CCP 02282022 - Laserfiche WebLink

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Grant Contract Agreement Page 2 of 2 Payment: As stated in the Grantee’s Application and Grant Program Guidance, the State will promptly pay the Grantee after the Grantee presents an invoice for the services actually performed and the State's Authorized Representative accepts the invoiced services and in accordance with the Grant Program Guidelines. Payment will not be made if the Grantee has not satisfied reporting requirements. Certification Regarding Lobbying: (If applicable.) Grantees receiving federal funds over $100,000.00 must complete and return the Certification Regarding Lobbying form provided by the State to the Grantee. 1. ENCUMBRANCE VERIFICATION3. STATE AGENCY Individual certifies that funds have been encumbered as required by Minn. Stat. §16A.15.Signed: _____________________________________________ (with delegated authority) Signed: _____________________________________________ Title: ______________________________________________ Date: _______________________________________________ Date: ______________________________________________ Grant Contract Agreement No. A-PTP-2022-ROSEVLPD-00008/ 3-78130 Project No.(indicate N/A if not applicable): ___N/A___________ 2. GRANTEE The Grantee certifies that the appropriate person(s) have executed the grant contract agreement on behalf of the Grantee as required by applicable articles, bylaws, resolutions, or ordinances. Signed: _____________________________________________ Print Name: __________________________________________ Title: _______________________________________________ Date: _______________________________________________ Signed: ______________________________________________ Print Name: __________________________________________ Distribution: DPS/FAS Title: ________________________________________________ Grantee State’s Authorized Representative Date: ________________________________________________ DPS Grant Contract Agreement non-state (Updated 12/2020)