HomeMy WebLinkAboutExpenditure Request Certification (OWR) - May 3 - EXECUTEDState 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 2
Expenditure Amount $13,425.00
Expenditure Start Date
Expenditure End Date
November 3, 2022
May 2, 2023
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 an (May 3, 2023 13:13 PDT) 5/3/23
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) - May
3
Final Audit Report
Created: 2023-05-03
By: Luis Moctezuma (Imoctezuma@palmdesert.gov)
Status: Signed
Transaction ID: CBJCHBCAABAAGne6JVGMBrK2XuUEggQ61iznz3Lxeu3C
2023-05-03
"Expenditure Request Certification (OWR) - May 3" History
Document created by Luis Moctezuma (Imoctezuma@palmdesert.gov)
2023-05-03 - 5:11:31 PM GMT
Document emailed to Todd Hileman (thileman@palmdesert.gov) for signature
2023-05-03 - 5:11:56 PM GMT
Email viewed by Todd Hileman (thileman@palmdesert.gov)
2023-05-03 - 6:13:15 PM GMT
r Document e -signed by Todd Hileman (thileman@palmdesert.gov)
Signature Date: 2023-05-03 - 8:13:23 PM GMT - Time Source: server
O Agreement completed.
2023-05-03 - 8:13:23 PM GMT
O Adobe Acrobat Sign