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<br />APPENDICES, Page | 62 <br /> <br />REQUIRED ATTACHMENT: Applicants will be prompted to upload this document to the <br />BSCC Submittable Application Portal. This is a sample. <br />Download a fillable form from the Prop 64 Grant homepage. <br /> <br />The Proposition 64 Public Health and Safety (Prop 64 PH&S) Grant Program, Cohort 4, <br />includes requirements that apply to non-governmental organizations that receive BSCC <br />grant funds as subcontractors. Grantees are responsible for ensuring that all <br />subcontracted third parties continually meet these requirements as a condition of receiving <br />any Prop 64 PH&S funds. These requirements are as follows. <br /> <br />Any non-governmental organization that receives Prop 64 PH&S funds as a subcontractor <br />must: <br />• Have been duly organized, in existence, and in good standing for at least six (6) <br />months prior to the start date of the grantee’s grant agreement with the BSCC. <br />Note: Non-governmental organizations that have recently reorganized or have merged <br />with other qualified non-governmental organizations that were in existence prior to the <br />six (6) month date are also eligible, provided all necessary agreements have been <br />executed and filed with the California Secretary of State prior to the start date of the <br />applicant’s grant agreement with the BSCC. <br />• Be registered with the California Secretary of State’s Office, if applicable. <br />• Have a valid business license, Employer Identification Number (EIN) and/or Taxpayer <br />ID (if sole proprietorship). <br />• Have any other state or local licenses or certifications necessary to provide the <br />services requested (e.g., facility licensing by the Department of Health Care Services), <br />if applicable. <br /> <br />In the table below, provide the name of the grantee and list all subcontracted third parties. <br /> <br />APPENDIX F <br />Criteria and Assurance for Non-Governmental Organizations that Receive BSCC Grant <br />Funds as a Subcontractor <br />Name of City or <br />County Applicant: <br />Name of Subcontracted <br />Third-Party NGO Address Email / Phone Meets All <br />Requirements <br /> Yes ☐ No ☐ <br /> Yes ☐ No ☐ <br /> Yes ☐ No ☐ <br /> Yes ☐ No ☐ <br />7.C. - Page 70 of 101 <br />129