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Applicant Certifi catlon <br />Certification is hereby given that the information provided is accurate and the applicable attachments are <br />complete and included as part of the application package. <br />I certifu that application tbresholds are met at the time of application. <br />tot4l2022 <br />Date <br />Sponsoring Agency <br />(If Applicable) <br />Signature of Agency Representrtive Date <br />Typed or Printed Name Ilate <br />Associrte Economic Development Organlzation Notificadon <br />The organization listed below hac received notllication of this appllcation rs demonstrated by the <br />signature of the organization ts representative. <br />of Organfuation <br />to/&?A?.? <br />Date <br />Ktttitac County llepartment of Public Works Receipt of Application <br />$ignature of KittiQc County DP\il Representstive Ilate <br />Typed or Printed Nome