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Agency Name: Adventure Centers Hawaii, Inc. <br /> Program Name: Climbing for Keiki <br /> 11. Certification of Understanding (Page 2 of 2) <br /> If awarded a grant from the County of liawai'i, 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 /> Hawaii 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, I (we)acknowledge that any funds awarded will be restricted for the <br /> purposes stated in the application, except for a maximum ten percent(10%)for administrative and <br /> overhead costs. I (we) acknowledge that a copy of the submitted application will become a part of any <br /> contract/agreement(as Exhibit A)entered into as a result of the proposal.Any funds unused by June <br /> 30,2026 must be returned to the County of Hawaii with the final report.Failure to return these funds <br /> in a timely manner will impact the evaluation of your agency's future funding request and may result in <br /> 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 /> January 8,2025 <br /> Signature of Authorized Person Date <br /> Donna Nichols,Chair <br /> Printed Name and Title/Position of Authorized Person <br /> NONPROFIT GRANT APPLICATION FY 2025-2026 Page 2 of 2 <br />