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THIS INSTRUMENT HAS BEEN EXECUTED IN TWO ORIGINALS BY THE PARTIES HERETO AS <br />FOLLOWS: <br />*Denotes required fields <br />NOTE� Facsimile copies of this document shall not be acceptable as ORIGINALS. �ncerscace �� rev. toios <br />* North Central Texas Council of Governments <br />Name of Participant (local government, agency, or non profit 616 Six Flags Drive, Arlington, Texas 760ll <br />corporation) <br />� <br />Mailing Address <br />* <br />City <br />*gy. <br />Signature of Authorized Official <br />� <br />Typed Name of Authorized Official <br />* <br />Typed Title of Authorized Official <br />State ZIP Code <br />Date <br />��2 <br />Signature of Authorized Official <br />*Monte Mercer <br />Typed Name of Authorized Official <br />*Deputy Executive Director <br />Typed Title of Authorized Official Date <br />