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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 t <br /> 2811 Oakes Avenue <br /> Everett, WA 98201 <br /> PROJECT DESCRIPTION CONTRACT NUMBER <br /> Public Assistance Grant Agreement D09-384 <br /> Presidential Disaster Declaration #FEMA-1825-DR-WA-- • <br /> Severe Winter Storm and Record and Near Record Snow <br /> x,eta.• �:t �' iy y"° y �s: G�`�'"a�R"a���. r3� ,. �ih�i�t 5�. >�.t^^�i'�' `�y�g.,_'� -�.�'L„`�`t.�. ,;ji A�.�; '-i]4 `^°n`•.`;�,,��y r I t <br /> �' .a�„s.€'v ` ., ��r�'se.L7 .�v ovot i^ ;.. 3 ,4,:m'�,: -wc;- 4r. •-``+ av'$, m.... .;: a:.: .;s+.lc <br /> 1. AUTHORIZING AUTHORITY <br /> SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE <br /> /46 RAY STEPHANSON MAYOR, CITY OF EVERETT <br /> - 1 s y n+r4i�.�� " �.°c''' ::;''' '';.. k -S Ci 3 'a ,�a i; s� q <br /> ... ,ri ,�r r..vim...,. � �„c'r��,., _.m __. � �� u:..�,��..._.....,.. z <br /> 2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS <br /> SIGNATURE PRINT OR TYPE NAME TITLE <br /> i RAY STEPHANSON(at MAYOR, CITY OF EVERETT <br /> JIM ILES CITY ATTORNEY <br /> iii . Ax d...., / ) SHARON MARKS CITY CLERK <br /> 3. 'a- v` .,y ( et- ..ff.'s'y�t°'' w3 ,,, at@ re Z <br /> a' L' {q'�':44W1:xr `t';5�#,�,• 1a Fl•x �Y 1 +� 7 F``�Lcgt W .+�.� ..1$�$ � t* ^t 4PVgO £-k SC,..'d,: <br /> 3. DESIGNATED APPLICANT AGENT AND ALTERNATE <br /> SIGNATURE PRINT OR TYPE NAME TITLE <br /> _> DAVE DeHAAN DIRECTOR, EMERGENCY MANAGEMENT <br /> 79-(1 _____---_--- <br /> JOE HUDEN HOMELAND SECURITY PLANNER _ <br /> ie/kLI'-- <br /> \\NAC-1\VOL ME\KARENB\....\WP\SIGNAUTH Revised 3/03 1 t j <br />