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<br />Application Attachment to SF-424 <br /> <br />CERTIFICATION OF REVIEW AND REPRESENTATION OF <br />COMPLIANCE WITH REQUIREMENTS <br /> <br />OMB Number: 1103-0098 <br />Expiration Date: 02/29/2008 <br /> <br />The signatures of the applicant's Authorized Organizational Representative (on-line applications only), Law Enforcement Ex cutive/Program <br />Official and Government Executive/Financial Official, and any applicable program partners on the Certification of Review and epresentation of <br />Compliance with Requirements: <br /> <br />1) Assures the COPS Office that the applicant will comply with all legal, administrative, and programmatic requirements that overn the applicant <br />for acceptance and use of federal funds as outlined in the applicable COPS Application Guide; AND <br /> <br />2) Attests to the accuracy of the information submitted with this application (including the Budget Detail Worksheets). <br /> <br />The signatures below must be made by the actual executives named on this application unless there is an officially docume ted authorization for <br />a delegated signature. If your jurisdiction has such an official document, it must be attached to this application. Applications ith missing, <br />incomplete, or inaccurate signatures or responses may not be considered for funding. Stamped or electronic signatures (un I ss applying online <br />via Grants.gov) also will not be accepted. Original signatures are required. Faxed copies will not be accepted. Applications ostmarked after the <br />final application deadline date may not be considered for funding. <br /> <br />Signatures shall be treated as a material representation of fact upon which reliance will be placed when the Department of J stice determines to <br />award the covered grant. <br /> <br />Please be advised that a hold may be placed on this application if it is deemed that the applicant agency is not in complianc with federal civil <br />rights laws, and/or is not cooperating with an ongoing federal civil rights investigation, and/or is not cooperating with a COP Office compliance <br />investigation concerning a current grant award. <br /> <br />By signing below, I certify that I have read, understand, and agree, if awarded, to abide by all of the applicable grant complia ce terms and <br />conditions as outlined in the COPS Application Guide. In addition, I certify that the information provided on this form and any attached forms is <br />true and accurate to the best of my knowledge. I understand that false statements or claims made in connection with COP programs may result <br />in fines, imprisonment, debarment from participating in federal grants, cooperative agreements, or contracts, and/or any oth r remedy available by <br />law to the federal government. <br /> <br />Authorized Organizational Representative's Signature: <br />Date: <br /> <br />I Completed Upon Submission to Grants.gov <br />I Completed Upon Submission to Grants.gov <br /> <br />Law Enforcement Executive/Program Official: <br /> <br />Prefix I I . First Name <br /> <br /> <br />Middle Name I D. <br /> <br />Paul <br /> <br />. Last Name <br /> <br />Laney <br /> <br />Suffix <br /> <br />Date: Completed Upon Submissio to Grants.gov <br /> <br />Signature: <br /> <br />Government Executive/Financial Official: <br /> <br />Prefix <br /> <br />. First Name Scott <br /> <br />Middle Name <br /> <br />. Last Name <br /> <br />Wagner <br /> <br />Suffix <br /> <br />Date: Completed Upon Submissio to Grants.gov <br /> <br />Signature: <br /> <br /> <br />Signing this page also assures the COPS Office that you have read, understand, and agree, if awarded, to abide by the gran terms and <br />conditions as outlined in the Assurances and Certifications. The signed hard copy of the Assurances and Certifications shou d be kept in the <br />agency's files and furnished upon request. <br />