HomeMy WebLinkAboutFY17 SAF - KittitasDATE SUBMITTED
PROJECT DESCRIPTION CONTRACT NUMBER
E17 - 021
1. AUTHORIZING AUTHORITY
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
Paul Jewell
Chairman Board of County
Commissioners, Jan 1, 2017 -
Dec 31, 2020
Laura Osiadacz
Vice Chair Board of County
Commissioners, Jan 1, 2017 -
Dec 31, 2020
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
Paul Jewell
Chairman Board of County
Commissioners, Jan 1, 2017 -
Dec 31, 2020
Laura Osiadacz
Vice Chair Board of County
Commissioners, Jan 1, 2017 -
Dec 31, 2020
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT (A-19)
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
Darlene Mainwaring Director/E911 Coordinator of
KITTCOM, appointed
Judy Pless Kittitas County Budget &
Finance, appointed
Please complete form with any new contract or any time personnel changes.
Submit one original to State E911 Office
NAME OF ORGANIZATION
Kittitas County
SFY17 E911 County Basic Service Operations
Contract
SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
CAMP MURRAY, WASHINGTON 98430-5122
NEW FORM WILL REPLACE PREVIOUS FORMS