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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 fi /10 /r6 <br />PROJECT DESCRIPTION CONTRACT NUMBER <br />18 EMPG E19-136 <br />1. AUTHORIZING AUTHORITY <br />SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE <br />~~ Gene Dana Sheriff/ 12/31/18 <br />2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS <br />SIGNATURE PRINT OR TYPE NAME TITLE <br />c; __ \) Gene Dana Sheriff - <br />3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT <br />PRINT OR TYPE NAME TITLE <br />Darren Higashiyama Commander <br />Kim Dawson Sheriff Admin <br />\\NAC-1 \VOL 1 \HOME\KARENB\ .... \WP\SIGNAUTH Revised 3/03