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<br />Attachment A <br /> <br />FY05 Homeland Security Grant Program <br />Applicatiou Cover Sheet for Operational Areas (page 2 of 2) <br />Applicant (county) <br /> <br />Statement of Certification - Approval Authority Body - SHSP and LETPP Only <br /> <br />By signing below, I hereby certifY that the Operational Area's application represents the Approval Authority Body's <br />consensus on the Operational Area's FY 2005 Homeland Security Grant Program needs for the State Homeland <br />Security Program and Law Enforcement Terrorism Prevention Program. <br /> <br />PositionlDesignee <br />County Public Health Officer <br />County Fire Chief <br />Municipal Fire <br />County Sheriff <br />Chief of Police <br /> <br />Signature <br /> <br />Printed Name <br /> <br />Title <br /> <br />Statement of Certification - County Authorized Agent - SHSP, LETPP and EMPG Only <br /> <br />By signing below, I hereby certifY I am the duly appointed Authorized Agent and have the authority to apply <br />for the FY 2005 Homeland Security Grant Program, and the Operational Area's application represents the <br />needs for the State Homeland Security Program, Law Enforcement Terrorism Prevention Program, and <br />Emergency Management Performance Grant program. <br /> <br />Signature of Authorized Agent <br /> <br />Printed Name <br /> <br />Title <br /> <br />Date <br /> <br />For$laleuseONLY <br /> <br />Application reviewed/Grant award approved by: <br />Name <br />Grant Performance Period: <br /> <br /> <br />Date <br /> <br />DES ID # <br /> <br />Award # <br /> <br />FY05 Homeland Security Grant Program <br /> <br />Page 33 <br />