Laserfiche WebLink
FYOS Emergency Management Performance Grant Exhibit B of ASR <br />Application for Assistance <br />Applicant: Narnia Coun <br />(County) <br />Contact Information: <br />1234 Broadway Street Marv Ann Smith, Program Mana¢er <br />Authorized Agent Mailing Address Name/Title <br />Anytown, CA 91919 X530)-666-5544 <br />City, State, Zip Code Area Code/Office Telephone Number <br />MAS(a) arniaoes.gov <br />E-Marl Address <br />Allocated Amount (from Appendix A) <br />Amount Requested per Budge[ Worksheet <br />89 111.00 <br />89 111.0 <br />Application Checklist -The following items must be included with this subgtant application package: <br />_~ Application for Assistance <br />.~ Program Narrative <br />X Budget Worksheet <br />X Governing Body Resolution (if required) <br />X Grant Assurances (if required) <br />Certification and Signature of Authorized Agent <br />t am the duly appointed Authorized Agent and have the authority to applyfor this subgrant and submit this application on beha f of <br />the Operational Area. <br />~JO~'A'I'~~'t'~ Cf10 John Adams,CAO <br />Signature ofAuthorized Agent Printed Name <br />CAO/Dir. of OES 5/30/2008 <br />Title Date <br />For State OES USE ONLY <br />Application Reviewed/Subgrant Award Approved: <br />Signature <br />Subgrant Performance Period: October 1.2007 to June 30 2009 <br />OES ID # 000-00000 Catalog ofFederal Domestic Assistance #97.042 <br />Date <br />Award # F1~iF-2008-GR- <br />Page 69 of 80 <br />FY08 EMPG Grant Guide for Local Government 51 <br />