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PUBLIC INFRASTRUCTURE GRANT PROPOSAL <br />I, the undersigned, do hereby certify that I have express authority to sign this proposal on behalf of the <br />above-described entity and to the best of my knowledge, that all data and information submitted in <br />proposal is truthful and accurate and no material fact has been omitted. <br />Name of Governmental Entity: <br />Name and Title of Authorized Representative: <br />Representative Signature: <br />Signature Date: <br />41 <br />