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Application for Federal Assistance SF-424 <br />16. Congressional Districts Of: <br />* a. Applicant WA02 * b. Program/Project WA02 <br />Attach an additional list of Program/Project Congressional Districts if needed. <br />Add Attachment Delete Attachment View Attachment <br />17. Proposed Project: <br />* a. Start Date: 10/01/2022 * b. End Date: 09/30/2025 <br />18. Estimated Funding ($): <br />* a. Federal 37, 989.00 <br />* b. Applicant 0 . 00 <br />* c. State 0.00 <br />* d. Local 0 . 00 <br />* e. Other 0 . 00 <br />* f. Program Income 0.00 <br />*g.TOTAL 37,989.00 <br />* 19. Is Application Subject to Review By State Under Executive Order 12372 Process? <br />n a. This application was made available to the State under the Executive Order 12372 Process for review on <br />b. Program is subject to E.O. 12372 but has not been selected by the State for review. <br />X 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 />1 Yes XNo <br />If "Yes", provide explanation and attach <br />Add Attachment Delete Attachment View Attachment <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 />0 ** I AGREE <br />** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency <br />specific instructions. <br />Authorized Representative: <br />Prefix: * First Name: Cassie <br />Middle Name: <br />* Last Name: Frankllin <br />Suffix: <br />* Title: Mayor <br />* Telephone Number: 425-257-7112 Fax Number: <br />*Email: CFranklin@everettwa.gov <br />* Signature of Authorized Representative: Completed by Grants gov upon submission. * Date Signed: Completed by Grants gov upon submission. <br />PREVIEW Date: Jun 30, 2022 <br />Workspace ID: WS00936451 Funding Opportunity Number: O-BJA-2022-171368 <br />