About DMG Exteriors & Their Commitment

DMG Exteriors is a leading general contractor in Lake Porter and LaPorte counties, providing exceptional service and superior results for all types of exterior home projects and needs. For more than ten years, DMG Exteriors has been dedicated to exemplifying the three principles our company was founded on:

1. Always providing outstanding customer service.

2. Always maintaining our unwavering attention to detail.

3. Always delivering top-quality work and the best results.

APPLICANT ATTESTATION

In consideration for the acceptance into the Fighting Cancer Today Grant Program I agree and certify as follows: 

1. I attest that the information provided in this application is complete and accurate to the best of my knowledge.
2. ​I understand that while every effort will be made to provide assistance, the program is limited to the availability of funds and I may not receive assistance even if I satisfy the eligibility requirements and the other terms and conditions in the program guidelines. ​I understand the program guidelines and eligibility criteria and program could be modified and discontinued without notice.
3. ​I understand that FCT has the right to audit my eligibility, the accuracy of any documents or information I provide, and request that additional information is provided. Upon review if the applicant is identified intentionally providing false information, the applicant will be denied, and no future consideration will be given for any Fighting Cancer Today Grant Program.
4. I understand that active claims cannot exist to be a recipient of the DMG Exteriors Grant for Northwest Indiana residents. 
5. Applicants must be the homeowner and have been a resident in Northwest Indiana for at least 5 years. No rentals residences will be approved.
6. ​I attest that I am not receiving assistance for the expenses for which I am seeking assistance from FCT from another entity. If applicable, I agree that FCT shall be entitled to receive such refunds and I will transfer such refund received to FCT immediately. I will notify FCT Immediately of any changes to information provided, including changes to my financial situation or medical condition.
7. ​I understand that FCT may disclose certain information from my application to other parties to fulfill my grant request.
8. I acknowledge that from time to time, FCT uses data from patients to create summary patient data which FCT may share with third parties, including but are not limited to researchers, partners, foundations, policy makers and other funding sources to help us apply and secure funding to continue advocating on behalf of patients, caregivers and their families or perform other health related research.
9. I understand that payments are not made automatically and are subject to review of the application and funds.
10. I understand that in no way shall FCT be liable in any way for damages alleged to result from errors or delays in the processing of the program application or the issuance of payment as part of the program.
11. ​I understand that all approved applicants are required to complete a survey of their experience with FCT.
12. Re-Disclosure: ​I understand that the information disclosed by this Authorization may be subject to re-disclosure by the recipient and no longer protected by Federal or state privacy requirements.I understand that my treatment, payment, enrollment or eligibility for benefits may not be conditioned on signing the Authorization. ​
13. By signing this document, I hereby authorize the above-named provider to disclose my protected health information as specified in this document. If this Authorization is signed by the patient’s personal representative, indicate such representative’s authority to act on behalf of the patient and proof indicating authority next to signature.

Fighting Cancer Today Media Release and Waiver 

(Referred to herein as the "Release") 

1. I, ______________________________________ hereby grant Fighting Cancer Today, its agents, philanthropic, community and business partners, subsidiaries and affiliates, and their respective licensees, successors and assigns (referred to collectively herein as "Fighting Cancer Today") the right to use, disclose, maintain, copy, publish, transmit, copyright and permit others to use my image, likeness, name, and personal information, including my story about Fighting Cancer Today and the grant that I received (the "Content"), for commercial or noncommercial purposes, including advertising, public relations, promotion of Fighting Cancer Today, its products and services and its partners or affiliates. This right shall be perpetual throughout the world and extend to any medium or format whatsoever (existing or yet-to-be created), including without limitation, in and on magazines, brochures, and other print publications, content displayed in Fighting Cancer Today corporate offices, press releases, electronic media, and the internet (including the website and social media sites of Fighting Cancer Today and its partners). 

2. I transfer and assign to Fighting Cancer Today my entire right, title and interest in the Content and agree that all Content used by Fighting Cancer Today in any manner is owned by Fighting Cancer Today. I agree that I have no right to review or approve Content before it is used by Fighting Cancer Today and Fighting Cancer Today shall be without liability to me for any editing, distortion or illusionary effect resulting from the publication of the Content. Fighting Cancer Today has no obligation to use the Content. 

 
3. I further agree and do hereby release and hold harmless Fighting Cancer Today from any and all claims, actions, suits, liabilities or damages arising from use of the Content, and whether resulting from the negligence of Fighting Cancer Today or any other person. I waive any right I may have to make or bring any claim against Fighting Cancer Today relating to its use of the content. I understand and agree that I will not be compensated in any way for providing the Content to Fighting Cancer Today or authorizing its use in the manner detailed herein. 

I HAVE CAREFULLY READ, CLEARLY UNDERSTAND AND VOLUNTARILY ACKNOWLEDGE THE INFORMATION SET FORTH IN THIS RELEASE FORM. I UNDERSTAND THAT THIS FORM PROVIDES FIGHTING CANCER TODAY WITH MY ABSOLUTE AND UNCONDITIONAL CONSENT, WAIVER AND RELEASE OF LIABILITY, ALLOWING FIGHTING CANCER TODAY TO PUBLICIZE PRIVATE INFORMATION ABOUT ME. BY SIGNING THIS RELEASE FORM, I UNDERSTAND IT HAS NO BEARING ON ANY DECISIONS MADE BY THE QUALIFICATIONS COMMITTEE REGARDING FINANCIAL ASSISTANCE.