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5 <br /> STATE HISTORIC PRESERVATION OFFICE <br /> CERTIFICATION OF MATCHING SHARE FORM <br /> for <br /> HISTORIC PRESERVATION FUND GRANTS <br /> PROJECT: <br /> GRANTEE: <br /> CERTIFYING OFFICIAL/TITLE: <br /> ADDRESS/PHONE: <br /> CERTIFICATION STATEMENT: <br /> As the official representative of the GRANTEE listed <br /> above, I certify that the required nonfederal funds, <br /> consisting of $ in cash, and (if applicable) <br /> $ of in-kind services, are available to match <br /> the Historic Preservation Fund grant which is reserved <br /> for the project noted above. <br /> I further certify that this matching share has not been <br /> designated for any other purpose. <br /> I understand that all costs charged to the grant <br /> project will be in payment of budget items approved by <br /> the State Historic Preservation Office, and which occur <br /> during the project period. An adequate financial <br /> management system (and audit procedure when deemed <br /> applicable) will be maintained which provides efficient <br /> and effective accountability and control of all <br /> property, funds and assets <br /> Notice to non-governmental grantees: please attach a <br /> statement of deposit from a local bank (prepared on <br /> bank letterhead) verifying that funds are available. <br /> Signed: <br /> Date: <br />