3950 Local Parks Maintenance Program
Local Parks Maintenance Program
Applicant Authorization and Electronic Signature
Organization Name (sponsor)
Resolution No. or Document Name
Project Number and Name
This resolution/authorization authorizes the person(s) identified below (in Section 2) to act as the authorized representative/agent on behalf of our organization and to legally bind our organization with respect to the above Project for which we seek grant funding assistance managed through the Recreation and Conservation Office (Office).
WHEREAS grant assistance is requested by our organization to aid in financing the cost of the Project referenced above; NOW, THEREFORE, BE IT RESOLVED that: 1. Our organization has applied for or intends to apply for funding assistance managed by the Office for the above “Project.” 2. Our organization authorizes the following persons or persons holding specified titles/positions (and subsequent holders of those titles/positions) to execute the following documents binding our organization on the above projects:
Grant Document Routing Order Name of Signatory and Title of Person Authorized to Sign Email Address
Grant application (submission thereof)
Project contact (day-to-day administering of the grant and communicating with the RCO)
Agreement/amendment approver1 Agreement/amendment approver Agreement/amendment approver Agreement/amendment approver RCO Grant Agreement signer2 Agreement amendments signer2
23-1642 MNT, 2023 Surf N Slide Deferred Maintenance Items
citymanager@cityofml.com
Doug Coutts
citymanager@cityofml.com
Kevin Fuhr
Doug Coutts
dcoutts@cityofml.comDoug Coutts
citymanager@cityofml.com
City of Moses Lake
Kevin Fuhr
dcoutts@cityofml.com
Resolution 3950
2
dcoutts@cityofml.com
1
Kevin Fuhr
4
3
Document Ref: BXJ29-GZUQG-XRCAF-KXU4S Page 1 of 3
The above persons are considered an “authorized representative(s)/agent(s)” for purposes of the documents indicated. Our organization shall comply with a request from the RCO to provide updated documentation of authorized signers, if needed.
3. Our organization acknowledges and warrants, after conferring with its legal counsel, that its authorized representative(s)/agent(s) have full legal authority to act and sign on behalf of the organization for their assigned role/document.
4. Grant assistance is contingent on a signed Agreement. Entering into any Agreement with the Office is purely voluntary on our part.
5. Our organization understands that grant policies and requirements vary depending on the grant program applied to, the grant program and source of funding in the Agreement, the characteristics of the project, and the characteristics of our organization.
6. Any grant assistance received will be used for only direct eligible and allowable costs that are reasonable and necessary to implement the project(s) referenced above.
7. Our organization acknowledges that the grant will only be used for maintenance of local park property owned by our organization.
8. This resolution/authorization is deemed to be part of the formal grant application to the Office.
9. Our organization warrants and certifies that this resolution/authorization was properly and lawfully adopted following the requirements of our organization and applicable laws and policies and that our organization has full legal authority to commit our organization to the warranties, certifications, promises, and obligations set forth herein. This resolution/authorization is signed and approved on behalf of the resolving body of our organization by the following authorized member(s): Signed
Title Date
On File at:
This Applicant Resolution/Authorization was adopted by our organization during the meeting held: Location: Date:
You may reproduce the above language in your own format; however, text may not change.
Mayor 2023-09-13
City of Moses Lake
Moses Lake Civic Center 2023-09-12
Document Ref: BXJ29-GZUQG-XRCAF-KXU4S Page 2 of 3
1 Agreement/Amendment Approver: refers to an individual or several individuals who review and approve the electronic document and contacts RCO if corrections are needed. The approver does not sign the document. You may add more than one approver but please designate the order for routing purposes. 2 RCO Grant Agreement/Agreement Amendments Signer: refers to the individual who must officially sign the document with an electronic signature and may be required to enter data such as title, date, agency name, etc. into fields. The signer of Agreements may differ from the individual who is delegated to sign Amendment documents, but we can only accept one signature per document.
Document Ref: BXJ29-GZUQG-XRCAF-KXU4S Page 3 of 3
Signature Certificate
Reference number: BXJ29-GZUQG-XRCAF-KXU4S
Document completed by all parties on:
14 Sep 2023 00:09:48 UTC
Page 1 of 1
Signer Timestamp Signature
Mayor Don Myers
Email: dmyers@cityofml.com
Recipient Verification:
Sent:13 Sep 2023 20:59:03 UTC
Viewed:14 Sep 2023 00:08:36 UTC
Signed:14 Sep 2023 00:09:48 UTC
✔Email verified 14 Sep 2023 00:08:36 UTC
IP address: 107.122.81.138
Location: Seattle, United States
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