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<br />Application for Funding Assistance <br />Florida Department of Law Enforcement <br />Local Law Enforcement Block Grant <br /> <br /> <br />In witness whereof, the parties affirm they each have read and agree to the conditions set <br />forth in this agreement, have read and understand the agreement in its entirety and have <br />executed this agreement by their duty authorized officers on the date, month and year set <br />out below. <br /> <br />Corrections on this page, including Strikeovers, <br />whiteout, etc. are not acceptable. <br /> <br /> <br />Signature: <br /> <br />Typed Name and Title: <br /> <br />Date: <br /> <br /> <br />Typed Name of Subgrant Recipient: <br /> <br />Signature: <br /> <br />Typed Name and Title: <br /> <br />Date: <br /> <br /> <br />Typed Name of Implementing Agency: <br /> <br />Signature: <br /> <br />Typed Name and Title: <br />Date: <br /> <br />Application Ref # 2005-LEBG-166 <br /> <br />Contract <br /> <br />Page 10 of 11 <br /> <br />SIB <br />