Laserfiche WebLink
<br /> <br />Grant Contract Agreement Page 2 of 2 <br /> <br /> <br />DPS Grant Contract Agreement Non-State (rev. September 2022) <br />Payment: As stated in the Grantee’s Application and Grant Program Guidance, the State will promptly pay the <br />Grantee after the Grantee presents an invoice for the services actually performed and the State's Authorized <br />Representative accepts the invoiced services and in accordance with the Grant Program Guidelines. Payment will <br />not be made if the Grantee has not satisfied reporting requirements. <br /> <br />Certification Regarding Lobbying: (If applicable.) Grantees receiving federal funds over $100,000.00 must <br />complete and return the Certification Regarding Lobbying form provided by the State to the Grantee. <br /> <br /> <br />1. ENCUMBRANCE VERIFICATION 3. STATE AGENCY <br />Individual certifies that funds have been encumbered as <br />required by Minn. Stat. § 16A.15. Signed: _____________________________________________ <br /> (with delegated authority) <br /> <br />Signed: _____________________________________________ Title: ______________________________________________ <br /> <br />Date: _______________________________________________ Date: ______________________________________________ <br /> <br />Grant Contract Agreement No./ P.O. No. A-FSG-2024-LINOLKPD-029 / 3-94757 <br />Project No.(indicate N/A if not applicable): __N/A___ <br /> <br />2. GRANTEE <br /> <br />The Grantee certifies that the appropriate person(s) <br />have executed the grant contract agreement on behalf of the Grantee <br />as required by applicable articles, bylaws, resolutions, or ordinances. <br /> <br />Signed: _____________________________________________ <br /> <br />Print Name: __________________________________________ <br /> <br />Title: _______________________________________________ <br /> <br />Date: _______________________________________________ <br /> <br /> <br /> <br />Signed: ______________________________________________ <br /> <br />Print Name: __________________________________________ <br /> <br />Title: ________________________________________________ <br /> <br />Date: ________________________________________________ <br /> <br /> <br />Signed: ______________________________________________ <br /> <br />Print Name: __________________________________________ <br />Distribution: DPS/FAS <br />Title: ________________________________________________ Grantee State’s Authorized Representative <br />Date: ________________________________________________ <br /> <br /> <br /> <br /> <br /> <br />78