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<br /> Exhibit A <br /> OFFICE OF CAPITAL IMPROVEMENTS I <br /> AUTlIORIZEIl SIGNATUIlE FOIlM <br /> Date: <br /> Grantee: <br /> Contact Name: <br /> Contact Phone & E-mail: <br />This form certifies the names, litles 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 thaI may be required by the Board of COUl)~ <br />CommissJoners for the disbursement of funds. These signature authorizations are retained by the Office of Capital Improvements fOI <br />auditing purposes_ Entities are required to submit updates to this lisl as they become necessary. <br />Name (a/ease tVDe or orlnfl Title (a/ease tVDe or orlnt) Slanature <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 vour first request for an advance or reimbursement. <br /> <br />Building Belter Communities <br />