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<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 Emergency Management MAY 9 , 2007
<br /> 2811 Oakes Avenue
<br /> Everett, WA 98201
<br /> PROJECT DESCRIPTION CONTRACT NUMBER
<br /> EMPG (Emergency Management Performance Grant) ��
<br /> between City of Everett and WA State -Military
<br /> Department
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<br /> 1. AUTHORIZING AUTHORITY
<br /> SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
<br /> RAY STEPHANSON MAYOR, CITY OF EVERETT
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<br /> 2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
<br /> SIGNATURE PRINT OR TYPE NAME TITLE
<br /> RAY STEPHANSON MAYOR, CITY OF EVERETT
<br /> ELMER E. "NED" JOHNSTON CITY ATTORNEY
<br /> ATTEST: SHARON MARKS CITY CLERK
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<br /> 3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT
<br /> SIGNATURE PRINT OR TYPE NAME TITLE
<br /> DAVE DEHAAN DIRECTOR, EMERGENCY
<br /> -_ MANAGEMENT
<br /> JOE JOHNSTON ASST. CHIEF, EVERETT
<br /> FIRE DEPARTMENT
<br /> \\NAC-1\VOL1\H• E\KA•ENB\....\WP\SIGNAUTH Revised 5/00
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