Versacare Foundation

You will be emailed a copy of this completed form for your records. Please contact the Versacare office (and do not complete the form) if any fields on this form appear blank or incorrect.

Grant Project Agreement:

Grant Type

Amount Awarded (US$)

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Grant Year

Start Date

End Date

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Project Name

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Organization

Funded Project Description

Contact

Contact Verification(Required)

YES–please send our grant check to the attention of the person named at left

NO–please send our check to the attention of a different person

All checks will be made out to the organization.

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SEND Email

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SEND Name

NEW Contact(Required)

First Last

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Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address Verification(Required)

YES–please send our grant check to the address shown at left

NO–please send our check to a different address

NEW Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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OLD Grant Award Year

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OLD Project Description

TERMS & CONDITIONS

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<li>PROJECT AND PURPOSE: Versacare Foundation is awarding this grant to carry out the project described above and to further the Grantee’s charitable purpose.</li>
<li>GRANT FUNDS: The grant funds shall be used exclusively for the project specified in this Grant Agreement as described in the Grant Application, and any alternative use of funds must be authorized in advance, in writing, by Versacare Foundation or all awarded funds must be immediately returned.</li>
<li>TAX-EXEMPT STATUS: Grantee will keep its tax-exempt status as a recognized 26 U.S. Code Section 501(c)(3), and Section 509(a)(2) or 509(a)(3) organization current throughout the period of this grant and will comply with all applicable federal and state laws and regulations that govern the use of funds from private foundations to the Grantee organization. This includes but is not limited to:
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<li>the prohibition against the use of any of the funds to influence legislation, to influence the outcome of elections, to carry on voter registration drives, to make grants to individuals or other organizations, or to undertake any nonexempt activity, when such use of the funds would be a taxable expenditure if made directly by Versacare Foundation</li>
<li>limiting the use of the grant funds to the Grantee’s authorized taxable purposes within the scope of the Grantee’s application. Grantee shall notify Versacare Foundation immediately of any change in the tax-exempt status of Grantee and of any change in the stated charitable purpose of Grantee.</li>
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<li>REPORTING: Grantee must submit a grant report regarding use of funds consisting of a narrative report and financial accounting no later than the end date noted above. The narrative portion of the report should account for how the grant was used and what impact the grant had in advancing the grant purposes. No future grant requests will be considered until the assigned interim and/or final grant report(s) is submitted. There is no guarantee of future funding.</li>
<li>RECORD KEEPING: Grantee must keep records of receipts and expenditures and make its books and records available to Versacare Foundation at reasonable times if requested by Versacare Foundation.</li>
<li>RESPONSIBILITY FOR OTHERS: Grantee is solely responsible for all acts and omissions of any of its trustees, directors, officers, employees, subgrantees, subcontractors, contingent workers, agents, volunteers, and affiliates assisting with the project and ensuring their compliance with the terms of this Agreement.</li>
<li>PUBLICITY: Grantee may publicly disclose information about the award of this grant, including the Versacare Foundation’s name, the total amount awarded, and a description of the project. Versacare Foundation maintains a branding page on its website for Grantee to capture images of Versacare Foundation’s logo for publicity. Such capture and publishing of Versacare Foundation’s name and logo are permissible without prior consent but subject to permission being withdrawn at Versacare Foundation’s discretion. Nothing in the communications released by Grantee shall infer or imply any relationship of any kind between Versacare Foundation and Grantee other than that of Donor and Grantee.</li>
<li>RELIANCE: Grantee acknowledges that Versacare Foundation is relying on the information Grantee provides in the grant application and in any reports or other information provided during due diligence conducted prior to the start date noted above and during the term of this Agreement. Grantee agrees that Versacare Foundation may continue to rely on this information and on any additional information it provides regarding activities, progress, and funded developments. In the event Grantee learns that any of the information provided to Versacare Foundation by Grantee, including the grant application and/or any report, is substantially incorrect, Grantee shall notify Versacare Foundation of the error immediately.</li>
<li>TERM: This Agreement commences on the start date noted above and continues until the end date noted above, unless terminated earlier as provided in this Agreement. Versacare Foundation, at its discretion, may approve in writing any request by Grantee for an extension, including amending the end date, extending expenditure of grant awarded funds beyond the end date, and adjusting any affected reporting requirements.</li>
<li>TERMINATION: Versacare Foundation may modify, suspend, or stop payment of grant funds or terminate this Agreement if:
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<li>Versacare Foundation is not reasonably satisfied with Grantee’s progress on the project</li>
<li>there are significant changes to Grantee’s leadership or other factors that Versacare Foundation reasonably believes may threaten the project’s success</li>
<li>there is a change in Grantee’s control</li>
<li>there is a change in Grantee’s tax status</li>
<li>Grantee fails to comply with this Agreement.</li>
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<li>RETURN OF FUNDS: Any grant funds that have not been used for, or committed to, the project upon expiration or termination of this Agreement must be returned promptly to Versacare Foundation.</li>
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COMPLIANCE

Versacare Foundation awards the grant based on the Grantee’s application only after Grantee accepts the terms and conditions set forth herein. By selecting the “I Accept Grant Terms and Conditions” option below, Grantee agrees to accept and comply with the stated terms and conditions of this grant.

ACCEPTANCE(Required)

I accept these Grant Terms and Conditions

I decline these Grant Terms and Conditions

Signature(Required)

Typed Name(Required)