Agenda - 04-15-2014 - 6j - Laserfiche WebLink

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RES-2014-022 3 • RESOLUTION DESIGNATION OF APPLICANT'S AGENT North Carolina Division of Emergency Management Organization Name(hereafter named Organization) Disaster Number. Orar.qe C�ur.l`yt NC FirMA--1-1t1Co—OP.-tJc Applicant's State Cognizant Agency for Single Audit purposes(If Cognizant Agency is not assigned,please indicate): Applicant's Fiscal Year(FY)Start Month:.1,,6 Y Day: 1 Applicant's Federal Employer's Identification Number Applicant's Federal Information Processing Standards(F1PS)Number 37 - 1 35 - PRIMARY AGENT SECONDARY AGENT Agent's Name Agent's Name Shari I?or4-erCit,1 d (` l ar ce Organization Organization Organization br CDund-y dr e - 4-e COLAY+111 Official Position Official Position 1-1 n0.vlt.,a( 5grvtices Mauch P scl-. Covo, O.In Mailing Address Mailing Address 13 v 4(X. I ti I 0 30x 81 - City,State,Zip City,State,Zip 1}iltsbvr-ov. ht iS C Z`7-23-£i +11 S1o�Y o ug1-.) tJ C ? i Z3 8 Daytime Telephone J Daytime Telephone 1 - at-I 5--2.y 5(a `l I`?-7L-15 Facsimile-Number Facsimile Number - alIq- (0yq- 53Z1-1 `7 i9- (.ti'-1- -6322-4 -Pager or Cellular Number Pager or Cellular Number 91 -yZ8 - o4(p BE IT RESOLVED BY the governing body of the Organization (a public entity duly organized under tholaws of-the State of North Carolina) that the above-named Primary and Secondary Agents are hereby authorized to execute and file applications for federal and/or state assistance on behalf of the Organization for the purpose of obtaining certain state and federal•financial assistance under the Robert T.Stafford Disaster Relief &Emergency Assistance Act,(Public Law 93-288 as amended)or as otherwise available.BE IT FURTHER RESOLVED that the above-named agents are authorized to represent and act for the Organization in all dealings with the State of North Carolina and the Federal Emergency Management Agency for all matters pertaining to such disaster assistance required by the grant agreements and the assurances printed on the reverse side hereof. BE IT FINALLY RESOLVED THAT the above-named agents are authorized to act severally PASSED AND APPROVED this day of ,20 . GOVERNING BODY CERTIFYING OFFICIAL Name and Title Name • Name and Title- Official Position. Name and Title Daytime Telephone CERTIFICATION I, ,(Name)duly appointed and (Title) of the Governing Body,do hereby certify that the above is a true and correct copy of a resolution passed and approved by the Governing Body of (Organization)on the day of ,20_ Date: Signature: Rev 06/02