Orange County NC Website
Browse       Search
<br />SIGNATORY FORM AND CERTIFICATION <br />Recipient Name ~,._Or.ange County <br />Address: P . 0 . Box 8181 <br />Hillsborough, N.C. 27278 <br />Grant No. 04~ C-12 3 9 <br />Signatures of individuals authorized to sign Requisition for Funds forms. (Two signatures required on each requisition.) <br />Kenneth T. Chavious,Fin~nce Director <br />.~~T......-.~ <br />(Signature) (Type ~lamej (i'yped i lej ~'~~^~ , <br />Roderick Visser, Asst. County Manager <br />(Signature) (Typed Name) (Typed Title) <br />(Signature) <br />Gwen Harvey, Asst. County Manager <br />(Typed Name) (Typed Title) <br />(Signature) <br />(Typed Name) (Typed Title) <br />CERTIFICATION <br />~. () I certify that the signatures above are of the individuals authorized to sign Requisition for Funds form for the <br />above recipient. <br />Certifying Official + Title <br />2. ()The governing board has passed a resolution authorizing the persons above to sign Requisition for Funds forms <br />for the above recipient. A copy of the resolution is,attached. <br />I certify that the signatures above are those of the individuals authorized by resolution of the governing board <br />of the recipient to sign Requisition for Funds forms. <br />Certifying Official + Title <br />