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Applicant Certification <br />Certification is hereby given that the information provided is accurate and the applicable attachments are complete and <br />included as part of the application package, <br />I certify that application thresholds are met at the time of application. <br />Signature of MOM Representative Date <br />Sponsoring Agency <br />(If Applicable) <br />Signature of Agency Representative <br />Typed or Printed Name <br />Date <br />Date <br />Associate Economic Development Organization Notification <br />The organization listed below has received not9fication of this application as demonstrated by the signature of <br />the organization's representative. <br />Name of Organization <br />Signature of Representative <br />Date <br />Kittitas County Department of Public Works Receipt of Application <br />Signature of Kialtas County DPW Representative <br />Typed or Printed Name <br />10 <br />