HomeMy Public PortalAbout2021.11.15 SF-424 Airport Grant ApplicationApplication for Federal Assistance SF-424
*1. Type of Subm ission : *2. Type of A pplication * If Revision , se lect appropriat e letter(s):
D Preapplica tio n ~ New
~ Application D Continu at ion *Othe r (S pec ify)
D Changed/Co rrected Applicat ion D Revisio n
*3. Date Received : 4 . A pp licant Identifier :
NA MY L (McCal l Mu nicipal) McCall , ID
*Sb . Federal Ent ity Identif ier : *Sb . Federal Awa rd Ident ifier :
16-0023
State Use Only:
6 . Date Rece iv ed by State : I 7 . State A pp lica tion Ide nt ifi er :
8. APPLICANT INFORMATION :
*a. Legal Name : City of McCall
*b . Employer/Taxpayer Identification Number (EIN/TI N): *c . O rgani zat ional DU NS :
82-6000223 18-892-2611
d . Address :
*St reet 1: 216 E Park
St reet 2:
*City: Mc Call
County/Pa ris h :
*State : ID
Provin ce:
*Country : US A : Uni te d States
*Zip / Posta l Cod e 83638
e . Organizational Unit:
Department Name: Divis ion Name :
f . Name and contact information of person to be contacted on matters involving this application :
Prefi x : Hon orable *Fi rst Name : Robert
Middle Name :
*Last Name : Gil es
Suffi x :
T itle : Mayor
Organ iz atio nal Affiliation :
*Telephone Nu mb er: 208-634-71 42 Fa x Number:
*Email : bgiles@ mccall.id .us
0 M B Number: 4040-0004
Expirat io n Date: 12/31 /2022
Application for Federal Assistance SF-424
16 . Congressional Districts Of:
*a . Applicant: 1 *b. Progra m/Project: 1
Attach an addi ti o nal lis t of Prog ra m/Proj ect Congre ss ional Di stricts if nee ded .
17 . Proposed Project:
*a. Start Date : NA *b . End Date : NA
18 . Estimated Funding($):
*a . Federal $32 ,000
*b . Applica nt $0
*c. State
$0
*d. Local
*e. Other
$0
*f. Program Income $0
*g . TOTA L $32 ,000
*19. Is Application Subject to Review By State Under Executive Order 12372 Process?
0MB Numb er: 4040-0004
Expiration Da te: 12/31/2022
D a . T his appli ca ti o n was made avai lab le to the St ate un der t he Executive Ord e r 12372 Process for review on __ .
D b . Prog ram is s ubj ect to E .O . 12372 bu t has no t bee n se lec ted by t he State for review.
[gJ c . Progra m is not covered by E. 0 . 12372
*20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes ", provide explanati on in attachment.)
D Yes [gj No
If "Yes ", provide explanation and attach
21 . *By sig ning thi s application, I ce rt ify (1) to the state ments con tai ned in th e lis t of cert ificati o ns ** a nd (2) that the stat eme nts
herein a re tru e , compl ete and accurate to the bes t of my kno w ledge . I a lso pro vid e the requ ire d as sura nces ** a nd ag re e to compl y
wit h any res ultin g te rm s if I acce pt a n award . I am aw are that a ny false , fic titiou s, o r fraudu lent state men ts or claims ma y s ub ject
me to crimina l, c ivil , o r adminis trativ e penalties. (U. S. Cod e , Tit le 218 , Section 1001)
[gJ ** I AG REE
** The list of ce rt ifications and ass urances , or an in ternet site w he re you may obt a in this list , is co nt a in ed in the a nn o un cement o r
agency specifi c inst ru ctions.
Authorized Representative :
Prefix : Ho norable *First Na me: Ro be rt
Middle Na me :
*Last Na me: Gil es
Suffix :
*Ti tle: Mayor
*T elephone Nu mber : 208-634-71 42 I Fax Nu mber:
* Email : bgiles@ mcca ll.id.us ....
*Si gna ture of Authori zed Represe nt ative : 1fluWJ-d . J{;dA / I *Date Si gned: -11/15/21