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FY08 Emergency Management Performance Grant Exhibit B of ASR <br />Application for Assistance <br />Applicant: <br />(County) <br />Artthorized Agent Mailing Address <br />City, State, Zip Code <br />Allocated Amount (from Appendix A) <br />Amount Requested per Budget <br />Worksheet <br /> <br />Contact Information: <br />Name/Tttle <br />Area Code/O~ce Telephone Number <br />E-Mail Address <br />Application Checklist -The following items must be included with this subgrant application package: <br />Application for Assistance <br />Program Narrative <br />._ Budget Worksheet <br />Certification and Signature of Authorized Agent <br />Governing Body Resolution (if required) <br />Grant Assurances (if required) <br />1 hereby cert~ L am vested with the authority, and have the approval of the Operational Area, to enter into this <br />subgrant award agreement; and all funds receivedpursuant to this agreement will be spent exclusively on the purposes <br />specified %he grant recipient signifies acceptance of this grant award and agrees to administer the subgrant in <br />accordance with the laws, regulations, guidance documents that apply to this grant program; the State OFS Recipient <br />subgrant Cndde for Local Governments; and the State OF.S audit requirements. <br />Signature ofAuthorizedAgent <br />Title <br />Printed Name <br />Date <br />For State OES USE ONLY <br />Application Reviewed/Subgrant Award Approved: <br />Signature <br />Dare <br />Subgrant Performance Period: October 1.2007 to J ~ e 30 2009 <br />OES ID # -00000 Catalog of Federal Domestic Assistance #97.042 Award # EMF-200~T~r ~~ <br />FY08 EMPG Recipient subgrant Guide for Local Government 33 <br />