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CITY <br /> 2019 Signature Authorization Form 40^ <br /> Effective January 1, 2019 through December 31, 2019 Snohomish County <br /> Human Services <br /> y MAIL COMPLETED ORIGINAL FORM TO: Snohomish County Human Services - Attn: HSD Contracts <br /> 3000 Rockefeller, M/S 305 - Everett, WA 98201 <br /> Please sign in blue ink and type or print names clearly. All sections (1-5) must be completed. <br /> SECTION 1: Official Business Name of Organization <br /> Business Name: City of Everett Date Submitted: <br /> Mailing Address: 2930 Wetmore Ave. Everett WA 98201 <br /> Street City State Zip <br /> SECTION 2: Authorizing Authority <br /> "ign. ure Type or Print Name Title <br /> Cassie Franklin Mayor <br /> SECTION 3: Authorization to Sign Contracts/Contract Amendments <br /> Signature Type or Print Name Title <br /> 4r assie Franklin Mayor <br /> SECTION 4: Authorization to Sign Invoices/ Requests for Reimbursements <br /> Signature Type or Print Name Title <br /> Rebecca A. McCrary Housing and Community Development <br /> Program Manager <br /> ( F - I _ Julie Frauenholtz Community Development Director <br /> a <br /> SECTION 5: Contract Delivery Designation— Email <br /> Email Address(please print) Type or Print Name Title <br /> ramccrary(c�everettwa.gov Rebecca A. McCrary Housing and Community Development <br /> Program Manager <br /> Rev. 12/3/18 <br />