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The Grantee attests to the fact that it is an independent non-profit 501(c)(3) public benefit corporation <br /> incorporated under the laws of the State of California, that its programs and administrative functions <br /> are managed by its independent board of directors and staff, and that the Grantee and the agents and <br /> employees of the Grantee shall act in an independent capacity and not as officers, employees, or <br /> agents of UWBA. <br /> The Grantee shall indemnify and hold harmless UWBA, its directors, officers, employees and agents <br /> against any and all liability, loss or expense imp�sed er claimed, including attorney's fees and other <br /> legal expenses arising directly or indirectly from any act or fail!are to act by Grantee or Grantee's <br /> assistants, employees or agents, including all claims relating to the injury or death of any person or <br /> damage to any property. <br /> USA PATRIOT ACT CERTIFICATION OF COMPLIANCE <br /> ❑ I hereby certify on behalf of ���'�1�.�`�1 -1�2� (P►,EasE PR/NT <br /> YOUR ORGANIZATION NAME, a requirement for re/ease of f nds) that all United Way funds and <br /> donations will be used in compliance with all applicable anti-terrorist financing and asset control laws, <br /> statues and executive orders. <br /> This MOU shall be signed and returned to UWBA by 6/1/2012, and shall remain in effect until <br /> 5/31/2013 unless terminated by UWBA as provided herein. No pavments will be released until <br /> (1) the sicaned Memorandum of Understandin� (MOU) is returned to UWBA, (2) a copv of the <br /> orqanization's certificate of insurance naminq UWBA as�an additional insured is returned to <br /> UWBA, and (3) anv special conditions requested bv UWBA are met. <br /> ❑ We hereby certify that the foregoin is a full, true, and correct copy of the MOU duly and <br /> regularly adopted on the � day of���, 24�':� by th� Grantee's board of directors. <br /> _ l r_. <br /> � <br /> � �� � Z. <br /> �gn ture Print Name Date <br /> Grant e Chief Volun er Officer <br /> (Board Chair, Board President) <br /> City of Redwood City <br /> ��/��� � ���1/ �r��%��: f�:���,4�> /��,i,-�., f-- � —j�-� -2��i Z. <br /> Signature Print Name /?��=�� Date <br /> Grantee Chief Professional Officer <br /> (Executive Director, CEO, President) <br /> City of Redwood ity <br /> . 2 <br /> Lo eedle D te <br /> C ef ommunity Investment Officer <br /> Unite Way of the Bay Area <br /> Payments will be delayed if any of the following is missing: <br /> • Name of your organization must be printed under the USA Patriat Act Certification(above) <br /> • Date your board adopted this MOU must be entered(above) <br /> • An updated copy of your Certificate of Liability Insurance policy naming UWBA as an additional insured,as <br /> outlined in the MOU. Providing proof of insurance is not sufficient.Grantee must contact insurance broker <br /> to amend coverage to include UWBA as an additional insured,which must be stated on the Certificate.This <br /> certificate must provide coverage for the full grant period. <br /> FYiz Community School Initiative Page 3 <br />