Agmt16 State of CA- Dept of Parks and Recreation, Division of Boating and Waterways

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1-111 IIIJI I V - VI aI It /WPM-n:41.11/4/11. L.OL CI t/I 1111.01 11/41 ■J%.IVIJG VI V V 111 h 0111/44 vv VI 11 I Sal I 1 . Applicant Certification Per Harbors and Navigation Code 525 (C) "A grant awarded by the department pursuant to subparagraph (A) shall be matched by a 10% contribution from the local agency receiving the grant " This matching fund may be rendered in cash, or through in-kind contributions which must be verified, and are at the discretion of DBW. These contributions may include (but are not limited to) the following: administrative costs, personnel hours, removal, and/or storage. Grant monies WILL NOT be reimbursed by D8W unless 10% of each reimbursement claim is met a. P Under penalty of perjury, I certify that I have examined this application and the document(s), proposal(s), and statement(s) submitted in conjunction herewith, and that to the best of my information and belief, the information contained herein is true, accurate, correct, and complete. b. P. I certify that I am the person authorized to submit this application on behalf of the applicant. Prepared by: Name: Vicki Sherman Date: 04/29/2016 Reviewed by: Name: Brandon Gilmore Date: 04/29/2016 Approving Name: Terence Kyaw Date: 04/29/2016 Officer: ATTY/AGR/2016.249/STATE OF CALIFORNIA DEPARTMENT OF PARKS & RECREATION DIVISION OR BOATING & WATERWAYS REV: 09-01-16 RL Page 33 of 33