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HomeMy WebLinkAboutAtmo Authorized Signatures Utility MgrRenewable Energy Fund Round 14 ALASKA Grant Application — Standard Form ,�� ENERc3Y AUTHO ITI' SECTION 13 —AUTHORIZED SIGNERS FORM CommunitylGrantee Name: Atmautluak Tribal Utilities Regular Election Is held: Data: November Authorized Grant Si ner s : Printed Name Title Term Signature Cad Gamechuk Utility Board Chairman 1 yr Henry Tikiun, Jr. Vice -Chairman 2 yrs Eliza Nicholai Sec.frreasurer 2 yr yP • v I�,�`/ Billy Gilman, Jr. Member 1 yr M�`eSPwv��(�,T� U�1� Nt er / I authorize the above person(s) to sign Grant Documents: Muet be authorized by the highest rankin or anization)communit /municl al official Printed Name Title Term Signature Cad Gamechuk Board Chairman (y r Grantee Contact Information: Mailing Address: PO BOX 6564 Atmauttuak, AK 99559 Phone Number: 907-553-5429 Fax Number: 907.553.5429 Email Address: attutilities@gmail.com Federal Tax ID #: 92-0069224 Please submit an updated form whenever there Is a change to the above information. AEA 23001 Page 33 of 35 11/16/2021