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OMB Number: 4040-0004 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 Application Continuation * Other (Specify): Changed/Corrected Application Revision * 3. Date Received: 4. Applicant Identifier: 09CH010385 5a. Federal Entity Identifier: 5b. Federal Award Identifier: N/A 09CH010385 State Use Only: 6. Date Received by State: 7. State Application Identifier: 8. APPLICANT INFORMATION: * a. Legal Name: MARICOPA, COUNTY OF * b. Employer/Taxpayer Identification Number (EIN/TIN): * c. Organizational DUNS: 866000472 050391270 d. Address: * Street1: 234 N Central Ave Street2: Fl 3 * City: Phoenix County/Parish: Maricopa County * State: AZ: Arizona Province: * Country: USA: UNITED STATES * Zip / Postal Code: 85004-0948 e. Organizational Unit: Department Name: Division Name: Human Services Early Education f. Name and contact information of person to be contacted on matters involving this application: Prefix: Ms. * First Name: Eve Middle Name: * Last Name: Del Real Suffix: Title: Assistant Director Organizational Affiliation: Maricopa County Human Services- Early Education Division * Telephone Number: (602) 372-3710 Fax Number: * Email: eve.delreal@maricopa.gov 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): * 10. Name of Federal Agency: ACF-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 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 and 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-005 Attach an additional list of Program/Project Congressional Districts if needed. 17. Proposed Project: * a. Start Date: 07/01/2019 * b. End Date: 06/30/2020 18. Estimated Funding ($): * a. Federal 14,095,268 * b. Applicant 3,523,817 * c. State * d. Local * e. Other 0 * f. Program Income *g.TOTAL 17,619,085 * 19. 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 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, 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. 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) ** 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 * Signature of Authorized Representative: * Date Signed: