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Agency Name: <br /> Program Name: <br /> 11. Certification of Understanding (Page 2 of 2) <br /> If awarded a grant from the County of Hawai'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 /> Hawai'i Finance Department, which specifically and explicitly indicates that the County of Hawai'i 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 301" 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 rms/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 Hawai'i 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 /> Signature of Authorized Person Date <br /> Printed Name and Title/Position of Authorized Person <br /> NONPROFIT GRANT APPLICATION FY 2025-2026 Page 2 of 2 <br />