HomeMy WebLinkAboutUS Department of Justice, Drug Enforcement Administration - Central Florida HIDTA - 2014 07 22 RECEIVED JUL 2 2 2014
STATE AND LOCAL HIDTA TASK FORCE AGREEMENT
"CENTRAL FLORIDA HIDTA"
This agreement is made this I"day of October 2014, between the United States Department of
Justice, Drug Enforcement Administration (hereinafter "DEA"), and the City of Winter Springs
Police Department (hereinafter "WSPD"). The DEA is authorized to enter into this cooperative
agreement concerning the use and abuse of controlled substances under the provisions of 21
U.S.C. § 873,
Whereas there is evidence that trafficking in narcotics and dangerous drugs exists in the Florida
area and that such illegal activity has a substantial and detrimental effect on the health and
general welfare of the people of Florida, the parties hereto agree to the following:
1. The DEA Orlando HIDTA Heroin Task Force will perform the activities and duties
described below:
a. disrupt the illicit drug traffic in the Florida area by immobilizing targeted violators and
trafficking organizations;
b. gather and report intelligence data relating to trafficking in narcotics and dangerous
drugs; and
c. conduct undercover operations where appropriate and engage in other traditional
methods of investigation in order that the task force's activities will result in effective
prosecution before the courts of the United States and the State of Florida.
2. To accomplish the objectives of the Heroin Task Force, the WSPD agrees to detail one (1)
experienced officer(s) to the Heroin Task Force for a period of not less than two years. During
this period of assignment, the WSPD officers will be under the direct supervision and control of
DEA supervisory personnel assigned to the task force.
3. The WSPD officers assigned to the task force shall adhere to all DEA policies and
procedures. Failure to adhere to DEA policies and procedures shall be grounds for dismissal
from the task force.
4. The WSPD officers assigned to the task force shall be deputized as task force officers of
DEA pursuant to 21 USC 878.
5. To accomplish the objectives of the DEA Heroin Task Force, DEA will assign four (4)
Special Agents to the task force. HIDTA will also, subject to the availability of annually
appropriated funds or any continuing resolution thereof, provide necessary funds and equipment
to support the activities of the DEA Special Agents and WSPD officers assigned to the task
force. This support will include: office space, office supplies, travel funds, funds for the
purchase of evidence and information, investigative equipment, training and other support items.
6. During the period of assignment to the DEA Heroin Task Force, the WSPD will remain
responsible for establishing the salaries and benefits, including overtime, of the WSPD officers
assigned to the task force and for making all payments clue them. HIDTA will, subject to
availability of funds, reimburse the WSPD for overtime payments made by it to the WSPD
officers assigned to the DEA Heroin Task Force for overtime, Lip to a sum equivalent to 25
percent of the salary of a GS-12, Step I (RUS) federal employee, currently $ 17, 374.25, per
officer, Note: Task Force Officer's overtime "Shall not include any costs for benefits, such as
retirement, FICA, and other expenses."
7. In no event will the WSPD charge any indirect cost rate to DEA for the administration or
implementation of this agreement.
8. The WSPD shall maintain on a current basis complete and aectirate records and accounts Of
all obligations and expenditures of funds under this agreement in accordance with generally
accepted accounting principles and instructions provided by DEA to facilitate on-site inspection
and auditing of such records and accounts.
9. The WSPD shall permit and have readily available for examination and auditing by DEA, the
United States Department of Justice, the Comptroller General of the United States and any of
their duly authorized agents and representatives, any and all records, documents, accounts,
invoices, receipts or expenditures relating to this agreement. The WSPD shall maintain all such
reports and records until all litigation, claim, audits and examinations are completed and resolved
or for a period of three (3) years after termination of this agreement, whichever is later.
10. The WSPD shall comply with Title VI of the Civil Rights Act of 1964, Section 504 of the
Rehabilitation Act of 1973, the Age Discrimination Act of 1975, as amended, and all
requirements imposed by or pursuant to the regulations of the United States Department of
Justice implementing those laws, 28 C.F.R. Part 42, Subparts C, F, G, H and I.
11. The WSPD agrees that an authorized officer or employee will execute and return to DEA
the attached ON Form 4061/6, Certification Regarding Lobbying; Debarment, suspension and
Other Responsibility Matters; and drug-Free Workplace Requirements. The WSPD
acknowledges that this agreement will not take effect and no federal funds will be awarded until
the completed certification is received.
12. When issuing statements, press releases requests for proposals, bid solicitations and other
documents describing projects or programs funded in whole or part with federal money, the
WSPD shall clearly state: (1) percentage of the total cost of the program or project which will be
financed with federal money and (2) the dollar amount of federal funds for the program or
project.
I'). The WSPD understands and agrees that HIDTA will provide the DEA Heroin Task Force
Officers with vehicles suitable for surveillance. HIDTA through DEA will furnish mobile radios
for installation in the HIDTA Task Force vehicles and HIDTA will assume the cost of
installation and removal. HIDTA will be financially responsible for the purchase of fuel for the
leased vehicles and for providing routine maintenance, i.e., oil changes, lubes and minor tune-
ups via the HIDTA lease contractor. DEA and HIDTA procedures for reporting and
investigating automobile accidents involving Official Government Vehicles (OGV'S)-HIDTA
lease vehicles shall apply to accidents involving the leased vehicles furnished to the WSPD
persorriiel, in addition to whatever accident reporting requirements the WSPD may have.
14. While on duty and acting on task force business, the WSPD officers assigned to the HIDTA
task force shall be subject to all DEA and federal government rules, regulations and procedures
governing the use of OGV's for home to work transportation and for personal business, The
HIDTA Executive Committee acknowledges that the United States is liable for the actions of
task force officer, while on duty and acting within the scope of their federal employment, to the
extent permitted by the Federal Torts Claim Act.
15. All sharing of federally forfeited property will be done in accordance with the U.S.
Department of Justice policies and procedures as set forth in Guide to Equitable Sharing for State
and Local Law Enforcement Agencies (April 2009). Every effort will be made by DEA to make
a fair and impartial distribution of federally forfeited assets.
16. Among members of the Orlando District Office HIDTA Task Force (ODOHTF), sharing of
federally forfeited property will be based on the number of officers each participating agency
assigns to the ODOHTF.
17. Equitable sharing distributions with non-ODOHTF agencies shall be based on the number of
work hours expended by the non-ODOHTF agencies in the investigation. In investigations
where agencies not comprising the ODOHTF participate in the investigation leading to the
seizure and federal forfeiture of assets, sharing may also be determined on the ultimate
qualitative value of the information provided to the ODOHTF. In making the distribution
determination, DEA will take into consideration the originator of the information, the
development and/or use of confidential informants or sources of information, and the critical
nature of the assistance to the investigation.
18. Equitable sharing distributions with contributing ODOHTF agencies (e.g. independent
agency units, narcotic squads, detective squads etc.) shall be based on the number of work hours
expended by contributing ODOHTF agencies in the investigation. In investigations where
agencies (e.g. independent agency units, narcotic squads, detective squads etc.) comprising the
ODOHTF participate in the investigation leading to the seizure and federal forfeiture of assets,
sharing may also be determined on the ultimate qualitative value of the information provided to
the ODOHTF. In making the distribution determination, DEA will take into consideration the
originator of the information, the development and/or use of confidential informants or sources
of information, and the critical nature of the assistance to the investigation.
19. The term of this agreement shall be effective from the date in paragraph number one until
September 30, 2015. This agreement may be terminated by either party on 30 days advance
written notice. Billing for all outstanding obligations must be received by DEA within 90 days of
the date of termination of this agreement. IIIDTA will be responsible only for obligations
incurred by WSPD during the term of this agreement.
For the Drug Enforcement Administration:
Date:
ark R. Trouvill v
Special
c
pecial Agent in Charge
I Field
Miami Field Division
For the Winter Springs Police Depa ent:
�O Date:
Kevin P. Brunelle
Chief
For the City of Winter Springs:
Date: 7 1,6
Kevivl�. Smith
City Manager
U.S. DEPARTMENT OF JUSTICE
A� _
r; OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
CERTIFICATIONS REGARDING LOBBYING; DEBA4 ME T, SUSPENSION AND
OTHER RESPONSIBILITYMATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS
Applicants should refer to the regulations cited below to determine the certification to which they are required to
attest. Applicants should also review the instructions for certification included in the regulations before completing this
from. Signature of this form provides for compliance with certification requirements under 28 CFR Part 69, "New
Restrictions on Lobbying" and 28 CFR Part 67, "Government-wide Department and Suspension (Nonprocurement) and
Government-wide Requirements for Drug-Free Workplace (Grants)."The certifications shall be treated as a rnaterial
representation of fact upon reliance will be placed when the Department of Justice determines to award the
covered transaction, grant, or cooperative agreement.
1. LOBBYING NVIQc (Federal ,State,.or local) tra a tion or c tract un er
transaction;, vrolatron of �edce�al or tat n itrus
As e air d b sse t�n 13 T tle 31 of the U.S. Code, an u es or commission of em ezfz ementt, hetefk oryer .mp�err�en d a�28 8FR Pa9, 1` rs ns e t nn into a� e fa sification.or d structeon o recor s, ma ing alsye
�arct e live ant centfes trhat� ,96,, as �e#ir at 2 FR s{ Men s, or receiving stolen property,
(�CC�))Are of present) indi t d for or th rwise criminal) or civil)
(a) No Federal appropriate funds have been paid or will be paid, Ar edYy a over�i nc4al ntit (�ec(eral, St te, or Kcal wi�r
by or on behalf of the undersigned, to any person for influencing omrii Sion of an of tie afteens�s enumerate in m paragra� �1)
or attemptin to influence an officer or employee of any agency, �)o thsis ce ifica on; and
a Member o� Congress, an officer or employee of Congress, or
an employee of a.Member of Conggress in connection with the t
making .of any Federal rant Te entering into of any (d�dNon not within ub� rya�sa period e�e era], is e PVTcap
cooperative agreement; .an� extension, continuation, renewal, ermina e for caus or e au t; an
amendment, or modification of any Federal grant or cooperative
agreement;
B. Where the a plic is unable to c rtify to an f the
statements rn thi c r ifi.cation, he or s ie shall a tacoh an
�b.If an ds of er than Federal a r riated fund have been exp lanation to this appleication.
+d Arc wit�oe id to anaTabn fo in �iencin�or aa�e tn? to
ue an o cer ore o ee p an a en a Mtn? o
Egress, a7� icer or em�o�ee of Connre� o�ar5 e ployaeef Or
DRUG-FREE WORKPLACE
a lvlomber o on res r co ne tion th is e era r n or
co erati are �n 1 the ersi ed s all co p e and GRANTEES OTHER THAN INDIVIDUALS)
sntt � nagare orm l�� disclosure o� obbying
c ivities, in accordance with its instructions; As required by e FLu Free Wgrkplace FA t of 1988, and
m le eat, art ri"> >ulb3r r� or r� t ,c as
do- ned ap 28 C art y Salo is C� 615,and �. 6
The undersi g stt 11 require that the topguage f this cer-
aC�`{{ tion b m hided int e award docrments tcrt Irsubawards a# A T e a li�a�t certifies that it will or will continue to provide a
l�c iers. inc�udin s prams, ooniract undar r)ant�s auT drug twee pv�o'rCplaceby:
coa erativ ��ree ens nd su contrac s� an A a su -
reci0ents sha ce r y and disclose accorling y.
(a) Dbllishinhq a stat ment notif�in emplo ees that the
rtlaw ma fa to e, �is ributian, s n i ssessio r
use o a conn,roe . sus nce Is r e. on h gran ee s
lON,AND OTHER workplace ndl s�eccif inb he acts sp fh arCert against
,ta(F employeesor vicatio�i osuch pro�ii�ition;
b) Establi hin an on-going drug-free awareness program to
As re aired b Executive Orr�Qr 1122549, barmesntt nd �nrorm empp�oye s about-
Sau (�c ngsgn,iandrimplemenvte d�tt�tSnS FK PS 67, de no e
R Dart 67,�nc�ion 97.91 (1)The dangers of drugs abuse in the workplace;
A. The applicant certifies that it and its principals: (2)The grantee's policy of maintaining a drug-free workplace;
(
a3s} A�1� available druga counseling, rehabilitation, and employee
(a) Are not presently debarred, suspended, proposed for debar- sis nce programs; n
ment declared ineli able, sentenced to a denial of Federal
benefits by a State orgFederal court, or voluntarilyexcluded from 1-he aloes that ma b impo e u on employees for drug
covered transactions by any Federal deparment or agency, use v o�a�ions occurringyinThe workp1au e,
rrc Mak ri�t a regYsment that each enlone to be en feed it
b)) Have nott
with a thr e yea .period reced n tis ap lic tion ih� er o ance t ran be given c py of the s men
�cen conyicted oTp r hada crviCAdga e�t rendetge�ahya' st the regYiirer by paragraph(a�;
o�r commis on of trau r a cn i of erase rn con ection wiT
tarning, a��empting to o�tarn,or performing a
d Notif i t�he em toe in he tatem nt eq fired b
rae rap i a�th�t, as cl;ON iition of empisoymenl under t ie grant,
OJP FORM 4061/6(3-91)REPLACES OJP FORMS 4061/2,4062/3 AND 4061/4 VVHICH ARE:.OBSOLETE.
(1)Abide by the terms of the statement; and
vl� ' io,fy he
ernpi 'ey n wRiuqg o
cchsrrior teethe workplace no
la e,than vecaYengar Ra�saer such con wicpion-
�e) N t f thea a % lendar days after
I,n notice
XT
'p, ,%wr,in�,w
p� a)§cp
e e su ppra� rom an e I e lace on file that are not identified
r o h wisp rete vi aptual notic o , uch conmV, I e Check I— there are workplace
��tog,n here.
Empto er, T c nvic mployqe t 11 t'( n
e a f i e i
osA Pit S��tiy'n 67, 6JO y 'cles.that a gpWee that i�
roprqm�, �r sko 'no ia a f the r ulationsrpovl
':7) �'0'1 c v e
ing n i e s al n u e t e identlfic4tioh ong ce i igg inftpch E
ep)TJJQa1
numpeiTs�of each a ected gran I �e inc, wi egart apTlica on
for Depao�6nt o g
6jlyForm
ice ales and e enc2s
may elec ton orm%
Taknq one. of the follo at,(C,, ith 30)(�TIenct
s r w w'M
s eceiving notice u pe (d Check f- if the State has elected to complete OJP Form
', un eT a
�r6p, J to any employee w o is so convi pr p 4061/7.
Taking t I t i against such
�Iopgo�qri.e � rsoqne .ac ior
Iq rm sis ent with C, REE WQRKP
I 'qFbne4ct'no?t*3c0a s amended or A% "Y'
req E it meed n )e e i a ES WHO AR INDIVIDUALS)
OuRequiring such em?,11,,%, p as uru
,,-I,tpa rtici pate safisfact I I d As ra�uir?d 'C Ju7,FWt7 VV k laceFA g g Itees, as
c or cp lb[ h it of 1988, and
se as�isianre a , a pg roovre 67.615 and
o�r a - r r?WeTa w en orcement, ections
EuT alle, 0 Ua M h Ye
tRses p Utcl agency;
r er a opr a e
Asa Tordition of the gTnt I 5ertify that I will not erigge in
(g) Making a good faith effort to continue to maintain a drug-fire
A. unla u manufuture isti'ibul ion, clijsglnsin�qaocs?p�
e c�eu se oly a pritro ed substance in condi ion 1v 10q1h
workplace through implementation of paragraphs (a), (b), (c), (d), t gra nt; an
(e), and (0.
The ranteF mal inserl in tl�e 1pace,Rrovided below the
tie e B. If convinced of a criminal drug offense resulting frac a
for tl�le per orm Ince o wor one J connection withe violation occurring during the conduct of any rant activity, I will
��,PeCITIC gram: report the conviction, in writing, PC
I Justice,
within 10 calendar days of the
conviction, to Department o u stice Office of Justice Programs,
Pla of Performance (Street address, city, country, state, zip ATTN: Control Desk, 633 Indiana Avenue, N.W., Washington,
c oc Fel D.C. 20531,
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications.
1. Grantee Name and Address:
Chief Kevin P. Brunelle
Winter Springs Police Department
300 N. Moss Rd. Winter Springs, FL 32708
2. Application Number and/or Project Name 3. Grantee IRSNendor Number
4. Typed Name and Title of Authorized Representative
Kevin P. Brunelle, Chief
7
5. Signature 6. Date
Y
U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
CERTIFICATIONS GA I LOBBYING; DEBARMENT, SUSPENSION AND
OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE RECS IRE E TS
Applicants should refer to the regulations cited below to determine the certification to which they are required to
attest. Applicants should also review the instructions for certification included in the regulations before completing this
from. Signature of this form provides for compliance with certification requirements under 28 CFR Part 69, "New
Restrictions on Lobbying" and 28 CFR Part 67, "Government-wide Department and Suspension (Nonprocurement) and
Government-wide Requirements for Drug-Free Workplace (Grants)." The certifications shall be treated as a material
representation of fact upon reliance will be placed when the Department of Justice determines to award the
covered transaction, grant, or cooperative agreement.
1. LOBBYING a Ic (Federal .State,,or local) tra a tion or c tr ct un er
u �i transaction;. vioiation of �ecfe�al or to n itrusn
As e uir d b gge t�Qp 13 Tale 31 of the U.,S. Code, and t lues o commissiond of em e ement, he� or er ,
irnplerr�enefed a 28FtZ Part C9, 1` r ns e t nn into t s�ater�ents�ofr cecelvir°r sto�en prtapertofi records, making �al�e
�arct bo tfnae appn ant cernifies r'$0,06, as �e#inent at 2 t g
((cc��Are of present) indi t d for or th rwise criminal or civil)
(a) No Federal appropriate funds have been paid or will be paid, Car ed�y a over�i nnc#aei ntit (nederal, St te, or ��cal wi
Dy or on behalf of the undersigned, to any person for influencing �a)mrii cion�fganty a tie ofteens s enumerated m parag% �1)
or attempting to influence an officer or employee of any agency, o tniis ce ifica on; and
a Member o�Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the tt
making .of any Federal grant the entering into of any dedHo�e notmohen ub�ie�ryaesranteriod p Ned'Ntale pffci"NP)
cooperative agreement, ,an extension, continuation, renewal, erminanecnfor cause or cnefauI t; an
� lr
amendment, or modification of any Federal grant or cooperative
agreement;
s Where the a plica t is unable to c rtify to an f the
stat meepts in this c rt�ftcation, he or s�ie shall aac� an
b.If an ff rads other than Federal o r riated fundi have ben exp app to this appnication.
Oil or wilNeNO,(,
id to an rson fop%r encin or ahem tin eto
+uence an ar or e nppp�o ee >r an a en a Mer belg of
ress, arer or ern ee onCo)n ,oiya e plog?of 3 DRUG-FREE WORKPLACE
a ember on res co ne tion th is Fe era r n o GRANTEES OTHER THAN INDIVIDUALS)
cc Qrati agree n nn nhe �r�c�ersi�ned sail corfnp e e Y ng
�,c 11 ities, in accordance with its instructionsosure o a b m
IAn"lS ler en eddd a eC p Frrre97W�ru�larce #orf 1988ee,s and
deNed at 28 PaFrt F Sections Ep ']rad V.V
The undersigned sh II requir that the lapgua)e of this cer-
n�{c oon b in hided int�,e aw rdedocuments t64 II 3u awards a A. Tea li a t c rtifies that it will or will continue to provide a
al�oniee ativ ncFAir�en s gr rad s§ucbo tacto s wander ti a atf� surp drug-ree r place by:
co
recipients shamcertify and disclose accordingly.
(a) P b ishin a stat meet notif in em to ees that the
urtlaw ma fa to e, is rib t, is nsm ssessio r
use kk OT a coR ro�1e� sins Nance Isn r ite h hgraeeQst
Wffl1ON,AND OTHER employees ar vS at�a�r o�such proh onion; wi be a e again
s
1k �� �i�11 YE TTTTEERRS (b Establi hin an on-going drug-free awareness program to
As required b Executive Ord r 125 9, barment and tn�orm employe s about-
S�LI enasijn,.ancplvimaremc implemented cls PS 67s de ine�an
�FR art 67, ec�son�7.? (1)The dangers of drugs abuse in the workplace;
(2)The grantee's policy of maintaining a drug-free workplace;
A. The applicant certifies that it and its principals:
3 A available dru c tinseling, rehabilitation, and employee
(a) Are not presentlygdebarred, suspended, proposed for debar- (as)sisaynce programs,gang
be efitdby arState olr-Felderalecourt or voluntare excluded from
covered transactions by any Federal department or agency, (a usev a�a�iolns occurrinagyinThe woorep�acpe n employees for drug
((c Mak n it a re itt�ment that each em io ee to be en ed i
b Have not wth a thr e- ea .period reced n tis ap lic tion th��er�otnnancego h grant be given s c�py of the snan ed nn
een convicted o r ha a ycivilgdnd e t rendeige�aciair�st die req fired by paragrap e(a
o9r commis on of.nrau r a on a o erase m con ection wits
tarninmg allempting to Atain, or performing a d}} Notif i the em toe in he tatem rat eq fired b
aer ec rap�1 2 tNh�t, as apcoync�ition of empisoymenet under tie grantfV
OJP FORM 4061/6(3-91)REPLACES OJP FORMS 4061/2,4062/3 AND 4061/4 WHICH ARE OBSOLETE.
(1)A�bide by the terms of the statement; and
Iai0nYo,aecmpnyeyrinSjut� occusrin
teethe workplacerno
later than lve calendar c after such congctpon
�e) Notif4jqtthe a writin with 1? lenclar dw after
Lq?T
EF
ece ry,i n, mice I e su parz 'Prom an e pI ee if there are workplace on file that are not iderifified
tS tice."o Check
Jr o n e wisp rece vi ar Fano Puch conv[,TPL,,n iere.
c
rn p[o r cQnvi MI)Co es st rov t' 1112
ro gaqT ot,ce '95fp" c
ositiop filtpe, , 11
Sf�fifi?'n 67, 610 of the Mations nee tlitiat i
ram yffi:: rol rp 19
2 e r� i%ach e erIJ ga
Tov�cles.that a gp
a N shall i�rn,11aTeath'e iclenflfic�fioh a a e.may e eF �c.T a on ce.i iga iloj jr,t
c rt
um a s e in h a ica ton
n Pelnr?sT)of each ected grant; encies
Urabe'offM o IT91
�;Vice' I �� c1daleswaInde e
may elec use orMB
rkTalon one one, of the, followag,act%ns, w,ithi% 30 � lendig
s to ecervin notice un s u p? ) (d)( T, wi Check F- if the State has elected to complete OJP Form
ip e co any employee who is so conv ep grapy 4061/7.
Taking ap royr,pte oqnel action nagt such q
r � Ts isle Idwrth t e rlW%-�VEJ WMPLAC
m n cossamen
req� r9her& aAqiant%neZ'no?tj1$b, a n ed; or G A E WHO RE 161VIDUALS)
WuRequirin,�such emIENy,%e d As reiuirrd lo� F W k I FA t of 1988, and
,,.to,pa rtici pate satisfactorily
p a sur c or c
se as§i ange 11er,a oor Uar?Wea'Ah'Vwrove I �hCF rt e t7, U g�ytees, as
EuT - , a erilorcemR., YNt art ectionsM09"an"I
tRses pbpr a I
r er appropriate agency-,
A As a �oridifion of the gTnt I �ertify that I will not enpage in
I I
-free tie unla u manufgture isti'ibu ton, clisy?ns
a good faith effort to continue to maintain a drug a�eu 'b ) it 2K�y"'q
(9) Making use oly a �ontro ed substance in con i ion'nh�a iv with
workplace through implementation of paragraphs(a), (b), (c), (d), grant: and
(e), and (0.
The ranter ma� insel in the 1pace. rovided elow toe tie
B. If convinced of a criminal drug offense resulting from a
fo,r Ale per arm Ince o) wor one iR connection wi e violation occurring during the conduc of any rant activity, I will
$eCITIC grant: report the conviction, in writing,Justice,
within 10 ca endar daVs of the
conviction,to: Deoartment o . fice, Office of Justice Prrograms,
P�11 a of Performance (Street address, city, country, state, zip ATTN: Control Desk, 633 Indiana Avenue, N.W., Washington,
D.C. 20531.
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications.
1, Grantee Name and Address:
Kevin L. Smith
1126 East SR 434
Winter Springs, FL 32708
2, Application Number and/or Project Name 3. Grantee IRSNendor Number
4. Typed Name and Title of Authorized Representative
Kevin L. Smith, City Manager
5. Signature 6. Date