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Recommended Steps to Successfully Submit an Extension for Approval

Read the Checklist. Ensure that each item listed is included with the contract submission, check each included item off the checklist, then sign the checklist. Submittal of the required checklist with your signature indicates that you have verified that each item is included with the extension and complete. If the checklist has not been used and/or signed, the documents will be returned to the Superintendent/CEO/Board President without being reviewed.

 The contract extension may be retrieved online as a fillable PDF form. The extension may be completed by either entering text in the PDF document and printing the extension or by printing the extension and then completing it by hand. You must submit one original plus two copies of the contract extension. Once approved, the original will be returned to you for your files.


  • All lines on the extension form must contain appropriate information or N/A, if information is not applicable, as we cannot accept extensions with any blanks. Extensions with blanks will not be accepted and will be returned to the Superintendent/CEO/Board President without being reviewed. It is also essential that you have a copy of your original contract for your reference when completing the extension. Please contact our office at (518) 473-8781 or email if you need a copy.
  • REQUIRED CHECKLIST – The required checklist is to help assist you in properly completing the extension and must be filled out and submitted with the document.
  • SECTION 1 – The commencing and ending dates must be the same as the original contract date (month, day, and year). See original contract, agreement section. Have a copy of the original contract for your reference to facilitate completing the extension. In the event you need a copy, please contact our office at (518) 473-8781.
  • SECTION 2 – The commencing and ending dates must be the same month and day with the appropriate year. If different, include proof of approval from the School Board via board meeting minutes or a letter signed by the School Board President.
  • Use the CPI-U online worksheet to:
  • Ensure math calculations for the extension of contract are correct.
  • Follow the same rounding convention used in the original bid price. For example, if the original bid price stated a dollar amount with 4 decimal places, then the extension amount must be a dollar amount with 4 decimal places.
  • Fill-in all required information for Type II or III contract meal pricing.
  • Guaranteed Return – This is not subject to CPI-U increase and must agree with section 1 of the extension or the original contract, if applicable.
  • Check Participation in the Summer Food Service Program.
  • Ensure all required SIGNATURES AND DATES are in blue ink only.
  • Complete Required FORM #1 – Nutrition Standards in the National School Lunch and Breakfast Programs
  • Return a completed “Certificate of Lobbying” form and the “Lobbying Activities” form, if applicable.
  • Return Debarment Option A (SFA) or Debarment Option B (FSMC). Do not submit both.
  • Ensure that checklist is completed and signed.

USDA Nondiscrimination Statement

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at:, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

  1. mail:
    U.S. Department of Agriculture
    Office of the Assistant Secretary for Civil Rights
    1400 Independence Avenue, SW
    Washington, D.C. 20250-9410; or
  2. fax:
    (833) 256-1665 or (202) 690-7442; or
  3. email:

This institution is an equal opportunity provider.

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