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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: 46 & 47 *b. Program/Project: 46 & 47 <br />17. Proposed Project: <br />*a. Start Date: 07/01/2009 *b. End Date: 06/30/2010 <br />18. Estimated Funding ($): <br />*a. Federal 6;800;000 <br />*b. Applicant <br />*c: State <br />*d. Local <br />*e. Other <br />*f. Program Income <br />*g. TOTAL 6,800,000 <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.) <br />^ Yes ® No <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 comply <br />with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject <br />me to criminal, civil, or administrative penalties. (U. S. Code, Title 218, Section 1001) <br />® ** 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 <br />agency specific instructions <br />Authorized Representative: <br />Prefix: Mr *First Name: David <br />Middle Name: N. <br />*Last Name: Ream <br />Suffix: <br />*Title: City Manager <br />*Telephone Number: 714-647-5200 Fax Number: 714-647-6713 <br />* Email: dream@santa-ana.org <br />*Signature of Authorized Representative: *Date Signed: <br />Authorized for Local Reproduction <br />Standard Form 424 (Revised 10/2005) <br />Prescribed by OMB Circular A-102 <br />291-20 <br />