ……………………
Please
indicate which of the following producer support services
or activities
you expect this hub to offer in [current
year].
Please select all that apply.
[_]
Marketing and promotional services for producers
[_]
Branding or labeling products to indicate origin of product or
other attributes
[_] Demonstration/Incubator farm
[_]
Production and post-harvest handling training
[_] Business
management services or guidance
[_] Paid consulting
[_]
Food safety and/or GAP Training
[_] Liability insurance
that you offer producers
[_] Transportation services for
producers such as picking up product from the farm for
distribution
[_] Other, please specify: ……………………
[_]
Other, please specify: ……………………
[_]
Other, please specify: ……………………
Please
indicate which of the following services
or activities
you expect this hub to offer to
the community
in [current
year].
Please select all that apply.
[_]
Paid employment opportunities for youth
[_] Accepting SNAP
benefits
[_] Accepting WIC or FMNP benefits
[_]
Matching programs for SNAP benefits
[_] Nutrition or cooking
education
[_] Meal preparation
[_] Health
screenings
[_] Transportation services for consumers to
access your operation
[_] Operating a mobile market
[_]
Subsidized farm shares
[_] Education programs for
institutions (e.g., at schools, colleges/universities,
hospitals)
[_] Other education or community awareness
programs
[_] Food donations to local food pantries/banks
[_]
Other, please specify: ……………………
[_]
Other, please specify: ……………………
[_]
Other, please specify:
……………………
============================================================================================
INFORMATION
LISTED IN THIS SECTION WILL NOT
BE PUBLISHED IN THE [current
year]
USDA NATIONAL FOOD HUB DIRECTORY. THIS IS FOR USDA’S INTERNAL
PURPOSES ONLY. THIS INFORMATION WILL BE KEPT CONFIDENTIAL.
Please
provide the total gross product sales for this food hub in 2013.
O
$500,000 or less
O $500,001 to $2,000,000
O
$2,000,001 to $5,000,000
O $5,000,001 to $10,000,000
O
Over $10,000,000
O Did not operate in [last
year]
Please
list the number of staff this food hub expects to have in the
following categories in [current
year].
If
you do not expect any staff in a given category, please enter 0
(zero). If you are unable to estimate a number of staff, please
leave that box empty.
Full-time
year-round paid employees: ……………………
Part-time
year-round paid employees: ……………………
Seasonal
paid employees: ……………………
Unpaid
interns/apprentices: ……………………
Cooperative
member volunteers: ……………………
Regular
volunteers: ……………………
Occasional
volunteers: ……………………
Consultants:
……………………
Other,
please specify: ……………………
Does
this food hub own or lease a facility for aggregation, storage, and
distribution purposes?
O
Yes => Go to Q34 (Total square footage)
O No => Skip
to Q35 (# of producers/suppliers)
What
is the total square footage that this hub’s facility
currently owns or leases from others?
Square
footage: ……………………
From
how many producers/suppliers do you expect this hub to purchase or
procure products in [current
year]?
Number
of producers/ suppliers: ……………………
(If
definition of “local” provided in Q19)
Based
on the hub’s definition of “local”, from how many
local producers do you expect this hub to purchase or procure
products in [current
year]?
Q36
B (If NO definition of “local” provided in Q19)
Using
400-mile radius from the hub as a definition of “local”,
from how many local producers do you expect this hub to purchase or
procure products in [current
year]?
Number
of “local” producers/suppliers: ……………………
Does
this hub purchase or procure products directly from any small or
mid-sized producers (generally-speaking, farms and ranches with
gross annual sales less than $500,000)?
O
Yes => Go to Q38 (Proportion of purchased products from small/
mid-sized producers)
O No => Skip to Q39 (Majority of
customers from x miles)
Please
indicate from how many small and mid-sized producers
(generally-speaking, farms and ranches with gross annual sales less
than $500,000) you expect this hub to purchase or procure products
in [current
year].
O
All of our products will be purchased/procured from small and
mid-sized producers
O Most of our products will be
purchased/procured from small and mid-sized producers
O Some
of our products will be purchased/procured from small and mid-sized
producers
O Few of our products will be purchased/procured
from small and mid-sized producers
Where
do you expect most (at least 75%) of this food hub's [current
year]
customers (based on [$] sales) will be located?
O
Under 50 miles away
O Under 100 miles away
O Under
150 miles away
O Under 200 miles away
O Under 250
miles away
O Under 300 miles away
O Under 350 miles
away
O Under 400 miles away
O 400 miles away or more
===============================================================================================
THANK-YOU PAGE
Dear Food Hub Manager/Representative,
Thank you for updating your food hub listing for the [current year] National Food Hub Directory. If you wish to enter information about an additional food hub, please click here.
We greatly appreciate your participation in this very important project to help keep consumers informed about food hubs.
If you have any questions about the Directory itself, please contact us at directoryupdates@ams.usda.gov or (202) 720-8317.
If you update information on your food hub by XXXX, it will appear in the [current year] USDA National Food Hub Directory by YYYY. This means consumers will be able to find your hub just as the busy summer season is getting underway. Food hub listings submitted after MMMM, but by KKKK will be published in the Directory by LLLL.
Thank you for updating your hub listing for the [current year] National Food Hub Directory.
Sincerely,
Velma Lakins
Agricultural Marketing Specialist
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information, unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0581-NEW. The time required to complete this information collection is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer..
2014-Directory
of food hubs ----
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | National Food Hub Survey |
| Author | Qualtrics |
| File Modified | 0000-00-00 |
| File Created | 2021-01-27 |