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A TRUE COPY CERTIFICATION ON LAST PAGE RYAN L. BUTLER, CLERK Section 33. is added to the Agreement as follows: State Funds Documentation. Pursuant to section 216.1366, F.S., if Contractor meets the definition of a non-profit organization under section 215.97(2)(m), F.S., Contractor must provide the Department with documentation that indicates the amount of state funds: i. Allocated to be used during the full term of the contract or agreement for remuneration to any member of the board of directors or an officer of Contractor. ii. Allocated under each payment by the public agency to be used for remuneration of any member of the board of directors or an officer of the Contractor. The documentation must indicate the amounts and recipients of the remuneration. Such information must be posted on the State's contract tracking system and maintained pursuant to section 215.985, F.S., and must be posted on the Contractor's website, if Contractor maintains a website. 4. Attachment A-3, Revised Grant Work Plan, is hereby deleted in its entirety and replaced with Attachment A-4, Revised Grant Work Plan, as attached to this Amendment and hereby incorporated into the Agreement. All references in the Agreement to Attachment A shall hereinafter refer to Attachment A-4, Revised Grant Work Plan. 5. Attachment B-1, Payment Request Summary Form, is hereby deleted in its entirety and replaced with Attachment B-2, Payment Request Summary Form, attached hereto and made a part of the Agreement. All references in the Agreement to Attachment B, shall hereinafter refer to Attachment B-2, Payment Request Summary Form. 6. Attachment D, Progress Report Form, is hereby deleted in its entirety and replaced with Attachment D- 1, attached hereto and made a part of the Agreement. All references in the Agreement to Attachment D shall hereinafter refer to Attachment D-1. 7. Attachment E, Special Audit Requirements, is hereby deleted in its entirety and replaced with Attachment E-1, Revised Special Audit Requirements, attached hereto and made a part of the Agreement. All references in the Agreement to Attachment E shall hereinafter refer to Attachment E-1, Revised Special Audit Requirements. 8. All other terms and conditions of the Agreement remain in effect. If and to the extent that any inconsistency may appear between the Agreement and this Amendment, the provisions of this Amendment shall control. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK DEP Agreement No. S0839, Amendment No. 4, Page 2 of 3