HomeMy WebLinkAboutAgreements/Contracts - BOCCK20-010
SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
CAMP MURRAY, WASHINGTON 98430-5122
NEW FORM WILL REPLACE PREVIOUS FORMS
NAME OF ORGANIZATION
DATE SUBMITTED
GRANT COUNTY
1/10/2020
PROJECT DESCRIPTION
CONTRACT NUMBER
FY20 SECO County Coordinator Professional
Chair, BOCC
Vice -Chair, BOCC
E20 - 043
Development (CPD) Contract
Member, BOCC
1. AUTHORIZING AUTHORITY
SIGNATURE
PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
I �,'
Dean Hane
Cindy Carter
Chair, BOCC
Vice -Chair, BOCC
MACC Financial Mana er
Richard Stevens
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE
PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
TITLE/TERM OF OFFICE
Dean Hane
Interim MACC Director
Tom Taylor
Vice -Chair, BOCC
MACC Financial Mana er
Richard Stevens
Member, BOCC
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT (A-19)
SIGNATURE
PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
Dean Hane
Interim MACC Director
Christal White
MACC Financial Mana er
Please complete form with any new contract or any time personnel changes.
Submit one original to State E911 Office