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PS 6011

Agreement for Acceptance of Food Items (4/2006)

Download and Print the PS 6011

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A. Organization Information

Organization Name

Contact Name (Last, first, MI)

Address (Number, street, suite, etc.)

City   -   State  -   ZIP+4┬«

Telephone Number  -  E-Mail Address (Optional)

B. Agreement

THE UNITED STATES POSTAL SERVICE® IS PROVIDING THE FOOD ITEMS AS IS AND MAKES NO
WARRANTIES, EXPRESS OR IMPLIED, AS TO THE CONDITION OR FITNESS FOR USE OF THE FOOD ITEMS.

The organization identified above, in consideration of accepting a donation of food items that the United States Postal Service has determined are undeliverable as addressed, represents to the United States Postal Service that:

1. It is a public or charitable organization, food bank, shelter, or other nonprofit organization.

2. It agrees to assume full responsibility for the transportation, distribution, and use of the donated food items.

3. It agrees to hold harmless the United States Postal Service and its agents, servants, and employees from and against any and all causes of action, claims, liens, rights, or interests of any kind or type whatsoever, for death, bodily injury, or personal injury to any person including its employees and agents, whether for compensatory or exemplary damages, incident to or resulting from the authorized or unauthorized handling and use of the subject food items by any person.

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