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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 /> NAME OF ORGANIZATION DATE SUBMITTED
<br /> City of Everett Emergency Management JULY 2, 2008
<br /> 2811 Oakes Avenue
<br /> Everett, WA 98201
<br /> PROJECT DESCRIPTION CONTRACT NUMBER
<br /> EMPG (Emergency Management Performance Grant) between City E08-307
<br /> of Everett and Washington State Military 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 /> JIM ILES CITY ATTORNEY
<br /> 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 /> Wir MANAGEMENT
<br /> f / ./ RENEE DARNELL ADMIN. ASSISTANT
<br /> \\NAC-1\VOL1\HOME\KARENB\....\WP\SIGNAUTH Revised 5/00
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