HomeMy WebLinkAboutAuthorizedSignersFormGrant Documents Authorized Signers
Please clearly print or type all sections of this form.
Community/Grantee Name- Eklutna, Inc.
Regular Election is held- Annually Date: Third Saturday November
I each year
Authorized Grant Sign r(s):
Printed Name Title Term pgriature
A
Curtis McQueen CEO 5 yrs //
I authorize the above person(s) to sign Grant Documents:
(Highest ranking organization/community/municipal official)
Printed Name
Title
Term
Signature
Curtis McQueen
CEO
5 yrs
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L 41irri =_9?*T1WMr1Tr*Tr1 ZT96",
Mailing Address,
16515 Centerfield Drive, Suite 201, Eagle
River, Alaska 99577
Phone Number-
907-696-2828
Fax Number:
907-696-2845
E-mail Address:
curtis@eklutnainc.com
Federal Tax ID
92-0044666
Please submit an updated form whenever there is a change to the above information.
Please return the original completed form to:
ALAS KA
Alaska Energy Authority
813 W. Northern Lights Blvd.
4y ERGY AUTHORITY
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