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Grant Documents Authorized Signers
Please
cleady print or type all sections of this form.
Community/Grantee Name:
Cold Ba _ G K Electric, INC.
Regular Election is held:
;
Date:
Authorized Grant Sir-05w—neer
Printed NameTitle
Term Signatur
Gary Ferguson
of G & K ,
I
authorize the above person(s) 1
a sign Grant Documents:
(Highest ranking org a n ization/cc
mmunitylmunicipaI official]
Printed Name
Title
Term
Signature
Gary Ferguson Owner
of G K
-- j
i 2�!
Grantee Contact Information:
Mailing Address:
P_o. Box 117. Cold Bay, AK 9957
I
�
Phone Number., 907-532-2407
Fax Number: 907-5324513
E-mail Address: GFergu9584@
1.com
Federal Tax ID #:
Please submit an updated fo
whenever there is a change to the above information.
Please return the original comps
Alaska Energy Authority
ted form to:
ALASKA
813 W. Northern Lights Blvd
4MMD ENERGY AUTHORITY
Anchorage, AK 99503
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s\AOL Dow nioads\Grant Authorized_Signers4.doc