HomeMy WebLinkAboutSignature Form FY22SAF-KittitasCountyBSOContractsDATE SUBMITTED
7/20/2021
PROJECT DESCRIPTION CONTRACT NUMBER
E22-024
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
Brett Wachsmith
Chairman, Board of County
Commissioners
01/01/2019-12/31/2022
Laura Osiadacz
Chairman, Board of County
Commissioners
01/01/2021-12/31/2024
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
Brett Wachsmith
Chairman, Board of County
Commissioners
01/01/2019-12/31/2022
Laura Osiadacz
Chairman, Board of County
Commissioners
01/01/2021-12/31/2024
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT (A-19)
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
George Long Director
Judy Pless Budget & Finance Manager
Please complete form with any new contract or any time personnel changes.
Submit one original to State E911 Office
1. AUTHORIZING AUTHORITY
NAME OF ORGANIZATION
KITTITAS COUNTY
FY22 SECO County Basic Service Operations
Contract
SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
CAMP MURRAY, WASHINGTON 98430-5122
NEW FORM WILL REPLACE PREVIOUS FORMS