04-12-21 McLarrin sworn - Laserfiche WebLink

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Application for Federal Assistance SF-424 16. Congressional Districts Of: * a. Applicant 36 * b. Program/Project C➢i Attach an additional list of Program/Project Congressional Districts if needed. 777771 Adtl Attachment ;Delete Attachnierit View Attachment.!: 17. Proposed Project: * a. Start Date: 11/O1/2021 * b. End Date: I2 /31/2025 18. Estimated Funding ($): * a. Federal 4, 000, 000. 00 * b. Applicant 0. 00 • c. State 0. 00 * d. Local 7, 400, 009.381 * e. Other 0.00 * f. Program Income 0. 00 *g.TOTAL 11,400,009.30 * 19. Is Application Subject to Review By State Under Executive Order 12372 Process? ❑ a. This application was made available to the State under the Executive Order 12372 Process for review on ❑ b. Program is subject to E.O. 12372 but has not been selected by the State for review. ® c. Program is not covered by E.O.12372. * 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) ❑ Yes ® No If "Yes", provide explanation and attach Add Attachment Qetete Attachmer t Uievu Attachment 21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances— and agree to comply with any resulting terms If I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) ® -* I AGREE ** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions. Authorized Representative: Prefix: Mr. * First Name: Louis Middle Name: * Last Name: Rigby Suffix: * Title: Mayor * Telephone Number: 281-399-3979 Fax Number: *Email: MayorsOffice@LaPorteTX.gov " Signature of Authorized Representative: * Date Signed: