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<br /> <br />LOCAL LAW ENFORCEMENT BLOCK GRANTS PROGRAM <br /> <br />1lU~t<-..'llit~;'f!f'~ <br /> <br />.,,~~~ <br /> <br />Your signature represents your legal binding acceptance of the terms of this application and your statement of the veracity of the <br />representations made in this application. The document has been duly authorized by the governing body of the applicant and the <br />applicant will comply with the three attached forms: J) Assurances; 2) Certifications Regarding Lobbying; Debarment, Suspension and <br />Other Responsibility Matters; and Drug-Free Workplace Requirements,' and 3)Certijication Regarding Public Safety Officer Health Benefits. <br />~" ",', .,~;~~ <br />5t . ,,(,:,' ""~ <br />~.;.~ <br />~. ~ <br />~tf:::rt:1__~~mB,Xi~&~"~S'!l7~~~~""Zlil:f:~::t!:'?~~~~'Zt~'II'~<>A~,f$1l1lr..t~iI'&l1\Ut1"~ <br /> <br />EXHIBIT At <br />