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Equitable Community Revitalization Grant Agreement <br />[GRANTEE’s Name] <br />Page 14 of 14 <br />Minor revisions and/or updates may be made to the sample Agreement prior to execution. <br />IN THE WITNESS WHEREOF, THE PARTIES HERETO EXECUTE THIS <br />AGREEMENT ON THE DATE SET FORTH BELOW AND GRANTEE ACCEPTS THE <br />AFOREMENTIONED TERMS AND CONDITIONS ELECTRONICALLY. <br />[INSERT GRANTEE NAME] <br />A [Insert Entity Type] <br />BY: <br />[Insert GRANTEE Signer’s Name and Title] <br />Authorized Signatory <br />Date: _____________________________________________ <br />Department of Toxic Substances Control <br />Site Mitigation and Restoration Program <br />BY: <br />Date: _____________________________________________ <br />References: <br />Exhibit A – Signed ECRG Application <br />Exhibit B – Site Map <br />Exhibit C – Site Diagram <br />Exhibit D – Site Access Agreement <br />Exhibit E – Scope of ECRG Activities <br />Exhibit F – ECRG Activities Budget Detail Table <br />Exhibit G – Regulatory Oversight Agreement <br />Exhibit H – Grant Commitments <br />Exhibit I – Summary of Costs Form* <br />April 28, 2022 <br />EXHIBIT 13