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<br /> <br /> <br /> <br /> ~l6 tSLAN9 Su@yS~p1~1cE A-e,SC C.ou,ac„ d.6.ck. <br /> KoKur~ EH~ ~~M~~o~El=. ~~STflNCI, pC~(~RM~ <br /> <br /> <br /> <br /> I (we) have read and understood all of the eligibility requirements; grant <br /> conditions; award procedures; and records, reporting and fiscal accountability <br /> requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawaii <br /> County Code, relating to Appropriation of Funds to Nonprofit Organizations. <br /> <br /> I (we) hereby certify that information supplied herein including all supporting <br /> documents is correct and that I (we) have the authority and ability to fully <br /> administer the program(s) pursuant to law. <br /> <br /> I (we) understand that information supplied herein shall be made public <br /> according to Chapter 92F, Hawaii Revised Statutes. <br /> <br /> If awarded a grant from the County of Hawai'i, I (we) understand and will <br /> comply with the requirement to submit a year-end report to the County <br /> Council within 60 days after June 30 of the fiscal year. The report shall <br /> include an explanation of the public benefits derived from the awarding of <br /> the grant, a complete accounting of all expenditures supported by County <br /> of Hawai'i grant funds, and a listing of other funding sources and amounts <br /> obtained during the award period. Failure to submit a timely, complete, and <br /> accurate year-end report will impact the evaluation of your program's or <br /> agency's future funding requests. <br /> <br /> <br /> <br /> <br /> Signature of Board Fresident/Chair Date <br /> <br /> <br /> <br /> <br /> 4igure of Exec jr ctor Date <br /> <br /> <br /> <br /> <br /> <br /> <br /> UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! <br /> <br /> <br /> <br /> <br /> <br /> NONPROFIT GRANT APPLICATION <br /> FISCAL YEAR 2009-10 <br /> Page Ct <br />