HomeMy WebLinkAbout19- Signature Certification Form - Montana Department of Commerce, Community Development Division - MT-CDBG-TL-17-02 EXHIBIT 1-D
SIGNATURE CERTIFICATION FORM
Montana Department of Commerce
Community Development Division, CDBG Program
301 S. Park
P.O. Box 200523
Helena, Montana 59620-0523
MT-CDBG-TL-17-02
This is to certify that the following officials) are authorized to sign requests for payment of
Montana Community Development Block Grant (CDBG) funds for the City of Bozeman:
Bozeman, Montana) FY 20 CDBG Planning Grant:
1. —Finance—Director
Signature Title
Kristin Donald
Typed Name
2, _Affordable_Housing_Program Manager
Signature Title
Loren Olsen
Typed Name
3.
Signatur e
Typed Na
It is understood that any two of the above signatories must sign each request for payment
submitted.
tSuggested signatories include the chief elected official(Mayor or Chairperson of County Commission),city or county clerk ortreasurer
and the CDBG project manager.At least three officials should sign;and it is acceptable to have more to assure that at least two
signatories will be available to sign requests for CDBG funds.
Community Development Block Grant(CDBG) Program CDBG/ NSP Administration Manual Montana
Department of Commerce October 2013
D.1
I hereby certify that I have witnessed the signing of the above named signatures.
Date: p
Signature of Witness e� 1 Z/' a
Typed Name and Title of Witness
STATE OF MONTANA ) .
)ss. JPAE C LAURAE CLARK
••' Notary Public
:NOTAA/q4'.. for the State of Montana
* Residing at:
9.SEAL.-, Bozeman, Montana
County of My Commission Expires:
January 31,2022
This instrument was acknowledged before me on , by
(NOTARIAL SEAL)
Printed Name: NOTARY PUBLIC FOR STATE OF MONTANA
Residing at My Commission expires
Community Development Block Grant(CDBG) Program CDBG/NSP Administration Manual Montana
Department of Commerce October 2013
D.2