SF424 APPLICATION_COMPLETED.PDF

Maricopa County — Formal (2020-06-10)

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OMB Number: 4040-0004 
Expiration Date: 12/31/2022 
Application for Federal Assistance SF-424 
* 1. Type of Submission: 
[--- Preapplication 
Application 
" 2. Type 
El New 
of Application: 	
* If Revision, select appropriate letter(s): 
Continuation 
*Other (Specify): 
Application 
n Changed/Corrected 
1-- Revision 
* 3. Date Received: 	
4. Applicant Identifier: 
05/11/2020 
5a. Federal Entity Identifier: 
5b. Federal Award Identifier: 
State Use Only: 
6. Date Received by 
7. State Application Identifier: 
State: 
8. APPLICANT INFORMATION: 
* a. Legal Name: 
Maricopa County 
* b. Employer/Taxpayer Identification Number (EINTTIN): 
* c. Organizational DUNS: 
866000472 
1377835560000 
d. Address: 
* Street1: 
Street2: 
* City: 
County/Parish: 
*State: 
Province: 
* Country: 
*Zip / Postal Code: 
550 West Jackson Street 
Phoenix 
AZ: Arizona 
USA: UNITED STATES 
85003-2412 
e. Organizational Unit: 
Department Name: 
Division Name: 
Maricopa Cnty Sheriff's Office 
Special Investigations 
f. Name and contact information of person to be contacted on matters involving this application: 
Prefix: 
Middle Name: 
* Last Name: 
Suffix: 
* First Name: 
Cindy 
Kenney 
Title: 	
Grant Administrator 
Organizational Affiliation: 
*Telephone Number: 
602-876-3266 	
Fax Number: 
*Etnaffi 	
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 
CFDA Title: 
* 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.): 
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* 15. Descriptive Title of Applicant's Project: 
High Intensity Drug Trafficking Area Program 
Attach supporting documents as specified in agency instructions. 
Add Attachments 
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Application for Federal Assistance SF-424 
16. Congressional 
* a. Applicant 
Districts Of: 
AZ 
*b. Program/Project 	
AZ 
Attach an additional list of Program/Project Congressional Districts if needed. 
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17. Proposed 
" a. Start Date: 
Project: 
01/01/2021 
* b. End Date: 	
12/31/2022 
18. Estimated Funding (6): 
" a. Federal 
* b. Applicant 
* c. State 
* d. Local 
* e. Other 
* f. Program Income 
* g. TOTAL 
671,414.00 
0 .00 
0.00  
0.00  
0.00  
0. 00 
671,414.00 
* 19. Is Application Subject to Review By State Under Executive Order 12372 Process? 
was made available to the State under the Executive Order 12372 Process for review on 
is subject to E.O. 12372 but has not been selected by the State for review. 
is not covered by E.O. 12372. 
. 
Ill a. This application 
ri b. Program 
1 c. Program 
* 20. Is the Applicant 
Yes 
If "Yes", provide 
Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) 
No 
explanation and attach 
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21. *By signing 
herein are true, 
comply with any 
subject me to 
this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements 
complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to 
resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may 
criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) 
and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency 
1 ** I AGREE 
** The list of certifications 
specific instructions. 
Authorized Representative: 
Prefix: 
Middle Name: 
* Last Name: 
Suffix: 
* First Name: 	
Clint 
Hickman 
* Title: 	
Chairman 
* Telephone Number: 602 - 506 - 7642 	
Fax Number: 
* Email: chickman@mail .maricopa . goy 
* Signature of Authorized Representative: 
* Date Signed: