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7.Attachment F- Certification and Authorized Signature
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2024-08-20 10:00 AM - Commissioners' Agenda
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7.Attachment F- Certification and Authorized Signature
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Last modified
8/15/2024 12:09:24 PM
Creation date
8/15/2024 12:09:20 PM
Metadata
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Meeting
Date
8/20/2024
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Item
Request to Approve a RFP (Request for Proposal) and a Request to Publish a Public Notice for the 1/10th of 1% Mental Health and Chemical Dependency Tax Grant
Order
4
Placement
Consent Agenda
Row ID
121365
Type
Call for bids
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Attachment F: Certification and Authorized Signature <br />Please provide the following signed document as a separate PDF attachment to your submission <br />email. <br /> <br />To the best of my knowledge and belief, the information contained in this application, and in the <br />additional required documentation submitted with this application, is true and correct. I <br />understand that any false information or omission may disqualify my organization from further <br />consideration for County Funding. I authorize the investigation of any or all statements contained in <br />this application and any other information pertinent to this application and my organization and its <br />employees and board members. <br />The signatory possesses the legal authority to apply for and receive funding from Kittitas County, <br />and the person signing the application has the proper authority from the governing body of the <br />organization. The applicant understands the County will not be responsible for any costs incurred <br />by the applicant in developing and submitting this application, and that all applications submitted <br />become the property of the County and applications are public record. <br /> <br /> <br /> <br />Signature of Authorized Signatory Date <br /> <br /> <br /> <br /> <br /> <br />Print Name of Authorized Signatory Title <br /> <br />
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