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<br />- <br /> <br />Application for Federal Assistance SF-424 Version 02 <br />16. Congressional Districts <br />Of: b. Program/Project: <br />a. Applicant: 17 17 <br />17. Proposed Project: <br />a. Start Date: 9/1/2010 b. End Date: 9/13/2013 <br />18. Estimated Funding ($): <br />a. Federal 200000 <br />b. Applicant <br />c. State <br />d. Local <br />e. Other <br />f. Program Income <br />g. TOTAL 200000 <br />19. Is Application Subject to Review By State Under Executive Order 12372 <br />Process? <br />D a. This application was made available to the State <br /> under the Executive Order 12372 Process for review on <br />D b. Program is subject to E.O. 12372 but has not [gJ c. Program is not covered by E. <br /> been selected by the State for review. O. 12372 <br />20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes", provide explanation.) <br />D Yes [gJ No <br />21. .By signing this application, I certify (I) to the statements contained in the list of certifications.. and (2) that the statements herein are <br />true, complete and accurate to the best of my knowledge. I also provide the required assurances.. and agree to comply with any resulting <br />tenns if] accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or <br />administrative penalties. (U. S. Code, Title 218, Section 1001) <br />By clicking this box and typing my name below, ] also certify that I have been legally and officially authorized by the appropriate goveming <br />body to submit this application and act on behalf of the grant applicant entity. I certify that I have read. understand, and agree, if awarded, to <br />abide by all of the applicable grant compliance terms and conditions as outlined in the COPS Application Guide, the COPS Grant Owner's <br />Manual, assurances, certifications and all other applicable program regulations, laws, orders, or circulars. In addition, I certify that the <br />information provided on this fonn and any attached forms is true and accurate to the best of my knowledge. ] understand that false statements <br />or claims made in connection with COPS programs may result in fines, imprisonment, debannent from participating in federal grants, <br />cooperative agreements, or contracts, and/or any other remedy available by law to the federal government. <br />[gJ I AGREE <br />.. The certifications and assurances as well as grant terms and conditions can be reviewed at www.cops.usdoj/???? <br />Authorized Representative: <br />Prefix: Title: Captain <br />Middle Name: A. First Name: Michael <br />Last Name: Grandinetti Suffix: <br />Telephone Number: 3057921857 Fax Number: 3057921653 <br />Email: mgrandinetti@sibfl.net <br />Signature (Typed Name) of Authorized Representative: Michael Date Signed: 6/18/2010 <br /> Grandinetti <br />