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6/1/2018 <br />https://dosgrants.com/GrantAppIication/PrintPreview?gid=5127 <br />I. Review and Submit Page 9of9 <br />1. Review and Submit * <br />® 1 hereby certify that I am authorized to submit this application on behalf of Indian River County Parks Division and that all information <br />indicated is true and accurate. I acknowledge that my electronic signature below shall have the same legal effect as my written signature. <br />I am aware that making a false statement or representation to the Department of State constitutes a third degree felony as provided for in <br />s. 817.155, F.S., punishable as provided for by ss. 775.082, 775.083, and 775.084. <br />Guidelines Certification * <br />® 1 hereby certify that I have read and understand the guidelines and all application requirements for this grant program as outlined under <br />section , Florida Statutes 267.0617 and 1A-39.001, Florida Administrative Code. <br />Signature (Enter first and last name) * <br />Elizabeth Powell <br />https://dosgrants.com/GrantApplication/PrintPreview?gid=5127 13/14 <br />