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' Application for Federal Assistance SF-424 <br /> 16.Congressional Districts Of. <br /> *a.Applicant *b.Program/Project <br /> ' Attach an additional list of Program/Project Congressional Districts if needed. <br /> Add Attachment Delete Attachment <br /> View Attachment <br /> ' 1.7:Proposed Project: <br /> *a.Start Date: 01/,01/2018 `b.End Date: ,32/31/2018 <br /> ' 18.Estimated Funding($): <br /> •a.Federal 2,572,155.00 <br /> •b.Applicant <br /> *c State <br /> •d.Local <br /> •e.Other 45,000,00 <br /> ' *f. Program Income 25,300.00 <br /> *g.TOTAL 2,642,45.5.00 <br /> ' *19.is Application Subjectto Review By State Under Executive Order 12372 process? <br /> Q a.This application was made available to the State under the Executive Order 12372 Process for review on <br /> F] b.Program is subject:to E.O.12.372 but has not been selected by the State for review. <br /> 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 /> ' Q Yes. No <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 /> ®**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: Pete <br /> Middle Name: <br /> *Last Name: Buttigieg <br /> Suffix: <br /> 'Title: Mayor, City of South Bend <br /> *Telephone Number. 151423551261 Fax Number. <br /> r *Email: Ipb.ttigiegg southbendin.gov <br /> *Signature of Authorized Representative: *Date Sigped: _ <br />