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S IG NAT URE AUT H O RIZATION 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 Sheriff's Office 1/08/2018 <br />PROJECT DESCRIPTION CONTRACT NUMBER <br />17EMPG Grant <br />E18-131 <br />1. AUTHORIZING AUTHORITY <br />SIGNATURE PRINT OR TYPE NAME TITLEITERM OF OFFICE <br />0-~ Gene Dana Sheriff 1 I ~-'.$ j 'k/~ <br />2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS <br />3. <br />SIGNATURE PRINT OR TYPE NAME <br />G~b __ Gene Dana <br />AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT <br />SIGNATURE PRINT OR TYPE NAME <br />Darren Higashiyama <br />~ <br />Heather ~b ert <br />\\NAC-1\vOL 1\HOME\KARENB\ .... \WP\SIGNAUTH Revised 3/03 <br />TITLE <br />Sheriff <br />TITLE <br />Commander <br />Chief Finance Officer