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Application for Federal Assistance SF-424 <br />16. Congressional Districts Of: <br />* a. Applicant CA-4 6 ' b. Frog ra m/ Project CA-4 6 <br />Attach an additional list of Program/Project Congressional Districts if needed. <br />Add Attachment DeMeMacho enc Vew acho enc <br />17. Proposed Project: <br />*a. Start Date: Ol/30/2022 ' b. End Date: 12/31/2023 <br />18. Estimated Funding ($): <br />* a. Federal 1,467,704.001 <br />* b. Applicant 1,467,704.00 <br />* c. State 0 . 0 0 <br />*d. Local 0.00 <br />* e. Other 0 . 0 0 <br />*f. Program Income 0.00 <br />*g.TOTAL F 2,935,408.00 <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 />® 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 />�1ddMacho enc DcMeMacho enc VLew acho enc <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 218, Section 1001) <br />® **IAGREE <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: <br />* First Name: Rudy <br />Middle Name: <br />* Last Name: Rosas <br />Suffix: <br />*Title: principal Civil Engineer <br />*Telephone Number: 714-647-3379 Fax Number: <br />*Email' rrosas@santa-ana.org <br />* Signature of Authorized Representative: completed by Grants.gov upon submission. * Date Signed: iCompleted by Grants.gov upon submission. <br />City Council <br />Lb — b 12l/I21LIL-1 <br />PREVIEW Date: Nov 03, 2021 Workspace ID: WS00800354 Funding Opportunity Number: R22AS00023 <br />