FY18 SRC CFMF PRESCRIPTION DRUG #1837(7,"a e Fe
MEMORIAL FOUNDATION
GRANT CONTRACT
Organization:
New Hanover County Senior Resource Center
Amount of Grant:
$10,000.00
Date of Payment:
10/15/2017
Term of Grant:
12 Months
Project Title:
Prescription Drug Assistance Counseling (PDAC) Program
Grant ID:
1837
The following terms are agreed upon as conditions for this grant:
1. The tax- exempt status verified in the proposal is still valid; any changes in the organization that could
lead to a change in the status will be reported to Cape Fear Memorial Foundation immediately.
2. The funds will be used by the above -named organization solely for the purposes described in the project
title above. No funds will be utilized for the purpose of promotion or advancement of political causes.
3. The organization will keep and maintain records of expenditures adequate to verify the use of grant funds.
Progress reports concerning budget, personnel and program developments will be timely completed and
returned to Cape Fear Memorial Foundation. Misappropriation of grants funds or unsatisfactory progress
(as determined by the Foundation) may result in a demand that the grantee repay grant funds to the
Foundation.
4. The organization will repay, upon demand, to Cape Fear Memorial Foundation the amount of the grant if
any condition of the contract is not upheld. Additionally, the organization will repay Cape Fear Memorial
Foundation an amount equal to the book value of any assets acquired through a capital grant from Cape
Fear Memorial Foundation if and when your organization is sold, or loses its tax- exempt status or no
longer provides services consistent with those supported by this grant.
The organization will send to the Foundation copies of any printed publicity regarding the awarding of the
grant or the program supported by the grant; the organization may, if it chooses, refer to Cape Fear
Memorial Foundation's support in any such publicity.
6. Future payments under multi -year grants will be subject to availability of funds and to satisfactory review
of progress reports which document meaningful progress toward the goal.
7. The following special terms will be observed: None
The terms of this contract are accepted by:
Cape Fear emorial F nation New Hanover County Senior Resource Center
By: By:
Anna Erwin, esident ted otee+JBoQ(1<hairman
Date: Z 2 O By: _. XV1
Signature of and Chairman
Date: (oUQ�
Grant Document Routing
Start date: 10/13/17
From: Teresa Hewett, Finance Department (7408)
matures e uired:
Chairman Woody White
Return to Teresa Hewett, Finance Department (7408)
Type(s) of document(s) attached:
2 originals — Cape Fear Memorial Foundation Prescription Drug Assistance Counseling
Program grant contract for the Senior Resource Center
Explanation of document(s):
The Cape Fear Memorial foundation has awarded the Senior Resource Center a Prescription
Drug Assistant Counseling Program grant in the amount of $10,000. This grant was included in
the FYI Adopted Budget, therefore a budget amendment is not necessary. Please let me know
if you have any questions. Thank you.
--------------------------- - - - - -- for finance department use------------ - - - - --
DATE ADDED TO LASERFICHE
PICKED UP BY:
Print Name & Date
T �a Fear
' ^�EMORIAL FOUNDATION
2508 INDEPENDENCE BLVD, STE 200 (910( 452 -0611 PHONE
KLINNCTON, NC 28412 (910) 452 -5879 FAX
September 28, 2017 - .cfmfdn.org
Enclosures
DEDICATED TO ADVANCING GOD'S DESIRE FOR OUR HEALING AND HEALTH
Ms. Amber Smith
Social Work Supervisor
New Hanover County Senior Resource Center
2222 South College Road
Wilmington, NC 28403
Re: Grant ID: 1837
BOARD OF DIRECTORS:
Prescription Drug Assistance Counseling (PDAC) Program
Dear Ms. Smith:
AcNES R. BEANS
WaIAm H. CAMERON
At its meeting on September 27, 2017, the Board of Directors of Cape
GARRY GARRIS, C.AIRNAN
Fear Memorial Foundation approved a grant of $10,000.00 for your
JAMES o. HUNDLEY, M.D.
organization. This grant is to help fund the above- referenced project. To
W. CARTER nMERANE, III
accept this grant, please have your Board Chair sign and date both copies of
RONALD SwcuIR
the enclosed Grant Contract. Retain one original for your records and return
ROBERT F. WARWICK, CPA
an original to us for our file. Please do not send any mailing to the
RCHARD L. WOODSURY
Foundation requiring a recipient's signature. If confirmation of receipt is
required, organizations are encouraged to follow up with an email or
telephone call. The grant check will be mailed by October 16, 2017 provided
ANNA ERWIN, CPA. PRESIDENT
a signed contract has been received.
With your acceptance of this grant you agree to use these funds only
for the purpose shown above and to provide progress reports as requested by
us. Misappropriation of grant funds or failure to timely and accurately
complete and return progress reports may result in our demand for a
repayment of monies to the Foundation.
Please feel free to publicize your receiving these funds. However, we
would appreciate a copy of any release you make.
The Directors of Cape Fear Memorial Foundation are pleased to
support you as you serve our community and wish you continued success.
S' erely,
Anna Erwin
President
Enclosures
DEDICATED TO ADVANCING GOD'S DESIRE FOR OUR HEALING AND HEALTH