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Application for Federal Assistance SF-424 ' <br /> 16.Congressio,pal 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 View Attachment <br /> 17.Proposed Project: ' <br /> *a,Start Date: 01/01/2018 *b.End Date' <br /> 18.Estimated Funding <br /> *a.Federal 1,030,317.00 <br /> •b.Applicant � J <br /> •c.State F 1 1 <br /> •d.Local <br /> •e.Other 447,213.00 <br /> •f. Program Income 45,868.00 <br /> *g.TOTAL �— 1,523;458,00 <br /> *19.Is Application Subject to 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 /> b.Program is subject to E.O.12372 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 Federai Debt? (if"Yes,"provide explanation in attachment.) <br /> [J Yes Z No 1 <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 penajties,(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: 1 <br /> PrefX: *First Name: Pete <br /> Middle Name: <br /> — —�*Last Name: 13uttigie9 <br /> Suffix: —�� <br /> *Title: Mayor, City of South Bend <br /> 'Telephone Numb,pr: 57 42 3592 61 Fax Number <br /> .. 1*Email: pbuttigieg @southbendin:gov <br /> Signature of Authorized Representative: *Date Signed: <br /> 1 <br />