SF 424 Application F19AC00021.pdf

Application for Federal Assistance SF-424

* 9. Type of Applicant 1: Select Applicant Type:

M: Nonprofit with 501C3 IRS Status (Other than Institution of Higher Education) I Type of Applicant 2: Select Applicant Type:

Type of Applicant 3: Select Applicant Type:

* Other (specify):

* 10. Name of Federal Agency:

lu. s. Fish & Wildlife Service I

11. Catalog of Federal Domestic Assistance Number:

!is. 658 I CFDA Title:

Natural Resource Damage Assessment, Restoration and Implementation

I

* 12. Funding Opportunity Number:

I

I

*Title:

I

13. Competition Identification Number:

N/A I Title:

IN/A

I

14. Areas Affected by Project (Cities, Counties, States, etc.):

I I Add Attachment 11 Delete Attachment 11 View Attachment I

* 15. Descriptive Title of Applicant's Project:

European Beach Grass Removal to Benefit Western Snowy Plover and Least Tern Habitat on Guadalupe- Nipomo Dunes National Wildlife Refuge

Attach supporting documents as specified in agency instructions.

I Add Attachments 11 Delete Attachments 11 View Attachments I

Torch/Platform Irene Oil Spill Restoration

Application for Federal Assistance SF-424

16. Congressional Districts Of:

* a. Applicant 124 I

Attach an additional list of Program/Project Congressional Districts if needed.

I I Add Attachment I

17. Proposed Project:

* a. Start Date: 111/1/20181

18. Estimated Funding($):

* a. Federal 109,000.00

* b. Applicant

* c. State

* d. Local

* e. Other

* f. Program Income

* g. TOTAL 109,000.001

* b. Program/Project

I I, Delete Attachment

* b. End Date:

* 19. Is Application Subject to Review By State Under Executive Order 12372 Process?

124 I

11 View Attachment i10/30/2023 1

D a. This application was made available to the State under the Executive Order 12372 Process for review on I � b. Program is subject to E.0. 12372 but has not been selected by the State for review.

D c. Program is not covered by E.0. 12372.

* 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.)

OYes �No

If "Yes", provide explanation and attach

I I I, Add Attachment 11

Delete Attachment 11 View Attachment

I

I-

I

21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001)

�**I AGREE

** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions.

Authorized Representative:

Prefix: IMr. I * First Name: I Jonathan I Middle Name: I I

* Last Name: lttall I Suffix: I I

* Title: jstewardship Director I

* Telephone Number: jsos-544-9096 I Fax Number: isos-544-5122

* Email: b onh@lcslo.org I

* Signature of Authorized Representative: Jonathan

* Date Signed: i10/15/2018 r

I

I