Sample Agreement

1. The funds must be used for charitable purposes directly related to the project goals outlined in your winning Solution entry.  
2. The funds may not be used for non-charitable purposes, such as:

• Influencing public elections or conducting voter registration drives.
• Attempting to influence legislation.
• Distributing funds to unrelated organizations or unidentified organizations/individuals.
• Providing general operating support for the Lead Organization identified in your Solution entry, and its partners.
• Funding government services or loans/microloans.

You hereby confirm the understanding that any expenditure of Award funds shall be aligned with the project milestones and objectives you submitted in your proposed Competition Solution, and the official Rules of the competition, attached hereto.

2. Reporting Requirements.

You are required to report on your progress towards project milestones and goals, which may involve submitting financial and narrative reports annually to the Foundation to ensure the proper use of Award funds and project advancement.

3. Sponsor's Rights.

The Foundation retains the following rights:

1. To either disqualify you or withdraw the Award funds if it is determined, at the Foundation’s sole discretion, i) there has been a violation of the Competition Rules, ii) that the use of the Award funds imposes any financial or reputational harm or burden to the Foundation, or iii) you have violated any of the Award restrictions set forth in 1. (b)(i)-(v), above.
2. To modify, suspend, or cancel the Competition for reasons such as a Force Majeure event or if an insufficient number of eligible entries are received.

4. Agreement Conditions.  

As a Winner, you must sign this Letter Agreement, which encompasses the terms of accepting Award funds, as well as any additional conditions or requirements that govern the use of the Award funds. The failure to execute this Agreement, or any breach thereof, may result in forfeiture of the Award funds.

5. Prize Metric: The accomplishment of the Prize’s Solution will be measured by:

• Insert metric (each applicant is required to include metrics as part of their proposal. Each metric will be unique to the proposal that is submitted.)

6. Release of Information and Publications: The Foundation may disclose information concerning the Prize as it deems appropriate. Conversely, you agree that you shall not use the Foundation's name in any publication (e.g., press release, annual report, newsletter, invitation, social media post, etc.) without the Foundation’s prior written approval.

7. Prize Recipient’s Publicity Obligation: Notwithstanding the publication prohibition in section 6, Prize Winner agrees to publicize the Foundation Patient Safety Prize and will collaborate with the Foundation on a mutually agreed upon communications strategy.

8. Governing Law and Dispute Resolution.

This agreement shall be governed by the laws of Indiana, United States. Any disputes arising from this Agreement shall be resolved through binding arbitration, and the parties waive the right to a jury trial or class action.

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Please review and sign this letter to acknowledge and agree to the terms outlined herein. Once signed, please return a copy to us for our records.

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Sincerely,

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[NAME]  

[Title]  

Elevance Health Foundation  

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Accepted and Agreed by:  

[WINNER’S NAME]

Signature: __________________________

Date: ______________________________