HomeMy WebLinkAbout20201027081728SIGNATURE AUTHORIZATION FORM
WASHI NGTON STATE MILITARY DEPARTMENT
CAMP MURRAY, WASHINGTON 98430-5122
NEW FORM WILL REPLACE PREVIOUS FORMS
NAME OF ORGANIZATION
KITTITAS COUNTY
DATE SUBMITTED
10/21/2020
PROJECT DESCRIPTION
FY20 SECO County Basic Service Operations
Contract
CONTRACT NUMBER
E20 - 0214
1. AUTHORIZINGAUTHORITY
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
Brett Wachsmith
Chair of the Board of County
Commissioners, Jan 1, 2019-
Dec 31 ,2022
Laura Osiadacz
Vice Chair of the Board of
County Commissioners, Jan 1,
2017-Dec 31,2020
2. AUTHORIZED TO S'G'V CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
Brett Wachsmith
Chair of the Board of County
Commissioners, Jan 1, 2019-
Dec 31 ,2022
Laura Osiadacz
Vice Chair of the Board of
County Commissioners, Jan 1,
2017-Dec 31,2020
IO S'GA' REQUESTS FOR REIMBURSEMENT
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
George Long Director/E91 I Coordinator of
KITTCOM, appointed
Kittitas County Budget &
Finance, appointedJudy Pless
Please complete form with any new contract or any time personnel changes
Submit one original to State Egl1 Office