Medical Office Registration Form s7

Medical Office Registration Form s7

<p>OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Capitol Region Town Code: NA Council of Government s Street State address: 241 Agency DUNS No. (if applicable): NA Main Street Code: NA 4th Floor City: ZIP Code: State: CT FEIN (required): 06-0845880 Hartford 06106 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-1 Project Title: Next Steps in Engaging Anchor Institutions and Neighborhoods in Transit-Oriented Development (TOD) Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 24 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $200,000.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $200,000.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official</p><p>FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty. OPM-NOGA-2015 rev 06/04/15</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $200,000.00 12060 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Lower CT River Valley Town Code: NA Council of Government s Street State address: 145 Agency DUNS No. (if applicable): NA Dennison Code: NA Road ZIP Code: City: Essex State: CT FEIN (required): 45-5533305 06426 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-2 Project Title: Development of a Regional Wetlands Data Set Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 42 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $95,000.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $95,000.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official</p><p>FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty. OPM-NOGA-2015 rev 06/04/15</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $95,000.00 12060 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Naugatuck Valley Town Code: NA Council of Government s Street address: 49 State Leavenworth Agency DUNS No. (if applicable): NA Street 3rd Code: NA Floor #303 City: ZIP Code: State: CT FEIN (required): 47-1630360 Waterbury 06702 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-3 Project Title: Wastewater Treatment Consolidation Study Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 26 months from the execution of the grant award by both grantor and grantee State: Amount of Federal: $ $1,350,000.0 Interest: $ NA Award NA 0 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $1,350,000. 00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official OPM-NOGA-2015 rev 06/04/15 FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty.</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $1,350,000.00 12060 20600 35457 13046 55050 NA NA 2015 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Northeaster n Connecticut Town Code: NA Council of Government s Street State address: 125 Agency DUNS No. (if applicable): NA Putnam Pike Code: NA City: ZIP Code: State: CT FEIN (required): 06-0850466 Dayville 06241 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-4 Project Title: Pre-Hospital Emergency Care Study, Phase II Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 15 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $100,000.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $100,000.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official</p><p>FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty. OPM-NOGA-2015 rev 06/04/15</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $100,000.00 12060 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Northeaster n Connecticut Town Code: NA Council of Government s Street State address: 125 Agency DUNS No. (if applicable): NA Putnam Pike Code: NA City: ZIP Code: State: CT FEIN (required): 06-0850466 Dayville 06241 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-5 Project Title: Regional Household Hazardous Waste Facility Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 27 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $708,500.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $708,500.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official</p><p>FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty. OPM-NOGA-2015 rev 06/04/15</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $708,500.00 12060 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Northeaster n Connecticut Town Code: NA Council of Government s Street State address: 125 Agency DUNS No. (if applicable): NA Putnam Pike Code: NA City: ZIP Code: State: CT FEIN (required): 06-0850466 Dayville 06241 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-6 Project Title: Enhanced Regional Animal Services Facility Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 21 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $608,000.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $608,000.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official</p><p>FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty. OPM-NOGA-2015 rev 06/04/15</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $608,000.00 12060 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Northwest Hills Council Town Code: NA of Government s Street address: 59 State Torrington Agency DUNS No. (if applicable): NA Road Suite Code: NA A-1 City: ZIP Code: State: CT FEIN (required): 38-3917142 Goshen 06756 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-7 Project Title: Rural Broadband & Mobile Enhancement: Technology and Business Model Study Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 22 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $200,000.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $200,000.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official OPM-NOGA-2015 rev 06/04/15 FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty.</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $200,000.00 12060 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Northwest Hills Council Town Code: NA of Government s Street address: 59 State Torrington Agency DUNS No. (if applicable): NA Road Suite Code: NA A-1 City: ZIP Code: State: CT FEIN (required): 38-3917142 Goshen 06756 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-8 Project Title: Regional Animal Shelter Facility Design and Engineering Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 22 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $110,000.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $110,000.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official OPM-NOGA-2015 rev 06/04/15 FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty.</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $110,000.00 12060 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Southeaster n Connecticut Town Code: NA Council of Government s Street State address: 5 Agency DUNS No. (if applicable): NA Connecticut Code: NA Avenue City: ZIP Code: State: CT FEIN (required): 06-0770236 Norwich 06360 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-11 Project Title: Development of a Community Rating System Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 18 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $200,000.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $200,000.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official OPM-NOGA-2015 rev 06/04/15 FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty.</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $200,000.00 12060 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Southeaster n Connecticut Town Code: NA Council of Government s Street State address: 5 Agency DUNS No. (if applicable): NA Connecticut Code: NA Avenue City: ZIP Code: State: CT FEIN (required): 06-0770236 Norwich 06360 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-12 Project Title: Study and Recommendations for Shared Services and Staff by Southeastern Connecticut Human Service Providers Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 21 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $150,000.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $150,000.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official OPM-NOGA-2015 rev 06/04/15 FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty.</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $150,000.00 12060 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: Western Connecticut Town Code: NA Council of Government s Street State address: 1 Agency DUNS No. (if applicable): NA Riverside Code: NA Road City: Sandy ZIP Code: State: CT FEIN (required): 47-1841490 Hook 06482 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-14 Project Title: Snow Plow Routing Study and Development Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 17 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $254,782.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $254,782.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official</p><p>FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty. OPM-NOGA-2015 rev 06/04/15</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT OPM $254,782.00 12060 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111 OPM-NOGA-2015 rev 06/04/15 STATE OF CONNECTICUT | OFFICE OF POLICY AND MANAGEMENT Division of Transportation, Conservation, and Development Policy and Planning 450 Capitol Avenue | MS# 54ORG | Hartford, CT 06106-1379 NOTICE OF GRANT AWARD </p><p>The Office of Policy and Management, Division of Transportation, Conservation, and Development Policy and Planning, hereby makes the following grant award in accordance with CGS Sec. 4-124s and in accordance with the grant solicitation and the attached grant application, if applicable. Grantee: South Central Regional Town Code: NA Council of Government s Street address: 4th State Floor West Agency DUNS No. (if applicable): NA 127 Code: NA Washington Avenue City: North ZIP Code: State: CT FEIN (required): 06-0770103 Haven 06473 OPM Grant Grant Program Name: Regional Performance Incentive Grant Program No.: RPI 16-13 Project Title: Regional Open Space Inventory Date of Award: Category (if applicable): NA June 24, 2016 Period of Start Date: ☒ The date Notice of Grant Award is signed by both Grantor & Grantee (whichever is later). Award: End Date: 21 months from the execution of the grant award by both grantor and grantee Amount of Federal: $ State: Interest: $ NA Award NA $74,228.00 State Match: Grantee Other: $ NA Specify: $ NA Match: $ NA Total Budget: Catalog of Federal Domestic Assistance (CFDA) Number: NA $74,228.00 Federal Grant No.: Grantee Fiscal Year: From: July 1 To: June 30 NA</p><p>My signature below, for and on behalf of the above named grantee, indicates acceptance of the above referenced award and further certifies that: 1.) I have the authority to execute this agreement on behalf of the grantee; and 2.) The grantee will comply with all attached Grant Conditions. </p><p>BY: ______Signature of Authorized Grantee Official Date Typed Name Typed Title of of Authorized Authorized Grantee Grantee Official Official OPM-NOGA-2015 rev 06/04/15 FOR THE OFFICE OF POLICY AND MANAGEMENT:</p><p>BY: ______Signature of OPM Secretary or OPM Deputy Secretary Date Benjamin Barnes, Secty. or Susan Weisselberg, Depty. Secty.</p><p>For OPM Business Use Only</p><p>AMOUNT FUND DEPT SID PROG ACCT CHART 1 CHART 2 BR YR PROJECT $74,228.00 12060 OPM 20600 35457 13046 55050 NA NA 2016 OPM00000000 1111</p>

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