HomeMy WebLinkAbout17 - Fireman's Fund Heritage Grant - Updated Attachment BAttachment B - Updated version Received After Agenda Printed:
Agenda Item No. 17
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Fireman's Fund''
Insurance Company
Protecting your future since 1863
The Heritage Program® by Fireman's Fund
Grant Compliance Agreement
This agreement is made and entered into by and between the
I s I ik (A I `C e— (Department/District) ( "the
De artme t ") located at (street address)
1OVCMi�'_ Ce_,t4cy- Orye rf- C'-4
and Fireman's Fund Insurance Company ( "Fireman's Fund ") of Novato, CA and its respective subsidiaries
(collectively referred to as the "Company "). Fireman's Fund provides donations to fire departments and
fire and burn prevention programs at non - profit organizations.
Whereas, it is intended that the Department will utilize a grant award or donation received from Company
for the specific purpose outlined in the Department's grant application and/or approved by Company.
Company reserves the right to communicate with and visit the Department on an ongoing basis to ensure
that the funding is utilized for the express purpose intended. The Department is required to apply a grant
or donation from Company within 90 days of receipt of funds or obtain an extension from Company.
Additionally, the Department must supply Company with a copy of the paid invoice within 30 days of
purchases utilizing funding from the Heritage Program. Invoice copies should be sent to:
Fireman's Fund Insurance Company
Attn: Melissa Queen
777 San Marin Drive
SM -1, A18
Novato, CA 94998 - .1000
melissa.queen@fflc.com
The Department must notify Company within 60 days of receipt of funds if it decides to purchase a
different quantity of items than what was awarded by Company, or if it chooses to apply funds differently
than originally intended or approved by Company. Unused funds must be returned to Company.
If the Department plans to use funds for any purpose other than originally outlined and approved by
Company, the Department must first obtain approval from Company. In the event that the funding is not
utilized for the purpose(s) approved by Company and/or outlined in the original application and Company
is not notified of any changes to the original request, Company reserves the right to revoke the funding or
donation, request the return of the full donation amount, and eliminate the Department from consideration
for future funding through the Heritage Program.
It is the intention of Company to promote the donation and Company will work with the Department on
promotional efforts to ensure that they are mutually beneficial. If the Department is awarded a grant or
donation, Company expects the Department to participate in a check presentation ceremony that is
scheduled mutually, but held within three months after the check is received and /or when the equipment
arrives. Company reserves the right to film and /or photograph the award presentation and publicize the
request and award in all internal and external marketing and communications activities related to the
Company Heritage Program. Company will provide stickers to the Department which indicate that the
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equipment was purchased with a donation from Company and the stickers are to be placed on the
equipment purchased with funds directed by Company, as well as an electronic logo for printed materials
For large donations such as fire safety houses, Company has the right to assist the Department with
design and signage on the equipment and may provide additional funding for this purpose. Company
invites your department to contact us to discuss any additional marketing or public relations assistance
we can provide on your behalf.
Finally, as a way to demonstrate the overall impact of this program, Company asks that the Department
provide documentation demonstrating the effect the donation has had on operations. This can be
documented via E -mail, letter, photos, video, or however the department sees fit. We request that this
impact be documented and shared with Company within six months of the receipt of the donation or as
special calls occur and the donation helped make a difference.
By signing this agreement, Department agrees to carry out the aforementioned activities as
planned.
Agreed to and Accepted:
Department: i f Lkj,(. -7( -f-
By: (X) Rre QhiE4l s Office
Date:
Print Name and Title:
Scoff L Po"
Dept. Tax/Fed ID #:
Make Checks
Payable to:
Send Check to:
(No PO Boxes)
If check is payable directly to a vendor:
Vendor Name:
Contact Name:
Tax ID Number:
Street Address (NO
PO Boxes) for check
to be sent:
PLEASE PRINT LEGIBLY
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APPROVED AS SD FORM
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Attorney