16-B Violence Agnst Women Grnt - Laserfiche WebLink

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(}RANT APPLICATION CERTIFICATION FORM OFFICE OF THE GOVERNOR CRIMINAL JUSTICE DIVISION P.O. Box 13428 AUSTIN, TEXnS 7871 I $12/463-1919 FAX: 5121475-2440 WWW.GOVERNOR.STATE.TX.US Applicants must complete and submit this form before they will receive state and/or federal funds. Recipients of state and/or federal funds must read, agree, fully underetsnd and comply with the requirements listed within in each form of this Grant Application Kit as detailed below. PART I: CERTIFICATIONS The grant applicant must: 1. SELECT 'Certify' or 'Unable to Certify' for each document that has been certified as true and correct by the Authorized Official. 2. If you SELECTED 'Unable to Certify': a) a brief explanation must be given why the document cannot be certified at the time the grant application kit is submitted to CJD; and b) a date must be ENTERED that notifies CJD when your organization anticipates that the Authorized Official will be able to certify and submit the document to CJD. Description of Document "1 Certify" "Unable to Explanation (ax: Incomplete, Not Date Certify" Applicable, etc.) Determine Eligibility Form * [] [] VAWA Project Narrative & Summary [] [] Form Comprehensive Certification and [] [] Assurances - Federal Funds Form Cooperative Working Agreement [] [] Purpose and Participant Form Financial Capability Questionnaire [] [] not applicable Form Coversheet Form [] [] Budget Form [] [] Match - GPi Form [] [] * Critical: The grant applicant mast complete the Determine Eligibility Form in its entirety and submit to CJD with the grant application kit. /f any portion of the form is left incomplete and the Authorized Official is unable to certify and/or submit the form, your project will be considered Ineligible and will not be reviewed by CJD. PART Ih ATTACH RESOLUTION FORM The Resolution from the governing body must be submitted along with the Grant Application Certification Form to CJD. Please indicate the status of this document below: 1. a) Is the Resolutio, n Form attached to the ceffification form? [] I Yes [] I No b) If you selected No', PROVIDE a bdef exp anat on for the de ay and the date that your 2/./J~u~ ...... ~ater~ - organization anticipates submission to CJD: Thc Gram Coordinator has begun closing various files in his office in preparation of impending retirement, and personnel affected by this grant who ,here newly assigned responsibility for Ibis year's application were unaware of the grant deadline in enough time to have a resolution placed on the January Cty Couac al]enda. A resolution will be placed on the first agenda in February. PART IIh SIGNATURE The organization's Authorized Official hereby assures and certifies their authorization for the submission of this grant application kit In it's entirety to the Office of the Govemor, Criminal Justice Division. City of Paris, Paris, Texas Applicant's Organization Michael E. Malone, City Manager Name and Title of the Authorized Official Violent Crimes Against Women Unit Project Title SignSture · th~Authefized Official ~ 111612004 Effective Date CJD GRANT APPLICATION KIT- PAGE 11 VAWA (CFDA-16.588) ISSUE DATE: NOVEMBER 2003