By signing your name below:

You certify that you are authorized to sign on behalf of all owners listed in this application.

You are declaring under penalty of perjury, that the foregoing is true and correct.

You agree that the following eligibility requirement does not exclude you from applying: No member of the governing body and no official, employee or agent of the local government, nor any other person may either for themselves or those with whom they have business or immediate family ties, who exercises policy or decision making responsibilities in connection with the planning and implementation of the program, shall directly or indirectly be eligible for this program.

You acknowledge that a review of all publicly available information will be made to determine if this grant would constitute a duplication of benefits under federal guidelines. Any grant funds received under the program that are later determined to be a duplication of benefits may require re-payment of the grant to the County of Butte or the City of Chico. The County of Butte, the City of Chico, and its program operator understand and support the public’s right to access public records. Certain information submitted through this application is public record and may be subject to disclosure under the California Public Records Act (PRA). In addition, the County of Butte, the City of Chico, and its program operator may determine in their sole discretion whether information submitted through this application is subject to disclosure under the PRA or through another legal process.