Laserfiche WebLink
6. Attach documentation of internal controls, conflict of interest, and firewall policies. <br /> Signature Page <br /> By signing below, the local CEO and Local Board chair request approval from the Governor to be <br /> an Adult and Dislocated Worker Career Services Provider. Each party certifies that this <br /> application submission was reviewed and demonstrates that the Local Board or administrative <br /> entity will meet all the requirements as an Adult and Dislocated Worker Career Services <br /> Provider under WIOA law and regulations. <br /> Instructions <br /> The Local Board chair and local CEO must sign and date this form. Include the original <br /> signatures with the request. <br /> Local Workforce Development Board Local Chief El- • • ficial <br /> Chair <br /> • <br /> Signature .ture <br /> Daisy Campos Valerie Amezcua <br /> Name Name <br /> Chair—Santa Ana WDB Mayor—City of Santa Ana <br /> Title Title <br /> tits L 206( 5 <br /> Date Date <br /> ATTEST: <br /> ����. <br /> . <br /> Jennifer L. H.: <br /> City C <br /> Page 7 of 7 <br />