United States Department of Veterans Affairs

MEMORANDUM OF UNDERSTANDING

Between

Veterans Health Administration

[Insert NGO Name]

I. PURPOSE:

This Memorandum of Understanding (MOU) is entered into between the Veterans Health Administration (VHA), [Insert Address], and the [Insert NGO Name, insert address] collectively referred to as the “Parties.” This MOU sets forth a structure in which both entities will work in a mutually beneficial manner to advance and improve the quality of life for our Nation’s Veterans.

Describe in 1 to 2 paragraphs what this partnership is seeking to do, what is the GOAL.  What service is going to be provided  Who is this going to help  How is this beneficial to VHA and the Veterans’ Community

II. BACKGROUND:

Veterans Health Administration VHA’s mission is to Honor America’s Veterans by providing exceptional health care that improves their health and well-being.

Include a description of your office or program.

[Insert a section discussing what authority VHA is relying on in entering into the MOU.]

[Insert NGO Name]

The [Insert NGO Name is insert boilerplate text that describes the NGO] III. RESPONSIBILITIES:

Veterans Health Administration: 1. VHA will [insert what you are committing VHA to do in this partnership.]

[Insert NGO Name] 1. The [insert Name of NGO and what the NGO is committed to in the partnership.]

IV. OBJECTIVES:

The Department and the [Insert NGO Name]have a shared goal to [insert a simplified version of your purpose from above (goal) of this partnership]. This partnership will be mutually beneficial as the Parties work together through a set of objectives to achieve this goal. This MOU sets forth a framework of intent and cooperation between the Parties to achieve the following objectives:

A GOAL is a broad, long term aim that you want to achieve; and an objective is a specific action that supports the goal/purpose (section I.) and is measurable (section V.).

For example…a GOAL could be “End homelessness amongst American Veterans and their families” and a corresponding OBJECTIVE could be “Reduce Veteran homelessness throughout the Capital Region by 10 percent within the next 12 months.”

1. [Insert objective #1 of this partnership that supports VHA's mission, goals, priorities, objectives, and/or strategies.]

V. PERFORMANCE:

The Department and the [Insert NGO Name] seek to enhance services to Veterans and their families through this partnership. [Need to insert a complete sentence with phrase describing what the partnership seeks to achieve]The ability to quantitatively and qualitatively capture objective performance through metrics that demonstrate the impact of this partnership is critical.

Therefore the Parties agree to use the following metrics to capture and record objective performance through related outcomes, outputs, measurables, and/or impacts, as appropriate:

VI. POINTS OF CONTACT:

VETERANS HEALTH ADMINISTRATION [Insert VHA POC Name] [Insert NGO NAME] [Title] [NGO POC Name] [Veterans Health Administration] [Title] [Address 1] [NGO Name] [Address 2] [Address 1] [City, State Zip Code] [Address 2] [Phone Number] [City, State Zip Code] 2 [Email Address] [Phone Number] [Email Address]

VII. LIMITATIONS:

(a) The [insert NGO Name] will not use this MOU to sell or promote any products or services.

(b) The [insert NGO Name] will not use the name of the Department or any of its components, except in factual publicity and with prior approval of VHA. Factual publicity includes announcements of dates, times, locations, purposes, agendas, speakers, and fees, if any, involved with activities or events. Such factual publicity shall not imply that the involvement of VHA serves as an endorsement of the general policies, activities, or products of the [insert NGO Name]. Where the publicity references the Department, publicity will be accompanied by a disclaimer to the effect that no VHA endorsement is intended. The [insert NGO Name] may use VHA’s logo, seals, flags, and other symbols only pursuant to a written determination by VHA that the proposed use by the [insert NGO Name] advances the aims, purposes and mission of the Department. VHA approval is not guaranteed.

(c) VHA will not use, and has obtained no ownership interests in the [insert NGO Name] or other [insert NGO Name] names, logos, and/or trademarks (the Marks). VHA will obtain the [insert NGO Name’s] prior written approval to use the Marks.

(d) This Agreement is not intended to be an exclusive arrangement. The relationship established in this Agreement in no way limits VHA or the [insert NGO Name] from establishing similar relationships with any other entity.

(e) This Agreement does not represent any endorsement by VHA of the general policies, activities, or products of the [insert NGO Name].

(f) Any publicity released by either Party concerning this MOU, the services or supports providing within, or any resulting outcomes, will be subject to prior approval of the other Party.

(g) Each party shall bear its own costs, risks, and liabilities incurred by it arising out of its obligations and efforts under this MOU. Nor can one Party commit the other to any cost, expense, or obligation without the prior written consent of that Party.

(h) This MOU may not be assigned or otherwise transferred by any Party, in whole or in part, without the expressed prior written consent of the other Party, which shall not be unreasonably withheld.

VIII. AMENDMENT, DURATION, REVIEW, AND TERMINATION:

3 This agreement is effective when signed by both parties and will remain in effect until terminated by either party or [insert length], whichever comes first. This agreement may be amended by written agreement of the Department and the [insert NGO Name]. This agreement will be reviewed annually for compliance and effectiveness. Either party may terminate this agreement upon written notice to the other party not less than thirty (30) days before the proposed termination date. The requirement for thirty (30) days’ notice may be waived by mutual written consent of both parties.

IX. APPROVALS:

Veterans Health Administration [Insert NGO Name]

By: ______By: ______[Name] [Name] [Position] [Position] Veterans Health Administration [NGO Name] Date: ______Date: ______