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RECEIVED PET
0r� i e
o AUG i s 2017 p o �" S®
a' CITY OF FORT WORTH
CITY SECRETARY
GRANT STATEMENT
THIS GRANT STATEMENT is entered into and forms a part of that certain Grant
Agreement dated October 13, 2011 (the "Agreement") by and between PetSmart Charities, Inc.
("PetSmart Charities") and the "Organization" identified below. The Parties are entering into
this Grant Statement to set forth additional terms and conditions for a Grant from PetSmart
Charities to the Organization. Capitalized terms not otherwise defined herein shall have the
meanings set forth in the Agreement.
Parties and Contact Information
PetSmart PetSmart Charities, Inc. Organization: City of Fort Worth
Charities:
Address: 19601 North 27th Ave Address: 1000 Throckmorton St
Phoenix, AZ 85027 Fort Worth TX 76102
Principal Bridget McBride Principal Randy Acosta
Contact: Contact:
Notice Legal Department Notice Randy Acosta
contact: contact:
Tel: 1-800-738-1385 Tel: 817-392-7020
Fax: 1-623-580-6561 Fax:
Grant Terms
Effective Date: upon date of full execution
Grant Funds: $28,132.00
Grant Conditions: First Impact report due 30 days after September NAW and second report
due 30 days after November NAW
Grant Distributions: Cash grant to be distributed in two installments. The first payment of
$18,754 upon full execution of agreement and the second payment of
$9,378.00 on October 15, 2017.
Page 1 of 4
PetSmart Charities Grant Statement(2010-06)
PetSmart Charities CONFIDENTIAL OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
Grant Purpose: The Grant Funds will total $28,132.00 for City of Fort Worth#1811 to host a
3 National Adoption Weekend events during May, September and
November at PetSmart Stores #187 and #2065 with a goal of 750
adoptions. Participation by other approved PetSmart Charities Adoption
Partners may be agreed upon by written permission of PetSmart Charities.
Grant funds will be used for:
1. Marketing: (social media boosted posts, ads, banners, radio
remotes and flyers). Any marketing materials created by the Organization
shall be submitted to PetSmart Charities at MMorgan@PetSmart.com for
review, prior to use, including any and all promotional or advertising
materials, press releases, written communication and/or social media posts
in which PetSmart Charities' name, trademarked material or copyrighted
material is used, at least 10 business days in advance of advertising and
print deadlines.
2. Event Equipment and Supplies: (tables, chairs, tents, fencing,
permits, heating and cooling).
3. If any grant funds remain after the expenses in items (1) through
(2), the remaining grant funds may be used, with written permission from
PetSmart Charities, Inc. toward spay/neuter surgeries for animals to assist
in preparing them for adoption.
Grant Period: The Grant Period will commence on the Effective Date set forth in
this Grant Statement, which in no event shall be earlier than effective
date of the Agreement and will continue for a period of 12 months.
Reporting Obligations: In addition to any reporting requirement set forth in the Master Support
Agreement and/or the In-Store Adoption Partner, the Organization agrees to
provide the following reports to PetSmart Charities in connection with this
event grant, on or before the deadlines set below. PetSmart Charities
reserves the right to change the method and format of how reports are
provided.
Unless otherwise specified, submit all reports via
www.cybergrants.com/petsmartcharities/reports/app. Reports are due no
later than 30 days after the completion of the event.
Additional Terms: PetSmart Charities supports established best practices for transport
such as those guidelines included in the Association of Shelter
Veterinarians Guidelines for Standards of Care in Animal Shelters.
Organization must operate transport vehicles within the Association
of Shelter Veterinarians recommended transport guidelines.
As of the date of signing this Grant Statement, the Organization
represents to PetSmart Charities that each of its representations,
warrants and covenants provided in the Agreement and this Grant
Statement are true and correct, including, but not limited to, those set
forth in Section 8 of the Agreement.
Page 2 of 4
PetSmart Charities Grant Statement(2010-06)
PetSmart Charities CONFIDENTIAL
This Grant Statement shall not be binding on either Party until executed by both Parties.
Organization acknowledges and agrees that PetSmart Charities may rescind any offer contained
herein at any time until the Agreement has been executed by both Parties.
[Signature page follows]
Page 3 of 4
PetSmart Charities Grant Statement(2010-06)
PetSmart Charities CONFIDENTIAL
IN WITNESS WHEREOF,the Parties have caused this Grant Statement to be signed by
their respective and duly authorized representatives as of the last date set forth below.
"PETSMART CHARITIES" "ORGANIZATION"
PETSMART CHARITIES,INC. CITY OF FORT WORTH
Signature{ X Signature•
Name `�)e1 Uk'l ' 6 NameA&
Title: U J► tC�t�.� Title: 1.
Date: C�"' Date: Z6 4 7
Please retain a copy of this document for your records
APPROVED AS TO FORM AND LEGALITY.
CITYATTORNEY
O��ORT�O {
U=:
J. 6r, City gemtwY
OFFICIAL RECORD
CITY SECRETARY
PetSmart Charities Grant Statement(2010-06) FT.
WORTH,TX Page 4 of 4
PetSmart Charities CONFIDENTIAL
Contract Compliance Manager:
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
Name of Employee/Signature
Title
7-103 _ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature