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I CERTIFY that I am familiar with the information contained in this application, and to the best of my knowledge <br />and belief such information is true, complete and accurate. I further certify that I possess the authority to apply <br />for this grant on behalf of this county. <br />nature of Authorized Representative Date <br />KII�IIV l R. MACHr, CILAIRMAN f BOARD OF C]t7UNTY C1lth4ISSIQNER.S <br />For further Information on the programs listed above in number 10, please contact Keep Florida Beautiful, Inc., <br />325 John Knox Road, M-240, Tallahassee, FL 32303, 904-385.1528. <br />Please return this form to Bobby Adams, Solid Waste Section, Bureau of Solid & Hazardous Waste, <br />Division of Waste Management, Florida Department of Environmental Protection, Twin Towers Office <br />Building, Mail Station # 4565, 2600 Blair Stone 'Road, Tallahassee, FL 32399-2400 <br />6/, <br />Page 2 of 2 5199 <br />