Attachment 5-Assurance of One DFC Grant at a Time NOFO CDC-RFA-CE20-2003.docx

Attachment 5. Assurance of One DFC Grant at a Time

The legal applicant/grant award recipient must read the statement below, and sign and date this document to assure that the legal applicant/grant award recipient will not hold more than one DFC grant at any time during the FY 2020 – FY 2025 funding cycle.

NOTE: DFC Mentoring and Sober Truth on Preventing Underage Drinking (STOP Act) grants are in a separate category and do not apply to this assurance.

Applicant Assurance of One DFC Grant at a Time

I attest that the [Legal Applicant/Grant Award Recipient] will be in receipt of only one DFC grant during the FY 2020 – FY 2025 funding cycle.

Authorized Official’s Name for the Legal Applicant/Grant Recipient

Authorized Official’s Signature for The Legal Applicant/Grant Recipient

Title

Organization/Agency

Date

NOTE: All forms must be dated between January 2019 and the deadline for submission of this application. All forms require handwritten signatures and dates or they will be screened out and not move forward to merit review.