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1. STATE ENCUMBRANCE VERIFICATION <br />Individiial cetwjies thatfiinds have been enminbei-ed as <br />tvqtih-ed ky Minn. "tat. 16A.1 S and 16C.05. <br />Signed: <br />Date: <br />SWIFT Contract/PO No(s). <br />2.GRANTEE <br />The Grantee certifies that the appropriate person(s) <br />have executed the grant contract on behalf of the Grantee as <br />required by applicable articles, bylaws, resolutions,, or ordinances. <br />By: <br />Title: <br />Date: <br />By: <br />Title: <br />Date: <br />3. STATE AGENCY <br />By: <br />(with delegated authority) <br />Title: <br />I Imm <br />Distribution: <br />Agency <br />Grantee <br />State" s Authorized Representative - Photo Copy <br />Grant (Rev. 09/11) 6 <br />