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<br />APPLICA TION COVER SHEET CERTIFICATION <br /> <br />6.20 <br />J=>age 7 <br /> <br />...~.. ::",.., :'. .:c-;-:~ ,. ".:...,.. '.. <br /> <br /> <br />. ,,-...-._-.-----.,. <br />'.n:.:._:::,._-.:.-.,;::...... <br />: ........: :"---::~' <br /> <br />!x <br />r--.-.---------.------.------.---..---.--.-.......m....--__..._..___.____._______...._m.__._.__..._.__.._____.._..__-.--....--...---------.-.-...---.....-.....---.....---.... <br />I Signature Authority (as authorized in Resolutjo~.______ . Date <br /> <br />L.~!I!!'Y~~~_~~~p~.i~_~_<?!'~~__~~I:y.i.~~s_P~~!2~m . . <br />L!)P.!_<?:.!!.~'!!t!'!!!!~.f!'!~_.!!~I~ . .._........______________... .. . ._._____m____._____. . .. _...._....._........_ <br /> <br />....."__n..___J <br /> <br />ENVIRONMENTAL JUSTICE <br /> <br />Public entities that receive grant funding from CIWMB for this grant program must comply with the following <br />principles of Environmental Justice. Environmental Justice is defmed in Government Code Section <br />65040.12(c) as: "...the fair treatment of people of all races, cultures, and incomes with respect to the <br />development. adoption, implementation, and enforcement of environmental laws, regulations, and policies." <br />Public Resources Code Sections 72000(a) and 72001 broadly require all California Environmental Protection <br />Agency boards, departments, and offices to conduct their "programs, policies, and activities that substantially <br />affect human health or the environment in a manner that ensures the fair treatment of people of all races, <br />cultures, and income levels, including minority populations and low-income populations of the state." <br /> <br /> <br />;x <br />j:~~ature ~'!!l!.OiJiJ!.._G;_a..ri!.lJ!!ii.~~~J!!ifiiQl~j~rlE=~::____==::______=~.__:___=::==__.=__=.=___.!f/!..t~_~=~___.__.____.___....__.__~_=_==1 <br /> <br />i LarIY. B~acz, _~ublic Yior~ S!lP~rinte1!de1!!._._________________________.._._________j <br />:JYP.~_'!!'. Print Name '!'!.4...!itle ____________._m_______~______.__.__________________........ ._........._.__: <br /> <br />RESOLUTION REQUIREMENT <br /> <br /> <br />x <br /> <br />o <br /> <br />An approved resolution is enclosed in the application. <br />(Note: A copy of a current approved resolution must be submitted with each application.) <br /> <br />We acknowledge that our approved resolution must be received by the CIWMB no later <br />than November 15.2006 Oetaber 6,2096. We further acknowledge that if our <br />Resolution is received after November 15.2006 Oetaber 6, 2006, our application will be <br />disqualified. <br />Fax to (916) 341-7555 and mail hard copy. The faxed copy will be used as a placeholder <br />only, pending receipt of the hard copy. <br /> <br />RECYCLED-CONTENT PURCHASING POLICY/DIRECTIVE <br /> <br /> <br />x <br /> <br />o <br /> <br />Yes, our organization has a recycled-content purchasing policy/directive <br />Date adopted: 11114/05 <br /> <br />No, our organization does not have a recycled-content purchasing policy/directive. We <br />acknowledge that our organization must adopt one and notify the CIWMB of such <br />adoption by November 15.2006 Oeteber ,~ 2006, or our application will be disqualified. <br />Fax to (916) 341.7555 and/or Email <br /> <br />Tre-Oeriwd Product (TOP) Grant Program, FY 2006-2007 <br /> <br />4 <br />