By submitting this application, the Applicant certifies/acknowledges:
1) That you are affirming adherence to all FY2021 SHIP eligibility and program requirements including the selection of menu investment(s) based upon the specific selection priorities listed in the SHIP Purchasing Menu Instructions. Hospitals that do not follow purchase priorities, and/or purchase hardware and/or software or services that are not listed on the SHIP Purchasing Menu, will be subject to penalties including suspension from the next SHIP funding opportunity.
2) That you are not only selecting an investment, but also a measure that correlates to your purchase. Your hospital will be expected to report to your State Office of Rural Health regarding progress at the end of the year.
3) That all information provided in connection with this application is true and correct to the best of Applicant’s knowledge.
4) That any misrepresentation or false statement made by Applicant, or an authorized agent of Applicant, in connection with this application, whether intentional or not, will constitute grounds for denial of this application.
5) That the acceptance of funds in connection with this application acts as an acceptance of the authority of the Health Resources and Services Administration (HRSA) Federal Office of Rural Health Policy (FORHP), TDA, and the State Auditor’s Office (SAO) or any successor agency to conduct an investigation in connection with those funds, and Applicant further agrees to cooperate fully with FORHP, TDA, and/or SAO or its successor in the conduct of the audit or investigation, including allowing FORHP, TDA, and/or SAO to inspect Applicant’s premises and providing all records requested.
6) That this application and any payments owed to Applicant in connection with this application may be reduced or denied because of Applicant’s owing any debt to the State of Texas.
7) The applicant acknowledges as a condition of receipt of grant funds under this program the Applicant will be required to execute a grant agreement with the Texas Department of Agriculture, and further acknowledges that failure to timely execute the grant agreement will result in withdrawal of any grant funds awarded, and those funds will be redistributed to other qualified applicants in accordance with state law and TDA rules.