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GRANT AGREEMENT by and between DAKOTA MEDICAL FOUNDATION/DAKOTA MEDICAL CHARITIES and CASS COUNTY SOCIAL SERVICES THIS AGREEMENT ("Agreement") b y a nd between Dakota Medical F oundation/Dakota Medical Charities ("Foundation") and Cass County Social Services (Grantee") is effective on the 2nd day of January, 2003 ("Effective Date"). The Foundation and the Grantee agree as follows: GRANT AMOUNT AND USE OF FUNDS Grant Amount. Subject to the foregoing conditions, the Foundation shall pay to the Grantee or to the Grantee's fiscal agent, if applicable, a total grant amount of $49, 782 in accordance with the payment schedule listed below: January 2 2003 $12,445 March t, 2003 $12,445 July 1,2003 $12,446 October 1,2003 $12,446 Additional funds will be provided if all conditions are met through October 2006. These funds will be allocated through an annual addendum to this grant agreement. Authorized Use of Grant Funds. The Grantee is authorized to use the grant funds solely to carry out the project entitled Enrollment Assistance Project described in the Robed Wood Johnson Covering Kids and Families grant application, which is hereby incorporated into this Agreement. Grant funds shall only be expended in accordance with the specifications and time frame contained in the Grant Application. Notification of Any Changes. Grantee shall notify the Foundation immediately if there is any pending or actual change in the purpose of the project, any modifications to the Grant Application, or any change in the scope of the project or the timetable or budget for the project. II. GRANTEE'S TAX STATUS A. Initial one of the following representations: (initials) Grantee hereby represents and warrants that it is exempt from federal income tax under Section 501(a) of the Internal Revenue Code of 1986, as amended (the Code) and as described in Section 501(c)(3) of the Code, and that its determination letters from the Internal Revenue Service ("Service") are still valid and have not been revoked. X (initials) (initials) Grantee hereby represents and warrants that it is a governmental entity operated for public purposes. Grantee is not exempt from federal income tax under Section 501(a) of the Code as described in Section 501(c)(3) of the Code, and is not a governmental entity for public purposes. Grantee hereby represents and warrants that its tax status is (e.g. "exempt under Section 501(c)(6)" or "not exempt"). Grantee shall use the funds as required herein in support of the Foundation's exempt purposes.