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ATTACHMENT"A" <br /> Orange County Certifications—2012-13 <br /> Outside Agency Performance Agreement <br /> Chief Contact,Administrators, Chief Executive Officer and Chief Financial Officer <br /> I certify that I have provided a list of the chief contact,administrators,chief executive officer <br /> and chief financial officer for my agency with this Agreement and that I will keep it current <br /> to the County of Orange. The list should be in writing with the name,title,residential <br /> address;phone and email address and if possible, fax number. <br /> Officers and Board of Directors <br /> I certify that I have provided a current list of the Officers and Board of Directors with this <br /> Agreement and that we will continue to update the list as changes occur. The list should be <br /> in writing,with the name,physical address,mailing address and if possible,phone, fax and <br /> email address. <br /> Budget Submission <br /> I certify that I have provided a budget for the period to be covered by funding Orange <br /> County,and that any substantive changes made to this budget have been in advance <br /> authorized in writing by Orange County. <br /> Annual Financial Review <br /> I certify that I have provided a copy of the latest annual Financial Review for our agency and <br /> the budget adopted by the agency for the fiscal years encompassing this Agreement. If not, <br /> please explain on a separate sheet of paper. <br /> Alignment with Organization's Mission <br /> I certify that the programs and services for which this funding is requested align with the <br /> mission of the organization. <br /> Intended Purpose <br /> I certify that the funds provided to the agency under the terms of this Agreement will be <br /> used for a public purpose and shall only be used for the purposes intended and any money <br /> not used for those purposes will be promptly returned to Orange County. <br /> Transparency <br /> I certify that board meetings are open to the public with the exception of closed session <br /> meetings. Additionally,all financial records are available for public inspection by request <br /> upon reasonable notice. <br /> Certified 4X e dzc fw (,cC ate: <br /> oZ <br /> EmPOWERment Inc. <br /> 2012-13 Orange County Outride Agency Perfo e Agreement <br /> Page 8 <br />