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STATE OF CALIFORNIA <br />GOVERNOR’S OFFICE OF EMERGENCY SERVICES Cal OES ID No: ______________________ <br />Cal OES 130 <br /> <br /> <br />DESIGNATION OF APPLICANT'S AGENT RESOLUTION <br />FOR NON-STATE AGENCIES <br /> <br />BE IT RESOLVED BY THE OF THE <br /> (Governing Body) (Name of Applicant) <br />THAT , OR <br />(Title of Authorized Agent) <br />, OR <br />(Title of Authorized Agent) <br />(Title of Authorized Agent) <br />is hereby authorized to execute for and on behalf of the , a public entity <br /> (Name of Applicant) <br />established under the laws of the State of California, this application and to file it with the California Governor’s Office of Emergency <br />Services for the purpose of obtaining certain federal financial assistance under Public Law 93-288 as amended by the Robert T. Stafford <br />Disaster Relief and Emergency Assistance Act of 1988, and/or state financial assistance under the California Disaster Assistance Act. <br /> <br />THAT the ________________________________________________, a public entity established under the laws of the State of California, <br /> (Name of Applicant) <br />hereby authorizes its agent(s) to provide to the Governor’s Office of Emergency Services for all matters pertaining to such state disaster <br />assistance the assurances and agreements required. <br /> <br />Please check the appropriate box below: <br /> <br />This is a universal resolution and is effective for all open and future disasters up to three (3) years following the date of approval below. <br />This is a disaster specific resolution and is effective for only disaster number(s) ________________________ <br /> <br />Passed and approved this day of , 20 <br /> (Name and Title of Governing Body Representative) <br />(Name and Title of Governing Body Representative) <br />(Name and Title of Governing Body Representative) <br /> <br />CERTIFICATION <br />I, , duly appointed and of <br /> (Name) (Title) <br /> , do hereby certify that the above is a true and correct copy of a <br />(Name of Applicant) <br />Resolution passed and approved by the of the <br /> (Governing Body) (Name of Applicant) <br /> <br />on the day of , 20 . <br /> (Signature) (Title) <br />Cal OES 130 (Rev.9/13) Page 1 <br /> 57