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explain your success/failures from previous grant award(s):", "reading_order": 3 }, { "id": "p4.5", "order": 7, "type": "form_field", "bbox": { "l": 46.68, "t": 636.12, "r": 560.88, "b": 582.96 }, "text": "", "attrs": { "field_kind": "text", "label": "If this is a conŸnuaŸon of a previous grant, explain your success/failures from previous grant award(s", "pdf_field_name": "Previous grants success/failure", "source": "acroform" }, "reading_order": 4 }, { "id": "p4.6", "order": 8, "type": "heading", "bbox": { "l": 42.96, "t": 564.48, "r": 162.24, "b": 552.24 }, "text": "APPLICANT SIGNATURE", "attrs": { "block_label": "paragraph_title" }, "level": 3, "reading_order": 5 }, { "id": "p4.7", "order": 9, "type": "text", "bbox": { "l": 42.48, "t": 547.44, "r": 564.24, "b": 471.84 }, "text": "Applicant-Grantee assumes sole responsibility for all claims, liabilities, demands, causes of action, judgments, and losses arising in favor of or asserted by Applicant-Grantee's employees and agents, its subcontractors, its subcontractor's employees and agents, or third parties on account of property damage, personal injury, bodily injury, death, or financial or other loss of any kind that in any way, directly or indirectly, in whole or in part, arise or allegedly arise out of or in connection with any loss prevention grant it is awarded.", "reading_order": 6 }, { "id": "p4.8", "order": 10, "type": "text", "bbox": { "l": 42.48, "t": 461.76, "r": 565.2, "b": 354.48 }, "text": "The State of Montana, its elected and appointed officials, agents, and employees (including, but not limited to, the Montana Department of Livestock, Montana Board of Livestock, and the Livestock Loss Board and Program) assume no responsibility for any claims, liabilities, demands, causes of action, judgments, and losses arising in favor of or asserted by Applicant-Grantee's employees and agents, its subcontractors, its subcontractor's employees and agents, or third parties on account of property damage, personal injury, bodily injury, death, or financial or other loss of any kind that in any way, directly or indirectly, in whole or in part, arise or allegedly arise out of or in connection with any loss prevention grant it awards to Applicant-Grantee.", "reading_order": 7 }, { "id": "p4.9", "order": 11, "type": "text", "bbox": { "l": 42.96, "t": 327.36, "r": 551.28, "b": 313.92 }, "text": "Applicant Signature: ___ Date: ___", "children": [ { "id": "p4.9.1", "order": 12, "type": "form_field", "bbox": { "l": 145.68, "t": 345.24, "r": 414.48, "b": 316.44 }, "text": "", "attrs": { "field_kind": "signature", "pdf_field_name": "Applicant Signature", "source": "acroform", "label": "Applicant Signature: ___ Date: ___", "label_source": "parent_text", "label_ref": "p4.9", "text_offset": 21, "text_span": 3 }, "reading_order": 0 }, { "id": "p4.9.2", "order": 13, "type": "form_field", "bbox": { "l": 448.56, "t": 345.24, "r": 550.08, "b": 316.44 }, "text": "", "attrs": { "field_kind": "text", "pdf_field_name": "Date", "source": "acroform", "label": "Applicant Signature: ___ Date: ___", "label_source": "parent_text", "label_ref": "p4.9", "text_offset": 31, "text_span": 3 }, "reading_order": 1 } ], "reading_order": 8 }, { "id": "p4.10", "order": 14, "type": "heading", "bbox": { "l": 42.72, "t": 302.88, "r": 187.44, "b": 289.92 }, "text": "SUBMISSION INFORMATION", "attrs": { "block_label": "paragraph_title" }, "level": 3, "reading_order": 9 }, { "id": "p4.11", "order": 15, "type": "text", "bbox": { "l": 42.72, "t": 302.4, "r": 561.84, "b": 287.76 }, "text": "2023", "reading_order": 10 }, { "id": "p4.12", "order": 16, "type": "text", "bbox": { "l": 75.36, "t": 284.88, "r": 528.96, "b": 256.56 }, "text": "Applications are due November 4, 2026. Late applications may be considered if time allows. The Livestock Loss Board will meet on December 9, 2026, to award grants.", "reading_order": 11 }, { "id": "p4.13", "order": 17, "type": "text", "bbox": { "l": 50.88, "t": 240.96, "r": 552.48, "b": 190.08 }, "text": "BEFORE SUBMITTING THIS APPLICATION, ENSURE YOU HAVE INCLUDED ALL MATERIALS:\nApplication Form Maps (if used)\nW-9 Additional supplemental documentation (if used)\nGrant Supplement (if required)", "children": [ { "id": "p4.13.1", "order": 18, "type": "form_field", "bbox": { "l": 299.614, "t": 225.983, "r": 311.702, "b": 213.896 }, "text": "", "attrs": { "field_kind": "checkbox", "label": "○ Maps (if used)", "pdf_field_name": "Maps", "source": "acroform", "label_source": "parent_text", "label_ref": "p4.13", "text_offset": 92, "text_span": 0 }, "reading_order": 0 }, { "id": "p4.13.2", "order": 19, "type": "form_field", "bbox": { "l": 48.4016, "t": 225.458, "r": 58.9126, "b": 214.421 }, "text": "", "attrs": { "field_kind": "checkbox", "label": "○ ApplicaƟon Form", "pdf_field_name": "Application", "source": "acroform", "text_offset": 0, "text_span": 0 }, "reading_order": 1 }, { "id": "p4.13.3", "order": 20, "type": "form_field", "bbox": { "l": 299.512, "t": 211.268, "r": 311.6, "b": 200.232 }, "text": "", "attrs": { "field_kind": "checkbox", "label": "○ AddiƟonal supplemental documentaƟon (if used)", "pdf_field_name": "Additional documents", "source": "acroform", "text_offset": 111, "text_span": 0 }, "reading_order": 2 }, { "id": "p4.13.4", "order": 21, "type": "form_field", "bbox": { "l": 48.4527, "t": 210.794, "r": 59.4893, "b": 200.282 }, "text": "", "attrs": { "field_kind": "checkbox", "label": "○ W-9", "pdf_field_name": "W-9", "source": "acroform", "label_source": "parent_text", "label_ref": "p4.13" }, "reading_order": 3 }, { "id": "p4.13.5", "order": 22, "type": "form_field", "bbox": { "l": 48.9272, "t": 196.501, "r": 59.4382, "b": 185.465 }, "text": "", "attrs": { "field_kind": "checkbox", "label": "○ Grant Supplement (if required)", "pdf_field_name": "Supplement", "source": "acroform", "label_source": "parent_text", "label_ref": "p4.13" }, "reading_order": 4 } ], "reading_order": 12 }, { "id": "p4.14", "order": 23, "type": "text", "bbox": { "l": 49.2, "t": 168, "r": 358.32, "b": 154.32 }, "text": "Total number of pages submitted with this application: ___", "children": [ { "id": "p4.14.1", "order": 24, "type": "form_field", "bbox": { "l": 320.52, "t": 175.655, "r": 356.28, "b": 156.84 }, "text": "", "attrs": { "field_kind": "text", "label": "Total number of pages submitted with this application: ___", "pdf_field_name": "Total Pages", "source": "acroform", "label_source": "parent_text", "label_ref": "p4.14", "text_offset": 55, "text_span": 3 }, "reading_order": 0 } ], "reading_order": 13 }, { "id": "p4.15", "order": 25, "type": "text", "bbox": { "l": 48.96, "t": 138.96, "r": 360, "b": 125.76 }, "text": "Submit your application and any supplemental documentation:", "reading_order": 14 }, { "id": "p4.16", "order": 26, "type": "text", "bbox": { "l": 50.16, "t": 123.6, "r": 492.24, "b": 81.84 }, "text": "Email: LIVLossBoard@mt.gov ~ OR ~ Mail: Livestock Loss Board PO Box 202001 Helena, MT 59620-2001", "reading_order": 15 }, { "id": "p4.17", "order": 27, "type": "text", "bbox": { "l": 44.64, "t": 65.04, "r": 562.32, "b": 30.24 }, "text": "Questions? Call Leslie Doely (406) 465-9319", "reading_order": 16 } ] } ] }