HomeMy WebLinkAbout4 - Tunt Grant Signers Form':J1d72552934 TCSA ELECTRICAL SVS.PAGE 01/01
Grant Documents Authorized Signers
Please clearly print or type all sections of this form.
Community/Grantee Name:TCSA Electrical Services
Regular Election is held:
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I Date:9/13/10
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Printed Name Title Term Signature
Carl Andrew Utility Director &J/-~
I authorize the above person(s)to sign Grant Documents:
(Highest ranking organization/community/municipal official)
Printed Name Title Term Signature
Carl Andrew Utility Director ct:-//-?-L--
Grantee Contact Infonnation:
Mailing Address:PO Box 8027,Tuntutuliak,AK 99680
Phone Number:907-256-2529
Fax Number:907 -256-2934
E-mail Address:tcsaelec@unicorn-alaska.com
Federal Tax ID #:<J:l-d(}5'7 7C(2
.
Please submit an updated form Whenever there is a change to the above information.
Please return the original completed form to:
Alaska Energy Authority
813 W.Northern Lights Blvd.
Anchorage,AK 99503
I i"AlASKA
ENERGY AUTHORITY
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