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AFMN Community Grant Application with Assurances (GK203)14 <br />Organization City of Orono <br />Address 2750 Kelley Parkway <br />City, ZIP Orono, 55365 <br />Phone 952-249-4684 <br />Email tzinnel@oronomn.gov <br />BUSINESS MANAGER/ FISCAL CONTACT <br />Name Maggie Jin <br />Title Director of Finance <br />Organization City of Orono <br />Address 2750 Kelley Parkways <br />City, ZIP Orono, 55365 <br />Phone 952-249-4611 <br />Email mjin@oronomn.gov <br />Was your application completed with assistance from an AFMN <br />TAP Grantee?☐Yes ⾙ No <br />If yes, please list TAP Grantee name: <br />Signature and Date <br />I certify I have read the Grant Application and Assurances (narrative, assurances, budget, and <br />supplemental documents, if applicable) and will comply with the approved application and assurances <br />herein and additional state, local, federal regulations and policies that apply to my organization. <br />Signatory further certifies that the Applicant’s articles of incorporation, by-laws, or corporate <br />resolutions authorize Signatory both to sign on behalf of and bind the Applicant to the terms of this <br />Agreement. Applicant and signatory agree that STATE relies on the signatory’s certification herein. <br />_________________________________________________________________ <br />Signature* Date <br />*The STATE will accept signatures that are handwritten or e-signatures that have been authenticated <br />by a third party (such as DocuSign or Adobe Sign). Grant Application and Assurances that are unsigned <br />and undated may be considered non-responsive and may result in the disqualification of the <br />Application. <br />107