Extracted text (via pymupdf_layout)
3993 characters
OMB Number 4040-0004 Expiration Date: 10/31/2019 ApplicationforFederal Assistance SF -424 " 1. Type of Submission: *2. Typo of Application: *If Revision, select appropriate letter(s): n Preapplication New X Application IXI Continuation * Other (Specify): 0 Changed/Corrected Application II Revision *3. Date Received: 4. Applicant Identifier: 09HP000105 5a. Federal Entity Identifier: 5. Federal Award Identifier: N/A 09H0000105 I State Use Only: 6. Date Received by State: 7. State Application Identifier: 8. APPLICANT INFORMATION: *a. Legal Name: MARICOPA, COUNTY OF I *b. Employer/Taxpayer Identification Number (EINfTIN): *c. Organizational DUNS: 866000972 050391270 d. Address: *Streetl: 239 N Central Ave Street2: Fl 3 * City: Phoenix County/Parish: Maricopa County *State: AZ: Arizona Province: *Country: USA: UNITED STATES *Zip / Postal Code: 185004 - 0948 e. Organizational Unit: Department Name: Division Name: Human Services Early Education Division f. Name and contact information of person to be contacted on matters involving this application: Prefix: * First Name: 'Eve Middle Name: *LastName: Del Real Suffix: I Title: Assistant Director Organizational Affiliation: *Telephone Number: (602} 372 - 3710 Fax Number: * Email: eve .delrealOmaricopa .gov Application for Federal Assistance SF424 * 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): * 10. Name of Federal Agency: ACE-Head Start 11. Catalog of Federal Domestic Assistance Number: 93.600 CFDA Title: Head Start * 12. Funding Opportunity Number: eGrants-N/A * Title: N/A 13. Competition identification Number: Not 07Applicable Title: Not Applicable 14. Areas Affected by Project (Cities, Counties, States, etc.): IMaricopa County, Excluding the City of Phae * 15. Descriptive Title of Applicant's Project: Early Head Start Attach supporting documents as specified In agency Instructions. Application for Federal Assistance SF-424 16. Congressional Districts Of: * a. Applicant AZ-007 b. Program/Project AZ -003,AZ -004,AZ -005,AZ -006 Attach an additional list of Program/Project Congressional Districts if needed. 17. Proposed Project: * a. Start Date: 09/01/2019 * b. End Date: 08/31/2020 18. Estimated Funding ($): * a. Federal 1,843,848 * b. Applicant 460,962 * c. State *d. Local * e. Other 0 * f. Program Income * g. TOTAL 2,304,810 * 19.1s Application Subject to Review By State Under Executive Order 12372 Process? Li a. This application was made available to the State under the Executive Order 12372 Process for review on • 0 b. Program is subject to E.O. 12372 but has not been selected by the State for review. X c. Program Is not covered by E.O. 12372. *20.1s the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) I I Yes N No if "Yee, provide explanation and attach I I 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, complete and accurate to the best of my knowledge. 1 also provide the required assurances** and agree to comply with any resulting terms if I accept 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. Code, Title 218, Section 1001) 11 ** I 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: Mr. * First Name: Bill Middle Name: * Last Name: Gates Suffix: *Title: Chairman, Maricopa County Board of Supervisor *Telephone Number: (602) 506 -7562 Fax Number: * Email: gatesb@mail_maricopa.gov 1E3'L912 * Signature of Authorized Representative: * Dat zt Signed: MAY 1 0 2019 . .........F- P• .1. An151*Alifiti-alt-frirfrawo Deputy County Attorney erg* of the Board MIA