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OMB Number: 4040-0004 <br />Expiration Date: 01/31/2009 <br />Application for Federal Assistance SF-424 Version 02 <br />16. Congressional Districts Of: <br />* a. Applicant Tx-025 "b. Program/Project Tx-025 <br />Attach an additional list of Program/Project Congressional Districts if needed. <br />I Add Attachment Delete Attachment View Attachment <br />17. Proposed Project: <br />* a. Start Date: 08/01/2009 * b. End Date: 07/31/2011 <br />16. Estimated Funding ($): <br />* a. Federal 498, 100.00 <br />b. Applicant 0.00 <br />* c. State 0.00 <br />' d. Local 0 .00 <br />' e. Other 0.00 <br />' f. Program Income 0.00 <br />'g. TOTAL 498,100.00 <br />' 19. Is Application Subject to Review By State Under Executive Order 12372 Process? <br />IX a. This application was made available to the State under the Executive Order 12372 Process for review on 06/25/2009 <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 Federal Debt? (If "Yes", provide explanation.) <br />? Yes 0 No Explanation <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 216, Section 1001) <br />Q *' 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: Mr. * First Name: Rick <br />Middle Name: <br />* Last Name: Menchaca <br />Suffix: <br />' Title: City Manager <br />*Telephone Number: 512.393.8000 Fax Number: 512. 396.1576 <br />`Email: RMenchaca@sanmarcostx.gov <br />" Signature of Authorized Representative: Completed by Grants.gov upon submission. ' Date Signed: Completed by Grants.govupon submission. <br />Authorized for Local Reproduction Standard Form 424 (Revised 10/2005) <br />Prescribed by OMB Circular A-102