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OMB Number: 4040-0004 Expiration Date: 12/31/2019 Application for Federal Assistance SF-424 * 1. Type of Submission: * 2. Type of Application: * If Revision, select appropriate letter(s): Ell Preapplication New 1 Application Continuation * Other (Specify): Changed/Corrected Application Revision * 3. Date Received: 4. Applicant Identifier: 5a. Federal Entity Identifier: 5b. Federal Award Identifier: State Use Only: 6. Date Received by State: 7. State Application Identifier: 8. APPLICANT INFORMATION: * a. Legal Name: Maricopa County * b. Employer/Taxpayer Identification Number (EIN/TIN): * c. Organizational DUNS: 866000472 1377835560000 d. Address: * Streetl: 550 West Jackson Street Street2: * City: Phoenix County/Parish: * State: AZ: Arizona Province: * Country: USA: UNITED STATES * Zip / Postal Code: 85003 - 2412 e. Organizational Unit: Department Name: Division Name: Maricopa County Sheriff's Offi Special Investigations f. Name and contact information of person to be contacted on matters involving this application: Prefix: * First Name: Cindy Middle Name: * Last Name: Kenney Suffix: Title: Grant Administrator Organizational Affiliation: * Telephone Number: 602 - 876- 3266 Fax Number: * Email: C_Kenney@MCSO.Maricopa.gov Application for Federal Assistance SF-424 * 9. Type of Applicant 1: Select Applicant Type: B: County Government Type of Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: * Other (specify): * 10. Name of Federal Agency: Office of National Drug Control Policy 11. Catalog of Federal Domestic Assistance Number: 95.001 CFDATffle: * 12. Funding Opportunity Number: HIDTA * Title: High Intensity Drug Trafficking Area 13. Competition Identification Number: N/A Title: 14. Areas Affected by Project (Cities, Counties, States, etc.): Add Attachment Delete Attachment View Attachment * 15. Descriptive Title of Applicant's Project: High Intensity Drug Trafficking Area program Attach supporting documents as specified in agency instructions. Add Attachments Delete Attachments View Attachments 1 Application for Federal Assistance SF-424 16. Congressional Districts Of: * a. Applicant AZ -all * b. Program/Project AZ -all Attach an additional list of Program/Project Congressional Districts if needed. Add Attachment Delete Attachment View Attachment 17. Proposed Project: * a. Start Date: 01/01/2019 * b. End Date: 12/31/2020 18. Estimated Fund ng ($): * a. Federal 641,666.00 " b. Applicant * c. State * d. Local " e. Other " f. Program Income * g. TOTAL 641,666.00 * 19.1s 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 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. * 20.1s the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) • Yes U No If "Yes", provide explanation and attach Add Attachment Delete Attachment View Attachment 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. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. 1 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) El **1AGREE ** 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: * First Name: Bill Middle Name: * Last Name: Gates Suffix: *Title: Chairman * Telephone Number: 602-506-7562 Fax Number: * Email: district3@mai1.maricopa. gov *Signature of Authorized Representative: * Date Signed: