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RECYCLING BUDGET <br />3. Attach a copy of your 2012 municipal budget for all recycling activities, including all funding sources. if: your governing <br />body has not adopted the budget, attach themostcurrent draft budget. <br />PUBLIC ENTITIES LAW COMPLIANCE <br />4. Attach a copy of the disclosure from your hauler(sj, or:a copy of the relevant portion of any contracts with haulers, that specifies <br />the facility at which waste collected from municipal, facilities is deposited: Minn. Stat, § 115A.9302 requires haulers to disclosethis <br />information to customers annually. <br />RESOLUTION <br />5: Attach a resolution from your governing body requesting the SCORE funding allocation, or:a certified copy of the official <br />proceedings at which the request was approved, SCORE grants agreements cannot be issued withoutsuch an attachment. <br />Jessie Hart <br />NAME OF PERSON AUTHORIZED TO SUBMIT GRANT <br />SIGNATURE (electronic signature is acceptable) <br />Treasurer <br />TITLE <br />December20, 2011€ <br />DATE <br />Applications will be considered complete when items 15 abovearesubmitted and a signature is on file. <br />Pleasereturn the completedgrant application form by DECEMBER 30, 2011. <br />SCORE Program <br />Saint Paul - Ramsey County Department of Public Health <br />Environmental Health Section <br />278.5 White Bear Avenue N., Suite 350 <br />Maplewood, MN 551.09=1320 <br />