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SIGNATURE AUTHORIZATION FORM <br />WASHINGTON STATE MILITARY DEPARTMENT <br />CAMP MURMY, WASHINGTON 98430-5122 <br />NEW FORM WILL REPLACE PREVIOUS FORMS <br />KITTITAS COUNTY <br />NAME OF ORGANIZATION DATE SUBMITTED <br />lnsert <br />date <br />submitted <br />FY23 SECO County Basic Service Operations <br />Contract <br />PROJECT DESCRIPTION CONTRACT NUMBER <br />E23 - 019 <br />1. AUTHORIZINGAUTHORITY <br />SIGNATURE PRINT ORryPE NAME TITLE/TERM OF OFFICE <br />Laura Osiadacz <br />Chair, Board of County <br />Com m ission ers, 1 I 1 121 -12131 124 <br />W ht <br />TO <br />Com mission ers 1 I 1 121 -12131 124 <br />Chair, Board of County <br />SIGNATURE PRINT OR TYPE NAME TITLEITERM OF OFFICE9Laura Osiadacz <br />Chair, Board of County <br />Com mission ers, 1 I 1 121 -12131 124 <br />W <br />Vice Chair, Board of County <br />Com m ission ers 1 I 1 121 -12131 124 <br />SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE <br />\reorge Lon E911-Coordinator <br />) <br />Brian Carlson Budget & Finance Director <br />Please complete form with any new contract or any time personnel changes <br />Submit one original to Staie E911 Office