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Signature Authorization Form 4-5-2016
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2016-04-05 10:00 AM - Commissioners' Agenda
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Signature Authorization Form 4-5-2016
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Last modified
6/14/2018 8:43:10 AM
Creation date
6/13/2018 10:45:56 AM
Metadata
Fields
Template:
Meeting
Date
4/5/2016
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Fully Executed Version
Supplemental fields
Alpha Order
j
Item
Request to Approve Contract Amendment A to the E911 State FY2016 #E16-020A for a Reduction of $5,890
Order
10
Placement
Consent Agenda
Row ID
28675
Type
Contract
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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 />NAM E OF ORGANIZATION DATE SUBMITTED <br />Kittitas County 4/5/2016 <br />PROJ ECT DESCRIPTION CONTRACT NUMBER <br />FY16 E911 County Contract E16 -020a <br />1. AUTHORI ZIN G AUTHORITY <br />SIGNATURt: PRINT OR TYP E NAM E TIT LEITERM OF OFFICE <br />~~~ ~ Ch airman Bo ard of County <br />Commissioners , Jan 1, 2015 · <br />Oble O'Bri en Dec 31 , 2018 -Vic e Chairman Board of County ~ Commissioners, Jan 1, 2013· <br />~.z. .-7 Paul Jewell Dec 31,2016 <br />2. AUTHORIZED TO SIGN CONTRACTS/CUN '-RACT AMENDMENTS <br />SIGNATUR E [PRINT OR TYP E NAME TITLEITERM OF OFFICE <br />~~ Chairman Board of County <br />Commissioners, Jan 1, 2015 - <br />Obie O'Brien Dec31,2018 <br />I~ Vice Chairman Board of County <br />Commissioners , Jan 1, 2013 · <br />1"'81:11 Jewell Dec 31,2016 <br />13 . AUTHORI ZE D TO SIGN RI=OI JI=~TS FOR REIMBURS EMENT (A·19) <br />SIGNATURE IPRINT OR TYP E NAME TITLErrERM OF OFFICE <br />~~~~oAVlK Director of KITTCOM , app Ointed <br />Darl ene Mainwaring <br />v <br />~~J Kittit as County budg et & <br />It7 '-2 Judy Pl ess Fi nance, appointed <br />Plea~o j lete fo rm with an p y new contract or an y tim e ersonnel chan es . p g <br />Submit one original to Stat e E911 Offic e <br />•
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