16. APPUCATION SIGNATURE <br /> As an authorized representative of COY & O - 1 certify that the applicant <br /> agrees that as a condition of receiving Local Govemment Grant Program assistance, it will comply <br /> with all applicable local, state and federal laws. This application has been prepared with full <br /> knowledge of and in compliance with the Oregon Administrative Rules Chapter 736, Division 6, for <br /> the Distribution of State Funding Assistance to Units of Local Government for Public Parks and <br /> Recreation and OPRD's Procedures Manual for the program. I also certify that to my best <br /> knowledge, information contained In this Application is true and correct. I will cooperate with OPRD <br /> by furnishing any additional information that may be requested in order to execute a State/Local <br /> Agreement, should the project receive funding assistance. <br /> Name Tithe <br /> OZ. /Zoos <br /> Authorized Representative Signa re Date <br /> • bbl - Jig 3v !l• • yvt2. <br /> Telephone Number Fax Number <br /> • <br />