ELGIN FOUNDATION GRANT AGREEMENTPage 1
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Elgin Foundation
4624 Chambliss Avenue
KnoxvilleTN37919
(865) 588-6250
Fax (865) 588-2033
Knox County Schools
Health Services
Attn: Lisa Wagoner, Director
PO Box 2188
L-700
KnoxvilleTN37901-2188
Re: Terms and Conditions Applicable to 2009-10 Grant
Dear Ms. Wagoner,
Elgin Foundation (“Elgin”) is pleased to confirm that your organization (the “Grantee”) will receive a grant, as more particularly described on Exhibit A, subject to the terms and conditions set forth herein. We are thankful that you are committed to serving children in your area.
We are fiduciaries of the funds entrusted to us and believe it is appropriate that we confirm in writing with you our joint understanding regarding the use of the funds granted, as follows:
1.Disbursements. Elgin has approved a grant of $25,000 (the “Grant”) to the Grantee for a school nurse.
2.Permitted and Prohibited Uses. The Grant funds are to be used solely for the purposes set forth in your letter to the Elgin Foundation, which is attached hereto as Exhibit B (the “Permitted Purposes”), with the ultimate objective of improving the scholastic achievement of the underserved children in Knox County, Tennessee. Without limiting the generality of the foregoing condition, the Grantee expressly acknowledges and agrees that none of the grant funds will be used (a) to carry on propaganda, or otherwise attempt to influence legislation, (b) to influence the outcome of any specific public election, or to carry on, directly or indirectly, any voter registration drive, or (c) to undertake any activities for any purpose that would not be deemed to be a charitable or educational purpose described in Section 170 of the Internal Revenue Code of 1986, as amended (the “Code”).
3.Project Data. The Grantee agrees to furnish to Elgin School Nurse Quarterly Reports.
4.Conditions for Future Grants. Grantee acknowledges that Elgin is not committed to make any grants or contributions in the future and that there are no oral or implied obligations or commitments to do so.
5.Unused Funds. The Grantee agrees that the Grant funds will be used only for the Permitted Purposes and the Grantee is legally obligated to return any funds not used in accordance with the terms of this Agreement within twelve (12)months from the date hereof. Grantee agrees to reimburse, indemnify, and hold Elgin harmless as to any funds not properly expended.
6.Status of Grantee as a Tax-Exempt Organization. The Grantee certifies that it is an organization described in Section 170(c) of the Code, classified as a public charityor a governmental entity eligible to receive charitable contributions. The Grantee will notify Elgin in the event of any change in status or any determination by the Internal Revenue Service with respect to its status as an organization described in Section 170of the Code. The Grantee further agrees to submit to Elgin, in a timely manner, any information required for Elgin’s tax filings, in connection with its audit(s), and such other information requested by Elgin in connection with the Grant.
7.Miscellaneous. This Agreement constitutes the full understanding of the parties and will be governed by the laws of the State of Tennessee. This Agreement may only be amended by a written instrument signed by an authorized director of Elgin and an authorized officer of the Grantee. A certified resolution of the Grantee’s governing board authorizing the Grantee to enter into this Grant Agreement and agreeing to comply with the terms hereof will be delivered to Elgin before any disbursement will be made. Elgin shall not be responsible for the products, programs or services obtained or provided by Grantee or its agents, Elgin shall have no liability in connection therewith, and Grantee hereby releases and shall indemnify and hold harmless Elgin and its directors, officers, agents, and contractors from any liability, risk, claim, loss, cost or expense (including professional fees) relating in any way to the Grant and/or the products, programs, and services funded in whole or in part with the Grant proceeds.
Please confirm your agreement to adhere to the terms and conditions set forth in this letter agreement and the exhibits attached by signing in the space provided below. Again, thank you for your efforts on behalf of the children.
Very truly yours,
ELGIN FOUNDATION
By: ______
Name:______
Title:______
Agreed:
Knox County Schools, Health Services of Knox County, Tennessee
By: ______Date: ______
Name: ______
Title: ______
STATE OF TENNESSEE
COUNTY OF KNOX
Before me, a Notary Public of the state and county aforesaid, personally appeared ______, with whom I am personally acquainted (or proved to me on the basis of satisfactory evidence), and who, upon oath, acknowledged himself to be ______of ELGIN FOUNDATION, the within named bargainor, a Tennessee nonprofit corporation, and that he as such ______executed the foregoing instrument for the purpose therein contained, being authorized to do so, by signing the name of ELGIN FOUNDATION by himself as ______.
Witness my hand, at office, this ____ day of ______, 20____.
______
Notary Public
My Commission Expires:______
STATE OF ______
COUNTY OF ______
Before me, a Notary Public of the state and county aforesaid, personally appeared ______, with whom I am personally acquainted (or proved to me on the basis of satisfactory evidence), and who, upon oath, acknowledged himself to be ______(or other officer authorized to execute the instrument) of Knox County Schools, Health Services, the within named bargainor, and that he/she as such ______executed the foregoing instrument for the purpose therein contained, being authorized to do so, by signing the name of ______by himself/herself as ______.
Witness my hand, at office, this ____ day of ______, 20____.
______
Notary Public
My Commission Expires:______
GRANT AGREEMENT-CONTINUED
EXHIBIT A
GRANT TERMS AND CONDITIONS
Date Authorized:July 24, 2009
Grantee Organization:KnoxCountySchools, Health Services
Contact person:Lisa Wagoner, Director
Grant Purpose:(see attached Exhibit B)
Amount Requested:$25,000.00
Amount Granted:$25,000.00
Grant Period:2009-2010
School Nurse Report:Quarterly
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ELGIN FOUNDATION GRANT AGREEMENT
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EXHIBIT B
Letter and proposal to the Elgin Foundation dated July 2, 2009 (attached)