HomeMy WebLinkAboutauth signers formGrant Documents Authorized Signers
Please clearly print or type all sections of this form.
Comm unity/Grantee Name: Glacier Fork Hydropower, LLC
Regular Election is held: N/A Date: SEPTEMBER 14, 2010
Authorized Grant Sianer(s):
Printed Name
Title
Term
Signature
JOEL GROVES
MEMBER/PROJECT
N/A
MANAGER
DAVID AUSMAN
MEMBER
N/A
4 J'6kA.
MICHAEL DAHL
MEMBER
N/A
EARLE AUSMAN
MEMBER
N/A
I authorize the above person(s) to sign Grant Documents:
(Highest ranking organization/community/municipal official)
Printed Name
Title
Term
Signature
JOEL GROVES
PROJECT MANAGER
N/A
Grantee Contact Information:
Mailing Address:
1503 WEST 33 RD AVENUE SUITE 211 A
ANCHORAGE, AK 99503
Phone Number:
907-258-2420
Fax Number:
907-258-2419
E-mail Address:
JOEL@POLARCONSULT. NET
Federal Tax ID #:
N/A
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
or= ALASKA
41[= ENERGY AUTHORITY
Z:\network\Jobs\Gladerjork Hydro-(08015)\Funding\FY12-AEA\F_AuthSignersForm\51- Grant AtAthorjzed__Signers4,doc