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ÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁ <br />Disaster No: <br />STATE OF CALIFORNIA <br />æ ÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁ <br />CALIFORNIA EMERGENCY MANAGEMENT AGENCYCal EMA ID No <br /> <br />Cal EMA 130 <br />DESIGNATION OFAPPLICANT'S AGENT RESOLUTION <br />FOR NON-STATE AGENCIES <br />ùÓÈÃùÍÇÎÙÓÐùÓÈÃÍÖêÓÆ×ÊÉÓØ× <br /> BE IT RESOLVEDBYTHE OFTHE <br /> (GoverningBody) (NameofApplicant) <br />ûÉÉÓÉÈÛÎÈùÓÈÃïÛÎÛÕ×Ê <br />THAT , OR <br />(TitleofAuthorizedAgent) <br />öÓÊ×ùÔÓ×Ö <br />OR <br />, <br />(TitleofAuthorizedAgent) <br />÷Ï×ÊÕ×ÎÙÃíÌ×ÊÛÈÓÍÎÉïÛÎÛÕ×Ê <br />(TitleofAuthorizedAgent) <br />ùÓÈÃÍÖêÓÆ×ÊÉÓØ× <br />is hereby authorized to execute for andon behalf of the , a public entity <br /> (NameofApplicant) <br />established under the laws of the State ofCalifornia, this application and tofile it with the California Emergency ManagementAgency for <br />the purpose of obtaining certain federal financial assistance under Public Law 93-288 as amended by the Robert T. Stafford DisasterRelief <br />and Emergency Assistance Act of 1988, and/or statefinancial assistanceunder theCaliforniaDisaster AssistanceAct. <br />ùÓÈÃÍÖêÓÆ×ÊÉÓØ× <br />THAT the________________________________________________, a public entity establishedunder the laws of the State ofCalifornia, <br /> (NameofApplicant) <br />hereby authorizes its agent(s) to provide to theCalifornia Emergency Management Agencyfor all matters pertaining to such state disaster <br />assistance theassurances and agreements required. <br />Please check the appropriate box below <br />: <br />This is a universal resolution and is effective for all open and futures disasters up to three (3) years following the date of approval below. <br /> <br />This is a disaster specific resolution and is effective for only disaster number(s) ________________________ <br />Passedand approved this day of , 20 <br />ûÉÉÓÉÈÛÎÈùÓÈÃïÛÎÛÕ×Ê <br />(NameandTitle ofGoverningBodyRepresentative) <br />öÓÊ×ùÔÓ×Ö <br />(NameandTitle ofGoverningBodyRepresentative) <br />÷Ï×ÊÕ×ÎÙÃíÌ×ÊÛÈÓÍÎÉïÛÎÛÕ×Ê <br />(NameandTitle ofGoverningBodyRepresentative) <br />CERTIFICATION <br />I, , dulyappointed and of <br /> (Name)(Title) <br /> , do hereby certify that the above isa true and correct copy of a <br />(NameofApplicant) <br />Resolutionpassed andapprovedbythe ofthe <br /> (GoverningBody)(NameofApplicant) <br />onthe day of , 20 . <br /> (Signature) (Title) <br />Cal EMA130 (Rev.4/11) Page 1 <br />