HomeMy WebLinkAboutDixon Diversion authorized signersRenewable Energy Fund Round 14 , ALAS KA
Grant Application — Standard Form ENERGY
04A AUTHORITY
SECTION 13 — AUTHORIZED SIGNERS FORM
Community/Grantee Name: Chugach Electric Association, Inc.
Regular Election is held: Annually in May Date: January 18, 2022
Authorized Grant Signer(s)
Printed Name
Title
Term
N/A
Signature
T✓-
Arthur Miller
Exec. VP, Regulatory and
External Affairs
Lee Thibert
CEO
N/A
l�
71
I authorize the above person(s) to sign Grant Documents:
(Must be authorized by the highest ranking organization/commu
Printed Name Title Term
Lee Thibert CEO N/A
Grantee Contact Information:
Mailing Address:
Phone Number:
Fax Number:
Email Address:
Federal Tax ID #:
unicipal offic
Signat.yre
F
PO Box 196300, Anchorage, AK 99519-6300
(907) 762-4747
(907) 562-0027
Lee.thibert@chugachelectric.com
92-0014224
Please submit an updated form whenever there is a change to the above information.
AEA 23001 Page 32 of 33 11/16/2021