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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 />NA M E OF O R~A NIZATI O N DATE SU BMITTED <br />Kittitas County <br />PROJECT DESCRIPTION CONTRACT NUMBER <br />SFY17 E911 County Basic Service Operations E17 -021 Contract <br />11. A UTHORI Z1NG A UTH GRITY I <br />SIGNATU~ ___ PRINT OR TYPE NAME TITLEITERM OF OFFICE <br />~-~ Chairman Board of County <br />Paul Jewell Commissioners, Jan 1, 2017 -----Dec 31, 2Q20 <br />~ Vice Chair Board of County <br />J Laura Osiadacz Commissioners , Jan 1, 2017 - <br />Dec 31,2020 <br />L....-/ "" 12 . AU TH O R IZED TO S IG N CO NTRAC TS/CONT RACT A M E NDME NT S I <br />SIGNA~ PRINT OR TYPE NAME TITLEITERM OF OFFICE <br />~ Chairman Board of County <br />Paul Jewell Commissioners, Jan 1, 2017 - <br />Dec 31,2020 <br />IV~~-) Vice Chair Board of County <br />Laura Osiadacz Commissioners, Jan 1, 2017 - <br />! "") {<-.. Dec 31,2020 <br />'--"'" ~ <br />3. A UTHO RIZED T O SIG N REQ UESTS FOR REIM B URSE MENT (A-19) <br />SIGNATURE PRINT OR TYPE NAME TITLEITERM OF OFFICE <br />~ <br />Directdr/E911 Coordinator of ~Cl'dlr\~40ln~k Darlene Mainwaring KITICOM, appointed <br />/', ?)u v <br />~~\.p a<V" Judy Pless Kittitas County Budget & <br />Finance , appointed <br />P l~1e cO :Plete form with any new contract or any time personnel changes . <br />Submit one original to State E911 Office