GRANT 09HP000200 COVID SF-424.PDF

* 1. Type of Submission:
* 2. Type of Application:
* 3. Date Received:
4. Applicant Identifier:
5a. Federal Entity Identifier:
5b. Federal Award Identifier:
6. Date Received by State:
7. State Application Identifier:
* a. Legal Name:
* b. Employer/Taxpayer Identification Number (EIN/TIN):
* c. Organizational DUNS:
* Street1:
Street2:
* City:
County/Parish:
* State:
Province:
* Country:
* Zip / Postal Code:
Department Name:
Division Name:
Prefix:
* First Name:
Middle Name:
* Last Name:
Suffix:
Title:
Organizational Affiliation:
* Telephone Number:
Fax Number:
* Email:
* If Revision, select appropriate letter(s):
* Other (Specify):
State Use Only:
8. APPLICANT INFORMATION:
d. Address:
e. Organizational Unit:
f. Name and contact information of person to be contacted on matters involving this application:
Application for Federal Assistance SF-424
Preapplication
Application
Changed/Corrected Application
New
Continuation
Revision
OMB Number: 4040-0004 
Expiration Date: 10/31/2019
050391270
Increase Award
09HP000200
Early Education
Ms.
AZ: Arizona
866000472
MARICOPA, COUNTY OF
(602) 372-3710
Maricopa County Human Services
Maricopa County Human Services
Fl 3
Del Real
09HP000200
05/15/2020
N/A
USA: UNITED STATES
Phoenix
Maricopa County
234 N Central Ave
Assistant Director
85004-0948
Eve
eve.delreal@maricopa.gov
C-22-20-003-G-02

* 9. Type of Applicant 1: Select Applicant Type:
Type of Applicant 2: Select Applicant Type:
Type of Applicant 3: Select Applicant Type:
* Other (specify):
* 10. Name of Federal Agency:
11. Catalog of Federal Domestic Assistance Number:
CFDA Title:
* 12. Funding Opportunity Number:
* Title:
13. Competition Identification Number:
Title:
14. Areas Affected by Project (Cities, Counties, States, etc.):
* 15. Descriptive Title of Applicant's Project:
Attach supporting documents as specified in agency instructions.
Application for Federal Assistance SF-424
Early Head Start-Child Care Partnership- One time COVID 19
County Government
N/A
93.600
Not Applicable
eGrants-N/A
Head Start
ACF-Head Start
Not Applicable
Maricopa County excluding City of Phoenix
C-22-20-003-G-02

* a. Federal
* b. Applicant
* c. State
* d. Local
* e. Other
* f.  Program Income
* g. TOTAL
.
Prefix:
* First Name:
Middle Name:
* Last Name:
Suffix:
* Title:
* Telephone Number:
* Email:
Fax Number:
* Signature of Authorized Representative:
* Date Signed:
18. Estimated Funding ($):
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)
** 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:
Application for Federal Assistance SF-424
* a. Applicant
Attach an additional list of Program/Project Congressional Districts if needed.
 b. Program/Project
* a. Start Date:
* b. End Date:
16. Congressional Districts Of:
17. Proposed Project:
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.
Yes
No
** I AGREE
* 20. Is the Applicant Delinquent On Any Federal Debt?  (If "Yes," provide explanation in attachment.)
* 19. Is Application Subject to Review By State Under Executive Order 12372 Process?
If "Yes", provide explanation and attach
140,609
140,609
AZ-003,AZ-005,AZ-008,AZ-009
clint.hickman@maricopa.gov
Mr
05/15/2020
Hickman
AZ-007
0
(602) 506-3011
0
07/01/2019
/* signed */ Clint Hickman
0
Clint
Chair, Maricopa County Board of Supervisors
06/30/2020
C-22-20-003-G-02