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Account Name Past Actual 3 <br />$ 0'00 <br />Contributions of Volunteer Time <br />Past Actual 3 <br />Number of Hours <br />Calculated Value of <br />Projected Volunteer <br />Time <br />$ 0.00 <br />Revenue Totals <br />Pasi Actual 3 <br />$ 0.00 <br />Past Actual 3 <br />$ 0.00 <br />Past Actual 3 <br />$ 0.00 <br />Expenses <br />Expense Totals <br />Profit & Loss <br />Past Actual 3 <br />$ 0.00 <br />Appl ication Certification <br />Past Actual 2 <br />$ 0.00 <br />Past Actual 2 <br />Past Actual 2 <br />$ 0.00 <br />Past Actual 2 <br />$ 0.00 <br />Past Actual 2 <br />$ 0.00 <br />Past Actual 2 <br />$ 0.00 <br />PastActual I <br />$ 0.00 <br />Past Actual 1 <br />0 <br />Past Actual 'l <br />$ 15000.00 <br />Past Actual 1 <br />$ 0.00 <br />Past Actual 1 <br />$ 0.00 <br />Past Actual 1 <br />$ 15000.00 <br />Projected <br />$ 0.00 <br />Projected <br />0 <br />Projected <br />$ 17000.00 <br />Projected <br />$ 0.00 <br />Proj6cted <br />$ o.oo <br />Projected <br />$ 17000.00 <br />The applicant here certifies and affirms: 1. That it does not now, nor will it during the performance of any contract arising <br />from this application, unlawfully discriminate against any employee, applicant for employment, client, customer, or other <br />person who might benefit from said contract, by reason of age, race, color, ethnicity, sex, religion, mililary staius, sexual <br />orientation, creed, place of birth, or disability; 2. That it will abide by all relevant local, state and federal laws and <br />regulaiions and; 3. That it has read the information contained in the lnstruciions on pages 1 and 2 and understands and <br />will comply wiih all provisions thereof. <br />Certified by: <br />Eafu&tarorsgr* <br />Name*Heather <br />Applicant's Title * National Sales Manager