HomeMy WebLinkAboutExpenditure Request Certification (OWR4) REVISED 5.5
SB 1383 Local Assistance Grant Program (FY2022–23)
Expenditure Request Certification
Complete the requested information. All fields are required.
Grantee Name City of Palm Desert
Grant Number OWR4-22-0104
Expenditure Request Number 02
Expenditure Amount $34,745.80
Expenditure Start Date October 1, 2024
Expenditure End Date April 1, 2025
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 (OWR4) 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.
Signature of Signature Authority or Authorized Designee Date
Chris Escobedo Interim City Manager
Print Name Title
IMPORTANT! Grantee must obtain 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.