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					       Endowment Agreement                                                 Fund Number: Enter Fund Number.
       Medical College of Georgia

                                            Perpetual Fund Agreement
                                                     Between
                                             Enter Name(s) of Donor(s).
                                                        and
                                 The Georgia Health Sciences Foundation, Inc.
                                                  to establish the
                                                 Enter Fund Name.
                                                 Endowment Fund

  I.          The Donor(s), Enter Name(s) of Donor(s)., enter(s) into this agreement with The Georgia
              Health Sciences Foundation, Inc. (“Foundation"), to establish the Enter Fund           Name.
              ("Endowment Fund"). All assets in the Fund shall be used for the purpose set forth below. To
              establish the Fund, the Donor(s) irrevocably gives to the Foundation Enter amount of money,
              description of assets, or reference pledge agreement as Attachment Number 1.
 II.          The purpose of the Fund is to Enter the purpose of the fund. If this is a scholarship, please
              attach the scholarship fund criteria form as Attachment #1 or 2..
                     All expenditures from the Fund shall adhere to the Spending Policy as set forth by the
              Foundation, as may be modified from time to time by the Foundation.
                     As long as the value of the Fund exceeds $Enter the minimum fund amount. it will be
              maintained as a perpetual fund by the Foundation for the purpose stated above. If the value of
              the Fund falls below this amount or if this gift is subject to a pledge agreement that is not
              fulfilled within the time frame specified within the pledge agreement, any balance in the Fund
              may be added to an unrestricted fund or for the donor’s purpose as follows: Enter the purpose
              of the donor..
                     If at any time the President of the Medical College of Georgia (“MCG”) and the
              Donor(s), provided that person(s) is reasonably available, certify to the Chairman of the
              Foundation that MCG has no need for a fund established for the purpose stated above, the
              parties agree that the distributions authorized herein may be made for any purpose benefiting
              the Enter the School/Institute/Center/Department. as determined by the Foundation.
III.          Requests for distributions will generally be initiated by the Enter the (Dean/Vice



       GHSF Endowment And Expendable Agreement MCG Version 20100915 for Word 2003                              1
             President/Director/Department Head. and approved by the appropriate Enter the Dean/Vice
             President/Director/Department Head..       Withdrawal requests must be supported by such
             documentation as the Foundation may require.
IV.          The Fund shall be administered in accordance with the Foundation’s policies and procedures
             and shall be consistent with MCG’s policies, as follows:
             A. The Fund shall be used only for a qualified charitable purpose consistent with the laws of
                 the State of Georgia and section 501(c)(3) of the Internal Revenue Code.
             B. The Fund shall be added to the Foundation’s endowment to be held in perpetuity (unless
                 transferred as stated under Section II). For investment purposes, the Fund shall be
                 commingled with the Foundation’s other restricted and unrestricted endowment funds, but
                 at all times the Fund will be separately accounted for and identified.
             C. The Fund shall be invested at the sole discretion of the Foundation in a manner consistent
                 with the investment policy of the Foundation, as may be modified from time to time by the
                 Foundation.
             D. The Fund shall be held and administered by the Foundation in accordance with the policies
                 and procedures of the Foundation governing the management and distribution of non-
                 endowed funds, including but not limited to administrative fee policies, as adopted and
                 amended from time to time by the Foundation. A summary of these current policies is
                 attached hereto as Exhibit A.
                 1. Distributions from the Fund shall be made in accordance with the current spending
                    policy of the Foundation and shall be used only for the purposes authorized by this
                    Agreement.
                 2. An administrative fee may be applied against the principal of the Fund and funded from
                    the investment return of the Fund according to the current fee policy of the Foundation.
                 3. The total investment return, less the administrative fee (if any), shall be credited to the
                    Fund.
V.           The Donor(s) acknowledges that all contributions to the Foundation are irrevocable and
             nonrefundable.
VI.          Should any questions or problems arise concerning the Fund that are not addressed in Part II of
             this agreement, the parties agree that in the absence, incapacity, or death of the Donor(s),) the
             Foundation may consult with the Enter the Dean/Vice President/Director/ Department Head.,
             who shall have the authority to act with regard to the Fund in such circumstances.
                    Annual reports concerning the Fund shall be made available to the Donor(s) upon


      GHSF Endowment And Expendable Agreement MCG Version 20100915 for Word 2003                                  2
       request.
                The Donor(s) and/or other persons may from time to time add to the Fund additional
       monies, securities or other assets, which, if acceptable to and accepted by the Foundation, shall
       become subject to the terms and conditions of this Agreement.
                This Agreement contains the entire understanding between the parties with respect to
       the subject matter of this Agreement and all prior agreements and discussions on this subject
       between the parties, whether oral or written, are nullified and superseded hereby.               This
       Agreement shall be governed by the laws of the State of Georgia.


Agreement made as of the Enter the date as the 1st or 2nd, etc. day of Enter the month., Enter the
year..


Signed: ________________________         Clayton Boardman, III
        Chairman of the Board            Printed Name                              Date
        Georgia Health Sciences Foundation


Signed:
          Donor or Representative            Printed Name                          Date


Signed:
          Donor or Representative            Printed Name                           Date



                                                                     RETURN FORM TO:
                                                                     GHS Foundation, Inc.
                                                      Attn: Linda Saunders, Director, Advancement Services
                                                                     LSaunders@mcg.edu
                                                                    Alumni Center, FI 1038
                                                                      Augusta, GA 30912
                                                                        (706) 721-6215




GHSF Endowment And Expendable Agreement MCG Version 20100915 for Word 2003                                     3
                                             EXHIBIT A
What is the Administrative Fee?
An administrative fee may be charged quarterly at an annual rate not to exceed 0.09 % of the Fund’s
value. The administrative fee covers both the direct expenses associated with the administration of the
Fund, and a reasonable general overhead charge that permits the Foundation to recover the cost of
other institutional resources that are needed for the accomplishment of the purposes of the Fund but
cannot be specifically traced to the Fund. The administrative fee will be assessed only if the spending
allocation (see below) has been funded first. The administrative fee pays for the cost of having the
Medical College of Georgia provide administrative facilities and services to the Foundation and any
excess is primarily used to fund academic programs, faculty salaries and supplements, and activities
serving MCG priorities as determined from time to time by the Foundation. The Board of Trustees of
the Foundation receives funding suggestions from senior MCG officials and approves all such
expenditures. The administrative fee is also used to fund the remaining operating costs of the
Foundation that are not provided by MCG.

How is the Spending Allocation Determined?
Once your Fund is fully funded and invested for at least one fiscal year, an annual spending budget
will be calculated for your Fund. Waiting at least one fiscal year before approving any expenditure
allows your Fund to earn investment returns to support spending and increases the probability of an
annual increase in the amount available to spend from your Fund. If there is no investment return in
excess of the amount of the original endowed gift, then spending may not be allowed.

The annual spending budget is based on a predetermined percentage applied to the average balance of
your Fund and is limited to available investment return. The spending percentage is determined
annually by the Foundation in consideration of maximizing both spending and endowment growth and
currently is 4.00% for fiscal year 2011. The average balance of your Fund is calculated using the
Fund’s previous monthly balances for up to 36 months. This averaging helps smooth the effects of
market fluctuations. Unused spending budgets can be rolled over to the next year subject to certain
limitations. Investment return in excess of the spending allocation is retained within the Fund,
increasing its size over time and, therefore, increasing the amount of support generated for your
specified program. More information may be found in the Foundation’s Spending Policy.

How Will My Fund Grow?
Your fund will be invested with the objective to promote growth and protect against inflation while
providing for a reasonable spending allocation to support the Fund’s purpose. The Foundation
considers all of these factors in determining the investment strategy which will work best for the long
term growth of the Fund. Ideally, as your Fund grows, so does the support it provides.


RETURN FORM TO:               GHS Foundation, Inc.
               Attn: Linda Saunders, Director, Advancement Services
                                  919 15th Street
                             Alumni Center, FI 1038
                               Augusta, GA 30912
                                 (706) 721-6215
                              LSaunders@mcg.edu




GHSF Endowment And Expendable Agreement MCG Version 20100915 for Word 2003                                4
       Expendable Agreement                                                   Fund Number: Enter Fund Number.
       Medical College of Georgia

                                           Expendable Fund Agreement
                                                    Between
                                            Enter Name(s) of Donor(s).
                                                        and
                                   The Georgia Health Sciences Foundation, Inc.
                                                  to establish the
                                                 Enter Fund Name.
                                                 Expendable Fund

  I.          The Donor(s), Enter Name(s) of Donor(s)., enter(s) into this agreement with The Georgia
              Health Sciences Foundation, Inc. (“Foundation"), to establish the Enter the name of the fund.
              ("Fund"). All assets in the Fund shall be used for the purpose set forth below. To establish the
              Fund, the Donor(s) irrevocably gives to the Foundation Enter the amount of the gift or a list of
              assets..
 II.          The purpose of the Fund is to Enter the purpose of the fund..
                    All expenditures from the Fund shall adhere to the Spending Policy as set forth by the
                                                                                                     .
              Foundation, as may be modified from time to time by the Foundation.
                         If at any time the President of the Medical College of Georgia (“MCG”) and the
              Donor(s), provided that person(s) is reasonably available, certify to the Chairman of the
              Foundation that MCG has no need for a fund established for the purpose stated above, the
              parties agree that the distributions authorized herein may be made for any purpose benefiting
              the Enter the School/Division/Dept. as determined by the Foundation.
III.          Requests for distributions will generally be initiated by the Enter the Dean/Vice
              President/Director/Department Head. and approved by the appropriate Enter the Dean/Vice
              President/Director/Department Head..      Withdrawal requests must be supported by such
              documentation as the Foundation may require.
IV.           The Fund shall be administered in accordance with the Foundation’s policies and procedures
              and shall be consistent with MCG’s policies, as follows:
          A. The Fund shall be used only for a qualified charitable purpose consistent with the laws of the
              State of Georgia and section 501(c)(3) of the Internal Revenue Code.


       GHSF Endowment And Expendable Agreement MCG Version 20100915 for Word 2003                                5
         B. The Fund shall be invested at the sole discretion of the Foundation in a manner consistent with
             the investment policy of the Foundation, as may be modified from time to time by the
             Foundation.
         C. The Fund shall be held and administered by the Foundation in accordance with the policies and
             procedures of the Foundation governing the management and distribution of non-endowed
             funds.
                      1. Distributions from the Fund shall be made in accordance with the current spending
                      policy of the Foundation and shall be used only for the purposes authorized by this
                      Agreement.
V.           The Donor(s) acknowledges that all contributions to the Foundation are irrevocable and
             nonrefundable.
VI.          Should any questions or problems arise concerning the Fund, the parties agree that in the
             absence, incapacity, or death of the Donor(s), the Foundation may consult with the Enter the
             Dean/Vice President/Director/Department Head., who shall have the authority to act with
             regard to the Fund in such circumstances.
                      Annual reports concerning the Fund shall be made available upon request to the
             Donor(s).
                      The Donor(s) and/or other persons may from time to time add to the Fund additional
             monies, securities or other assets, which, if acceptable to and accepted by the Foundation, shall
             become subject to the terms and conditions of this Agreement.
                      This Agreement contains the entire understanding between the parties with respect to
             the subject matter of this Agreement and all prior agreements and discussions on this subject
             between the parties, whether oral or written, are nullified and superseded hereby.            This
             Agreement shall be governed by the laws of the State of Georgia.

      Agreement made as of the Enter the date as the 1st or 2nd, etc. day of Enter the month., Enter the
      year..


      Signed: ________________________         Clayton Boardman, III
              Chairman of the Board            Printed Name                            Date
              Georgia Health Sciences Foundation


      Signed:
                Donor or Representative            Printed Name                        Date



      GHSF Endowment And Expendable Agreement MCG Version 20100915 for Word 2003                                  6
Signed:
          Donor or Representative           Printed Name                           Date


                                                                      RETURN FORM TO:
                                                                      GHS Foundation, Inc.
                                                       Attn: Linda Saunders, Director, Advancement Services
                                                                      LSaunders@mcg.edu
                                                                     Alumni Center, FI 1038
                                                                       Augusta, GA 30912
                                                                         (706) 721-6215




GHSF Endowment And Expendable Agreement MCG Version 20100915 for Word 2003                                    7

				
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