HomeMy WebLinkAbout00 - Certification of Understanding 9-3-26CERTIFICATION OF UNDERSTANDING Rev. 9/26 Page 1 of 2
Agency Name: Program Name:
Certification of Understanding (Page 1 of 2)
I (we) have read and understand all of the eligibility requirements; grant conditions; award procedures;
and records, reporting, and fiscal accountability requirements as mandated in Article 25, Sections 2-
135 – 2-142.1, Hawai‘i County Code, relating to Appropriation of Funds to Nonprofit Organizations.
I (we) agree to allow the County (the Legislative Auditor, the Department of Finance, designated
Council representative, or expending/oversight agency) full, free, and unrestricted access and authority
to examine and inspect any facility, equipment, property, or records pertinent to the grant, contract, or
program for which funds were used.
I (we) understand that information supplied herein may be made public according to Chapter 92F,
Hawai‘i Revised Statutes.
I (we) hereby certify under penalty of perjury that the following is true as it pertains to the organization
seeking funds, and/or its fiscal sponsor that information supplied herein, including all supporting
documents, is correct and that I (we) have the authority and ability to fully administer the program(s)
pursuant to law.
Initial each item to certify compliance:
_____ I (we) understand that information supplied herein may be made public according to Chapter
92F, Hawai‘i Revised Statutes.
_____ I (we) certify that the organization has a governing board whose members serve without
compensation.
_____ I (we) certify that the organization has written policies and procedures addressing nepotism
and the management of actual and potential conflicts of interest. “Nepotism” means
appointing persons to positions on the basis of their blood or marital relationship to the
appointing authority, rather than on merit or ability.
_____ I (we) certify that the organization's conflict of interest policy complies with the requirements
of the Internal Revenue Service (IRS) and state law, and conforms to the County of Hawaiʻi's
conflict of interest policy. “Conflict of interest” means a substantial probability that action
taken by an individual will result in measurable direct benefits accruing to the individual as
opposed to benefits accruing in general to an industry.
CERTIFICATION OF UNDERSTANDING Rev. 9/26 Page 2 of 2
Agency Name: Program Name:
11.Certification of Understanding (Page 2 of 2)
If awarded a grant from the County of Hawai‘i, I (we) understand and will furnish proof of compliance
with the requirements of 103D-310(c), HRS, prior to receiving payment(s). Proof of compliance may be
established through Hawai‘i Compliance Express. To register, go to http://vendors.ehawaii.gov,
complete the easy step-by-step process. An annual registration fee online using a credit card will be
required to utilize this platform.
If awarded a grant from the County of Hawai‘i, I (we) understand that a current Certificate of Liability
($2,000,000 general aggregate and $1,000,000 each occurrence) must be provided to the County of
Hawai‘i Finance Department, which specifically and explicitly indicates that the County of Hawai‘i is an
additional insured prior to receiving any payment(s).
I (we) understand that failure to submit any required reports shall result in loss of all grant funds
received during the grant period (must be refunded to County) and exclusion from future grant
participation for a minimum of one year or until a written report is submitted to, and accepted by,
the County of Hawai‘i granting department.
As part of this application, you 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. Any funds unused by end of the contractual term must be returned to the County of Hawai‘i with
the final report. Failure to return these funds in a timely manner will impact the evaluation of your
agency’s future funding request and may result in actions taken to recover these funds.
_____ I am authorized to affirm this information on behalf of the applicant organization or fiscal
sponsor.
By signing below, I acknowledge that I have read and understand these requirements.
Signature of Authorized Person Date
Title/Position of Authorized Person