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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ACTIVITY FUNDS REQUEST FORM",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"P a g e   1"]
["Yes",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"     PREPARER'S INFORMATION"]
["Yes",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
["Good Job Everyone!!! And Congratulations in the completion of this project. Please turn in a final setup and completion report to the department (community development block grant).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Preparer's Name:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E-mail:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Preparer's Organization Name:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Phone:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Jurisdiction Name:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E-mail:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"  Payee Name:    ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Phone:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Payee Address:    "]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"     PROJECT INFORMATION"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Project Name:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CDBG Contract #"]
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[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"IDIS Activity #",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CDBG Project #",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Is this a \"Supplemental\" Activity?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"YES"]
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[]
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[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(BL27:BX27)","v":0},null,null,{"$f":"IF(OR($AA$24=Validation!$B$3,$AA$24=Validation!$B$49,$AA$24=Validation!$B$50,$AA$24=Validation!$B$51,$AA$24=Validation!$B$53,$AA$24=Validation!$B$54,$AA$24=Validation!$B$55,$AA$24=Validation!$B$58,$AA$24=Validation!$B$59,$AA$24=Validation!$B$61,$AA$24=Validation!$B$62,$AA$24=Validation!$B$63,$AA$24=Validation!$B$64),\"Activity Delivery (AD)\",\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(AX26,BD39)-BD43","v":0},null,null,null,null,null,null,{"$f":"SUM(BE26,BD43)","v":0},null,null,null,null,null,null,null,{"$f":"AQ26-(BL26+BS26)","v":0}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"AQ26/AQ24","v":{"$error":"#DIV/0!"}},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(BL24:BQ26)","v":0},null,null,null,null,null,null,{"$f":"SUM(BS24:BX26)","v":0}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Date HCD approved the increased Project Budget/Costs ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"What is the amount of PI approved by HCD to be added to the project?"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"REQUEST FOR REIMBURSEMENT",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Program Income Certification"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ",null,null,null,null,null,null,null,null,"Date Prepared:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Project Completed?",null,null,null,null,null,null,null,null,null,null,null,null,"No",null,null,null,null,null,"Total PI on-hand as of:",null,null,null,null,null,null,null,null,null,null,null,"Amount"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Type of Request:",null,null,null,null,null,null,null,null,null,"Select Option",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DATE",null,null,null,null,null,null,null,null,null,null,null,null,0]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Total  Activity Expenses",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"RLFs PI Certification"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR($AA$24=Validation!$B$3,$AA$24=Validation!$B$49,$AA$24=Validation!$B$50,$AA$24=Validation!$B$51,$AA$24=Validation!$B$53,$AA$24=Validation!$B$54,$AA$24=Validation!$B$55,$AA$24=Validation!$B$58,$AA$24=Validation!$B$59,$AA$24=Validation!$B$61,$AA$24=Validation!$B$62,$AA$24=Validation!$B$63,$AA$24=Validation!$B$64),\"Total Activity Delivery (AD) Expenses\",\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Total RLF on-hand as of:",null,null,null,null,null,null,null,null,null,null,null,"Amount"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"PI USED for reimbursement on this Activity",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DATE"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR($AA$24=Validation!$B$3,$AA$24=Validation!$B$49,$AA$24=Validation!$B$50,$AA$24=Validation!$B$51,$AA$24=Validation!$B$53,$AA$24=Validation!$B$54,$AA$24=Validation!$B$55,$AA$24=Validation!$B$58,$AA$24=Validation!$B$59,$AA$24=Validation!$B$61,$AA$24=Validation!$B$62,$AA$24=Validation!$B$63,$AA$24=Validation!$B$64),\"PI USED for reimbursement on (AD) Expenses\",\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Housing RLF",null,null,null,null,null,null,null,null,null,null,null,null,0]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"CDBG only processes funds request greater than $1000 (unless Final request)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ED RLF",null,null,null,null,null,null,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Total GRANT Funds Request",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM($BD$37+$BD$39)-(BD41+BD43)","v":0}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Total Project Balance before/after this request",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(CA24:CG26)","v":0}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ",null,null,null,null,null,null,null,null,null,{"$f":"IF(BD48<0,\"Project balance may not be less then ZERO\",\"\")","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(BG34=\"Yes\",\"Complete a FINAL Setup and Completion Report\",\"\")","v":""}]
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[]
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[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"STATE OF CALIFORNIA\nCOMMUNITY DEVELOPMENT BLOCK GRANT (CDBG)\nACTIVITY FUNDS REQUEST CERTIFICATION\n",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"P a g e   2"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Preparer's Name:",null,null,null,null,null,null,null,null,{"$f":"IF(AL5>0,AL5,\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,"E-mail:",null,null,null,{"$f":"IF(BG5>0,BG5,\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AQ19>0,AQ19,\"\")","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Preparer's Organization Name:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AR6>0,AR6,\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Phone:",null,null,null,{"$f":"IF(BT6>0,BT6,\"\")","v":""},null,null,null,null,null,null,null,null,"Funds Request #"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Jurisdiction Name:",null,null,null,null,null,null,null,null,null,{"$f":"IF(AL7>0,AL7,\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Phone:",null,null,null,{"$f":"IF(BT6>0,BT6,\"\")","v":""},null,null,null,null,null,null,null,null,null,"Total Grant Funds Request",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"BD46","v":0}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Payee Name:    ",null,null,null,null,null,null,null,{"$f":"IF(AL8>0,AL8,\"\")","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Payee Address:    ",null,null,null,null,null,null,null,{"$f":"IF(AL9>0,AL9,\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"E-mail:",null,null,null,{"$f":"IF(BJ7>0,BJ7,\"\")","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Project Name:",null,null,null,null,null,null,null,{"$f":"IF(AL13>0,AL13,\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Project Address:",null,null,null,null,null,null,null,{"$f":"IF(AL15>0,AL15,\"\")","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"IDIS Activity #",null,null,null,null,null,null,{"$f":"IF(AJ17>0,AJ17,\"\")","v":""},null,null,null,null,null,null,"CDBG Project #",null,null,null,null,null,null,null,{"$f":"IF(BA17>0,BA17,\"\")","v":""},null,null,null,null,null,null,null,null,null,"CDBG Contract #",null,null,null,null,null,null,null,{"$f":"BV15","v":0}]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"The funds being requested have been awarded to the State of California from the U.S. Department of Housing and Urban Development."]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"The undersigned certifies the following with respect to the above-named project or activity:"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,"The funds being requested are for work completed for the identified project or activity, and"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,"The work represented by the funds request has been inspected and/or verified as completed."]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,3,null,"All invoices for the expenses represented in this funds request have been received, and"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,4,null,"The funds requested are a reimbursement of costs, and"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,5,null,"All construction contractors or subcontractors paid with proceeds from this funds request are licensed and in good standing with the California State Contractor’s License Board and are not listed on the Federal Consolidated List of Debarred, Suspended and Ineligible Contractors, and"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,6,null,"That there are no mechanics liens recorded against the property from previous funds requests for construction activities (public works projects fall under sovereign immunity), and"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,7,null,"I am specifically authorized to sign documents for the CDBG Program on behalf of the above-named Jurisdiction by authorization previously submitted to the Department or as an attachment to this funds request."]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"PREPARER NAME",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"TITLE"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"PREPARER SIGNATURE",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DATE"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"AUTHORIZED SIGNER NAME",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"TITLE"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"AUTHORIZED SIGNER SIGNATURE",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DATE"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\nMaking false statements is a felony under laws of the State of California (Penal Codes 115, 118, 487, 532), and Title 19, Section 1001 of the United States Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department or agency of the United States.                                                                                                 \n\n                                                                                                                                                                                                           \n Page 2 of 2"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"END OF DOCUMENT"]

{"sheet":"Validation","index":1,"n_rows":67,"n_cols":8,"rows_kept":67,"cut":false,"hidden":true,"merged":[]}
[null,"Matrix Code",null,null,null,null,null,"Type"]
[null,"Select Option",null,"14/15","Select Option",null,null,"Select Option"]
[null,"(01) Acquisition of Real Property (for development) ",null,"15/16","Original","Yes",null,"General Administration Funds Request"]
[null,"(03) Public Facilities & Improvements (General) ",null,"16/17","Revised","No",null,"Project Funds Request"]
[null,"(03A) Senior Centers ",null,"17/18",null,null,null,"Program Funds request"]
[null,"(03B) Handicapped Centers ",null,"18/19"]
[null,"(03C) Homeless Facilities (not operating costs) ",null,"19/20"]
[null,"(03D) Youth Centers ",null,"20/21"]
[null,"(03E) Neighborhood Facilities  ",null,"21/22"]
[null,"(03F) Parks/ Recreational Facilities ",null,"22/23"]
[null,"(03G) Parking Facilities ",null,"23/24"]
[null,"(03H) Solid Waste Disposal Improvements "]
[null,"(03I) Flood/ Drainage Improvements ",null," "]
[null,"(03J) Water/ Sewer Improvements "]
[null,"(03K) Street Improvements "]
[null,"(03L) Sidewalks "]
[null,"(03M) Child Care Centers "]
[null,"(03N) Tree Planting "]
[null,"(03O) Fire Station/ Equipment "]
[null,"(03P) Health Facilities "]
[null,"(03Q) Abused and Neglected Children Facilities "]
[null,"(03R) Asbestos Removal "]
[null,"(03S) Facilities to AIDS Patients (not operating costs) "]
[null,"(03T) Operating Cost Homeless/ AIDS Patients "]
[null,"(04) Clearance, Demo, Remediation "]
[null,"(04A) Cleanup of Contaminated Sites "]
[null,"(05) Other Public Services "]
[null,"(05A) Senior Services "]
[null,"(05B) Handicapped Services "]
[null,"(05C) Legal Services "]
[null,"(05D) Youth Services "]
[null,"(05E) Transportation Services "]
[null,"(05F) Substance Abuse Services "]
[null,"(05G) Battered and Abused Spouses "]
[null,"(05H) Employment Training "]
[null,"(05I) Crime Awareness "]
[null,"(05J) Fair Housing Activities "]
[null,"(05K) Tenant/ Landlord Counseling "]
[null,"(05L) Child Care Services "]
[null,"(05M) Health Services "]
[null,"(05N) Abused/ Neglected Children "]
[null,"(05O) Mental Health Services "]
[null,"(05P) Screening for Lead-Based Paint/ Lead Hazards "]
[null,"(05Q) Subsistence Payments "]
[null,"(05T) Security Deposits "]
[null,"(05U) Housing Counseling "]
[null,"(05V) Neighborhood Cleanups "]
[null,"(05W) Food Banks - Operating Costs "]
[null,"(13) Homeownership Direct Assistance "]
[null,"(14A) Rehab; Single-Unit Residence "]
[null,"(14B) Rehab; Multi-Unit Residential "]
[null,"(14D) Rehab; Other than Public-Owned Residential Bids "]
[null,"(14E) Rehab; Pub./Private-Owned Commercial/Industrial "]
[null,"(14F) Energy Efficiency Improvements "]
[null,"(14G) Acquisition for Rehabilitation  "]
[null,"(14I) Lead Base Paint/Hazards Test/Abatement "]
[null,"(15) Code Enforcement (Public Service) "]
[null,"(16A) Residential Historic Preservation "]
[null,"(16B) Non-Residential Historic Preservation "]
[null,"(17B) C/I infrastructure Development "]
[null,"(17C) C/I Building Acq., Construction, Rehabilitation  "]
[null,"(17D) Other Commercial/ Industrial Improvements "]
[null,"(18A) ED Direct Financial Assistance to For-Profits  "]
[null,"(18C) Micro Financial Assistance "]
[null,"(18C) Micro Technical Assistance "]
[null,"(20A-CD) Planning for CD "]
[null,"(20A-ED) Planning for ED "]