HomeMy WebLinkAboutSignature Authorization Form 4-5-2016SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
CAMP MURRAY, WASHINGTON 98430 -5122
NEW FORM WILL REPLACE PREVIOUS FORMS
NAM E OF ORGANIZATION DATE SUBMITTED
Kittitas County 4/5/2016
PROJ ECT DESCRIPTION CONTRACT NUMBER
FY16 E911 County Contract E16 -020a
1. AUTHORI ZIN G AUTHORITY
SIGNATURt: PRINT OR TYP E NAM E TIT LEITERM OF OFFICE
~~~ ~ Ch airman Bo ard of County
Commissioners , Jan 1, 2015 ·
Oble O'Bri en Dec 31 , 2018 -Vic e Chairman Board of County ~ Commissioners, Jan 1, 2013·
~.z. .-7 Paul Jewell Dec 31,2016
2. AUTHORIZED TO SIGN CONTRACTS/CUN '-RACT AMENDMENTS
SIGNATUR E [PRINT OR TYP E NAME TITLEITERM OF OFFICE
~~ Chairman Board of County
Commissioners, Jan 1, 2015 -
Obie O'Brien Dec31,2018
I~ Vice Chairman Board of County
Commissioners , Jan 1, 2013 ·
1"'81:11 Jewell Dec 31,2016
13 . AUTHORI ZE D TO SIGN RI=OI JI=~TS FOR REIMBURS EMENT (A·19)
SIGNATURE IPRINT OR TYP E NAME TITLErrERM OF OFFICE
~~~~oAVlK Director of KITTCOM , app Ointed
Darl ene Mainwaring
v
~~J Kittit as County budg et &
It7 '-2 Judy Pl ess Fi nance, appointed
Plea~o j lete fo rm with an p y new contract or an y tim e ersonnel chan es . p g
Submit one original to Stat e E911 Offic e
•