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SIGNATURE AUTHORIZATION FORM <br />WASHINGTON STATE MILITARY DEPARTMENT <br />CAMP MURRAY, WASHINGTON 98430-5122 <br />NEW FORM WILL REPLACE PREVIOUS FORMS <br />NAME OF ORGANIZATION <br />DATE SUBMITTED <br />KITTITAS COUNTY <br />612212020 <br />PROJECT DESCRIPTION <br />CONTRACT NUMBER <br />FY20 SEGO County Basic Service Operations <br />Contract <br />E21-024 <br />1. AUTHORIZING AUTHORITY <br />SIGNATURE <br />PRINT OR TYPE NAME <br />TITLE/TERM OF OFFICE <br />r-- <br />Darlene Mainwaring <br />r Board of County <br />o pr y wri l n't <br />Commissioners,J O y �! Zolo <br />_ <br />Judy Pless <br />Dec 31, )-09-0 <br />l <br />Vice Chair of the Board of <br />` <br />Laura Osiadacz <br />County Commissioners, Jan 1, <br />2017 -Dec 31, 2020 <br />2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS <br />SIGNATURE <br />PRINT OR TYPE NAME <br />TITLE/TERM OF OFFICE <br />r-- <br />Darlene Mainwaring <br />Board of County <br />cc)ry A/I-11 ri {'1t <br />Commissioners, ,J�s I <br />�, <br />Judy Pless <br />Dec 31, 20' <br />l <br />Vice Chair of the Board of <br />Laura Osiadacz <br />County Commissioners, Jan 1, <br />2017 -Dec 31, 2020 <br />3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT (A-19) <br />SIGNATURE <br />PRINT OR TYPE NAME <br />TITLE/TERM OF OFFICE <br />(4v n -n <br />QA6KITTCOM, <br />Darlene Mainwaring <br />Director/E911 Coordinator of <br />appointed <br />�_. �� / <br />�,, <br />Judy Pless <br />Kittitas County Budget & <br />Finance, appointed <br />l <br />Please complete form with any new contract or any time personnel changes. <br />Submit one original to State E911 Office <br />