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Kaiser Foundation Hospitals, Northern California Region <br />- Grant Agreement - <br />In addition to the specific terms of the Grant Award Letter for Grant Number 20655606, <br />Kaiser Foundation Hospital's ("KFH") award of this Grant, managed by the KFH <br />Northern California Community Benefit Programs Division, is contingent upon <br />Grantee's compliance with the following terms and conditions, and Grantee agrees to <br />all these terms and conditions. Together, the Grant Award Letter and these terms and <br />conditions are "the Agreement." <br />1. Tax -Exempt Status <br />Grantee is a (i) tax-exempt organization currently recognized by the Internal Revenue <br />Service ("IRS") as a public charity described in section 501(c)(3), (8), (10) or (19) or <br />501(k) or 509(a)(1), (2), or (3) of the Internal Revenue Code of 1986, as amended (the <br />"Code") or (ii) a local, state orfederal government agency. If Grantee is a public charity <br />as described in (i), then Grantee represents and warrants that <br />Grantee's tax-exempt status under the Code has not been revoked or modified <br />since the issuance of the IRS determination letter provided to KFH and shall <br />not be revoked or modified during the term of this Grant; and <br />there is no issue presently pending before any office of the IRS that could <br />result in any proposed changes to Grantees' tax-exempt status under the <br />Code;and <br />Grantee shall immediately notify KFH if Grantee's tax-exempt status is <br />revoked, suspended or modified during the term of this Grant. <br />2. Exaenditure of Funds <br />This Grant must be used for the project identified in the Grant Award Letter, as <br />described in the Grantee's proposal and related correspondence, and may not be <br />expended for any other purposes without KFH's prior written approval. If the Grant is <br />intended to support a specific project or to provide general support for a specific period, <br />any portion of the Grant unexpended at the completion of the project at the end of the <br />period shall be returned immediately to KFH, unless otherwise agreed by KFH in <br />writing. Grantee may not expend any Grant funds for any purpose that is not charitable <br />or educational, for any political or lobbying activity, or for any purpose other than one <br />specified in Section 170(c)(2)(b) of the Code. Grantee must obtain prior written <br />approval from KFH for changes to budgetary allocations that amount to 10% or more <br />of the total budget of the Grant award or for changes to the Grant period. <br />Grantee may not use any portion of this grant in connection with the enrollment of <br />individuals in any Qualified Health Plan or non -Qualified Health Plan. If Grantee serves <br />as a Certified Enrollment Entity or Navigator funded by the California Health Benefit <br />Exchange (Covered California), Grantee will fully comply with any applicable state and <br />federal statutes, regulations, and sub -regulatory guidance requiring disclosure of <br />receipt of this funding to Covered California and consumers receiving application <br />assistance from Grantee's personnel. <br />#20655606 Pagel <br />