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6,*1$785($87+25,=$7,21)250 <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 />PROJECT DESCRIPTION <br />Public Assistance Program, Disaster -DR-WA <br />CONTRACT NUMBER <br />1. AUTHORIZING AUTHORITY <br />SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE <br />2. OTHER INDIVIDUALS AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS <br />SIGNATURE PRINT OR TYPE NAME TITLE <br />SIGNAUTH – PA, Revised 11/09 <br />County of Kittitas September 1, 2020 <br />4481-DR-WA D20-189 <br />Brett Wachsmith Chairman, Board Co Commissioners <br />Laura Osiadacz Vice-Chairman Board Co Commissioners <br />Cory Wright Co Commissioner <br />Judy Pless Budget & Finance Manager <br />Jerry Pettit County Auditor