Cal. Code Regs. Tit. 4, § 7036 - Content of Application Form
For the First Funding Round and Second Funding Round, the following items shall accompany the Application Form:
(a) Financial Information. The Children's
Hospital or the California nonprofit corporation of which the Children's
Hospital is an operating entity shall submit its Most Recent Audited Financial
Statements.
(b) Organization
Information.
(1) If the Applicant is a Non
University of California Children's Hospital, the Applicant shall submit both
of the following:
(A) A copy of the
Applicant's 501(c)(3) determination letter from the Internal Revenue Service
and a copy of either the tax-exemption letter or Letter of Good Standing from
the Franchise Tax Board. For Children's Hospitals that are operating entities
of a California nonprofit corporation, the Internal Revenue Service and
Franchise Tax Board Letters are required for the parent corporation.
(B) A copy of the Applicant's Articles of
Incorporation and Bylaws. For Children's Hospitals that are operating entities
of a California nonprofit corporation, the Articles of Incorporation and Bylaws
are required for the parent corporation.
(2) For all Applicants, a copy of its current
general acute care hospital license from the California Department of Public
Health or a copy of the general acute care hospital license of the California
nonprofit corporation of which the Children's Hospital is an operating
entity.
(c) Legal
Information. Applicant shall complete a legal status questionnaire.
(d) Agreement and Certification. Within the
Application Form and as memorialized in a separate Grant Agreement, the Chief
Executive Officer, Chief Financial Officer or other authorized officer of the
Applicant, on behalf of the Applicant, shall agree and certify to the following
terms and conditions as a requirement of receiving any Grant:
(1) The information contained in the
Application Form and attachments is true and correct to the best of its
knowledge and belief and understands that any misrepresentation may result in
the cancellation of a Grant and other actions permitted by law and the Grant
Agreement.
(2) Applicant may be
required to return all or a portion of the Grant including any unused
investment earnings if the Applicant fails to complete the Project as approved.
In cases where the Grant will fund architect, design, or engineering fees or
land acquisition costs as part of an approved Project, the Applicant may be
required to return all Grant funds and any unused investment earnings if the
Authority cannot determine that the associated larger Project has been
completed, based on timelines provided within the Application Form.
(3) Grant funds will only be used for the
Project described in the Application Form unless a change in the Project is
approved in writing by the Authority pursuant to Section
7043.
(4) The Project and financial records of the
Applicant's Project are subject to audit and inspection by the Authority staff
and the Bureau of State Audits.
(5)
Applicant has disclosed all information requested by the legal status
questionnaire.
(6) Applicant will
notify the Authority in writing at the time of Project completion with evidence
of completion included.
(7)
Applicant will provide all documents and information required by law and meet
all necessary requirements prior to the release of the
Grant.
Notes
2. New section refiled 5-26-2005 as an emergency; operative 5-26-2005 (Register 2005, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-23-2005 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 5-26-2005 order, including amendment of section, transmitted to OAL 9-14-2005 and filed 10-27-2005 (Register 2005, No. 43).
4. Amendment of first paragraph filed 5-19-2014; operative 5-19-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 21).
5. Change without regulatory effect amending subsections (b)(1), (b)(2) and (d)(4) filed 8-13-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).
Note: Authority cited: Sections 1179.22, 1179.24 and 1179.32, Health and Safety Code. Reference: Sections 1179.22, 1179.24, 1179.25 and 1179.32, Health and Safety Code.
2. New section refiled 5-26-2005 as an emergency; operative 5-26-2005 (Register 2005, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-23-2005 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 5-26-2005 order, including amendment of section, transmitted to OAL 9-14-2005 and filed 10-27-2005 (Register 2005, No. 43).
4. Amendment of first paragraph filed 5-19-2014; operative
2. New section refiled 5-26-2005 as an emergency; operative 5-26-2005 (Register 2005, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-23-2005 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 5-26-2005 order, including amendment of section, transmitted to OAL 9-14-2005 and filed 10-27-2005 (Register 2005, No. 43).
4. Amendment of first paragraph filed 5-19-2014; operative 5-19-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 21).
5. Change without regulatory effect amending subsections (b)(1), (b)(2) and (d)(4) filed 8-13-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).
2. New section refiled 5-26-2005 as an emergency; operative 5-26-2005 (Register 2005, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-23-2005 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 5-26-2005 order, including amendment of section, transmitted to OAL 9-14-2005 and filed 10-27-2005 (Register 2005, No. 43).
4. Amendment of first paragraph filed 5-19-2014; operative 5-19-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 21).
5. Change without regulatory effect amending subsections (b)(1), (b)(2) and (d)(4) filed 8-13-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).
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