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City of Pleasanton <br />City Grant Application for Funds <br />Fisca/ Year 2008/09 <br />12. Collaboration Agency <br />Affidavit Form <br />o This form is to be completed by each collaborating organization as named by the <br />applicant agency in the proposed project. <br />o Completed forms must be submitted at time of application. <br />Collaborating Agency: <br />Agency Division/Department <br />Project Title <br />Project Role Description (i.e., facility space, staff support, etc.): <br />Agency Project Contact Person <br />Title <br />Phone Email <br />I attest that the applicant agency and our organization agree to work collaboratively to implement <br />the proposed project and identified in the FY 2008/09 City Grant application. <br />Executive Director Date <br />Project Contact Person Date <br />