HomeMy WebLinkAbout4 - Kong Grant Signers FormGrant Documents Authorized Signers
Please clearly print or type all sections of this form.
Community/Grantee Name: Puvurnaq Power Company
Regular Election is held: 1st Tuesday of October Date: 9/14/10
Authorized Grant Signer(s):
Printed Name
Title
Term
Signature
Harvey Paul
General Manager
N/A
Daniel Azean, Sr.
Chairman, Board of
Directors
2010
I authorize the above person(s) to sign Grant Documents:
(Highest ranking organization/community/municipal official)
Printed Name
Title
Term
'gnature
Peter. niel, Sr.
Council President
2013
Kon i anak Traditional
Grantee Contact Information:
Mailing Address:
PO Box 5009, Kongiganak, AK 99545
Phone Number:
907-557-5616
Fax Number:
907-557-5614
E-mail Address:
puvurnaq@hughes.net
Federal Tax ID #:
92-0091186
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
Attn: Butch White, Grants Administrator
CAUsers\HBPauI\Documents\Kong Grant_Authorized_Signers4.doc