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GRANTEES: YOU WILL NOT BE PAID FOR SERVICES RENDERED PRIOR TO <br /> NECESSARY STATE APPROVALS <br /> I hereby certify and affirm I am eligible and authorized to sign this <br /> agreement on behal of the GRANTEE. <br /> BY~ Date <br /> Title: <br /> Mailing Address: ~ f ' G (~r <br /> Facsimile: ~L~~ ' (Y~~'7 j~ ~ ~ <br /> l <br /> ~ j <br /> STATE OF OREGON <br /> Acting by and through its <br /> Oregon Youth Conservation Corps City of Eugene Public Works <br /> <br /> Grantor Grantee <br /> o ~ <br /> uthorized Signature to A orized Si tore Dat <br /> Ron Adams Director <br /> Printed Name Title Printed N e ~itle <br /> 6 <br /> <br />