I hereby certify that all information, which has been or will be furnished in support of this application, is given for the purpose of obtaining funds through the Tupper Lake Energize Uptown Fund and that all information submitted has been examined and approved by me and is true, correct, and complete. I understand that this information will be used to assess and rank my proposed project in accordance with funding criteria. I agree to abide by all requirements to be set forth in connection with said program and the penalties and provisions of all applicable local, state, and federal laws pertaining to falsification of any item contained herein or fraudulent misrepresentation of my business. I understand that this is a competitive award program and that my project may not be awarded funding. I agree that verification of any information contained herein may be obtained.
I also hereby certify that to the best of my knowledge, neither I nor my spouse, child, close relative, general partner, or any organization for which I am serving as an officer, director, trustee, general partner or employee, has a financial interest in or with the Franklin County Economic Development Corporation, or in or with any person that will have decision making authority with regard to this grant request.
I further certify to the best of my knowledge that this application, if it is approved, will not affect the financial interests of any member of my household; no relative with whom I have a close relationship; no one with whom my spouse, parent or dependent child has or seeks employment; and no organization with which I am seeking a business relationship nor which I now serve actively or have served within the last year.
I also acknowledge my responsibility to disclose the acquisition of any financial or personal interest as described above that would be affected by the matter, and to disclose any interest I, or anyone noted above, has in any person or organization that does become involved in, or is affected at a later date by, the conduct of this matter.