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COPY <br /> 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 /> NAME OF ORGANIZATION DATE SUBMITTED <br /> City of Everett Office of Emergency Management December 8, 2016 <br /> PROJECT DESCRIPTION CONTRACT NUMBER <br /> Emergency Management Performance Grant (EMPG) between the E17-148 <br /> City of Everett and the WA State Military Department o <br /> 1. AUTHORIZING AUTHORITY <br /> SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE <br /> 12a46/1140httit/WS Ray Stephanson Mayor, City of Everett <br /> 2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS <br /> SIGNATURE PRINT OR TYPE NAME TITLE <br /> Ray Stephanson Mayor, City of Everett <br /> cow <br /> . - . - ., , • , - - <br /> Sharon f-u+lct C <br /> 3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT <br /> SIG►ATURE PRINT OR TYPE NAME TITLE <br /> Brent Stainer Director, Everett OEM <br /> Eric Hicks AC/Fire Marshal, Everett Fire <br /> \\ •C-1\. e 1\HOME\KARENB\....\WP\SIGNAUTH Revised 3/03 <br />