Approve SECO County Coordinator Professional Development contract SFY2022. SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
CAMP MURRAY, WASHINGTON 98430-5122
NEW FORM WILL REPLACE PREVIOUS FORMS
NAME OF ORGANIZATION DATE SUBMITTED
LE .. COUNTY
IS
PROJECT DESCRIPTION CONTRACT NUMBER
FY22 SECO County Coordinator Professional
Development (CPD) Contract E22-026
1. AUTHORIZING AUTHORITY
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
4 3,(,,,,r___ Gary Stamper Board of County Commissioners
1/1/2019-12/31/2022
Lindsay Pollock, DVM Board of County Commissioners
fi� 1�/� 01/01/2021-12/31/2024
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
1 V--air Gary Stamper Board of County Commissioners
1/1/2019-12/31/2022
2,c0/C e- ___-- Scott Smitherman Administrator, Lewis County 911
_,ei-,-,----e-e
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT (A-19)
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
Scott Smitherman Administrator, Lewis County 911
r- /.
•
Erik Martin County Manager, Lewis County
Please complete form with any new contract or any time personnel changes.
Submit one original to State E911 Office