02-25-2019 Council Packet - Laserfiche WebLink

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Revised 11/2018 Attachment A – REQUIRED CERTIFICATIONS Complete the Required Certifications form below with original signatures. For Grant Applicants: “I hereby certify that all of the information provided in this application is true and accurate to the best of my knowledge. I recognize that in the event of the proposed project being funded, this document will be used as an addendum to the agreement between the sponsoring unit of government and the state to guide project scope and reimbursement. I also acknowledge that all work must be completed by June 30, 2021, and no reimbursement will be sought for an in-house labor services and/or to meet existing payroll. I also preliminarily agree with plans to develop the proposed trail related project on land administered by my agency.” Name: Adam T. Edwards Title: Director of Public Works/ City Engineer Unit of Government: City of Orono Signature: Date: For Trail and Park Administrators: “I substantially agree that the proposed trail related project will be mutually beneficial to the local community, as well as to the goals and purposes for which this recreation unit was established. I will cooperate in its provision if the project proposal should be funded.” Name: Adam T. Edwards Title: Director of Public Works/ City Engineer Unit of Government: City of Orono Signature: Date: For All Administrators of Public Lands Crossed/Utilized in the Proposed Linkage (Required only if the proposed project will utilize public land that is not under the jurisdiction of the grant applicant): “I preliminarily agree with plans to develop the proposed trail related project on land administered by my agency, and I will cooperate in seeking more formal authorization in the event the project proposal is authorized for reimbursement.” Name: Title: Unit of Government: Signature: Date: