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<br />13. CERTIFICATION <br />J certify that the infonnation contained in this application is true and correct and that it contains no misrepresentations, falsifications, <br />intentional omissions, or concealment of material facts, J further certify that no contracts have been awarded, funds committed or <br />construction begun on the proposed project, and that none will be prior to issuance of a Release of Funds by the program <br />administrator. <br />SignallJre of Authorized Official <br />Name of Authorized Official <br />Title <br />Dale <br /> <br /> <br />14. R uired Documentation to be submitted with <br />General: <br />Res onses to narrative uestions <br />Resolution of overnin bod re uestin rant or Board Minutes a rovin submission of a lication <br />Benefit documentation surve results, census data, etc, <br />State and Federal Tax Exam tion Detemnination Letter - 403 b Non Profit <br />cgJ List of Board of Directors <br />Pro' ect S jfic Documentation rovide items below which a <br />cgJ Pro'ect Scheduleffimeline <br />cgJ Buildin /area information and <br />IZI A raisals <br />IZI Ma of roo eet area <br />IZI Professional certification/anal sis of feasibilitit and/or cost estimate <br />IZI Letters in su rt of ro'ecUcommitment letters <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />nal Documentation leue s <br /> <br />if an addltlonal documents <br /> <br /> <br />D Other <br /> <br />. Audit and Insurance documents will be requested after HRA recommendations for project funding are complete. <br /> <br />Page 5 <br />