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with the Recipient. As part of his/her duties, the Program Manager for the Division will monitor and document <br />Recipient performance. <br />c. The Division's Program Manager for this Agreement is: <br />Erin White <br />Division of Emergency Management <br />2555 Shumard Oak Boulevard <br />Tallahassee, Florida 32399-2100 <br />Telephone: 850-815-4458 <br />Email: Erin.White@em.myflorida.com <br />d. The name and address of the representative responsible for the administration of this Agreement is: <br />Melissa Shirah <br />Division of Emergency Management <br />2555 Shumard Oak Boulevard <br />Tallahassee, Florida 32399-2100 <br />Telephone: 850-815-4455 <br />Email: Melissa.Shirah@em.myflorida.com <br />e. The contact information of the representative of the Recipient is: <br />Authorized Representative: clktt-:5 CertiJ • 9u-,C4C <br />Title: ( r(f1r S, <br />Address: I RO 0 `v <br />Telephone::2 -- <br />Email: era S.50 6ilbrX, � <br />(7) PAYMENT <br />a. In order to obtain funding under this Agreement, the Recipient must file with the Division Program Manager <br />information and documentation, including but not limited to the following: <br />i. Local government name, Entity's Taxpayer Identification Number, DUNS number, and address; <br />ii. Authorized representative name, title, and email; <br />iii. Contact person name, title, phone, and email; <br />iv. Financial institution information (e.g., routing and account number, financial institution name and <br />contact information); <br />v. Total NEU budget (defined as the annual total operating budget, including general fund and other <br />funds, in effect as of January 27, 2020) or top -line expenditure total (in exceptional cases in which the <br />NEU does not adopt a formal budget); <br />vi. Signed Assurances of Compliance with Title VI of the Civil Rights Act of 1964. (Attachment D); and <br />vii. Signed Award Terms and Conditions Agreement (Attachment E). <br />b. Payment requests must include a certification, signed by an official who is authorized to legally bind the <br />Recipient, which reads as follows: <br />By signing this report, I certify to the best of my knowledge and belief that the report is true, <br />complete, and accurate, and the expenditures, disbursements and cash receipts are for the <br />purposes and objectives set forth in the terms and conditions of the Federal award. I am <br />aware that any false, fictitious, or fraudulent information, or the omission of any material fact, <br />may subject me to criminal, civil or administrative penalties for fraud, false statements, false <br />claims or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and <br />3801-3812). <br />4 <br />