HomeMy WebLinkAboutSAF for E911 Contract E21-024SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
CAMP MURRAY, WASHINGTON 98430-5122
NEW FORM WILL REPLACE PREVIOUS FORMS
NAME OF ORGANIZATION
DATE SUBMITTED
KITTITAS COUNTY
612212020
PROJECT DESCRIPTION
CONTRACT NUMBER
FY20 SECO County Basic Service Operations
Contract
E21-024
1. AUTHORIZING AUTHORITY
SIGNATURE
PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
Darlene Mainwaring
Chair of the Board of County
Brett Wachsmith
Commissioners, Jan 1, 2019 -
Dec 31, 2022
Vice Chair of the Board of
Judy Pless
Vice Chair of the Board of
Laura Osiadacz
County Commissioners, Jan 1,
County Commissioners, Jan 1,
2017 -Dec 31, 2020
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE
PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
Darlene Mainwaring
Chair of the Board of County
Brett Wachsmith
Commissioners, Jan 1, 2019 -
Dec 31, 2022
Judy Pless
Vice Chair of the Board of
Laura Osiadacz
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