HomeMy WebLinkAboutTKE_AuthSignersFormGrant Documents Authorized Signers
Please clearly print or type all sections of this form.
CITY OF TENAKEE SPRINGS
YES /0(-
Date:
a--5i d616
Wm=-100=7 lac-1112-1101
Printed Name
Title
Term
Signature
ARTHUR BLOOM
CITY COUNCIL
HYDRO PROJECT
MGR
OCT 2011
,
DON PEGUES
MAYOR
OCT 2011
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I authorize the above person(s) to sign Grant Documents:
(Highest ranking organization/community/municipal official)
Printed Name
Title
Term
Sio'nate
DON PEGUES
MAYOR
OCT 2011
9
Grantee Contact Information:
PO BOX 52
TENAKEE SPRINGS, AK 99841
(907) 736-2207
(907) 736-2207 fax
citytke@gmail.com
Federal Tax ID #:
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.
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