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DATE SUBMITTED <br />7/20/2021 <br />PROJECT DESCRIPTION CONTRACT NUMBER <br />E22-024 <br />SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE <br />Brett Wachsmith <br />Chairman, Board of County <br />Commissioners <br />01/01/2019-12/31/2022 <br />Laura Osiadacz <br />Chairman, Board of County <br />Commissioners <br />01/01/2021-12/31/2024 <br />2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS <br />SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE <br />Brett Wachsmith <br />Chairman, Board of County <br />Commissioners <br />01/01/2019-12/31/2022 <br />Laura Osiadacz <br />Chairman, Board of County <br />Commissioners <br />01/01/2021-12/31/2024 <br />3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT (A-19) <br />SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE <br />George Long Director <br />Judy Pless Budget & Finance Manager <br />Please complete form with any new contract or any time personnel changes. <br />Submit one original to State E911 Office <br />1. AUTHORIZING AUTHORITY <br />NAME OF ORGANIZATION <br />KITTITAS COUNTY <br />FY22 SECO County Basic Service Operations <br />Contract <br />SIGNATURE AUTHORIZATION FORM <br />WASHINGTON STATE MILITARY DEPARTMENT <br />CAMP MURRAY, WASHINGTON 98430-5122 <br />NEW FORM WILL REPLACE PREVIOUS FORMS