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ATTACHMENT G <br /> CERTIFICATION OF APPLICABILITY TO SINGLE AUDIT ACT REPORTING <br /> Grantee ' s Name . <br /> Grantee Fiscal Year Period : FROM : TO : <br /> Total State Financial Assistance Expended during Grantee ' s most recently completed Fiscal Year: <br /> Total Federal Financial Assistance Expended during Grantee ' s most recently completed Fiscal Year: <br /> CERTIFICATION STATEMENT : <br /> I hereby certify that the above information is correct . <br /> Signature Date <br /> Print Name and Position Title <br /> DEP Agreement No . G0353 , Attachment G , Page I of 3 <br />