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SUBSTANTIAL AMENDMENT TO THE I 2010/11- 2014/15 CITY OF SANTA ANA CONSOLIDATED PLAN 2011/12 ACTION PLAN OMB Number: 4040-0004 Expiration Date: 01/31/2009 Application for Federal Assistance SF-424 Version 02 16. Congressional Districts Of: *a. Applicant: 46 & 47 *b. Program/Project: 46 & 47 17. Proposed Project: *a. Start Date: 07/01/2011 *b. End Date: 06/30/2013 18. Estimated Fundin $ : *a. Federal $471,714 *b. Applicant *c. State *d. Local *e. Other (Prior Year) *f. Program Income *g. TOTAL $471,714 *19. Is Application Subject to Review By State Under Executive Order 12372 Process? ? a. This application was made available to the State under the Executive Order 12 372 Process for review on ? b. Program is subject to E.O. 12372 but has not been selected h} the State for revie?v. ® c. Program is not covered by E. O. 12372 *20. Is the Applicant Delinquent On Any Federal Debt? (If "l'es", provide explanation.) ? Yes ® No 21. *By signing this application, I certil' (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. 1 am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U. S. Code, "Title 218, Section 1001) ® ** I AGREL ** The list of certi lications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions Authorized Representative: Prefix: Mr. *First Name: Paul Middle Name: M. *Last Name: Walters Suffix: *Title: Interim City Manager *Telephone Number: 714-647-5200 *Telephone Number: 714-647-5200 * Email: pwalters@santa-ana.org *Signature of Authorized Representative: *Date Signed: SUBSTANTIAL AMENDMENT TO THE 2011-2012 ANNUAL ACTION PLAN 12 03/15/2012 EA4 2