HomeMy WebLinkAboutSignature Authorization FormSIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
CAMP MURRAY, WASHINGTON 98430-5122
NEW FORM WILL REPLACE PREVIOUS FORMS
NAME OF ORGANIZATION
KITTITAS COUNTY
DATE SUBMITTED
10/21/2020
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
A
RE PRINT OR TYPE NAME TITLE/TERM OF OFFICEncBrett Wachsmith
Chair of the Board of County
Commissioners, Jan 1, 2019-
Dec 31 ,2022qLaura Osiadacz
Vice Chair of the Board of
County Commissioners, Jan 1,
2O17-Dec 31,2020
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
George Long Director/E91 1 Coordinator of
KITTCOM, appointed
Judy Pless Kittitas County Budget &
Finance, appointed
Please plete rm with any new coniract or any time personnel changes
Submit one original to State Eg'11 Office