Agreement

Blue Cross® Blue Shield® of Arizona (BCBSAZ) is awarding the grant described below, subject to the 
Grantee’s compliance with the terms and conditions in this agreement.
MOBILIZE AZ GRANT AGREEMENT
Grantee:  [full legal name]
Grantee Primary Contact: 
Amount of Grant Award:
Grant Period:
Grant Type:
 Diabetes   
 Mental Health
 Social Determinants of Health
 Substance Use Disorder   
 N/A
Grant Project Name: 
Grant Overview: 
Detailed information about the grant project is set forth in the grant application and budget outline, which is 
attached as Exhibit 1 and incorporated into this agreement.
BCBSAZ Grant Contact:
BCBSAZ Address for Submission of Invoices and Reports:
I. GRANT INFORMATION
Grantor: Blue Cross Blue Shield of Arizona, a not-for-profit company and an independent licensee of the 
Blue Cross Blue Shield Association.
II. PAYMENT TERMS
Before issuing payment to a Grantee, BCBSAZ must: (i) have a signed grant package,
including the grant agreement, invoice in the form of Exhibit 2, completed W-9, and Supplier
Onboarding Form; and (ii) complete a kick-off call with Grantee.
BCBSAZ shall send Grantee:
 payment for total awarded grant funds 
   first payment 
no later than 45 days after completion of both requirements.
City of Glendale Fire Department
Gary Benson, Assistant Chief
$30,000
7/1/2021 - 6/30/2022
xpand Glendale Fire Dept. Resiliency/Peer Program
Glendale Fire Department is expanding resiliency training, specialized counseling services, peer support training, continuing 
education, and resources for families of firefighters to address acute and post-traumatic stress to prevent and address substance 
use. 
Dan Greenleaf
dan.greenleaf@azblue.com
I
I

III. GRANTEE OBLIGATIONS AND ACKNOWLEDGMENTS
• Grantee shall adhere to the purpose and activities described in the grant application. Grantee
shall not materially deviate from the approved grant proposal without prior written approval
from BCBSAZ.
• Grantee shall adhere to the budget described in the grant application. Grantee shall not
materially deviate from the approved grant budget without prior written approval from
BCBSAZ. BCBSAZ may recoup prior payments for expenditures that materially deviate from
proposed budget without BCBSAZ approval.
• If Grantee receives periodic payments rather than total funds at the start of the grant,
Grantee shall submit invoices for the periodic payments if BCBSAZ asks the Grantee
to do so.
• Grantee shall submit quarterly budget and narrative reports to BCBSAZ-designated grant
contact. Reports not submitted by the fourteenth day following the end of a grant quarter are
considered delinquent, and may result in suspension of activities and/or payment. BCBSAZ
may also recoup prior payments for incomplete reports that lack material information about
the Grantee’s progress.
• Grantee shall participate in monthly progress review calls with BCBSAZ. Grantee may also
request that additional calls be scheduled.
• Grantee shall not use the Blue Cross or Blue Shield tradenames or trademarks (Blue Brands)
without the express written permission of BCBSAZ. Grantee may reference the Blue Brands
in the ordinary course of its business to reflect the receipt of grant funds and its obligations
under this agreement. Grantee may also publicly disclose that BCBSAZ has funded, or
contributed to funding, of its grant project. Grantee shall obtain BCBSAZ’s prior approval of
the form and content of the disclosure.
• Grantee understands that the grant is for a 12-month period only and is not subject to
automatic renewal. If BCBSAZ opens the request for proposal process in subsequent years,
Grantee must reapply to be considered for another grant. There is no guarantee of renewal for
additional years.
• Grantee shall not assign any rights or duties under this agreement to any other individual
or organization, except as otherwise already identified in Exhibit 1. To the extent that the
Grantee has identified third parties who will participate in grant-funded activities, Grantee is
responsible to BCBSAZ for named party’s compliance with the terms of this agreement.
• Other requirements:    
IV. BCBSAZ RIGHTS AND OBLIGATIONS
• BCBSAZ shall make grant payments as described in Section II, subject to BCBSAZ’s right
to recover payments for untimely and/or incomplete reports or Grantee’s breach of its
obligations under this agreement.
• BCBSAZ’s grant contact shall be reasonably available to Grantee to address questions and
concerns about the grant award, and Grantee’s obligations.
Not applicable.

• BCBSAZ will keep the Grantee’s confidential information private and will share it only with
BCBSAZ employees, personnel, authorized agents, to the extent necessary for such persons to
perform functions related to the grant. “Confidential information” means information about the
Grantee’s financial condition and identifying information about any individuals who may be the
subject of Grantee’s grant activities. Confidential information does not include information already
in the public domain or outcomes of projects funded through the grant.
• BCBSAZ may publicize information about the project funded through this grant award and the
outcomes/results of the project.
• BCBSAZ may recoup grant awards if the Grantee materially deviates from the project and/or
budget described in Exhibit 1 without prior BCBSAZ approval.
• Other requirements:  
V. TERM; TERMINATION; EFFECT
• This agreement is for a 12-month period beginning on the first day of the grant period and ending
on the last day of the grant period. The parties may mutually agree to extend this agreement if
Grantee applies for and is awarded a grant for an additional grant period.
• BCBSAZ may terminate this agreement and any further grant distributions for cause. In this
agreement cause means any one or a combination of the following: (a) Grantee breaches its
obligations under this agreement and does not cure the breach within thirty (30) days’ notice
of breach from BCBSAZ; (b) Grantee becomes financially insolvent, fails to pay debts when
due, or has a bankruptcy; (c) Grantee or its officers or directors perform actions that are likely to
materially injure the interests or reputation of BCBSAZ; (d) a government agency with regulatory
authority over BCBSAZ determines that it is unlawful for BCBSAZ to continue the grant funding
program.
• Either party may terminate this agreement without cause with 90 days’ prior written notice to the
other party.
• If Grantee terminates this agreement, Grantee shall pay BCBSAZ the remainder of unspent funds
regardless of goals achieved within grant period within 30 days of termination.
• If a termination occurs, it will not affect any rights or obligations incurred before the date of
termination. Any term of this agreement that reasonably should survive termination of this
agreement shall survive termination.
• Other requirements:
VI. GENERAL
• Choice of Law; Jurisdiction; Venue. This agreement is governed by the laws of the State of
Arizona. Exclusive jurisdiction and venue for any dispute arising under this agreement is in
Maricopa County Superior Court. Prior to initiating any lawsuit to enforce this agreement senior
leadership of the Grantee and BCBSAZ shall meet and attempt to informally resolve the dispute.
• Independent Contractors. BCBSAZ and Grantee are independent entities. Nothing in this
agreement gives either party the right to act on behalf of the other party.
Not applicable.
Not applicable.