HomeMy WebLinkAboutRenewable Energy Fund Round IX - Grant Application 9-28-2015Renewable Energy Fund Round IX OJCMCD&6AS"m�-
Application - Standard Form
Giant pp 61111C' ENERGY AUTHORITY
SECTim 13 — AUTHORIZED SIGNERS FORK. �� W
Community/Grantee Name: 1
L i r `6
Regular Election is held: Date:
A�thvrized Grant Signer(s):
Printed Name
Title
e
& t-g
I
I
0/1,00.94-
I authorize the above person(s) tq •sign Grant Documents:
Must be authorized by the highest ranking or anizatlon/community1municipal ofFic
Printed Name n Title Term Signature
Roeck(di<�oi,jtog li/`)/`+155�1n�PJC&0990
Grantee Contad information:
Mailing Address:
Phone Number:
Fax Number:
E-mail Address:
Federal Tax ID #:
Please submit an updated fvrrrr-W4eneer them is a change to the above information,
AEA 15003 Page 24 of 25 7/8/14
M
v