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California Health & Human Services Agency California Department of Social Services <br />CCD 34 (2/23) Page 8 of 32 <br /> <br /> <br /> <br />Section VIII – Contractor Certification <br />I, the official named below, certify under penalty of perjury that I have read the full contents of this <br />application and that, to the best of my knowledge and belief, the information in this application and <br />any attachments hereto are true and correct. I further certify the applicant agency will fulfill all of <br />the agreements, certifications, and conditions described in this RFA, appendices to the RFA, and <br />this application as well as abide by all applicable federal and state laws. I declare: <br />• I have supervisory authority over the child development program, have actual, personal <br />knowledge of the information provided in this Application and certify that it is true and correct in <br />all material respects. <br />• I am familiar with and will ensure that the Contractor complies with all applicable program <br />statues and regulations, including: <br />• Subcontracting requirements, including competitive bidding, CDSS approval, and audit <br />requirements in 5 CCR, Section 18026. <br />• Prohibitions on conflicts of interests, including (i) the assurances required to establish that <br />transactions with officers, directors and other related party transactions are conducted at arm’s <br />length, and (ii) employment limitations stated in Welfare and Institutions Code, Section 10399. <br />• Cost reimbursement requirements, including reimbursable and non- reimbursable costs, <br />documentation requirements, the provisions for determining the reimbursable amount and <br />other provisions in 5 CCR, Section 18033. <br />• Accounting and reporting requirements in 5 CCR, Section 18063. <br /> <br />• Operational and programmatic requirements, and all fiscal and program attachments in <br />Sections IX and X. <br /> <br /> <br />The Authorized Representative must provide the following information: <br />Printed Name: Timothy Pagano <br />Title: Recreation Manager <br />Telephone Number: (714) 571-4219 <br />Email-Address: tpagano@santa-ana.org <br />Signature: <br />Date of Signature: