Department of Health Care Services
Budget Act of 2022 Legislative Priorities
Control Section 19.56
Vendor Self Certification
Vendor Name: City of Huntington Beach
Funding Amount: $1,500,000
The City of Huntington Beach is receiving the amount appropriated from the State General Fund pursuant to Control Section 19.56 indicating legislative priorities. The funding authority is identified in Assembly Bill 179 (2022) and modified by Executive Order (EO 22/23- 157) as applicable. Your signature at the bottom certifies that the funds will be used for the mobile crisis response program.
Vendor Signature
_________________________________
Name/Title
Please provide warrant remittance address:
Date
______________________________________
______________________________________
______________________________________
DHCS Use Only
FI$Cal Accounting Information
Amount for this line: $ 1,500,000
ENY: 2022-2023 Account/Alt Account: 5442000/5442000000 Fund: 0001 Service Location: 55590 Appropriation Reference: 101 36 Project: N/A Reporting Structure: 4260YA0F Activity: N/A
____________________________ ______________ ____________________________________ DHCS Approving Signature Date Name/Title
Please email this self-certification letter to: [email protected]