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<br /> Exhibit A <br />I OFFICE OF CAPITAL IMPROVEMENTS I <br />AUTHORIZED SIGNATURE FORM <br /> Date: <br /> Grantee: <br /> Contact Name: <br /> Contact Phone & E-mai/: <br />This form certifies the names, titles and signatures of individuals authorized by the Grantee to sign contracts, and requests for; scoPE <br />changes, budget revisions, advances, reimbursements, and any other requests that may be required by the Board of Count) <br />Commissioners for the disbursement of funds. These signature authorizations are retained by the Office of Capital Improvements for <br />auditing purposes. Entities are required to submit updates to this list as they become necessary. <br />Name to/ease tvoe or orintl Title to/ease tvoe or orint) Sianature <br />Contracts & Subcontracts <br />Requests for Scope Changes <br />Requests for Budget Revisions <br />Requests for Advances & Reimbursements <br />Please submit this form with or before your first request for an advance or reimbursement. <br /> <br />Building Better Communities <br />