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OMB Number: 4040 -0004 <br />Fxniratinn F)ate- 01/31/200q <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: 07/01/2011 *b. End Date: 06/30/2012 <br />18. Estimated Funding($): <br />*a. Federal 6,800,000 <br />*b. Applicant <br />*c. State <br />*d. Local <br />*e. Other (Carry Forward) <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. 0. 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 herein are true, <br />complete and accurate to the best of my knowledge. I also provide the required assurances ** and agree to comply with any resulting terms if I accept <br />an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U. S. <br />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 agency specific <br />instructions <br />Authorized Representative: <br />Prefix: *First Name: <br />Middle Name: <br />*Last Name: <br />Suffix: <br />*Title: City Manager <br />*Telephone Number: 714 - 647 -5200 <br />Fax Number: 714 - 647 -6713 <br />* Email: <br />*Signature of Authorized Representative: <br />*Date Signed: <br />Authorized for Local Reproduction <br />04/21/2011 <br />Exhibit 1 <br />Standard Form 424 (Revised 10/2005) <br />Prescribed by OMB Circular A -102 <br />2010 -2011 ANNUAL ACTION PLAN <br />