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A-2020-122 <br />of Orange <br />April 13, 2020 <br />County Executive Office <br />I, Frank Kim, am the chief executive of the County of Orange, and I certify that: <br />1. I have the authority on behalf of the County of Orange to request direct payment from the <br />Department of the Treasury ('Treasury') pursuant to section 601(b) of the Social Security Act, as <br />added by section 5001 of the Coronavirus Aid, Relief, and Economic Security Act, Pub. L. No. 116- <br />136, div. A, Title V (Mar. 27, 2020). <br />2. 1 understand that Treasury will rely on this certification as a material representation in making a <br />direct payment to the County of Orange. <br />3. The County of Orange's proposed uses of the funds provided as direct payment under section <br />601(b) of the Social Security Act will be used only to cover those costs that - <br />a. are necessary expenditures incurred due to the public health emergency with <br />respect to the Coronavirus Disease 2019 (COVID-19); <br />b. were not accounted for in the budget most recently approved as of March 27, 2020, <br />for [insert name of local government entity]; and <br />c. were incurred during the period that begins on March 1, 2020, and ends on <br />December 30, 2020. <br />By: Frank Kim <br />Signature: <br />Title: County Executive Officer <br />Da te: 4113/20 <br />PAPERWORK REDUCTION ACT NOTICE <br />The information collected will be used for the U.S. Government to process requests for support. The <br />estimated burden associated with this collection of information is two hour per response. Comments <br />concerning the accuracy of this burden estimate and suggestions for reducing this burden should be <br />directed to the Office of Privacy, Transparency and Records, Department of the Treasury, 1500 <br />Pennsylvania Ave., N.W., Washington, D.C. 20220. DO NOT send the form to this address. An agency may <br />not conduct or sponsor, and a person is not required to respond to, a collection of information unless it <br />displays a valid control number assigned by OMB. <br />333 W Sant., Ana 61vd., 3i1 Flnor. Santa Ana, CA 92701-4062 • Phnne (714) 834-6201 • Fax (7141 fi34-3018 • wwI ncgn.cum <br />