HomeMy WebLinkAboutReimbursable Work Request - Public WorksGRANT COUNTY
REQUEST TO THE COUNTY ROAD DEPARTMENT
FOR REIMBURSABLE WORK
To The County Engineer/ Public Works Director:
Pursuant to terms of an agreement between the County and Adams County
(Name of Requesting Agency)
Adopted and approved on July 30,2012 the undersigned hereby requests the County to perform the
work listed below at a time and in a manner convenient to the County. The undersigned further requests that the
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work be completed no later than Approximately October 27th to November 4th, 2022 with a total of 4 days of
inspection and hereby guarantees reimbursement to the
County for all work done up to a maximum of $7000.00.
All terms of said agreement shall apply with the following exceptions:
DATED: 101412022
Work Requested: SIGNATURk�
Asphalt Plant Inspection (Agency Resentative)
for McKinney Rd Project #1
CRP -192 TITLE Adams County --- Engineer
To the Board of County Commissioners:
DATE I0,i3� ZD Z.2
I have examined the above request and made the following recommendations:
XThe request is approved 11 The request is disapproved or modified as follows:
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County EngineJr / Public Works Director
Action of the Board of County Commissioners: DATE
The Engineer's / Director's recommendation is hereby approved.
0 The Engineer's / Director's recommendations is disapproved or modified as follows:
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Recommended for use with Section 2 of Form:
CRAB #101 and WAC 136-32-030 Revised 10/19
BOARD OF COUNTY COMMISSIONERS OF GRANT COUNTY, WASHINGTON
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