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SIGNATURE AUTHORIZATION FORM <br />W ASHINGTON STATE MILITARY DEPARTMENT <br />Camp Murray, Washington 98430-5122 <br />P/ease read instructions on reverse side before completing this form. <br />N AME OF ORGANIZATION DATE SUBMITTED <br />Kittitas County 4/1 2/18 <br />P ROJECT DESCRIPTION CONTRACT NUMBER <br />SHSP FFY-17 <br />E18-180 <br />1 . AUTHORIZING AUTHORITY <br />SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE <br />~~~ ~~, <br />~~ -- . _—_ <br />Gene Dana Sheriff 12/31/2018 <br />2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS <br />SIGNATURE PRINT OR TYPE NAME TITLE <br />~ <br />~~~ < <Gene Dana Sheriff <br />3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT <br />SIGNATURE PRINT OR TYPE NAME TITLE <br />~~Darren Higashiyama Commander <br />,. <br />3!/~Heather Seibert Chief Financial Manager <br />\\NAC-1\VOL1\HOME\KARENB\....\WP\SIGNAUTH Revised 3103