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Exhibit Et Cost Certification <br /> I certify that: <br /> 1. I have authority and approval from the governing body on behalf of L <br /> Boys&Girls Clubs of Snohomish County <br /> ("Subrecipient")to accept proceeds from the City of Everett(the "City")per the Agreement by and between <br /> the City and Subrecipient from the City's allocation of the Coronavirus Local Fiscal Recovery Fund as created <br /> by the American Rescue Plan Act of 2021, Section 9901("ARPA")for eligible costs included on the <br /> corresponding Reimbursement Request Form for report period 11/30/2021 <br /> through 12/31/2022 <br /> u.... .F._.,� _.,� <br /> 2. I understand the City will rely on this certification as a material representation in processing reimbursements <br /> or payment requests. <br /> 3. I understand the Subrecipient receiving funds pursuant to this certification shall retain documentation of all <br /> uses of the funds,including but not limited to invoices and/or sales receipts in a manner consistent with <br /> §200.333 Retention requirements for records of 2 CFR 200 Uniform Administrative Requirements,Cost <br /> Principles, and Audit Requirements for Federal Awards(Uniform Guidance). Such documentation shall be <br /> produced to the City upon request and may be subject to audit by the State Auditor. <br /> 4. I understand any funds provided pursuant to this certification cannot be used for costs for which the <br /> Subrecipient has received any other funding,whether public or private in nature,for that same cost. <br /> I hereby certify that I have read the above certification, and that the information and my statements provided <br /> herein by me are true and correct to the best of my knowledge, and by my signature on this document, <br /> acknowledge my understanding that any intentional or negligent misrepresentation or falsification of any of the <br /> information in this document could subject me to punishment under federal and/or civil liability and/or in criminal <br /> penalties, including but not limited to fine or imprisonment or both under Title 18,United States Code,Sec.1001, <br /> et seq.and punishment under federal law. <br /> Ken Salem <br /> Printed Name Signature OretfAtt <br /> Development Director 'APR 262022 <br /> Title teialinialltettAdnonistralm <br /> EVE RETT Everett Forward Grant Program I Subrecipient Agreement I Page 19 <br /> WASHINGTON <br />