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Grant Contract Agreement Page 2 of 2 <br />Payment: As stated in the Grantee’s Application and Grant Program Guidance, the State will promptly pay the <br />Grantee after the Grantee presents an invoice for the services actually performed and the State's Authorized <br />Representative accepts the invoiced services and in accordance with the Grant Program Guidelines. Payment will <br />not be made if the Grantee has not satisfied reporting requirements. <br />Certification Regarding Lobbying: (If applicable.) Grantees receiving federal funds over $100,000.00 must <br />complete and return the Certification Regarding Lobbying form provided by the State to the Grantee. <br />1. ENCUMBRANCE VERIFICATION3. STATE AGENCY <br />Individual certifies that funds have been encumbered as <br />required by Minn. Stat. §16A.15.Signed: _____________________________________________ <br /> (with delegated authority) <br />Signed: _____________________________________________ Title: ______________________________________________ <br />Date: _______________________________________________ Date: ______________________________________________ <br />Grant Contract Agreement No./ P.O. No. A-ICPOE-2025-ROSEVLPD-025/ 3-98869 <br />Project No.(indicate N/A if not applicable): __N/A________ <br />2. GRANTEE <br />The Grantee certifies that the appropriate person(s) <br />have executed the grant contract agreement on behalf of the Grantee <br />as required by applicable articles, bylaws, resolutions, or ordinances. <br />Signed: _____________________________________________ <br />Print Name: __________________________________________ <br />Title: _______________________________________________ <br />Date: _______________________________________________ <br />Signed: ______________________________________________ <br />Print Name: __________________________________________ <br />Title: ________________________________________________ <br />Date: ________________________________________________ <br />Signed: ______________________________________________ <br />Print Name: __________________________________________ <br />Distribution: DPS/FAS <br />Title: ________________________________________________ Grantee <br /> State’s Authorized Representative <br />Date: ________________________________________________ <br />DPS Grant Contract Agreement Non-State (rev. March 2024) <br />Qbhf!283!pg!286 <br /> <br />