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HomeMy Public PortalAbout43-E Certification��p,ae��v��e+rf 4 mat u e P yk W Y} PROGRAM 1 P P 1 " ��g4fYpRNiP 3. Certifications and Identity of Interest Disclosure State of California Infill Infrastructure Grant Program On behalf of the entity identified in the signature block below, I certify that: 1. The information, statements and attachments included in this application are, to the best of my knowledge and belief, true and correct. 2. 1 possess the legal authority to submit this application on behalf of the entity identified in the signature block. 3. The following is a complete disclosure of all identities of interest  of all persons or entities, including affiliates, that will provide goods or services to the project wither (1) in one or more capacity or (b) that qualify as a "related Party" to any person or entity that will provide goods or services to the project. "Related Party" is defined in Section 10302 of the California Code of regulations (TCAC Regulations): Truckee Development Associates, LLC Truckee Railyard, LLC Holliday Development, LLC In addition, I acknowl ge that all information in this application and attachments is public, and may be disclose y th e. 8.5 " ?--r-> 13 Signatu Date Richard M. Holliday All of above Printed Name of Signatory Entity Represented Manager Printed Title of Signatory Grant Application- PartE_Rev05 -29 -13 Certification - Page 1