WA State Department of Commerce 10/5/2016

APPLICANT AGENCY INFORMATION The Authorizing Official is an individual who has the authority to apply for and accept grants on behalf of the organization or jurisdiction.The Program Contact is the primary contact for grant activities.The Fiscal Contact is the individual who will be contacted if there are financial questions on the grant. Agency Name Everett Police Department (Applicant/Organization) Authorizing Official's Ray Stephenson Name(required) Authorizing Official's Mayor Title(required) Authorizing Official's RStephanson@everettwa.gov Email(required) Program Contact Jerry Strieck Title Lieutenant Phone (425)257-7410 Fax Email JStrieck@everettwa.gov Fiscal Contact Tracey Versteeg Title Police Finance Manager Phone (425)257-8447 Fax Email TVersteeg@everettwa.gov System for Award Management Applicants must be current with the System for Award Management(SAM)prior to submitting an application. Failure to keep current in SAM may result in a delay of receiving funding. All applicants must register with SAM and renew their registration annually. Applicants can access SAM at https://www.sam.gov. There is no fee associated with the registration process. Applicant's SAM Expiration Date January 10,2017 (must be valid beyond October 17,2016) Equal Employment Opportunity Plan Certification Local Government Applicants Only-If your agency meets all three of the following conditions,your office must have an Equal Employment Opportunity Plan on file that that has been approved within the last two years by the federal Office for Civil Rights. 1)Local Government Agency;AND 2)Employ 50 or more employees;AND 3)Single largest Department of Justice award is$25,000 or more. This link will provide more information on an Equal Employment Opportunity Plan(EEOP). We do not meet all of the above conditions for an EEOP. I have consulted with the appropriate person in my organization and we are not required to have an EEOP. I have consulted with the appropriate person in my organization and we are required to have any EEOP,which has been updated within the last two years. The EEOP was last updated August 1,2016 Subgrantee Information: If the application includes more than one agency receiving funds,please provide the requested contact information for each subgrantee on the next page(s). The granting agency receiving a STOP Grant directly from OCVA will be responsible for monitoring subgrants in accordance with all applicable federal statutes,federal and state regulations,the provisions of this application,the Department of Justice Grants Financial Guide(DOJ Financial Guide)including updates,and any conditions of the recipient's grant.