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SIGNATURE AUTHORIZATION FORM <br />WASHINGTON STATE MILITARY DEPARTMENT <br />Camp Murray, Washington 98430-5122 <br />Please read instructions on reverse side before completing this form. <br />JAN 0 2 2018 <br />'TRACTS <br />NAME OF ORGANIZATION <br />City of Everett <br />DATE SUBMITTED <br />PROJECT DESCRIPTION <br />EMAC and PNEMA Assistance <br />CONTRACT NUMBER <br />IGA #U18-090 <br />1. AUTHORIZING AUTHORITY <br />SIGNATURE <br />PRINT OR TYPE NAME <br />TITLE/TERM OF OFFICE <br />100-4 <br />2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS <br />SIGNATURE <br />PRINT OR TYPE NAME <br />TITLE <br />21464441 <br />--Yleu-i pe p haft S 0 in <br />Mc <br />�,Y <br />��JJ <br />— t_c_41 t 20 1Li' <br />31 Zo 4 <br />3. <br />AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT <br />SIGNATURE <br />PRINT OR TYPE NAME <br />TITLE <br />\\NAC-1 \VOL1 \HOME\KARENB\....\WP\SIGNAUTH Revised 3/03 <br />