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04-101
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04-101
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7/8/2005 3:34:22 PM
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7/8/2005 10:00:26 AM
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<br />1. ENCUMBRANCE VERIFICATION <br />Individual certifies that funds have been encumbered as <br />required by Minn. Stat. sf; 16A.15 and 16C. 05. <br /> <br />Signed: <br /> <br />Date: <br /> <br />Grant Contract No.: <br /> <br />200S-LLEBG-00338/9300-1378 <br /> <br />2. GRANTEE <br /> <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 /> <br />By: <br /> <br />Ti tIe: <br /> <br />Date: <br /> <br />By: <br /> <br />Title: <br /> <br />Date: <br /> <br />Vj~ <br />~~i <br />~~A~ <br /> <br />- <br /> <br /> <br />~ <br /> <br />LLEBG (11/04) <br />Local Law Enforcement Block Grant 05 <br />QJP GUlnt Number 200S-LLEBG--0O338 <br /> <br />- 3. STATE AGENCY <br /> <br />By: <br /> <br />(with delegated authority) <br /> <br />Title: <br /> <br />Date: <br /> <br />Distribution: <br />DPS/FAS <br />Grantee <br />State's Authorized Representative <br /> <br />6 <br />
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