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Agency Name: Action 4 Animals Hawaii <br /> Program Name: The Iris Project <br /> 11. Certification of Understanding (Page 2 of 2) <br /> If awarded a grant from the County of Hawaii, I (we) understand that a current Certificate of Liability <br /> ($2,000,000 general aggregate and$1,000,000 each occurrence) must be provided to the County of <br /> Hawai'i Finance Department, which specifically and explicitly indicates that the County of Hawaii is an <br /> additional insured prior to receiving any payment(s). <br /> I (we) understand that failure to submit the final report within 60 days of June 30th shall result in loss <br /> of all grant funds received during the grant period (must be refunded to County)and exclusion from <br /> future grant participation for a minimum of one year or until a written report is submitted to,and <br /> accepted by,the council. <br /> I (we) understand there is no provision for further notification to submit the final report. Information <br /> and instructions are available at http://www.hawaiicounty.gov/fn-nonprofit-grant-forms/on or. about <br /> May 30 of the year the final report is due. <br /> As part of this application, you acknowledge that any funds awarded will be restricted for the purposes <br /> stated in the application, except for a maximum ten percent (10%) for administrative and overhead <br /> costs. Any funds unused by June 30, 2025 must be returned to the County of Hawaii with the final <br /> report. Failure to return these funds in a timely manner will impact the evaluation of your agency's <br /> future funding request and may result in actions taken to recover these funds. <br /> Awards cannot provide funds for Capital Improvements (Cost of Construction, materials, insurance <br /> or securities)on private properties unless otherwise authorized by law. <br /> By signing below,you are acknowledging that you have read and understood these requirements. <br /> Jan 22, 2024 <br /> Signature of Authorized Person Date <br /> President <br /> Title/Position of Authorized Person <br /> NONPROFIT GRANT APPLICATION FY 2024-2025 Page 2 of 2 <br />