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11. Agreement and Certification — Please'print and mail this page <br />to Commission when application has been submitted <br />Authorized officials of the organization MUST sign the following statements. <br />Certification: This grant application has been approved by the lead applicant <br />organization's governing body. <br />Certification: This organization has no conflicts of interest as defined by the policy <br />below. <br />To avoid any real conflict of interest or perceived conflict of interest between <br />the Health and Wellness Trust Commission grant recipients and tobacco <br />manufacturing and related entities, grant recipients must not currently accept <br />any grants or anything of value from any tobacco manufacturer, distributor, or <br />other tobacco-related entities. The only exception is when these grant funds <br />or items of value are totally for NON - tobacco related purposes and do note <br />present any danger of promotion of or use of tobacco products or otherwise <br />conflict with policies and program known to prevent and reduce teen tobacco <br />use. <br />Agreement. All sub - recipients (includes partners, collaborators and other contractors) <br />under the .grant will be identified on an ongoing basis. <br />Agreement. All accounts, books and ledgers can be audited by the Commission or the <br />State auditor. <br />CERTIFICATION: The information provided in this material is correct and complete. <br />Applicant Organization: Orange County Health <br />Signed by -94 ���151,L,Pr14st.L.Li! Signed-by: <br />.. .: <br />Page Is <br />17 <br />