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O Ka'u Kakou - Agency Name <br /> Ka'u Family Fun Fest - Program Name <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 /> 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 /> I (we) understand that information supplied herein shall be made public <br /> according to Chapter 92F, Hawaii Revised Statutes. <br /> I (we) understand that applications will not be reviewed by County personnel <br /> accepting our County Nonprofit Grant submittal, and that we have full <br /> responsibility to ensure that all documents are complete and accurate prior to <br /> submittal. <br /> I (we) understand that all documents requiring a signature must be the <br /> ORIGINAL, SIGNED document. Unsigned documents will be disqualified. <br /> Faxed or copied documents will not be accepted as original documents. <br /> If awarded a grant from the County of Hawaii, I (we) understand and will comply <br /> with the requirement to submit a year-end report to the County Council within 60 <br /> days after June 30 of the fiscal year. The report shall include an explanation of <br /> the public benefits derived from the awarding of the grant, a complete accounting <br /> of all expenditures supported by County of Hawaii grant funds, and a listing of <br /> other funding sources and amounts obtained during the award period. Failure to <br /> submit a timely, complete, and accurate year-end report will impact the <br /> evaluation of your program's or agency's future funding requests. I (we) <br /> understand there is no provision for further notification to submit the final report. <br /> No late or incomplete reports will be accepted after the 60 day due date. <br /> Information and instructions are available at co.hawaii.hi.uslforms/grantapps.html <br /> on or about May 30 of the year the final report is due. <br /> NONPROFIT GRANT APPLICATION <br /> FISCAL YEAR 2012-13 <br /> Page 5 of 6 <br />