HomeMy WebLinkAboutExpenditure Request Certification (OWR) - Nov 22 - signedState of California Department of Resources Recycling and Recovery
SB 1383 Local Assistance Grant Program (FY2021-22)
Expenditure Certification
Complete the requested information. All fields are required. Please refer to the Procedures and
Requirements for information regarding electronic and original signatures.
Grantee Name City of Palm Desert
Grant Number OWR1-21-0026
Expenditure Request Number 1
Expenditure Amount $5,625
Expenditure Start Date
Expenditure End Date
July 1, 2022
September 30, 2022
I certify under penalty of perjury, under the laws of the State of California, that I have read the
SB 1383 Local Assistance Grant Program Procedures and Requirements and Terms and
Conditions, that the submitted expenditure information is correct, and that all funds received
under the Program have been expended in accordance with the Procedure and Requirements
and Terms and Conditions.
Todd (Nov 21, 2022 12:28 PST) 11/1/22
Signature of Signature Authority or Authorized Designee Date
L. Todd Hileman City Manager
Print Name Title
IMPORTANT! Grantee must obtain the signature of authorized signatory (as authorized in the
Resolution or Letter of Designation), upload the signed document to GMS with the Expenditure
Itemization Summary, and retain the original document in your grant file.
SB 1383 Local Assistance Grant Program, FY 2021-22
Expenditure Request Certification (OWR) - Nov
22
Final Audit Report
Created: 2022-11-21
By: Amy Lawrence (alawrence@cityofpalmdesert.org)
Status: Signed
Transaction ID: CBJCHBCAABAA5rU3LfPWBaCrunMZ69dcKUxILO3apbZJ
2022-11-21
"Expenditure Request Certification (OWR) - Nov 22" History
Document created by Amy Lawrence (alawrence@cityofpalmdesert.org)
2022-11-21 - 8:22:43 PM GMT- IP address: 64.60.5.80
Document emailed to Todd Hileman (thileman@cityofpalmdesert.org) for signature
2022-11-21 - 8:23:00 PM GMT
Email viewed by Todd Hileman (thileman@cityofpalmdesert.org)
2022-11-21 - 8:27:35 PM GMT- IP address: 154.36.111.254
r Document e -signed by Todd Hileman (thileman@cityofpalmdesert.org)
Signature Date: 2022-11-21 - 8:28:12 PM GMT - Time Source: server- IP address: 64.60.5.80
O Agreement completed.
2022-11-21 - 8:28:12 PM GMT
O Adobe Acrobat Sign