HomeMy WebLinkAboutAuthorized Signed Forms - Grant Applicationenewable Energy Fund 'o►
Grant ppdard Form iGNED ENERGY AUTHORITY
Community/Grantee Name: City of Hoonah
Regular Election is held:
General municipal election
Date:
October 6, 2015
Printed Name
Title
Term
Signature
Kenneth K. Skaflestad
Mayor
Ends October 2017
I authorize the above persons) to sign Grant Documents:
(Must be authorized by the highest ra king organization/community/municipal official)
Printed Name
Title
Term
Signature
Kenneth K. Skaflestad
Mayor
Ends October 2017
Mailing Address:
PO Box 360
Hoonah, AK
99829
Phone Number:
907-95-3663
Fax Number:
907-945-3445
E-mail Address:
mayor@cityofhoonah.org
Federal Tax ID #:
926001151
Please Submit an updated form whenever there is a change to the above information.
AEA 15003 Page 33 of 34 7/8/14
Renewable Energy Fund Round IX ip ONIO
Grant WEED ENERGY A
RITY
Application Standard Form •
A. Contact information and resumes of Applicant's Project Manager, Project
Accountant(s), key staff, partners, consultants, and suppliers per application form
Section 3A, 3.4 and 3.6.
Applicants area to provide resumes submitted with applications in separate electronic
documents if the individuals do not want their resumes posted to the project web site.
B. Letters or resolutions demonstrating local support per application form Section 9.
C. For
projects involving
heat: Most recent invoice
demonstrating the cost of heating
fuel
for the building(s)
impacted by the project.
n/a
D. 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 project 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, state, and local,
laws including existing credit and federal tax obligations.
E. An electronic version of the entire application on CD or other electronic media, per
RFA Section 1.7.
F. CERTIFICATION
The undersigned certifies that this application for a renewable energy grant is truthful
and correct,
and that the applicant is in
compliance with, and will continue to comply
with, all federal and state laws including
existing credit and federal tax obligations and
that they can
indeed commit the entity to these obligations.
Print Name
Kenneth K.Skaflestad—
Signature
Title
Mayor
Date
September 15, 2015
AEA 15003 Page 34 of 34 7/8/14