HomeMy WebLinkAboutSignaturesRenewable Energy Fund Round VII i0mr- ALASKA
Grant Application - Standard Form 4111111111L ENERGY AUTHORITY
SECTION 10 - AUTHORIZED SIGNERS FORM
Community/Grantee Name: Naknek Electric Association, Inc.
Regular Election is held: Annually Date: April 27, 2013 (most recent
Annual Membership Meeting and Election)
Authorized Grant Si ner(s):
Printed Name
Title
Term
Signature
Donna Vukich
NEA - General Manager
Annual Contract
I authorize the above person(s) to sign Grant Documents:
(Highest ranking organization/community/municipal official)
Printed Name Title Term Signature
Grantee Contact Information:
Mailing Address:
Naknek Electric Association, Inc.
Donna Vukich
PO Box 118
Naknek, Alaska 99633
Phone Number:
907 246 4261
Fax Number: 907 246 6242
E-mail Address:
dvukich@nea.coop
Federal Tax ID #:
02-0027674
Please submit an updated form whenever there is a change to the above information.
AEA 2014-006 Grant Application Page 27 of 28 7/1/2013
Renewable Energy Fund Round VII ALASKA
Grant Application - Standard Form ENERGY AUTHORITY
SECTION 11 —ADDITIONAL DOCUMENTATION AND CERTIFICATION
SUBMIT THE FOLLOWING DOCUMENTS WITH YOUR APPLICATION:
A. Contact information, resumes of Applicant's Project Manager, key staff, partners,
consultants, and suppliers per application form Section 3.1 and 3.4. Applicants
are asked 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 8.
C. For heat projects only: Most recent invoice demonstrating the cost of heating fuel
for the building(s) impacted by the project.
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
Donna Vukich
Signature
V K�
Title
General Manager - Naknek Electric Association, Inc.
Date
August 23, 2013
AEA 2014-006 Grant Application Page 28 of 28 7/1/2013