Skip to content
KOMEN.ORG
SUBSCRIBE
|
HOME
|
CONTACT US
Search for:
DONATE NOW
HOME
ABOUT US
OUR HISTORY
OUR IMPACT
MEET THE TEAM
ABOUT BREAST CANCER
UNDERSTANDING BREAST CANCER
WARNING SIGNS OF BREAST CANCER
MAMMOGRAM / CLINICAL BREAST EXAM REMINDER
DISCOUNT PRESCRIPTION DRUG CARD
COVID-19 (CORONAVIRUS) INFORMATION
GET INVOLVED
Komen Miami/Ft. Lauderdale COVID-19 Action Fund
ADVOCACY
COMMUNITY EDUCATION AND OUTREACH OPPORTUNITIES
FACES OF A WARRIOR
DONATE/FUNDRAISING
VOLUNTEER
VOLUNTEER TRAINING
INTERNSHIPS
EVENTS
COVID-19 (CORONAVIRUS) EVENT FAQS
VIRTUAL MORE THAN PINK
®
Walk
RALLY FOR THE CURE
PARTNERSHIPS
NEED HELP?
Community Support
Komen Treatment Assistance Program
KOMEN KORNER
BEYOND PINK BLOG
Real Pink Podcasts
Newsletter
April 2020 E-Newsletter
Winter 2020 Mission: Possible Newsletter
Fall 2019 Mission: Possible Newsletter
Summer 2019 Mission:Possible Newsletter
Spring 2019 Mission: Possible Newsletter
CONTACT US
Search for:
SPONSORSHIP AGREEMENT FOR THE Miami/Ft. Lauderdale MORE THAN PINK WALK™ (“MTP Walk”)
Katty Payne
2019-04-26T16:00:33+00:00
SPONSORSHIP AGREEMENT FOR THE Miami/Ft. Lauderdale MORE THAN PINK WALK™ (“MTP Walk”)
SPONSORSHIP AGREEMENT FOR THE Miami/Ft. Lauderdale MORE THAN PINK WALK™ (“MTP Walk”) **CONFIDENTIAL**
KOMEN AFFILIATE:
SUSAN G. KOMEN MIAMI/FT. LAUDERDALE
KOMEN AFFILIATE ADDRESS (STREET, CITY, STATE, ZIP):
1333 S. UNIVERSITY DR. SUITE 204 PLANTATION, FL 33324
CONTACT:
VANESSA EDWARDS-GEORGE
TELEPHONE:
(954) 909-0454
FACSIMILE:
(954) 440-4998
EMAIL ADDRESS:
VANESSA@KOMENMIAFTL.ORG
WEBSITE:
WWW.KOMENMIAFTL.ORG
SPONSOR:
*
SPONSOR TAX ID/EIN:
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darrussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
CONTACT:
*
First
Last
TELEPHONE:
*
FACSIMILE:
*
EMAIL ADDRESS:
*
Website
*
SPONSOR NAME TO APPEAR IN ACKNOWLEDGEMENTS (if different than above):
*
MTP WALK(S):
*
MTP WALK DATE(S):
*
MTP WALK LOCATION(S):
*
SPONSORSHIP CONTRIBUTION (check all that apply):
*
Select All
Cash payment in the amount of $50,000
In-kind donation described below
Quantity
Item Description
Fair Market Value Per Item
Total Fair Market Value of the Donation (Col.1 x Col. 3)
Item Necessary for Walk(s)? (Y/N)
Y
N
Quantity
Item Description
Fair Market Value Per Item
Total Fair Market Value of the Donation (Col.1 x Col. 3)
Item Necessary for Walk(s)? (Y/N)
Y
N
Quantity
Item Description
Fair Market Value Per Item
Total Fair Market Value of the Donation (Col.1 x Col. 3)
Item Necessary for Walk(s)? (Y/N)
Y
N
Quantity
Item Description
Fair Market Value Per Item
Total Fair Market Value of the Donation (Col.1 x Col. 3)
Item Necessary for Walk(s)? (Y/N)
Y
N
*After reasonable inquiry and to the best of Sponsor’s knowledge and belief, the Sponsor certifies that the Total Fair Market Value of the Donation is true, complete and accurate and acknowledges that Komen Affiliate may require Sponsor to provide additional documentation to support the value of in-kind donations prior to accepting such donations (if applicable).
TOTAL FAIR MARKET VALUE OF SPONSORSHIP CONTRIBUTION**:
*
** Monetary donation plus the Total Fair Market Value of the Donation (aggregate total of column 4). Sponsor should contact its tax advisor to determine the tax deductible amount, if any, of the Sponsorship Contribution for federal income tax purposes.
VALUE OF SPONSORSHIP CONTRIBUTION FOR SPONSORSHIP LEVEL (reflecting any reduction due to lack of necessity***):
*
*** For the sole purpose of determining the Sponsorship Level of the Sponsor, in the event an in-kind donation is not necessary for the MTP Walk), the Total Fair Market Value of the Donation may be reduced by one-half. Such reduction shall not have an impact on the fair market value or tax-deductible amount of the Sponsorship Contribution.
CASH SPONSORSHIP CONTRIBUTION PAYMENT METHOD:
*
Check payable to Komen Affiliate
ACH transfer (instructions available on request)
Visa
MasterCard
American Express
Discover
Name of cardholder:
Credit card number:
Verification code (3 or 4 digits):
Expiration date:
SPONSORSHIP CONTRIBUTION PAYMENT SCHEDULE:
*
Full amount of Sponsorship Contribution due and payable to Komen Affiliate upon execution of this Agreement.
Payment of of the Sponsorship Contribution due and payable to Komen Affiliate upon execution of this Agreement, with the remainder of the Sponsorship Contribution due and payable to Komen Affiliate on or before
Payment of the full amount of the Sponsorship Contribution due and payable to Komen Affiliate on or before
Other (explain schedule or attach timeline):
• Sponsor’s failure to make the contributions on the due dates indicated above shall result in a forfeiture of those Sponsorship Benefits set forth on Schedule A to this Agreement.
SPONSORSHIP LEVEL: See Schedule A to this Agreement (attached)
SPONSORSHIP BENEFITS: See Schedule A to this Agreement (attached)
KOMEN AFFILIATE PERMISSION FOR SPONSOR TO USE THE FOLLOWING MARKS (check all that apply):
*
Komen Affiliate name
[Insert Komen Affiliate Name] More Than Pink Walk™ word mark
Susan G. Komen More Than Pink Walk™ logo and design (must be used in close proximity to Komen Affiliate name)
The marks selected above (collectively, “Komen Marks”) may be used by the Sponsor during the term of this Agreement for the sole purpose of promoting the Sponsorship. • Sponsor will present to Komen Affiliate for its approval (which approval shall not be unreasonably withheld), prior to printing, distribution, publication, display, or use, any and all promotional materials and scripts of all statements, oral or written, to be made by Sponsor, its agents or spokespersons, which use or refer to any Komen Marks. • Sponsor shall not use the Komen Marks in advertisements or promotions that contain a reference to any entity that is not an authorized local or national sponsor of the MTP Walk(s).
Sponsor may only distribute sponsorship materials and statements in the following service area of Komen Affiliate (if this Agreement applies to more than one MTP Walk, please specifically describe the distribution area for each MTP Walk):
Sponsorship materials and statements must state that the Komen Marks are registered trademarks of Komen and must be consistent with both parties’ outstanding public images.
Sponsorship materials and statements may only refer to each MTP Walk in the following form: “Local Sponsor of the Susan G. Komen More Than Pink Walk™” (Or “[Add Sponsorship level here] ________________________________________Level Sponsor of the Susan G. Komen Miami/Ft. Lauderdale More Than Pink Walk™”). If this Agreement covers more than one MTP Walk location, please set forth the additional MTP Walk names in the “SPECIAL TERMS/OTHER” section below.
Yes
SPONSOR PERMISSION FOR KOMEN AFFILIATE TO USE THE FOLLOWING SPONSOR MARKS AND LOGOS (collectively, “Sponsor Marks”)
*
Komen Affiliate shall have the right to use the Sponsor Marks for the purpose of advertising and promoting the MTP Walk(s), on MTP Walk t-shirts, brochures, posters, websites and the MTP Walk stage and banner (as determined by Sponsorship Level). • Prior to the date of , Sponsor must provide to Komen Affiliate a high-resolution, digital image of the Sponsor’s Marks. Sponsor’s failure to submit the images required on the due date indicated above shall result in a forfeiture of those Sponsorship Benefits set forth on Schedule A to this Agreement.
SPECIAL TERMS/OTHER:
*
By executing this Agreement, Sponsor agrees to be bound by the Standard Terms and Conditions as set forth on Page 3 of this Agreement and all attachments hereto, which are hereby incorporated herein as if set forth in their entirety. All terms set forth in all bold and capitalized letters herein shall have the meaning specifically designated above. The signatories to this Agreement hereby warrant that they have read and agree to the terms, conditions and provisions of this Agreement, including the Standard Terms & Conditions and Schedules, and have full power and authority to sign for and bind their respective organizations.
Effective Date
*
Date Format: MM slash DD slash YYYY
(“Komen Affiliate”)
By:
Name/Title: SHERRI MARTENS-CURTIS – EXECUTIVE DIRECTOR
Date: 04/12/2019
(“Sponsor”)
*
Signature
*
Name
*
First
Last
Title:
*
Date
*
Date Format: MM slash DD slash YYYY
This iframe contains the logic required to handle Ajax powered Gravity Forms.
Translate »