HomeMy WebLinkAboutSAFSIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
Camp Murray, Washington 98430-5122
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NAME OF ORGANIZATION DATE SUBMITTED
KITTITAS COUNTY JANUARY 3,2017
PROJECT DESCRIPTION CONTRACT NUMBER
FEMA HAZARD MITIGATION PLANNING GRANT HMP #E17-062
1. AUTHORIZING AUTHORITY
SIGNATURE PRINT OR TYPE NAME TITLEITERM OF OFFICE
OBIE O'BRIEN COMMISSIONER
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_-+ __ -...:.P~AUL JEWELL COMMISSIONER
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LAURA OSIADACZ COMMISSIONER
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2 . AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE
'7t{ ,~ MARK COOK DIRECTOR PUBLIC WORKS
lAA \~I);\N'& ~II, KATHY JURGENS PW FINANCE SYSTEM MGR
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3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT
SIGNATURE PRINT OR TYPE NAME TITLE
MARK COOK DIRECTOR PUBLIC WORKS
~~~ KATHY JURGENS PW FINANCE SYSTEM MGR
IINAC-1IVOL 1IH OM ~B~.IWPISIGNAUTH Revised 3/03