HomeMy WebLinkAboutSignature pages- REFenewable Energy Fund Round 13 A$
KA
rant Application — Standard Form ENERGY
AUTHORITY
13 — AUTHORIZED SIGNERS FORM
unity/Grantee Name: Puvurnaq Power Company
anak
it Election is held: October F Date:
d Grant Signer(s):
Printed Name
Title
Term
Signature
oderick Phillip
Manager
N/A
Woody Phillip
Chairman
2022
eroy Igkurak
Vice Chairman
2022
arlene Daniel
Secretary
2021
11authorize the above person(s) to sign Grant Documents:
ust he authnri70r1 by tho hir.he.+
Printed Name
Title
Term
s:
Signature
seph Joseph
President
2021
rantee Contact Information:
Ming Address:
one Number:
K Number:
sail Address:
feral Tax ID #:
Please, submit an u
PO BOX 5009
907-557-5616
907-557-5614
Kongppc6@gmail.com
92-0091186
form whenever there is a
to the abVphre information.
21010 Page 40 of 42 I 7/20/2020
enewable Energy Fund Round 13ALAS�
rant Application — Standard Form ENERGY
AUTHORITY
ECTION 14 — ADDITIONAL DOCUMENTATION AND CERTIFICATION
SUBMIT THE FOLLOWING DOCUMENTS WITH YOUR AP
3LICATION:
. Contact information and resumes of Applicant's Project Manager, P
oject Accountant(s),
key staff, partners, consultants, and suppliers per application form
3.6.
ection 3.1, 3.4 and
Applicants are asked to provide resumes submitted with applications in sitparate
electronic
documents if the individuals do not want their resumes posted to the project
web site.
Letters or resolutions demonstrating local support per application form
Section 9.
. For projects involving heat: Most recent invoice demonstrating the C
st of heating fuel
for the building(s) impacted by the project.
. Governing Body Resolution or other formal action taken by the applicant's
governing
body or management per RFA Section 1.4 that:
• Commits the organization to provide the matching resources for roject at the match
amounts indicated in the application.
• Authorizes the individual who signs the application has the authority to commit the
organization to the obligations under the grant.
• Provides as point of contact to represent the applicant for purposes of this
application.
• Certifies the applicant is in compliance with applicable federal, st te, and local, laws
including existing credit and federal tax obligations.
An electronic version of the entire application on CD or other electro nic media, per RFA
Section 1.7.
CERTIFICATION
t
e undersigned certifies that this application for a renewable energy grant
d correct, and that the applicant is in compliance with, and will continue
ith, all federal and state laws including existing credit and federal tax obligations
at they can indeed commit the entity to these obligations.
is truthful
to comply
and
int Name
Roderick Phillip
gnature
tle
Manager
Elate
09/28/2020
A 21010
Page 41 of 42
7/20/2020