c. Sheriff-state surplus program eligibility application
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c. Sheriff-state surplus program eligibility application
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0,;: AUTHORIZED REPRESENTATIVES <br /> 411, ro, OFFICE OF MANAGEMENT AND BUDGET <br /> .?� .„F” STATE SURPLUS PROPERTY <br /> •. SFN 54201 (10-2011) <br /> Name of Organization <br /> Cass County Sheriff's Office <br /> Mailing Address(P.O.Box Number and Street) City State ZIP Code <br /> Box 488 211 9th st S Fargo ND 58103 <br /> Location Organization Email <br /> 211 9th st S. harmonm@casscountynd.gov <br /> County Telephone Number Fax Number <br /> Cass 701 241 5800 _ 701 241 5805 <br /> Typed or Printed Name of Administrative Official <br /> Michele D. Harmon <br /> Signature A uministrative Official Title Date <br /> �► Captain, Administrative/Court Services 08/18/2014 <br /> The following representatives are designated to acquire federal surplus property,obligate necessary funds for this purpose,and execute distribution <br /> documents agreeing to terms,conditions,reservations,and restrictions applying to all property obtained. <br /> New Designations(Delete all previous authorizations) n Additional Designations Only(Add to previous authorizations) <br /> LIDelete Designations Only(Remove from previous authorizations) <br /> REPRESENTATIVES <br /> Name (Please Type or Print) Title E-Mail Signature <br /> Jeff Olson Deputy Sheriff olsonj @casscountynd.gov <br /> Michele Harmon Deputy Sheriff harmonm @casscountynd.gw C' '' <br /> Mitch Burris Deputy Sheriff burrism @casscountynd.gov <br /> 4 7 7 � <br /> NOTE: PLEASE MAIL ORIGINAL-SIGNATURES MUST BE ON FILE. <br /> MAIL TO: North Dakota State Agency for Surplus Property <br /> 600 E Boulevard Ave Dept 15 <br /> Bismarck, ND 58505-0608 <br /> Telephone (701)328-9665 Fax(701)328-9669 <br />
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