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SIGNATURE AUTHORIZATION FORM <br />WASHINGTON STATE MILITARY DEPARTMENT <br />Camp Murray, Washington 98430-5122 <br />Please read instructions on reverse side before completing this form. <br />NAME OF ORGANIZATION DATE SUBMITTED <br />Kittitas County Sheriffs Office 1/08/2018 <br />PROJECT DESCRIPTION CONTRACT NUMBER <br />17EMPG Grant <br />E18-131 <br />AUTHORIZING AUTHORITY <br />SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE <br />Gene Dana Sheriff / V?-- 3 i -2c;e <br />Z. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS <br />SIGNATURE PRINT OR TYPE NAME <br />TITLE <br />Gene DanaC��. �_-- <br />Sheriff <br />3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT <br />SIGNATURE PRINT OR TYPE NAME TITLE <br />Darren Higashiyarna Commander <br />Heather Ebert Chief Finance Officer <br />D,l Air, f r r r. <br />\\NAC-1�VOLI1HOME\KARENS\----\WP\SIGNAUTH Revised 3103 <br />