COM 0100.002 2024-2026 - Laserfiche WebLink

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Agency Name: Pro z am Name: .`r> q)Tz— A ii. Certification of Understanding (Page 2 of 2) If awarded a grant from the County of Hawaii, I (we) understand that a current Certificate of Liability 2,000 000 general aggregate100,000 each occurrence) must be provided to the County of Hawa i'j Finance Department, which specifically and explicitly indicates that the County of Hawa i'j is an additional insured prior to receiving any payment(s). I (we) understand that failure to submit the final report within 60 days of June 30' shall result in loss of all grant funds received durin the Brant period (must be refunded to County} and exclusion from, future grant Partici ation for a minimum of one ear or until a written report is submitted to and accepted by, the council, I (we) understand there is no provision for further notification to submit the final report. Information and instructions are available athLIIE3://Www.hawaiicounty-gov/fn-nonprofit-grant -forms/ onorabout May 30 of the year the final report is due. As part of this application, I (we) acknowledge that any funds awarded will be restricted for the purposes stated in the application, except for a maximum ten percent (10%) for administrative and overhead costs. I (we) acknowledge that a copy of the submitted application will become a part of any contract/agreement (as Exhibit A) entered into as a result of the proposal. Any funds unused by June 30, 2026 must be returned to the County of Hawai'i with the final report. Failure to return these funds in a,timely manner will impact e evaluation of your a enc sLuture funding request and may result in actions taken to recover tfitEtfunds. Awards cannot provide funds for Capital Improvements (Cost of Construction., materials, insurance or securities) on Private properties unless otherwise authorized by law. By signing below, you are acknowledging that you have read and understood these requirements. Signature of Authorized Person Date Printed Name and Title/Position of Authorized Person NONPROFIT GRANT APPLICATION FY 2025-2026 Page 2 of 2