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OMB Number: 4040-0004 C-22-16-011-G-20 Expiration Date: 10/31/2019 Application for Federal Assistance SF-424 * 1. Type of Submission: * 2. Type of Application: * If Revision, select appropriate letter(s): [_] Preapplication [|New Other | Application [| Continuation * Other (Specify): [ | Changed/Corrected Application Revision Budget Revision | * 3. Date Received: 4. Applicant Identifier: | |09cH010385 | 5a. Federal Entity Identifier: 5b. Federal Award Identifier: [w/a | [oscHo10385 State Use Only: 6. Date Received by State: jf 7. State Application Identifier: | | 8. APPLICANT INFORMATION: “a, Legal Name: |wartcopa, COUNTY OF | * b. Employer/Taxpayer Identification Number (EIN/TIN): * ¢. Organizational DUNS: 866000472 | [050391270 d. Address: * Streett: (234 N Central Ave | Street2: [ra 3 | * City: | Phoenix | County/Parish: IMaricopa County | * State: [az: Arizona | Province: [ | * Country: lusa: UNITED STATES | * Zip / Postal Code: [35004-0948 e. Organizational Unit: Department Name: Division Name: Human Services | leary Education f. Name and contact information of person to be contacted on matters involving this application: Prefix: [Ms | * First Name: lave | . Middle Name: | * Last Name: [pet | Real Suffix: | | Title: [assistant Director Organizational Affiliation: [mcusp Early Education Division | * Telephone Number: Fax Number: | (602) 372-3710 * Email: [eve .delreal@maricopa.gov | C-22-16-011-G-20 Application for Federal Assistance SF-424 * 9. Type of Applicant 1: Select Applicant Type: County Government | Type of Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: * Other (specify): * 410. Name of Federal Agency: lacr-Head Start 11. Catalog of Federal Domestic Assistance Number: [93.600 CFDA Title: Head Start * 42. Funding Opportunity Number: eGrants-N/A * Title: N/A 13. Competition Identification Number: Not Applicable Title: Not Applicable 14. Areas Affected by Project (Cities, Counties, States, etc.): East Maricopa County * 15. Descriptive Title of Applicant's Project: Head Start / Early Head Start COLA and Quality Improvement Attach supporting documents as specified in agency instructions. C-22-16-011-G-20 Application for Federal Assistance SF-424 16. Congressional! Districts Of: * a. Applicant b. Program/Project AZ-005 Attach an additional list of Program/Project Congressional Districts if needed. 17. Proposed Project: * a. Start Date: 07/01/2020 *b. End Date: |06/30/2021 18. Estimated Funding ($): * a, Federal | 0| *b. Applicant | -2,202, 051| * c, State * d. Local | * e, Other | o| * f. Program Income | | * g, TOTAL | -2, 202,051 * 49. Is Application Subject to Review By State Under Executive Order 12372 Process? [] a. This application was made available to the State under the Executive Order 12372 Process for review on [ds [| b. Program is subject to E.O. 12372 but has not been selected by the State for review. c. Program is not covered by E.O. 12372. * 20. Is the Applicant Delinquent On Any Federal Debt? (if Yes, provide explanation in attachment.) [ ]Yes No If Yes, provide explanation and attach 21. *By signing this application, | certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. | also provide the required assurances** and agree to comply with any resulting terms if 1 accept an award. | am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) ** | AGREE ** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions. Authorized Representative: Prefix: (or | * First Name: | Jack | . Middle Name: | | * Last Name: [se11ers | Suffix: | | * Title: [chairman, Maricopa County Board of Supervisor | * Telephone Number: | Fax Number: | (602) 506-1776 * Email: [sellers}@mail.maricopa.gov | i 7 roWiwWaW:3 * Signature of Authorized Representative: Date Signed: p MaAR-Z “tebe ATES + 4 2021 Dui) lo-Lrate 2 Approved as to form: 5s plata MAR 2 at ae