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Applicant Certification <br />Certification is hereby given that the information provided is accurate and the applicable attachments are complete and <br />included as part of the application package. <br />I certify that application thresholds are met at the time of application. <br />d/U91fM.1 A41 S/:;rtwf <br />°Slg nature ?' Offl cl alJ\epresentative <br />Signature of Agency Representative <br />Typed or Printed Name <br />Sponsoring Agency <br />(If Applicable) <br />Date <br />Date <br />Associate Economic Development Organization Notification <br />The organization listed below has received notification of this application as demonstrated by the signature of <br />the organization's representative. <br />k"j fu -\-C6 GUJ-')tu {lolA mYJI' ,/ 0& U)IrYIIN1.t:J((e, <br />Name of Organization j • <br />Date I <br />Kittitas County Department of Public Works Receipt of Application <br />Signature of Kittitas County DPW Representative Date <br />Typed or Printed Name <br />11