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This Charitable Donation Agreement (this Agreement) is made and entered into as of March
17, 2017 (the "Effective Date), by and between
Company Name :
Company ID :
Street Address :
City and Postal Code :
Country :
Represented by :
(the Recipient)
a charitable donation as described herein (the "Contribution"). The purpose of this Agreement is to
set forth the terms and conditions pursuant to which the Company shall provide and the
Recipient shall receive the Contribution.
1
MAGISTRT SUVERNNHO MILITRNHO A PITLNHO EKUMENICKHO DU
SVATHO JANA JERUZALMSKHO RYT RHODOSU A MALTY
OBANSK SDRUEN
CZ 110 00, Praha 1, Kamzkova Nr.6 / 543, Tel / Fax : +420-224-225-
174
Background
2. Company and Recipient acknowledge that the Recipient shall have sole and complete
control over the manner in which the Contribution is used by the Recipient for such
charitable program(s)/purpose(s), subject to any restrictions that the Company has placed
on the Contribution.
3. The Recipient and Company acknowledge and agree that the Contribution shall not
obligate or otherwise influence the Recipient to purchase, use, recommend, or arrange for
the use of any products of the Company or an affiliate of the Company.
4. The Recipient represents and warrants to the Company that the Recipient is a tax-exempt
entity pursuant to applicable sections of the Internal Revenue Code of the Czech republic.
5. To the extent it directly or indirectly engages in activities outside the United States,
Recipient hereby certifies to the Company that:
a. it shall comply with all laws and regulations in the territory where it is conducting
activities and will comply with the U.S. Foreign Corrupt Practices Act (the
FCPA);
2
MAGISTRT SUVERNNHO MILITRNHO A PITLNHO EKUMENICKHO DU
SVATHO JANA JERUZALMSKHO RYT RHODOSU A MALTY
OBANSK SDRUEN
CZ 110 00, Praha 1, Kamzkova Nr.6 / 543, Tel / Fax : +420-224-225-
174
political office, for the purpose of influencing decisions favorable to the Company
and/or its affiliates in contravention of the FCPA or the laws of the country in
which it is conducting activities contemplated by this Agreement;
c. it does not and will not employ or retain a person who is a governmental official
or employee, including employees of government owned or government
controlled corporations, agencies or bodies (such as health or medical institutions
which are owned or controlled by the government), unless services retained are
bona fide services and where required the retained person has obtained
necessary approvals by competent authorities/employer to be retained for said
services; and
7. If a party fails to comply with any of the provisions of this Agreement, the other party
shall have the right to terminate this Agreement upon written notice to the breaching
party, without penalty or liability of any nature whatsoever.
8. This Agreement will commence on the Effective Date and will extend for a period of
twelve (12) months unless earlier terminated by Recipient or the Company upon thirty
(30) days written notice. In the event of a termination, the parties will mutually agree as
to the disposition of the Contribution. For avoidance of doubt, in no event, may the
Contribution be used in any way other than furtherance of the Recipients charitable
program(s)/purpose(s).
9. The Parties acknowledge that certain state or federal laws now or in the future may
require Company to disclose information on donations provided to charitable entities.
Company may report information about the Contribution provided under this Agreement,
as required by law. Once reported, such information may be publicly accessible.
10. Notwithstanding any other provision in this Agreement, Recipient understands and agrees
that Company reserves the right to post on a website accessible to the public, information
regarding funding under this Agreement, whether or not required by law, including the
identity of the Recipient, the value of the Contribution, and the purposes for such
Contribution, and other information as the Company determines is appropriate.
3
MAGISTRT SUVERNNHO MILITRNHO A PITLNHO EKUMENICKHO DU
SVATHO JANA JERUZALMSKHO RYT RHODOSU A MALTY
OBANSK SDRUEN
CZ 110 00, Praha 1, Kamzkova Nr.6 / 543, Tel / Fax : +420-224-225-
174
11. Neither party may assign, directly or indirectly, by operation of law, change of control or
otherwise, this Agreement or any rights or obligations hereunder, without the prior
written consent of the other party.
12. This Agreement inures to the benefit of Recipient and Company only, and no third party
shall have any rights under it, except as expressly provided herein.
IN WITNESS WHEREOF, the parties have signed and thereby caused this Agreement to be
duly executed effective as of the date written above.
COMPANY RECIPIENT
4
MAGISTRT SUVERNNHO MILITRNHO A PITLNHO EKUMENICKHO DU
SVATHO JANA JERUZALMSKHO RYT RHODOSU A MALTY
OBANSK SDRUEN
CZ 110 00, Praha 1, Kamzkova Nr.6 / 543, Tel / Fax : +420-224-225-
174
Payment Instruction for donation
COMPANY RECIPIENT
5
MAGISTRT SUVERNNHO MILITRNHO A PITLNHO EKUMENICKHO DU
SVATHO JANA JERUZALMSKHO RYT RHODOSU A MALTY
OBANSK SDRUEN
CZ 110 00, Praha 1, Kamzkova Nr.6 / 543, Tel / Fax : +420-224-225-
174