HomeMy WebLinkAbout*Other - BOCC (002)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 3/15/2019
PROJECT DESCRIPTION CONTRACT NUMBER
FY19 SECO County Coordinator Professional E19 - 019
Development (CPD) Contract
1. AUTHORIZING AUTHORITY
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
Tom Taylor Chair, BOCC
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
Cindy Carter Vice -Chair, BOCC
Richard Stevens Member, BOCC
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT A-19)
SIGNATURE
PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
C-
Jackie Jones
MACC Director
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Christal White
MACC Financial Manager
Please complete form with any new contract or any time personnel changes.
Submit one original to State E911 Officef -;M D
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