Common use of Confirmation and Execution Clause in Contracts

Confirmation and Execution. 13.1 I confirm that I am authorised to sign this Agreement on behalf of . 13.2 I understand that by signing this Agreement I am committing the Organisation to comply with the terms and conditions as set out in the Agreement, and the Schedule (s). 13.3 I accept and agree on behalf of the Organisation to the conditions in this Agreement and affirm that the Organisation is duly authorised to enter into and perform this Agreement. Signature: Date: / / Name (Title): Contact Number: Signature: Date: / / Name (Title): Contact number: The Funding provided under this Grant Aid Agreement is Public Exchequer Funding you should Clarity Understand the purpose and conditions of the funding and the outputs required Apply funding only for the business purposes for which they were provided Apply for funding drawdown only when required for business purposes Seek clarification from the grantor where necessary – on use of funds, governance and accountability arrangements. Governance Ensure appropriate governance arrangements are in place for: oversight and administration of funding control and safeguarding of funds from misuse, misappropriation and fraud accounting records which can provide, at any time, reliable financial information on the purpose, application and balance remaining of the public funding Accounting for the amount and source of the funding, its application and outputs/outcomes. Value for Money Be in a position to provide evidence on effective use of funds value achieved in the application of funds avoidance of waste and extravagance Fairness Manage public funds with the highest degree of honesty and integrity Act in a manner which complies with relevant laws and obligations (e.g. tax, minimum wages) Procure goods and services in a fair and transparent manner Act fairly, responsibly and openly in your dealings with your Grantor Provide details of the Organisation that is to receive the Grant award. This may include the Organisation’s mission, objectives and current activities. This section should specify details of the health and personal social services which will be provided by the Organisation in consideration for the Funding (as set out in Clause 10) provided by the Executive. Provide details of the target Client group(s) that will benefit from the funding. Complete the Timetable schedule below stating the submission of performance data and other relevant returns. Review arrangements may also be specified. The Officer nominated by the Executive to deal with this grant is: The Officer nominated by the Organisation to deal with this grant is: The Officer nominated by the Executive to deal with any Disputes arising from this Grant is: Complete the Payment schedule below Specifying the date or period / dates / number of instalments where appropriate. Special conditions - Clause 11 above Please set out any special conditions pertaining to this grant. All information requirements in this Grant Aid Agreement shall also be provided to the {Insert relevant Drug and Alcohol Task Force name} namely clauses 3.1, 3.4, 3.5, 4.2, 7.2, 7.3, 7.4, 8.1, 8.4, and 8.5.  The Organisation, with the support of the DATF, will support and promote the aims and objectives of the current National Drug and Alcohol Strategy: Reducing Harm Supporting Recovery. A health led response to drug and alcohol use in Ireland 2017-2025.  The Organisation will provide the Health Research Board with data on each service user entering a service or exiting, in compliance with the National Drug Treatment Reporting System (NDTRS).  Projects providing Prevention or Education type services should provide these responses in accordance with a uniform set of drug and alcohol education standards (such as the DEWF Quality Standards in Substance Use Education) and should be developed with explicit reference to education and prevention evidence-based good practice.  Organisations of treatment and rehabilitative services will be guided by the National Drugs Rehabilitation Framework; ensuring that people are offered a range of integrated options. The use of standardised assessment tools and integrated referral pathways are central to this process.  The organisation will participate and update details when necessary on the national service directory on xxx.xxxxx.xx.  The organisation will use the Monitoring Template (based on the logic model process) as developed by the NAAGG Audit Review Group.  Funding is allocated annually based on recommendations from the DATF to the HSE through the Section 39 Governance process.  The organisation will support and promote Tobacco Free Ireland.  HSE funded services will not take part in campaigns, programmes or initiatives that are funded or co- funded, directly or indirectly by alcohol, tobacco, e-cigarette/vape manufacturers or their related ‘Social Aspect Public Relations Organisations’  The organisation will deliver quality services in line with the National Standards for Safer Better Healthcare (HIQA, 2012) addiction services workbooks (HSE, 2017). Please be advised that in signing this Grant Aid Agreement Schedule you are agreeing to the Standard Terms and Conditions of the HSE Grant Aid Agreement which is available on the HSE internet site xxxx://xxx.xxx.xx/eng/services/publications/Non_Statutory_Sector/Section_39_Documentation.html Signature: Date: / / Name (Title): Contact Number: Signature: Date: / / Name (Title): Contact number: [HSE Department Address] [To the Chief Officer/Manager], [Service Organisation] Date: Re: Contract Change Note Dear , With reference to your Grant Aid Agreement with the HSE for [insert Year], I write to confirm that your funding has been adjusted by [insert funding adjustment plus or minus €xxx], due to [Insert reason for change] It is not necessary at this time to sign a new Grant Aid Agreement, as this letter shall constitute a supplement agreement, therefore I would appreciate if you could confirm your agreement with the above by signing in the area provided below and return to the undersigned at the above address. Thanking you. Yours sincerely, Name: Title: Name: Title: Page 1 details Organisations requirements for Grants up to €9,999 Page 2 details Organisations requirements for Grant between €10,000 and € 49,999 Page 3 details Organisations requirements for Grants between €50,000 and €149,999 Page 4 details Organisations requirements for Grants between €150,000 and €250,000 *Note* Grant Aid Agreement utilised where funding being provided is less than €250,000, except with ‘For-Profit’ & Out-of-State Agencies, or where the Executive is of the opinion that the Service Arrangement governance document is more appropriate.

Confirmation and Execution. 13.1 I confirm that I am authorised to sign this Agreement on behalf of . 13.2 I understand that by signing this Agreement I am committing the Organisation to comply with the terms and conditions as set out in the Agreement, and the Schedule (s). 13.3 I accept and agree on behalf of the Organisation to the conditions in this Agreement and affirm that the Organisation is duly authorised to enter into and perform this Agreement. Signature: Date: / / Name (Title): Contact Number: Signature: Date: / / Name (Title): Contact number: The Funding provided under this Grant Aid Agreement is Public Exchequer Funding you should Clarity Understand the purpose and conditions of the funding and the outputs required Apply funding only for the business purposes for which they were provided Apply for funding drawdown only when required for business purposes Seek clarification from the grantor where necessary – on use of funds, governance and accountability arrangements. Governance Ensure appropriate governance arrangements are in place for: oversight and administration of funding control and safeguarding of funds from misuse, misappropriation and fraud accounting records which can provide, at any time, reliable financial information on the purpose, application and balance remaining of the public funding Accounting for the amount and source of the funding, its application and outputs/outcomes. Value for Money Be in a position to provide evidence on effective use of funds value achieved in the application of funds avoidance of waste and extravagance Fairness Manage public funds with the highest degree of honesty and integrity Act in a manner which complies with relevant laws and obligations (e.g. tax, minimum wages) Procure goods and services in a fair and transparent manner Act fairly, responsibly and openly in your dealings with your Grantor Provide details of the Organisation that is to receive the Grant award. This may include the Organisation’s mission, objectives and current activities. This section should specify details of the health and personal social services which will be provided by the Organisation in consideration for the Funding (as set out in Clause 10) provided by the Executive. Provide details of the target Client group(s) that will benefit from the funding. Complete the Timetable schedule below stating the submission of performance data and other relevant returns. Review arrangements may also be specified. The Officer nominated by the Executive to deal with this grant is: The Officer nominated by the Organisation to deal with this grant is: The Officer nominated by the Executive to deal with any Disputes arising from this Grant is: Complete the Payment schedule below Specifying the date or period / dates / number of instalments where appropriate. Special conditions - Clause 11 above Please set out any special conditions pertaining to this grant. All information requirements in this Grant Aid Agreement shall also be provided to the {Insert relevant Drug and Alcohol Task Force name} namely clauses 3.1, 3.4, 3.5, 4.2, 7.2, 7.3, 7.4, 8.1, 8.4, and 8.5.  The Organisation, with the support of the DATF, will support and promote the aims and objectives of the current National Drug and Alcohol Strategy: Reducing Harm Supporting Recovery. A health led response to drug and alcohol use in Ireland 2017-2025.  The Organisation will provide the Health Research Board with data on each service user entering a service or exiting, in compliance with the National Drug Treatment Reporting System (NDTRS).  Projects providing Prevention or Education type services should provide these responses in accordance with a uniform set of drug and alcohol education standards (such as the DEWF Quality Standards in Substance Use Education) and should be developed with explicit reference to education and prevention evidence-based good practice.  Organisations of treatment and rehabilitative services will be guided by the National Drugs Rehabilitation Framework; ensuring that people are offered a range of integrated options. The use of standardised assessment tools and integrated referral pathways are central to this process.  The organisation will participate and update details when necessary on the national service directory on xxx.xxxxx.xx.  The organisation will use the Monitoring Template (based on the logic model process) as developed by the NAAGG Audit Review Group.  Funding is allocated annually based on recommendations from the DATF to the HSE through the Section 39 Governance process.  The organisation will support and promote Tobacco Free Ireland.  HSE funded services will not take part in campaigns, programmes or initiatives that are funded or co- funded, directly or indirectly by alcohol, tobacco, e-cigarette/vape manufacturers or their related ‘Social Aspect Public Relations Organisations’  The organisation will deliver quality services in line with the National Standards for Safer Better Healthcare (HIQA, 2012) addiction services workbooks (HSE, 2017). Please be advised that in signing this Grant Aid Agreement Schedule you are agreeing to the Standard Terms and Conditions of the HSE Grant Aid Agreement which is available on the HSE internet site xxxx://xxx.xxx.xx/eng/services/publications/Non_Statutory_Sector/Section_39_Documentation.html Signature: Date: / / Name (Title): Contact Number: Signature: Date: / / Name (Title): Contact number: [HSE Department Address] [To the Chief Officer/Manager], [Service Organisation] Date: Re: Contract Change Note Dear , With reference to your Grant Aid Agreement with the HSE for [insert Year], I write to confirm that your funding has been adjusted by [insert funding adjustment plus or minus €xxx], due to [Insert reason for change] It is not necessary at this time to sign a new Grant Aid Agreement, as this letter shall constitute a supplement agreement, therefore I would appreciate if you could confirm your agreement with the above by signing in the area provided below and return to the undersigned at the above address. Thanking you. Yours sincerely, Name: Title: Name: Title: Page 1 details Organisations requirements for Grants up to €9,999 Page 2 details Organisations requirements for Grant between €10,000 and € 49,999 Page 3 details Organisations requirements for Grants between €50,000 and €149,999 Page 4 details Organisations requirements for Grants between €150,000 and €250,000 *Note* Grant Aid Agreement utilised where funding being provided is less than €250,000, except with ‘For-Profit’ & Out-of-State Agencies, or where the Executive is of the opinion that the Service Arrangement governance document is more appropriate.

Confirmation and Execution. 13.1 I confirm that I am authorised to sign this Agreement on behalf of . 13.2 I understand that by signing this Agreement I am committing the Organisation to comply with the terms and conditions as set out in the Agreement, and the Schedule (s). 13.3 I accept and agree on behalf of the Organisation to the conditions in this Agreement and affirm that the Organisation is duly authorised to enter into and perform this Agreement. Signature: Date: / / Name (Title): Contact Number: Signature: Date: / / Name (Title): Contact number: The Funding provided under this Grant Aid Agreement is Public Exchequer Funding you should Clarity Understand the purpose and conditions of the funding and the outputs required Apply funding only for the business purposes for which they were provided Apply for funding drawdown only when required for business purposes Seek clarification from the grantor where necessary – on use of funds, governance and accountability arrangements. Governance Ensure appropriate governance arrangements are in place for: oversight and administration of funding control and safeguarding of funds from misuse, misappropriation and fraud accounting records which can provide, at any time, reliable financial information on the purpose, application and balance remaining of the public funding Accounting for the amount and source of the funding, its application and outputs/outcomes. Value for Money Be in a position to provide evidence on effective use of funds value achieved in the application of funds avoidance of waste and extravagance Fairness Manage public funds with the highest degree of honesty and integrity Act in a manner which complies with relevant laws and obligations (e.g. tax, minimum wages) Procure goods and services in a fair and transparent manner Act fairly, responsibly and openly in your dealings with your Grantor Provide details of the Organisation that is to receive the Grant award. This may include the Organisation’s mission, objectives and current activities. This section should specify details of the health and personal social services which will be provided by the Organisation in consideration for the Funding (as set out in Clause 10) provided by the Executive. Provide details of the target Client group(s) that will benefit from the funding. Complete the Timetable schedule below stating the submission of performance data and other relevant returns. Review arrangements may also be specified. The Officer nominated by the Executive to deal with this grant is: The Officer nominated by the Organisation to deal with this grant is: The Officer nominated by the Executive to deal with any Disputes arising from this Grant is: Complete the Payment schedule below Specifying the date or period / dates / number of instalments where appropriate. Special conditions - Clause 11 above Please set out any special conditions pertaining to this grant. All information requirements in this Grant Aid Agreement shall also be provided to the {Insert relevant Drug and Alcohol Task Force name} namely clauses 3.1, 3.4, 3.5, 4.2, 7.2, 7.3, 7.4, 8.1, 8.4, and 8.5.  The Organisation, with the support of the DATF, will support and promote the aims and objectives of the current National Drug and Alcohol Strategy: Reducing Harm Supporting Recovery. A health led response to drug and alcohol use in Ireland 2017-2025.  The Organisation will provide the Health Research Board with data on each service user entering a service or exiting, in compliance with the National Drug Treatment Reporting System (NDTRS).  Projects providing Prevention or Education type services should provide these responses in accordance with a uniform set of drug and alcohol education standards (such as the DEWF Quality Standards in Substance Use Education) and should be developed with explicit reference to education and prevention evidence-based good practice.  Organisations of treatment and rehabilitative services will be guided by the National Drugs Rehabilitation Framework; ensuring that people are offered a range of integrated options. The use of standardised assessment tools and integrated referral pathways are central to this process.  The organisation will participate and update details when necessary on the national service directory on xxx.xxxxx.xx.  The organisation will use the Monitoring Template (based on the logic model process) as developed by the NAAGG Audit Review Group.  Funding is allocated annually based on recommendations from the DATF to the HSE through the Section 39 Governance process.  The organisation will support and promote Tobacco Free Ireland.  HSE funded services will not take part in campaigns, programmes or initiatives that are funded or co- funded, directly or indirectly by alcohol, tobacco, e-cigarette/vape manufacturers or their related ‘Social Aspect Public Relations Organisations’  The organisation will deliver quality services in line with the National Standards for Safer Better Healthcare (HIQA, 2012) addiction services workbooks (HSE, 2017). Please be advised that in signing this Grant Aid Agreement Schedule you are agreeing to the Standard Terms and Conditions of the HSE Grant Aid Agreement which is available on the HSE internet site xxxx://xxx.xxx.xx/eng/services/publications/Non_Statutory_Sector/Section_39_Documentation.html Signature: Date: / / Name (Title): Contact Number: Signature: Date: / / Name (Title): Contact number: [HSE Department Address] [To the Chief Officer/Manager], [Service Organisation] Date: Re: Contract Change Note Dear _, With reference to your Grant Aid Agreement with the HSE for [insert Year], I write to confirm that your funding has been adjusted by [insert funding adjustment plus or minus €xxx], due to [Insert reason for change] It is not necessary at this time to sign a new Grant Aid Agreement, as this letter shall constitute a supplement agreement, therefore I would appreciate if you could confirm your agreement with the above by signing in the area provided below and return to the undersigned at the above address. Thanking you. Yours sincerely, Name: Title: Name: Title: Page 1 details Organisations requirements for Grants up to €9,999 Page 2 details Organisations requirements for Grant between €10,000 and € 49,999 Page 3 details Organisations requirements for Grants between €50,000 and €149,999 Page 4 details Organisations requirements for Grants between €150,000 and €250,000 *Note* Grant Aid Agreement utilised where funding being provided is less than €250,000, except with ‘For-Profit’ & Out-of-State Agencies, or where the Executive is of the opinion that the Service Arrangement governance document is more appropriate.

Confirmation and Execution. 13.1 I confirm that I am authorised to sign this Agreement on behalf of .of 13.2 I understand that by signing this Agreement I am committing the Organisation to comply with the terms and conditions as set out in the Agreement, and the Schedule (s). 13.3 I accept and agree on behalf of the Organisation to the conditions in this Agreement and affirm that the Organisation is duly authorised to enter into and perform this Agreement. Signature: Date: / / Name (Title): Contact Number: Signature: Date: / / Name (Title): Contact number: The Funding provided under this Grant Aid Agreement is Public Exchequer Funding you should Clarity Understand the purpose and conditions of the funding and the outputs required Apply funding only for the business purposes for which they were provided Apply for funding drawdown only when required for business purposes Seek clarification from the grantor where necessary – on use of funds, governance and accountability arrangements. Governance Ensure appropriate governance arrangements are in place for: oversight and administration of funding control and safeguarding of funds from misuse, misappropriation and fraud accounting records which can provide, at any time, reliable financial information on the purpose, application and balance remaining of the public funding Accounting for the amount and source of the funding, its application and outputs/outcomes. Value for Money Be in a position to provide evidence on effective use of funds value achieved in the application of funds avoidance of waste and extravagance Fairness Manage public funds with the highest degree of honesty and integrity Act in a manner which complies with relevant laws and obligations (e.g. tax, minimum wages) Procure goods and services in a fair and transparent manner Act fairly, responsibly and openly in your dealings with your Grantor Provide details of the Organisation that is to receive the Grant award. This may include the Organisation’s mission, objectives and current activities. This section should specify details of the health and personal social services which will be provided by the Organisation in consideration for the Funding (as set out in Clause 10) provided by the Executive. Provide details of the target Client group(s) that will benefit from the funding. Complete the Timetable schedule below stating the submission of performance data and other relevant returns. Review arrangements may also be specified. The Officer nominated by the Executive to deal with this grant is: The Officer nominated by the Organisation to deal with this grant is: The Officer nominated by the Executive to deal with any Disputes arising from this Grant is: Complete the Payment schedule below Specifying the date or period / dates / number of instalments where appropriate. Special conditions - Clause 11 above Please set out any special conditions pertaining to this grant. All information requirements in this Grant Aid Agreement shall also be provided to the {Insert relevant Drug and Alcohol Task Force name} namely clauses 3.1, 3.4, 3.5, 4.2, 7.2, 7.3, 7.4, 8.1, 8.4, and 8.5.  The Organisation, with the support of the DATF, will support and promote the aims and objectives of the current National Drug and Alcohol Strategy: Reducing Harm Supporting Recovery. A health led response to drug and alcohol use in Ireland 2017-2025.  The Organisation will provide the Health Research Board with data on each service user entering a service or exiting, in compliance with the National Drug Treatment Reporting System (NDTRS).  Projects providing Prevention or Education type services should provide these responses in accordance with a uniform set of drug and alcohol education standards (such as the DEWF Quality Standards in Substance Use Education) and should be developed with explicit reference to education and prevention evidence-based good practice.  Organisations of treatment and rehabilitative services will be guided by the National Drugs Rehabilitation Framework; ensuring that people are offered a range of integrated options. The use of standardised assessment tools and integrated referral pathways are central to this process.  The organisation will participate and update details when necessary on the national service directory on xxx.xxxxx.xx.  The organisation will use the Monitoring Template (based on the logic model process) as developed by the NAAGG Audit Review Group.  Funding is allocated annually based on recommendations from the DATF to the HSE through the Section 39 Governance process.  The organisation will support and promote Tobacco Free Ireland.  HSE funded services will not take part in campaigns, programmes or initiatives that are funded or co- funded, directly or indirectly by alcohol, tobacco, e-cigarette/vape manufacturers or their related ‘Social Aspect Public Relations Organisations’  The organisation will deliver quality services in line with the National Standards for Safer Better Healthcare (HIQA, 2012) addiction services workbooks (HSE, 2017). Please be advised that in signing this Grant Aid Agreement Schedule you are agreeing to the Standard Terms and Conditions of the HSE Grant Aid Agreement which is available on the HSE internet site xxxx://xxx.xxx.xx/eng/services/publications/Non_Statutory_Sector/Section_39_Documentation.html Signature: Date: / / Name (Title): Contact Number: Signature: Date: / / Name (Title): Contact number: [HSE Department Address] [To the Chief Officer/Manager], [Service Organisation] Date: Re: Contract Change Note Dear , With reference to your Grant Aid Agreement with the HSE for [insert Year], I write to confirm that your funding has been adjusted by [insert funding adjustment plus or minus €xxx], due to [Insert reason for change] It is not necessary at this time to sign a new Grant Aid Agreement, as this letter shall constitute a supplement agreement, therefore I would appreciate if you could confirm your agreement with the above by signing in the area provided below and return to the undersigned at the above address. Thanking you. Yours sincerely, Name: Title: Name: Title: Page 1 details Organisations requirements for Grants up to €9,999 Page 2 details Organisations requirements for Grant between €10,000 and € 49,999 Page 3 details Organisations requirements for Grants between €50,000 and €149,999 Page 4 details Organisations requirements for Grants between €150,000 and €250,000 *Note* Grant Aid Agreement utilised where funding being provided is less than €250,000, except with ‘For-Profit’ & Out-of-State Agencies, or where the Executive is of the opinion that the Service Arrangement governance document is more appropriate.