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STATE OF WASHINGTON
COUNTY OF JEFFERSON
In the matter of:
x
Designation of an
Applicant's Agent
Disaster No. 1641-DR-WA
x
x
x
RESOLUTION NO. 42-06
WHEREAS, the Jefferson County Board of Commissioners has reviewed the Disaster Assistance
Application submitted by the Jefferson County Department of Public Works; and
WHEREAS, the Robert T. Stafford Disaster Relief and Emergency Assistance Act, Public Law
93-288, as amended in 1999, is the authorization for federal assistance to supplement the efforts
of states to assist local government after a disaster is declared; and
WHEREAS, the Washington Military Department, State Emergency Management Public Assistance
Program requests that the affected entity appoint an official representative, and alternate to be the point
of contact. This person must be authorized to make decisions on behalf of the public entity,
NOW, THEREFORE BE IT RESOLVED by the Board of Commissioners of Jefferson County that
Frank Gifford, Public Works Director (Applicant Agent), and Monte Reinders, County Engineer
(Alternate Applicant Agent), are hereby authorized on behalf of Jefferson County, a public agency
established under laws ofthe State of Washington, to execute all contracts, certify completion of
projects, request payments, and prepare all required documentation for funding requirements. The
purpose of this designation is to be the authorized representative for obtaining federal and/or emergency
or disaster assistance funds.
ADOPTED THIS
3rd
DA Y OF July
2006 .
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
P~JI
~~ '~~-
Patrick M. Rodgers, Member
~
-
CUA{1,~~
~rna L. De aney, Clerk of e B
DISASTER ASSISTANCE APPLICATION
OEM - 131
Application Identifier:
State Number:
Federal ()tsaster Number: FE:.M A '''41 - OR - viA
FederaICatal()gNumber: 97.036
Title::Publlc Assistance
Declaration Date: M ~ '1 2. 00
ApplicanfsFEMA Project Application Nlil'l1ber:
Legal Applicant Recipient:
Applicant's Name: Ie.+'(e.($O(\ Coun t'j De.pf: of Pvblt'c....
Street Address: 132.2. "" ~.s~"t'\~ tv.... s t:
Mailing Address: ~ O. Box 2..010
City: Port "Towa'lsef\d State: W A
Works
County: It... .t-4!(,.( son
Zip Code: q 63 to B
Applicant Agent:
Name: Ft"IA." k 4 i +ford.
~9M:ill~: :;Zlr;-D,'w,tor
Alternate Applicant Agent: f
Name: MOIl1"(" Ret'nders
Title: Co v " .,.. j e. (\ <3 ' (\ e.e.r
Contact Information:
Phone:
Fax:
E-mail,:
Date:
3100 - 365'- 91(Po
3fQO - .3BS - 92.34-
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Signature:
Phone: 3~o- 385- '12.42-
Fax: 3(g(:) - 38S" - 92.34
E-mail: I11r~..it1d~r!;.(iJGo.it..t.t-ersol).
Date: ~ .. "2..4-- . 0 4<'..... v.s
Type of Applicant:
A - State
B - County
C - City
o - School District
E - Special Purpose District
F - Higher Educational Institution
G - Indian Tribe
H - Private NonProfit
I - Other (Specify)
Enter Appropriate Letter B
Congressional District Number: ~
State Legislative District Number: 2.4
Governor's Authorized Representative:
Signature
NOTE: Shaded blocks for WA EMD use.
Date:
F-2
9/05