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Exhibit C <br />CERTIFICATION <br />G 10 -U PA -82 <br />I certify under penalty of perjury that the information I have entered on this application is true and complete to the <br />best of my knowledge and that I am an employee of the applicant authorized to submit the application on behalf <br />of the applicant. I further understand that any false, incomplete, or incorrect statements may result in the <br />disqualification of this application. By signing this application, I waive any and all rights to privacy and <br />confidentiality of the proposal on behalf of the applicant, to the extent provided in this program. <br />Applicant Signature <br />/ City Manager <br />Printed Name / Title of Applicant <br />Date <br />Page 3of3 <br />