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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 />Signature of Official Representative <br />Sponsoring Agency <br />(If Applicable) <br />Signature of Agency Represeatative <br />Typed or Printed Mane <br />Late <br />Date <br />Date <br />Associate Economic Development Organization Notification <br />The organization listed below has received notification of this project as demonstrated by the signature of the <br />organization's representative. <br />Name of Organization <br />Signature of Representative <br />Dais <br />Kittitas County Department of Public Works Conceptual Approval <br />Approval of the project feasibility, scope and estimated costs. <br />Signature of Kittitas County DPW Representative Dat: <br />Typed or Printed dame <br />11 <br />