HomeMy WebLinkAboutAuthorized Signature FormFLORIDA DEPARTMENT OF EDUCATION
FOOD AND NUTRITION MANAGEMENT
SUMMER FOOD SERVICE PROGRAM FOR CHILDREN
Authorized Signature Form
Sponsor Name: City 'bf""Miami`' Department ' of Parks and Recreation
Agreement Number: 0 4- 0 8 9 9
Please type or print the names, titles, and signatures of persons authorized to sign the application,
agreements, documents, forms and claim for reimbursement. All authorized signers, authorized
representatives, and program contacts must be legal employees of the institution.
AUTHORIZED SIGNERS:
Ernest W. Burkeen Jr. Director
Type of Print Name Type or Print Title
Jose Mat as Princippl Staff Analyst
Type of Print Name Type or Print Title ignature
Elizabeth Ott Admin. Assjs,ant 111
Type of Print Name Type or Print Title
Juan Pascual Superintendent
Type of Print Name
Type or Print Title
Alb7-
Signa fire
Signature
I certify that the persons above are authorized to sign the claim for reimbursement.
AUTHORIZED REPRESENTATIVE:
Joe Arriola City Manager
Type or Print Name & Title of Authorized Representative
MAY 0 1 2006
Date signed
Signature of Authorized Representative
SFSP-F15
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