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DocuSign Envelope ID:24392949-6CFE-4A47-8FC6-54FF2C794193 <br /> Exhibit `B" <br /> Orange County Certifications—FY 2015-16 <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 and chief <br /> financial officer for my agency with this Agreement and that I will keep it current to the County of <br /> Orange. The list should be in writing with the name, title,residential address;phone and email address <br /> 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 Agreement and <br /> that we will continue to update the list as changes occur. The list should be in writing,with the name, <br /> physical address,mailing address and if possible,phone, fax and email address. <br /> Budget Submission <br /> I certify that I have provided a budget for the period to be covered by funding Orange County, and that <br /> any substantive changes made to this budget have been in advance authorized in writing by Orange <br /> County. <br /> Intended Purpose <br /> I certify that the funds provided to the agency under the terms of this Agreement will be used for a public <br /> purpose and shall only be used for the purposes intended and any money not used for those purposes will <br /> be promptly returned to Orange County. <br /> DocuSignrre''d11lby:LL <br /> A-a�U (N k 9/20/2015 <br /> Certified by: Title: Executive Director Date: <br /> E�P78DEm;5&��5... <br /> (Provider's Signature) <br /> Family Alliance Success Zone Navigators Page 10 of 10 <br /> Rev. 8115 <br />