FY18 SRC CFMF Prescription Drug Assistance Programa-P
ear
EMORIAL FOUNDATION
Organization:
New Hanover County Senior Resource Center
Amount of Grant:
$10,000.00
Date of Payment:
10/15/2018
Term of Grant:
12 Months
Project Title:
Prescription Drug Assistance Program
Grant ID:
1942
The following terms are agreed upon as conditions for this grant:
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
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.
5. 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 Fe a emori Fou ion
By:
An a Erwin, Presi ent
Date: Iv/? .
New Hanover County Senior Resource Center
By: V . 1
Printed or Typed . a e of Bo*d Chairman
By: V�
Signature of oar hairman
Date: j l U� 1,a)
CaQe Fear
-1 MEMORIAL FOUNDATION
2508 INDEPENDENCE BLVD, STE 200 (910) 452 -0611 PHONE
WILMINGTON, NC 28412 (910) 452 -5879 FAX
www.cfmfdn.org
October 8, 2018
Mr. Andrew Zeldin, Social Work Supervisor
New Hanover County Senior Resource Center
Enclosures
DEDICATED TO ADVANCING GOD'S DESIRE FOR OUR HEALING AND HEALTH
2222 South College Road
Wilmington, NC 28403
Re: Grant ID: 1942
BOARD OF DIRECTORS:
Prescription Drug Assistance Program
AGNEB R. BEANE
Dear Mr. Zeldin:
MOTT P. BLAIR, IV, M.D.
At its meeting on October 3, 2018, the Board of Directors of Cape
WILLIAM H. CAMERON
Fear Memorial Foundation approved a grant of $10,000.00 for your
GnRRr GnRRIS. «AIRMAN
organization. This grant is to help fund the above- referenced project. To
.LAMES D. HDNDLEY, M.D.
accept this grant, please have your Board Chair sign and date both copies of
W. CARTER MEBANE, III
the enclosed Grant Contract. Retain one original for your records and return
1ANELLE A. RHYNE, M.D.
an original to us for our file. The grant check will be mailed by October 15,
RONALD SmcuIR
2018 provided a signed contract has been received.
ROBERT F. WARWICK, CPA
With your acceptance of this grant you agree to use these funds only
RICHARD L. WOODBURY
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
ANNA ERWIN, PRESIDENT
repayment of monies to the Foundation.
Please do not send any mailing to the Foundation requiring a
recipient's signature. If confirmation of receipt is required, organizations are
encouraged to follow up with an email or telephone call.
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.
r
President
Enclosures
DEDICATED TO ADVANCING GOD'S DESIRE FOR OUR HEALING AND HEALTH
Grant Document Routing
Start date: 10/29/18
From: Teresa Hewett, Finance Department (7408)
Signatures required:
V Chairman Woody White
Return to Teresa Hewett, Finance 7408 Department P ( )
Type(s) of document(s) attached:
2 originals — SRC — Cape Fear Memorial Foundation Prescription Drug Assistance
Program Grant
Explanation of document(s):
This is a recurring grant that was included in the adopted budget. Please let me know if you have
any questions. Thank you.
--------------------------- - - - - -- for finance department use--------------------------------------------- - - - - -'
DATE ADDED TO LASERFICHE klVaZW
PICKED UP BY:
Print Name & Date
Signature