Laserfiche WebLink
Application for Federal Assistance SF424 1 <br /> 16.Congressional Districts Of. <br /> *a.Applicant 2nd *b.Program/Project 2nd <br /> Attach an additional list of Program/Project Congressional Districts If needed. <br /> Add Attachment , Delete Attachment, ViewAttachment <br /> 17.Proposed Project: <br /> *a.Start Date: 07/01/2021 *b.End Date: 06/30/2022 <br /> 18.Estimated Funding($): <br /> *a.Federal 902,167.00 <br /> *b.Applicant 0.0DI <br /> *c.State 0_Do <br /> • <br /> *d.Local 0.00 <br /> *e.Other 0.00 <br /> *f. Program Income 300,000.00 <br /> *g.TOTAL 1,202,167.0D <br /> *19.Is Application Subject to Review By State Under Executive Order 12372 Process? <br /> a.This application was made available to the State under the Executive Order 12372 Process for review on I 1 <br /> • <br /> El b.Program is subject to E.O.12372 but has not been selected by the State for review. <br /> ® c.Program Is not covered by E.O.12372. <br /> *20.Is the Applicant Delinquent On Any Federal Debt? (If"Yes,"provide explanation in attachment) <br /> ❑Yes ®No <br /> If"Yes",provide explanation and attach <br /> Add Attachment Delete Attachmeh View Attaptu ent� <br /> 21.*By signing this application,I certify(1)to the statements contained in the list of certifications**and(2)that the statements <br /> herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to <br /> comply with any resulting terms if I accept an award.I am aware that any false,fictitious,or fraudulent statements or claims may <br /> subject me to criminal,civil,or administrative penalties.(U.S.Code,Title 218,Section 1001) <br /> ® **I AGREE <br /> *"The list of certifications and assurances,or an internet site where you may obtain this Ilst, is contained In the announcement or agency <br /> specific instructions. <br /> Authorized Representative: <br /> Prefix: *First Name: cassie <br /> Middle Name: <br /> *Last Name: Franklin <br /> Suffix: <br /> *Title: Mayox <br /> *Telephone Number: 425-257-7112 Fax Number: <br /> *Email: cfranklin@everettwa_gov <br /> *Signature of Authorized Representative: • • • *Date Signed: 10y j <br /> i _/ Office of the City Attorney <br /> APPA rAtI` �. David C.HalED AS CityT FORM <br /> ,, 21411.w.. C.Hall, Attorney <br /> _ " City Clerk <br />