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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 I View Attachment <br /> 17.Proposed Project: <br /> *a.Start Date; 01/01/2018 *b.End Date: 12/31/2018 <br /> ' 18.Estimated Funding($): <br /> *a.Federal 2,12,959.00 <br /> *b.Applicant <br /> *c.State <br /> *d.Local <br /> ' *e,Other <br /> *f. Program Income <br /> g.TOTAL 212,959.00 <br /> *19.Is Application Subject to Review By State Under Executive Order 12372 Process? <br /> a,This application was made available to the State under the Executive Order 12372 Process for review on <br /> 0 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 Federal Debt? (if"Yes,"provide explanation in attachment) <br /> �]Yes ®No <br /> If"Yes",provide explanation and attach <br /> TAdd Attachment I Delete Attachment I View Attachment <br /> 21.*By signing this application,I certify(1)to the statements contained in the fist of certifications**and(2)that the statements <br /> herein are true, complete and accurate to the best of my knowledge. 1 also provide the required assurances*"and agree to <br /> comply with any resulting terms if I accept on 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 /> specif(c instructions, <br /> ' Authorized Representative: <br /> Prefix *First Name: Pete <br /> Middle Name: <br /> *Last Name: Btttigieg <br /> Suffix; --� <br /> Title: Mayoac, City of South Bend <br /> *Telephone Number. 5742359261 Fax Number. <br /> 'Email: pbuttigieg@southbendin.gov <br /> Signature of Authorized Representative: *Date Signed: <br />