US Dept of Homeland Security 6/1/2021

Application for Federal Assistance SF-424 16.Congressional Districts Of: *a.Applicant WA02 *b.Program/Project wA02 Attach an additional list of Program/Project Congressional Districts if needed. Add Attachment Delete Attachment View Attachment 17.Proposed Project: *a.Start Date: 10/01/2021 *b.End Date: 09/30/2024 18.Estimated Funding($): *a.Federal 134,171.00 *b.Applicant 44,724.00 *c.State 0.00 *d.Local 0.00 *e.Other 0.00 *f. Program Income 0.00 *g.TOTAL 178,895.00 *19.Is Application Subject to Review By State Under Executive Order 12372 Process? n a.This application was made available to the State under the Executive Order 12372 Process for review on n b. Program is subject to E.O. 12372 but has not been selected by the State for review. ® c. Program is not covered by E.O. 12372. *20.Is the Applicant Delinquent On Any Federal Debt? (If"Yes,"provide explanation in attachment.) Yes ®No If"Yes", provide explanation and attach Add Attachment Delete Attachment View Attachment 21.*By signing this application, I certify(1)to the statements contained in the list of certifications**and (2)that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award.I am aware that any false,fictitious,or fraudulent statements or claims may subject me to criminal,civil,or administrative penalties.(U.S.Code,Title 218,Section 1001) **I AGREE ** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions. Authorized Representative: Prefix: *First Name: Cassie Middle Name: *Last Name: Franklin Suffix: *Title: Mayor *Telephone Number: 425-257-7112 Fax Number: *Email: CFranklin@everettwa.gov *Signature of Authorized Representative: Completed by Grants.gov upon submission. *Date Signed: Completed by Grants.gov upon submission.