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E;ki6/-4,f/ 4r/444.J <br /> ` 1J <br /> 1:,;73 o Office of the State Fire Marshal <br /> Washington State Patrol <br /> National Fire incident <br /> Reporting System 5.0 <br /> Contract Application Cover Sheet <br /> 2003-2004 <br /> Organization: City of Everett Fire Department <br /> Point of Contact: Warren Burns <br /> Address 2811 Oakes, Everett 98201 Phone 425 257-8121 <br /> Fax 425 257-8139 Email wburnsci.everett.wa.us <br /> Agencies Represented in contract: <br /> City of Everett Fire Department initially. All fire agencies in Snohomish <br /> County eventually. <br /> Funds Requested $30,000.00 <br /> I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT THE INFORMATION IN <br /> THIS APPLICATION IS TRUE AND CORRECT, THAT I AM AUTHORIZED TO SIGN <br /> AND SUBMIT THIS INFORMATIO N BEHALF OF THE APPLICANT. <br /> Signature <br /> Office of the State Fire Marshal Use Only <br /> Date Received Received By <br /> Date Reviewed Action <br /> Taken <br /> Date of Reply <br /> 140 <br />