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AGENDA PACKET_2021-12-07
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AGENDA PACKET_2021-12-07
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12/9/2021 2:13:26 PM
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12/6/2021 5:43:05 PM
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City Clerk
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12/7/2021
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EXHIBIT 1 <br />OMB Number: 4040-0004 <br />Expiration Date: 12/31/2022 <br />Application for Federal Assistance SF-424 <br />1. Type of Submission: <br />❑ Preapplication <br />® Application <br />❑ Changed/Corrected Application <br />' 2. Type of Application: ' If Revision, select appropriate letter(s): <br />® New <br />❑ Continuation ' Other (Specify): <br />❑ Revision <br />3. Date Received: 4. Applicant Identifier: <br />Completed by Grants.gov upon submission. <br />5a. Federal Entity Identifier: <br />5b. Federal Award Identifier: <br />State Use Only: <br />6. Date Received by State: <br />7. State Application Identifier: <br />8. APPLICANT INFORMATION: <br />• a. Legal Name: <br />City of Santa Ana <br />• b. Employer/Taxpayer Identification Number (EIN/TIN): <br />' c. Organizational DUNS: <br />0831532470000 <br />95-6000785 <br />d. Address: <br />'Street1: 220 S. Daisy Ave <br />Street2: <br />• City: <br />County/Parish: <br />Santa Ana <br />Choose State... <br />'State: <br />CA: California <br />Province: <br />• Country: <br />USA: UNITED STATES <br />• Zip / Postal Code: <br />92 7 0 3- 9 0 0 0 <br />e. Organizational Unit: <br />Department Name: <br />Division Name: <br />f. Name and contact information of person to be contacted on matters involving this application: <br />Prefix: <br />Middle Name: <br />' First Name: <br />Rudy <br />Last Name: Rosas <br />Suffix: <br />Title: principal Civil Engineer <br />Organizational Affiliation: <br />City of Santa Ana <br />• Telephone Number: <br />714-647-3379 <br />Fax Number: <br />• Email: <br />rros s to-ana. org <br />PREVIEW Date: Nov 03, 2021 Workspace ID: WS00800354 Funding Opportunity Number: R22AS00023 <br />
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